Non-suicidal self-injury (NSSI) represents a significant public health concern, particularly among adolescents. Understanding the prevalence of NSSI within specific at-risk populations, such as athletes, is crucial for developing effective prevention programs. Given the unique stressors and pressures experienced by young athletes, it is essential to examine the factors contributing to their vulnerability. This study aimed to determine the occurrence of NSSI in adolescent athletes and to investigate the role of emotional regulation in their self-injurious behaviors.

This study involved 456 adolescent athletes, aged 13 to 18 (mean age 14.66 years, SD = 2.80), recruited in Tehran in 2024. The sample consisted of 183 female (40.1%) and 273 male (59.9%) participants. Participants completed surveys measuring self-injury behaviors, cognitive emotion regulation and behavioral emotion regulation strategies. Data analysis employed Pearson correlation coefficients and regression testing.

The findings revealed a concerning prevalence of self-injury among the adolescent athletes in Tehran. A significant relationship was found between self-injury and cognitive and behavioral emotion regulation. The regression model indicated that self-injury could be predicted by the level of behavioral emotion regulation, followed by cognitive emotion regulation.

This study highlights the importance of considering emotion regulation in understanding and addressing self-injurious behaviors among adolescent athletes. The findings suggest that interventions aimed at improving cognitive and behavioral emotion regulation strategies may be beneficial in reducing NSSI among this population.

To explore the impact of social ecological risk factors (SERFs) from seven dimensions of individual, family, school, community, policy, culture, and chronosystem on suicide-related behavior (SRB) and non-suicidal self-injury (NSSI) among adolescents.

A longitudinal study was conducted in China. A total of 2114 adolescents (aged 15.25 ± 1.99 years, 48.5 % males) completed questionnaire at baseline and follow-up. Restricted Cubic Spline and logistic regression was performed to identify the association of SERFs with suicidal ideation (SI), suicidal plan (SP), suicidal attempt (SA) and NSSI. Back-propagation artificial neural network was used to test the importance values of SERFs for SRB and NSSI.

RCS showed the risk of SI, SP, SA and NSSI among adolescents increased with the increase of cumulative social ecological risk when the risk score exceeded the median (All P for overall<0.001). Logistic regression analysis showed the high cumulative social ecological risk was associated with SI (OR = 3.028, 95 % CI:2.192-4.183), SP (OR = 2.672, 95 % CI:1.738-4.109), SA (OR = 6.267, 95 % CI:3.087-12.723) and NSSI (OR = 3.541, 95 % CI:2.528-4.971). The similar results were also found in the individual, family, school, community, and culture dimensions (All P < 0.05). The individual dimension of social ecological risk was the most important for predicting SRB and NSSI.

Adolescents with high culminative social ecological risk had higher SRB and NSSI risks. Schools and families could strengthen adolescents' self-efficacy and cultivate positive coping styles on the basis of exerting their own functions. Shaping optimistic personality characteristics and correct cultural values may effectively reduce the risk of SRB and NSSI among adolescents.

Non-suicidal self-injury (NSSI) is a prevalent and concerning issue in adolescent mental health, often intertwined with depressive symptoms. Despite extensive research on NSSI, a comprehensive understanding of its multifaceted nature and the intricate interplay of risk and resilience factors remains crucial. This Letter to the Editor examines a novel study by Yang et al, which utilized latent profile analysis and network analysis to delineate distinct NSSI subtypes within a Chinese adolescent population and investigate the underlying dynamics of associated factors. The study identifies three distinct NSSI subtypes: NSSI with depression, NSSI without depression, and neither, underscoring bullying as a prominent risk factor. Concurrently, the findings emphasized the pivotal role of emotional regulation and family support as protective factors. The focus of this article is to contextualize these findings within the broader framework of adolescent mental health and to highlight their implications for developing targeted interventions. These insights not only advance our understanding of adolescent NSSI but also provide a foundation for the development of targeted interventions that address the identified risk and protective factors. By focusing on these critical areas, mental health professionals can implement more effective strategies to mitigate NSSI behaviors and cultivate resilience in this vulnerable population.

Childhood sexual abuse (CSA) is a well-established risk factor for a range of psychological and behavioral issues, including non-suicidal self-injury (NSSI), making it a critical area of research for understanding adolescent mental health. Despite its prevalence, the mechanisms underlying their relationship remain insufficiently explored. This study aims to explore the relationship between CSA and NSSI behavior, as well as the mediating role of social avoidance and the moderating role of perceived family support.

1737 Chinese adolescents with a mean age of 14.86 years (SD = 1.65) from hospitals' psychiatric departments in nine provinces of China were recruited to complete surveys on CSA experiences, NSSI behavior, and social support.

The results suggested that the effect of CSA on adolescent NSSI behavior was mediated by social avoidance, and the effect of CSA on social avoidance and NSSI behavior varied by the level of perceived family support. CSA led to social avoidance and increased risk for NSSI behavior. Higher levels of perceived family support had a protective effect, which reduced the motives of social avoidance and NSSI behavior.

These findings revealed the risk of CSA and emphasized the role of social avoidance as an NSSI motive and the protective role of perceived family support for adolescents experiencing CSA. The clinical implications emphasize the need for interventions targeting family support and alternative coping strategies in the Chinese context. Additionally, future research should explore the complexity of intra- and extra-familial abuse and the roles of peer and professional support.

Non-suicidal self-injury (NSSI) is a prevalent and concerning behavior among adolescents worldwide, particularly in China. This study aimed to investigate the relationships between social support, cognitive flexibility, and NSSI, and to examine the potential mediating role of cognitive flexibility in the association between social support and NSSI among adolescents.

A multicenter cross-sectional study was conducted with 2,109 adolescents (aged 12-18 years, mean age 15.00 ± 1.65 years, 52.3% female) recruited from 14 psychiatric hospitals/outpatient clinics. Participants completed self-report measures of social support and NSSI, along with a cognitive flexibility assessment using the Wisconsin Card Sorting Test. Structural equation modeling was employed to test the hypothesized mediation model.

Social support was negatively associated with NSSI frequency (β = -0.11, p < 0.001) and positively related to cognitive flexibility (β = 0.09, p < 0.001). The mediation effect of cognitive flexibility was statistically significant [β = -0.01, 95% CI (-0.01, -0.01)] accounting for 8.33% of the total effect of social support on NSSI. Multi-group analysis revealed that the association between social support and cognitive flexibility was stronger in females (β = 0.11, p < 0.001) compared to males (β = 0.02, p > 0.05).

This multicenter study provides evidence for the protective roles of social support and cognitive flexibility against NSSI in adolescents. The findings suggest that cognitive flexibility partially mediates the relationship between social support and NSSI, with notable gender differences. These results highlight the importance of enhancing both social support and cognitive flexibility in interventions aimed at reducing NSSI among adolescents.

Non-suicidal self-injury (NSSI) among adolescents represents an alarming public health concern worldwide. Both family function and family socioeconomic status (SES) were found to play important roles in adolescent NSSI engagement. However, the effects of family function on NSSI among adolescents in different family SES are not well evidenced.

This study aimed to explore how family functions (adaptation, partnership, growth, affection, and resolve) affect NSSI among adolescents in different family SES levels.

Data used in this study was derived from the Students' Mental Health Network Project (SMHN), a survey conducted among 8,872 pairs of adolescent-caregivers in a city in central China. Socio-demographic characteristics, family function, NSSI, adverse life events, and depressive symptoms were measured among adolescents. Family SES were generated from caregivers self-reported information using principal component analysis. Chi-square test and multivariate binary logistic regression analyses were adopted to analyze the effects of family function on NSSI.

It revealed that 10.2% of adolescents reported engaging in NSSI in the past 12 months. Poor family function and high family SES were positively associated with NSSI. Partnership, both adaptation and affection, resolve were NSSI-protective factors for adolescents in low, middle, high family SES, respectively.

Efforts to address NSSI should acknowledge the association between family function and NSSI among adolescents in different family SES levels.

Increasing evidence has shown an increased risk of non-suicidal self-injury (NSSI) in left-behind children and adolescents (LBCAs). However, a systematic summary of studies comparing the risk of NSSI between LBCAs and non-LBCAs in China is lacking.

To investigate the risk of NSSI among LBCAs in China.

We performed a systematic search of Embase, PubMed, and Web of Science from initiation to October 25, 2024, for all relevant studies of NSSI and LBCAs. The effect sizes were reported as odds ratios (ORs) with 95% confidence intervals (CI). Sensitivity analyses were conducted to further confirm the stability of the findings.

A total of 10 studies with 165276 children and adolescents were included in this study. LBCAs had significantly higher rates of NSSI compared with non-LBCAs (OR = 1.33, 95%CI: 1.19-1.49), with high heterogeneity observed (I 2 = 77%, P < 0.001). Further sensitivity analyses were consistent with the primary analysis (OR = 1.29, 95%CI: 1.21-1.39, I 2 = 0%).

LBCAs are found to be at an increased risk of NSSI compared with children and adolescents of non-migrants. More attention and intervention are urgently needed for LBCAs, especially those living in developing countries.

Non-suicidal self-injury (NSSI) is an important health problem among adolescents and young adults. The aims of this study were to determine NNSI status and its associated factors among students.

This cross-sectional study has been conducted in 4715 high school and university students from the West and Northwest provinces of Iran. Multi-stage sampling was used to select students and all students completed survey questionnaires. Data analysis was performed using chi-square, Fisher's exact test, binary and logistic regression.

The lifetime prevalence of NSSI was estimated as 24.4% among all participants (21.4% in high school students vs. 29.3% in university students). After adjustment for other factors, age (OR=1.08,95%CI:1.03-1.12), cigarette smoking as an experimenter (OR=1.94,95%CI:1.61-2.34) and regular (OR=3.80,95%CI:2.96-4.89) compared to nonsmokers, membership in a sport team (OR = 1.26,95%CI:1.08-1.48), having physical fight (OR = 2.18,95%CI:1.85-2.57), doing general risk taking behavior (OR = 2.05,95%CI:1.66-2.53), and self-esteem (OR=0.93,95%CI:0.92-0.95) were associated with experience of NSSI.

Our results suggested that the prevalence of NSSI was relatively high among high school and university students. To diagnose, prevent, and treat NSSI in teenagers and young adults in Iran, more research is needed to identify the root causes.

To explore associations among psychological resilience, self-esteem, social support, and non-suicidal self-injury (NSSI) behaviors in adolescents receiving inpatient psychiatric care.

In this cross-sectional study, 505 Chinese adolescents (aged 10 to 19 years) receiving inpatient psychiatric care completed a general characteristics questionnaire, the Psychological Resilience Scale (PRS), Self-Esteem Scale (SES), and Child and Adolescent Social Support Scale (CASSS). Statistical tests were used to compare NSSI incidence, scale scores, and factors influencing NSSI.

The incidence rate of NSSI was 77.82% (n = 393). Total and dimension scores on the PRS, SES, and CASSS in the NSSI group were significantly lower than those in the non-NSSI group (p < 0.01). Binary logistic multifactorial regression analysis showed that participants who were female and aged 10 to 14 years were more prone to NSSI behavior (p < 0.05). Having close friends, high parental expectations, and moderate to high self-esteem were protective factors for NSSI behavior (p < 0.05).

Nursing personnel should prioritize enhancing psychological resilience, self-esteem, and social support in adolescents receiving inpatient psychiatric care to mitigate the risk of NSSI and ensure the safety of hospitalized individuals. [Journal of Psychosocial Nursing and Mental Health Services, 62(9), 47-54.].

Objective: This current study aimed to validate the Indonesian version of the Inventory of Statements About Self-Injury (ISAS) questionnaire, which provides a better understanding of Non-Suicidal Self-Injury (NSSI) disorders. Method : The study used a cross-sectional design and involved 314 adolescents and young adults in high school or university. A stratified sampling method was used. All participants filled out the ISAS questionnaire. Data were analyzed for content validity, construct validity, item discrimination value, and internal consistency (Croncbach's α). The translation process was carried out using forward and back-translation methods. Results: The ISAS questionnaire consists of section I, the behavioral scale, and section II, the functional scale. For content validity, Aiken's V coefficient obtained for both scale sections I and II is in the range of 0.917 - 1. This result shows that all items on the scale have very good validity. Confirmatory Factor Analyses were carried out using Lisrel 8.80 software on section II, resulting in several goodness of fit values that were not good enough (χ2 = 457.68; P < 0.000; df = 64; χ2 / df = 7.151, RMSEA = 0.130) and several other values that are quite acceptable (CFI = 0.95; SRMS = 0.057; NFI = 0.95; GFI = 0.83). The factor loading from section II ranges from 0.43 - 0.91. The item discrimination value using the corrected item-total correlation of section I is in the range of 0.031 - 0.837 and section II ranges from 0.290 - 0.854. The reliability analysis values in section I and II of the ISAS are α = 0.527 and α = 0.966, respectively. Conclusion: This is the first study to have validated the Indonesian version of the ISAS questionnaire. The Indonesian version of the ISAS questionnaire is considered a valid and reliable instrument to assess NSSI disorders.

Non-suicidal self-injury (NSSI) is a common psychological and behavioral problem among adolescents. The COVID-19 pandemic has had a significant impact on people's mental health. To date, few studies have documented the temporal changes in adolescents' psychological status during the pandemic, as well as the impact of large-scale public health intervention strategies. This study contributes to the existing evidence on the subject.

Participants were 6,023 adolescents aged 10 years and older, with data from two waves of longitudinal surveys, including data for a 7-month interval before and during the pandemic. A cross-lagged model was used to test the bidirectional relationship between NSSI and depressive symptoms in adolescents; logistic regression analysis was used to explore the predictors of NSSI implementation in adolescents with depressive symptoms.

In this study, 32.69% participants reported depressive symptoms at baseline and 34.27% at follow-up; 44.34% participants with depressive symptoms reported NSSI at baseline and 53.44% at follow-up. The duration of the online class, depressed affect, and somatic and related activity were the risk factors for NSSI; sleep duration and positive mood were the protective factors. The lag effect of depression symptoms on NSSI is significant, and so is NSSI on depressive symptoms.

During the COVID-19 pandemic, adolescents' mental health has worsened, resulting in an increase in the prevalence of NSSI among those with depressive symptoms compared to pre-pandemic levels. Early screening for depression is crucial in preventing or decreasing NSSI in adolescents.

Nonsuicidal Self-Injury (NSSI) in China has increasingly interested clinicians, although few studies have investigated its risk and protective factors. This study examined the risk factors of NSSI among Chinese adolescents.

The researchers recruited adolescent participants with NSSI from a hospital outpatient clinic to form a case group and recruited adolescents without NSSI who provided informed consent from the school to form a control group. Participants completed a questionnaire, and data were analyzed using logistic regression.

A total of 138 cases and 276 controls participated in this study. Binary multivariate logistic regression analysis with adjusting for age and sex showed that domestic violence (OR = 8.615, 95%CI: 3.081-24.091), parental overconcern (OR = 6.995, 95%CI: 3.447-14.192), guilt (OR = 4.949, 95%CI: 2.227-10.996), and school bullying (OR = 21.676, 95%CI: 6.799-69.109) increased the risk of NSSI, while peer support (OR = 0.068, 95%CI: 0.030-0.150) and living in an urban environment (OR = 0.157, 95%CI: 0.056-0.437) decreased the risk of NSSI.

Some psychosocial factors were confirmed to be independent risk and protective factors for NSSI in this study. However, the clinical significance of the results needs to be interpreted with caution due to sample size limitations.

Non-suicidal self-injury (NSSI) impacts not only adolescents who engage in it but also their parents. However, there has been limited research into the psychological well-being of these parents. This cross-sectional study aims to investigate the symptoms of anxiety and depression among parents of adolescents who engaged in NSSI in China and the factors associated with them.

A total of 400 parents of adolescents with NSSI were included. Socio-demographic information of these parents was collected. The Generalized Anxiety Disorder 7-item (GAD-7), the Patient Health Questionnaire 9-item (PHQ-9), and the Connor-Davidson Resilience Scale (CD-RISC) were used to assess symptoms of anxiety, depression, and psychological resilience, respectively.

The majority of the parents were female (83.5%), married (86.3%), and had a senior high school or equivalent and lower education level (67.1%). The study found that 35.3% of the parents experienced clinically significant symptoms of anxiety (GAD-7 ≥ 7) and 40.1% had clinically significant symptoms of depression (PHQ-9 ≥ 7). Parents with larger ages and lower levels of psychological resilience were more likely to experience symptoms of anxiety and depression (p < 0.05). Parents who reported bad parent-child relationships showed a higher level of anxiety.

This study provides important insights into the symptoms of anxiety and depression among parents of adolescents with NSSI. Parental age, parent-child relationship, and psychological resilience were associated with symptoms of anxiety and depression in these parents. Implications for the development of interventions aimed at addressing symptoms of anxiety and depression in parents of adolescents with NSSI were discussed.

Emerging non-Western studies indicate new patterns in the functionality of nonsuicidal self-injury (NSSI) warranting further investigation in different cultures. The current study aims to investigate the function (etiology and underlying mechanism) of NSSI among a sample of university students in Tehran, Iran, using the Inventory of Statements About Self-Injury (ISAS). The ISAS was administered to 63 students who self-injured (52.4% female; Mage = 22.15). An exploratory factor analysis using the Bayesian estimation method was conducted. A three-factor model of NSSI functions emerged including an intrapersonal factor representing within-self functions (e.g., self-punishment); a social identification factor consisting of functions establishing a sense of self/identity (e.g., peer bonding); and a communication factor representing an influencing/communicating functionality (e.g., marking distress). Intrapersonal and social identification factors were associated with greater severity of NSSI method and increased anxiety. Findings support the use of the ISAS among an Iranian sample and revealed additional patterns beyond the commonly referenced two-factor model (intrapersonal and interpersonal functions) in a culturally novel sample. The results are situated within the sample's sociocultural context.

Assessing suicidal behaviours among students would help to understand the burden and enhance suicide prevention.

We aimed to determine the prevalence of suicidal behaviour among students living in Muslim-majority countries.

We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was conducted in Medline, EMBASE and PsycINFO. Meta-analyses were performed to pool the lifetime, 1-year and point prevalence rates for suicidal ideation, plans and attempts.

From 80 studies, 98 separate samples were included in this analysis. The majority (n = 49) were from the Eastern Mediterranean, and 61 samples were of university students. The pooled prevalence of suicidal ideation was 21.9% (95% CI 17.4%-27.1%) for lifetime, 13.4% (95% CI 11.1%-16.1%) for the past year and 6.4% (95% CI 4.5%-9%) for current. The pooled prevalence of suicide plans was 6.4% (95% CI 3.7%-11%) for lifetime, 10.7% (95% CI 9.1%-12.4%) for the past year and 4.1% (95% CI 2.7%-6.2%) for current. The pooled prevalence of suicide attempts was 6.6% (95% CI 5.4%-8%) for lifetime and 4.9% (95% CI 3.6%-6.5%) for the past year. The lifetime prevalence of suicidal ideation was highest (46.2%) in South-East Asia, but the 12-month prevalence was highest (16.8%) in the Eastern Mediterranean.

The study revealed notably high rates of suicidal behaviours among students living in Muslim-majority countries. However, the quality of studies, differences in regional and cultural factors, stages of studentship and methods of measurement should be considered when generalising the study results.

To study the current status of non-suicidal self-injury (NSSI) incidents among middle school students in Chengdu during the COVID-19 epidemic and to explore the mechanism of action of depression on the relationship between family environment and NSSI.

Data were obtained from the Chengdu Positive Child Development (CDPD) cohort. In June and July 2020, after primary and secondary schools were reopened after the closure due to the COVID-19 epidemic, on-site questionnaire surveys were conducted with the Deliberate Self-Harm Inventory (DSHI), the Chinese Family Assessment Instrument (C-FAI), and Center for Epidemiologic Studies Depression Scale for Children (CES-DC), thereby obtaining the data of 3595 middle school students. Two-sample t-test and χ 2 test were used to compare the incidence of NSSI among middle school students of different grades and genders, and the Model 58 test of the SPSS PROCESS component was used to analyze the mediating effect of gender-mediated depression.

1) The incidence of NSSI among middle school students in Chengdu during the COVID-19 epidemic was 49.67%. The incidence of NSSI among ninth-graders (80.70%) was significantly higher than those of the eighth graders (33.82%) and seventh graders (32.32%), and the incidence of NSSI among female middle school students (54.75%) was significantly higher than that of male students (44.52%). 2) Family environment ( r=0.34, P<0.001) and depression ( r=0.50, P<0.001) were positively correlated with NSSI. 3) Depression partially mediated the effect of family environment on NSSI, with the mediating effect accounting for 64.64% of the total effect. Compared with that of male students, the positive predictive effect between family environment and depression and that between depression and NSSI in female middle school students were more significant.

During the COVID-19 pandemic, middle school students in Chengdu had a high incidence of NSSI, which indicates that the family environment should be improved, more attention should be given to gender differences, and early screening and intervention for depression should be strengthened to reduce the incidence of NSSI.

The functions of nonsuicidal self-injury (NSSI) consist of social and emotional aspects (Social influence, Sensation seeking, Internal and External emotion regulation). Previous studies have indicated that dysfunction in reward-related brain structures especially the striatum might drive this habitual behavior. However, no studies to date have investigated the associations between striatum and different functions for adolescents engaging in NSSI behaviors. Here, we recruited 35 depressed adolescents with recent NSSI behaviors and 36 healthy controls and acquired structural brain images, depressive symptoms, social, academic and family environments assessments, in addition to NSSI functions in patients only. Subcortical volumes and cortical thickness were estimated with FreeSurfer. Mixed linear regressions were performed to examine associations between striatal structures (caudate, putamen, nucleus accumbens, pallidum) and NSSI functions, with age, sex, total intracranial volume, hemisphere and depression severity included as covariates. Effect of environmental factors and potential associations with cortical thickness and other subcortical volumes were also tested. We found that, among the four functions, external emotional regulation represented the main function for NSSI engagement. Increased external emotion regulation was significantly associated with smaller putamen volume. No environmental factors biased the association with putamen. No associations with other cortical or subcortical regions were observed. Our findings suggested that smaller putamen might be a biomarker of NSSI engagement for depressed adolescents when they regulated frustrated or angry emotions. The results have potentially clinical implications in early identification and brain intervention of NSSI in youth.

To investigate the association between coping styles, gender, their interactions and non-suicidal self-injurious (NSSI) behaviors among middle school students in rural western China under COVID-19.

A multicentre cross-sectional study method was used to conduct an online survey of 8,361 students from 23 middle schools in the northern Sichuan region by clustering sampling, using the General Information Questionnaire, the Ottawa Self-Injury Inventory, and the Coping Style Scale for Middle School Students.

The past year prevalence of NSSI among middle school students in rural west China was 5.7%. The differences in scores between those with and without NSSI on all dimensions of coping styles were statistically significant (p < 0.001). Multivariate logistic regression analysis revealed that vocational high school (OR = 1.67), girls (OR = 2.5), single parent with divorced parents (OR = 1.89), remarriage with divorced parents (OR = 1.81), and tolerance (OR = 1.17), venting emotions (OR = 1.15) and fantasy/denial (OR = 1.07) in coping styles may increase the risk of NSSI among middle school students, while problem solving (OR = 0.9) and seeking social support (OR = 0.9) among coping styles may reduce the risk of NSSI among middle school students. The interaction results show that gender has a moderating role in the process of endurance, avoidance, venting of emotions, and fantasy/denial influencing non-suicidal self-injury in middle school students.

There is an association between coping styles and self-injury among middle school students in rural areas in western China, with gender playing a moderating role. Active attention should be paid to students' coping styles and encouraging them to adopt positive coping styles as well as avoid negative coping styles, especially in the case of girls, which can help prevent self-injury.

Non-suicidal self-injury (NSSI) in adolescents is a significant mental health problem around the world. Here, we performed a meta-analysis to systematically delineate the risk factors for NSSI.

We searched Medline, Embase, Web of Science and Cochrane for relevant articles and abstracts published prior to 12 November 2021. Pooled odds ratios (ORs) and 95% confident intervals (CIs) were used to assess various risk factors, and publication bias was assessed by Egger's test, the trim and fill method and meta-regression. This study is registered with PROSPERO, CRD42021265885.

A total of 25 articles were eventually included in the analysis. Eighty risk factors were identified and classified into 7 categories: mental disorders (ORs, 1·89; 95% CI, 1·60-2·24), bullying (ORs, 1·98; 95% CI, 1·32-2·95), low health literacy (ORs, 2·20; 95% CI, 1·63-2·96), problem behaviours (ORs, 2·36; 95% CI, 2·00-2·77), adverse childhood experiences (ORs, 2·49; 95% CI, 1·85-3.34), physical symptoms (ORs, 2·85; 95% CI, 1·36-5·97) and the female gender (ORs, 2·89; 95% CI, 2·43-3·43). The range of heterogeneity (I²) was from 20·3% to 99·2%.

This meta-analysis found that mental disorders, low health literacy, adverse childhood experiences, bullying, problem behaviours, the female gender and physical symptoms appear to be risk factors for NSSI.

Non-suicidal self-injury (NSSI) is a serious public health concern among adolescents, especially in clinical settings. Social support plays a critical role in the onset and maintenance of NSSI in adolescence. NSSI is closely associated with borderline personality disorder (BPD), yet no previous work has analyzed the mediating role of borderline traits in the relationship between perceived social support (PSS) and NSSI. This study aimed to address this gap.

Participants were 228 adolescent patients (12 to 18 years old), who completed a clinical interview and self-report measures of BPD-traits, current psychological distress, emotion dysregulation and PSS. They were grouped based on the presence (vs. absence) of NSSI. Univariate and multivariate logistic regression analyses were used to identify risk factors of NSSI, and a mediation analysis was conducted to examine the intermediary role of borderline traits in the relationship between PSS and NSSI.

NSSI was highly prevalent in our sample (58%) and was associated with higher clinical severity. Low PSS predicted NSSI in univariate, but not multivariate regression. Mediation analyses showed that borderline traits fully accounted for the relationship between low PSS and NSSI, even when controlling for current psychological distress and gender.

Cross-sectional design through self-report assessment.

Findings suggest that adolescents with low PSS are especially vulnerable for developing NSSI due to elevated BPD traits. In clinical settings, interventions aimed to reduce borderline symptoms may be a promising treatment option for adolescents with NSSI and low PSS.

Non-suicidal self-injury is a serious health problem among patients with depression or bipolar disorder. However, few studies within the Chinese context have investigated the prevalence of NSSI and its risk factors in above populations. The purpose of this study was to investigate the prevalence of non-suicidal self-injury and its risk factors in patients with depression or bipolar disorder in China.

The final sample comprised of 394 inpatients(M_age = 29.71; SD_age = 11.95) with depression or bipolar disorder from two psychiatric hospitals in Beijing, China. A General Demographic Data Form, the Non-suicidal Self-injury Questionnaire(NSSI-Q), Impulsivity Item and the Adverse Childhood Experiences-International Questionnaire(ACE-IQ) were completed by all patients.

Of the 394 patients examined, 245(62.2%) of this sample reported NSSI in past year. Of the 245 patients with NSSI, 135(55.1%) were diagnosed with depression and 110(44.9%) were diagnosed with bipolar disorder. The most common methods of NSSI for female was "pinching"(23.1%) and "scratching"(22.8%), while for male it was "hiting hard objects"(12.7%). By multivariate regression analysis, young age, unemployment, a higher monthly family income, single, impulsivity, long duration of illness and ACEs were risk factors for NSSI in patients with depression and bipolar disorder(P<0.05).

Our study points to the fact that there was an unfortunate message about the prevalence of NSSI among patients with depression or bipolar disorder in China. It is necessary not only to raise the awareness of NSSI in families and society, but also to formulate targeted assessment and intervention. Moreover, future research should not only focus on individuals being hospitalized, but should be representative of individuals treated at home or in the community because there are no national statistics on NSSI among such patients in China.