{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T15:12:40Z","timestamp":1783955560454,"version":"3.55.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to analyze the influencing factors of non-suicidal self-injury (NSSI) in adolescents with depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. We systematically searched PubMed, Embase, Web of Science, the Cochrane Library, and the China National Knowledge Infrastructure (CNKI) for observational studies on factors influencing NSSI behavior in adolescents with depression published between 1 January 2010 and 7 May 2026. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Newcastle\u2013Ottawa Scale. Meta-analyses were performed in RevMan 5.4 using mean differences (MDs) with 95% confidence intervals. Between-study heterogeneity was evaluated using the \u03c7\u00b2 test and I\u00b2 statistic, and fixed- or random-effects models were applied as appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 11 studies were included, involving 529 patients in the study group and 1,716 patients in the control group. The meta-analysis showed that, compared with the control group, the study group had significantly higher scores for interpersonal problems, negative emotions, alexithymia, and negative self-esteem [MD = 5.88, 95% CI (3.19, 8.57), P &amp;lt; 0.001], somatic symptom scores [MD = 5.20, 95% CI (\u20130.03, 10.43), P = 0.05], emotional deficit [MD = 6.82, 95% CI (0.32, 13.31), P = 0.04], Hamilton Depression Rating Scale scores [MD = 2.97, 95% CI (1.76, 4.18), P &amp;lt; 0.001], emotional abuse [MD = 2.10, 95% CI (1.06, 3.13), P &amp;lt; 0.001], physical abuse [MD = 0.64, 95% CI (0.08, 1.20), P = 0.025], sexual abuse [MD = 0.27, 95% CI (0.12, 0.42), P &amp;lt; 0.001], emotional neglect [MD = 1.67, 95% CI (0.37, 2.97), P = 0.009], physical neglect [MD = 0.81, 95% CI (0.43, 1.19), P &amp;lt; 0.001], and Childhood Trauma Questionnaire total scores [MD = 8.93, 95% CI (3.63, 14.24), P &amp;lt; 0.001].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adolescents with depressive disorders and NSSI tend to exhibit more severe depressive symptoms, maladaptive emotional regulation patterns, negative coping styles, and higher levels of childhood trauma exposure than those without NSSI. These psychosocial and emotional factors may play important roles in the occurrence and maintenance of NSSI behaviors. Early psychological assessment and targeted intervention may help reduce the risk of NSSI in adolescents with depressive disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1758127","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T14:58:40Z","timestamp":1783954720000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A meta-analysis of influencing factors of non-suicidal self-injury behavior in adolescents with depression"],"prefix":"10.3389","volume":"17","author":[{"given":"Yanfei","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]},{"name":"Huzhou Third Municipal Hospital","place":["Huzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xudong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Huzhou Third Municipal Hospital","place":["Huzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leiwen","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.23038","article-title":"Nonsuicidal self-injury, difficulties in emotion regulation, negative urgency, and childhood invalidation: A study with outpatients with eating disorders","volume":"77","author":"Va","year":"2021","journal-title":"J Clininal Psychol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/casp.2478","article-title":"How others respond to non-suicidalself-injurydisclosure: A systematic review","volume":"31","author":"Park","year":"2020","journal-title":"J Community Appl Soc Psychol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.912441","article-title":"Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis","volume":"13","author":"Xiao","year":"2022","journal-title":"Front Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2022.106634","article-title":"Self-injury prevalence in adolescents: A global systematic review and meta-analysis","volume":"142","author":"Lucena","year":"2022","journal-title":"Children Youth Serv Rev"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.912441","article-title":"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","volume":"13","author":"Xiao","year":"2022"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-023-02264-y","article-title":"The prevalence of self-injury in adolescence: a systematic review and meta-analysis","volume":"33","author":"Farkas","year":"2024","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.121208.131258","article-title":"Self-injury","volume":"6","author":"Nock","year":"2010","journal-title":"Annu Rev Clin Psychol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1434958","article-title":"A meta-analysis on the lifetime and period prevalence of self-injury among adolescents with depression","volume":"12","author":"Wu","year":"2024","journal-title":"Front Public Health"},{"key":"B9","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1186\/S12888-023-04808-7","article-title":"Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis","volume":"23","author":"He","year":"2023"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.1256","article-title":"Prevalence and correlates of suicide and nonsuicidal self-injury in children: A systematic review and meta-analysis","volume":"79","author":"Liu","year":"2022","journal-title":"JAMA Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1186\/s12888-023-04938-y","article-title":"Relationship between alexithymia, loneliness, resilience and non-suicidal self-injury in adolescents with depression: a multi-center study","volume":"23","author":"Zhang","year":"2023","journal-title":"BMC Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1186\/s12888-023-04800-1","article-title":"Relationship between borderline personality features, emotion regulation, and non-suicidal self-injury in depressed adolescents: a cross-sectional study","volume":"23","author":"Chen","year":"2023","journal-title":"BMC Psychiatry"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101350","article-title":"Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis","volume":"46","author":"Wang","year":"2022","journal-title":"eClinicalMedicine"},{"key":"B14","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1186\/s12888-025-07361-7","article-title":"A review of the scope of non-suicidal self-injury behavior in adolescents with depressive disorders: an analysis of related influencing factors","volume":"25","author":"Ling","year":"2025","journal-title":"BMC Psychiatry"},{"key":"B15","author":"Wells","year":"2014","journal-title":"The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomised studies in meta-analyses"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/JCM10163561","article-title":"Examining the neurobiology of non-suicidal self-injury in children and adolescents: The role of reward responsivity","volume":"10","author":"Cja","year":"2021","journal-title":"J Clin Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/FPSYG.2023.989711","article-title":"Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder","volume":"14","author":"Bo","year":"2023","journal-title":"Front Psychol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/FPSYT.2022.925672","article-title":"A resting state functional magnetic resonance imaging study of unmedicated adolescents with non-suicidal self-injury behaviors: evidence from the amplitude of low-frequency fluctuation and regional homogeneity indicator","volume":"13","author":"Yi","year":"2022","journal-title":"Front Psychiatry"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3390\/children9020201","article-title":"Assessing clinical features of adolescents suffering from depression who engage in non-suicidal self-injury","volume":"9","author":"Maria","year":"2022","journal-title":"Children (Basel)"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/FPED.2022.822046","article-title":"Childhood maltreatment, low serum cortisol levels, and non-suicidal self-injury in young adults with major depressive disorders","volume":"10","author":"Bo","year":"2022","journal-title":"Front Pediatr"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291711001814","article-title":"Longitudinal predictors of past-year non-suicidal self-injury and motives among college students","volume":"42","author":"Wilcox","year":"2012","journal-title":"Psychol Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/FNINS.2022.972870","article-title":"Prefrontal cortex neural activity predicts reduction of non-suicidal self-injury in adolescents with major depressive disorder: An event related potential study","volume":"16","author":"Huishan","year":"2022","journal-title":"Front Neurosci"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.757933","article-title":"Comparison of patterns of non-suicidal self-injury and emotion dysregulation across mood disorder subtypes","volume":"13","author":"So Yung","year":"2022","journal-title":"Front Psychiatry"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.637407","article-title":"Cognitive impairment in adolescent major depressive disorder with nonsuicidal self-injury: Evidence based on multi-indicator ERPs","volume":"15","author":"Yujiao","year":"2021","journal-title":"Front Hum Neurosci"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2024.1336631","article-title":"Predictors of non-suicidal self-injury in adolescents with depressive disorder: the role of alexithymia, childhood trauma, and body investment [Original Research","volume":"15","author":"Cao","year":"2024"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-024-01858-0","article-title":"Psychosocial factors affect the occurrence of nonsuicidal self-injury in adolescents with major depressive disorder through chain mediation","volume":"275","author":"Ren","year":"2025","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn113661-20200107-00004","article-title":"Childhood trauma experiences and their impact on non-suicidal self-injury in adolescents with first episode depressive disorder","volume":"53","author":"Yi","year":"2020","journal-title":"Chin J Psychiatry"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2019.104384","article-title":"How is problematic smartphone use related to adolescent depression? A moderated mediation analysis","volume":"104","author":"Pengcheng","year":"2019","journal-title":"Children Youth Serv"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-020-01648-8","article-title":"A comprehensive mapping of outcomes following psychotherapy for adolescent depression: The perspectives of young people, their parents and therapists","volume":"30","author":"Krause","year":"2021","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1097\/nmd.0000000000001641","article-title":"The characteristics and influencing factors of nonsuicidal self-injury of adolescents with depressive disorder in China: A meta-analysis","volume":"211","author":"Niu","year":"2023","journal-title":"J Nervous Ment Dis"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1177\/2167702613514563","article-title":"The four-function model of nonsuicidal self-injury: Key directions for future research","volume":"2","author":"Bentley","year":"2014","journal-title":"Clin psychol Sci"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1007\/s10862-008-9107-z","article-title":"Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements About Self-injury (ISAS)","volume":"31","author":"Klonsky","year":"2009","journal-title":"J Psychopathol Behav Assess"},{"key":"B33","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1037\/abn0000229","article-title":"The emotion regulation function of nonsuicidal self-injury: A momentary assessment study in inpatients with borderline personality disorder features","volume":"126","author":"Houben","year":"2016","journal-title":"J Abnormal Psychol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.09.002","article-title":"Meta-analysis of risk factors for nonsuicidal self-injury","volume":"42","author":"Fox","year":"2015","journal-title":"Clin Psychol Rev"},{"key":"B35","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.psychres.2016.04.083","article-title":"Functions of nonsuicidal self-injury (NSSI): Cross-sectional associations with NSSI duration and longitudinal changes over time and following treatment","volume":"241","author":"Victor","year":"2016","journal-title":"Psychiatry Res"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1713461","article-title":"Risk and protective factors for nonsuicidal self-injury among adolescents: a latent profile analysis [Original Research","volume":"16","author":"He","year":"2025"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.06.027","article-title":"Self-esteem and non-suicidal self-injury in adulthood: A systematic review","volume":"221","author":"Forrester","year":"2017","journal-title":"J Affect Disord"},{"key":"B38","article-title":"A systematic review on relations between non-suicidal self-injury and self-esteem by using semantic analysis approach","author":"Wu","year":"2024"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.actpsy.2025.105306","article-title":"Non-suicidal self-injury in adolescent depression: A bibliometric study and visualization analysis","volume":"259","author":"Liu","year":"2025","journal-title":"Acta Psychologica"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1434958","article-title":"A meta-analysis on the lifetime and period prevalence of self-injury among adolescents with depression [Original Research","volume":"12","author":"Wu","year":"2024"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1111\/jcap.70039","article-title":"Non-suicidal self-injury in adolescents: A systematic review on prevention and intervention programmes","volume":"38","author":"Escofet-Colet","year":"2025","journal-title":"J Child Adolesc Psychiatr Nursing: Off Publ Assoc Child Adolesc Psychiatr Nurses Inc"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1601073","article-title":"Interventions for adolescent depression comorbid with non-suicidal self-injury: a scoping review [Review","volume":"16","author":"Fang","year":"2025"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00262","article-title":"Using the body when there are no words for feelings: Alexithymia and somatization in self-harming adolescents","volume":"11","author":"Raffagnato","year":"2020","journal-title":"Front Psychiatry"},{"key":"B44","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.jad.2023.06.041","article-title":"Physiological response to pain in female adolescents with nonsuicidal self-injury as a function of severity","volume":"339","author":"van der Venne","year":"2023","journal-title":"J Affect Disord"},{"key":"B45","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s10802-011-9578-3","article-title":"Differentiating adolescent self-injury from adolescent depression: possible implications for borderline personality development","volume":"40","author":"Crowell","year":"2012","journal-title":"J Abnormal Child Psychol"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.70533","article-title":"Mediating role of depression severity in the relationship between childhood trauma and non-suicidal self-injury among adolescents with mood disorders","volume":"15","author":"Li","year":"2025","journal-title":"Brain Behav"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.2147\/prbm.S530888","article-title":"The relationship between nonsuicidal self-injury and depression symptoms in Chinese adolescents: A cross-lagged panel network analysis","volume":"18","author":"Xu","year":"2025","journal-title":"Psychol Res Behav Manage"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1139705","article-title":"The effects of childhood maltreatment on adolescent non-suicidal self-injury behavior: mediating role of impulsivity [Original Research","volume":"14","author":"Li","year":"2023"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1080\/20008066.2025.2466279","article-title":"Childhood maltreatment and non-suicidal self-injury: the mediating role of mentalization and depression","volume":"16","author":"Yang","year":"2025","journal-title":"Eur J Psychotraumatol"},{"key":"B50","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/S2215-0366(17)30469-8","article-title":"Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis","volume":"5","author":"Liu","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2024.107048","article-title":"Childhood maltreatment and non-suicidal self-injury in adolescent population: a systematic review and meta-analysis","volume":"157","author":"Calvo","year":"2024","journal-title":"Child Abuse Negl"},{"key":"B52","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1186\/s40359-024-02236-0","article-title":"The effect of depression on non-suicidal self-injury and psychological status in adolescents with unipolar and bipolar disorders","volume":"12","author":"Ye","year":"2024","journal-title":"BMC Psychol"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1758127\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T14:58:42Z","timestamp":1783954722000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1758127\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":52,"alternative-id":["10.3389\/fpsyt.2026.1758127"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1758127","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]},"article-number":"1758127"}}