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      Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis

      systematic-review

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          Abstract

          Background

          Adolescents with immature mind and unstable emotional control are high-risk groups of non-suicidal self-injury (NSSI) behavior. We meta-analyzed the global prevalence of NSSI and prevalence of NSSI characteristics in a non-clinical sample of adolescents between 2010 and 2021.

          Methods

          A systematic search for relevant articles published from January 1, 2010 to June 30, 2021 was performed within the scholarly database search engines of CBM, CNKI, VIP, Wanfang, PubMed, Web of Science, PsycINFO, and Embase. Eligibility criteria were as follows: provided cross-sectional data on the prevalence of NSSI; the subjects were non-clinical sample adolescents; and a clear definition of NSSI was reported. We used the following definiton of NSSI as our standard: the deliberate, self-inflicted destruction of body tissue, such as cutting, burning, and biting, without attempted suicide. The quality evaluation tool for cross-sectional studies recommended by the JBI was used. The global prevalence of NSSI was calculated based on the random-effects model by Comprehensive Meta-analysis version 3.0. Subgroup analyses were performed to compare the prevalence according to sex, living place, smoking or drinking history, and family structure.

          Results

          Sixty-two studies involving 264,638 adolescents were included. The aggregate prevalence of NSSI among a non-clinical sample of adolescents was similar between over a lifetime (22.0%, 95% CI 17.9–26.6) and during a 12-month period (23.2%, 95% CI 20.2–26.5). Repetitive NSSI was more common than episodic NSSI (20.3% vs. 8.3%) but the frequency of mild injury (12.6%) was similar to that of moderate injury (11.6%). Multiple-method NSSI occurred slightly more often compared than one-method NSSI (16.0% vs. 11.1%). The top three types of NSSI in adolescents were banging/hitting (12.0%, 95% CI 8.9–15.9), pinching (10.0%, 95% CI 6.7–14.8), and pulling hair (9.8%, 95% CI 8.3–11.5), and the least common type was swallowing drugs/toxic substances/chemicals (1.0%, 95% CI 0.5–2.2). Subgroup analyses showed that being female, smoking, drinking, having siblings, and belonging to a single-parent family may be linked to higher prevalence of NSSI.

          Conclusion

          This meta-analysis found a high prevalence of NSSI in non-clinical sample of adolescents, but there are some changes in severity, methods, and reasons. Based on the current evidence, adolescents in modern society are more inclined to implement NSSI behavior by a variety of ways, which usually are repetitive, and moderate and severe injuries are gradually increasing. It is also worth noting that adolescents with siblings or in single-parent families are relatively more likely to implement NSSI behavior due to maladjustment to the new family model. Future research needs to continue to elucidate the features and risk factors of NSSI so as to intervene in a targeted way.

          Limitation

          The limitation of this study is that the heterogeneity among the included studies is not low, and it is mainly related to Chinese and English studies. The results of this study should be used with caution.

          Systematic review registration

          [ www.crd.york.ac.uk/prospero/], identifier [CRD42022283217].

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          Most cited references94

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

          David Moher, Alessandro Liberati, Jennifer Tetzlaff … (2011)
          David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
          Article 0 comments Cited 4878 times – based on 0 reviews     Review now
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            Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data.

            Zachary Munn, Catalin Tufanaru, Dagmara Riitano … (2015)
            There currently does not exist guidance for authors aiming to undertake systematic reviews of observational epidemiological studies, such as those reporting prevalence and incidence information. These reviews are particularly useful to measure global disease burden and changes in disease over time. The aim of this article is to provide guidance for conducting these types of reviews.
            Article 0 comments Cited 715 times – based on 0 reviews     Review now
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              Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression.

              Sarah V Swannell, Graham Martin, Andrew Page … (2014)
              Published prevalence estimates of nonsuicidal self-injury (NSSI) among nonclinical samples are highly heterogeneous, raising concerns about their reliability and hindering attempts to explore the alleged increase in NSSI over time. Accordingly, the objectives of this study were to investigate the influence of methodological factors on heterogeneity in NSSI prevalence estimates, explore changes over time, and estimate overall international NSSI prevalence. Results showed that methodological factors contributed over half (51.6%) of the heterogeneity in prevalence estimates, and, after adjusting for these factors, NSSI prevalence did not increase over time. Overall, pooled NSSI prevalence was 17.2% among adolescents, 13.4% among young adults, and 5.5% among adults. Clearly, development of standardized methodology in NSSI research is crucial if accurate estimates are desired. © 2014 The American Association of Suicidology.
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Psychiatry
                Journal ID (iso-abbrev): Front Psychiatry
                Journal ID (publisher-id): Front. Psychiatry
                Title: Frontiers in Psychiatry
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-0640
                Publication date (Electronic): 10 August 2022
                Publication date Collection: 2022
                Volume: 13
                Electronic Location Identifier: 912441
                Affiliations
                [1] 1Mental Health Center, West China Hospital, Sichuan University , Chengdu, China
                [2] 2West China School of Nursing, Sichuan University , Chengdu, China
                Author notes

                Edited by: Laura Hemming, Orygen Youth Health, Australia

                Reviewed by: Sadhbh Josephine Byrne, Trinity College Dublin, Ireland; Yumei Wang, The First Hospital of Hebei Medical University, China

                *Correspondence: Xuehua Huang, huangxuehua10@ 123456163.com

                This article was submitted to Adolescent and Young Adult Psychiatry, a section of the journal Frontiers in Psychiatry

                Article
                DOI: 10.3389/fpsyt.2022.912441
                PMC ID: 9399519
                PubMed ID: 36032224
                SO-VID: 8e0e2e3a-00b9-4d92-9219-df113fa1f3e3
                Copyright © Copyright © 2022 Xiao, Song, Huang, Hou and Huang.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 05 April 2022
                Date accepted : 25 July 2022
                Page count
                Figures: 5, Tables: 4, Equations: 0, References: 94, Pages: 16, Words: 9791
                Categories
                Subject: Psychiatry
                Subject: Systematic Review

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: adolescents,non-suicidal self-injury,prevalence,characteristics,meta-analysis
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: adolescents, non-suicidal self-injury, prevalence, characteristics, meta-analysis

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