- 2026-08
- Journal of affective disorders 407
- Qian You
- Linglin Guo
- Xiaozhen Song
- Feng Wang
- Shouqin Wen
- Qin Ding
- Juan Chen
Study Design
- Type
- Meta-Analysis
- Population
- 13,224 adolescents
- Methods
- Systematic review and meta-analysis; searched ten databases up to September 2025; PRISMA guidelines; two reviewers; Newcastle-Ottawa Scale
Background
The increasing prevalence of non-suicidal self-injury (NSSI) among adolescents underscores the need for targeted prevention. Understanding its longitudinal trajectories is essential for early intervention. However, existing evidence has not been systematically synthesized.Methods
A comprehensive search across ten databases was performed up to September 2025. Following PRISMA guidelines, two reviewers independently screened studies and extracted data, with discrepancies resolved by a third reviewer. Study quality was assessed using the Newcastle-Ottawa Scale.Results
Ten high-quality studies involving 13,224 adolescents were included. Between two and four distinct NSSI trajectories were identified across the studies. A subgroup of adolescents consistently followed a medium-to high-risk NSSI trajectory, with a pooled prevalence of 22.9% (95% CI: 13.2, 36.9). Significant moderators of NSSI trajectory included country (Q1 = 26.09, P < 0.001), recruitment setting (Q2 = 5.01, P < 0.05), analysis type (Q3 = 46.46, P < 0.001), and follow-up duration (Q4 = 14.95, P < 0.001). In contrast, the type of NSSI assessment instrument did not show a significant moderating effect (Q5 = 5.16, P = 0.16). Meta-regression indicated that recruitment setting and follow-up duration were statistically significant sources of heterogeneity (P < 0.05). Key predictors associated with NSSI trajectories included emotional dysregulation, psychiatric symptoms (e.g., depression), and family-related factors (e.g., family conflict, parental psychological control, and parental criticism).Conclusions
Adolescents on medium-to high-risk NSSI trajectories demonstrate considerable heterogeneity, which is moderated by contextual factors such as country, recruitment setting, analysis type, and follow-up duration.