Forrester Rebecca L, Slater Hayley, Jomar Khowla, Mitzman Susan, Taylor Peter James
Institute of Psychology Health and Society, University of Liverpool, Liverpool, England L69 3GB, United Kingdom.
Division of Health Research, University of Lancaster, Lancaster, England LA1 4YG, United Kingdom.
J Affect Disord. 2017 Oct 15;221:172-183. doi: 10.1016/j.jad.2017.06.027. Epub 2017 Jun 15.
Non-suicidal self-injury (NSSI) is a self-destructive act that represents a considerable burden on the individual and society. Low self-esteem may be a psychological variable that is related to NSSI. However, little is known about the nature of this relationship in adulthood. This systematic review therefore aimed to provide a synthesis of the available literature on the relationship between self-esteem and NSSI.
Articles were independently identified and risk of bias assessed by two reviewers searching PsycINFO, CINAHL, Medline and Web of Science databases. Inclusion criteria were: (1) a mean sample age of eighteen years or over (2) full manuscripts available in English (3) assessment of NSSI (4) assessment(s) of self-esteem. A narrative synthesis of results was undertaken. A random-effects meta-analysis of differences in self-esteem between NSSI and non-NSSI groups was also undertaken.
Seventeen studies were identified and indicated a significant negative relationship between self-esteem and NSSI. The meta-analysis indicated lower self-esteem in those with experiences of NSSI versus those without, d = 0.59 - 1.17. Results suggested that although low self-esteem and NSSI are related in both clinical and non-clinical populations, there are a number of factors which also influence this relationship.
The absence of longitudinal research is a major limitation of this literature.
It will be important for clinicians to consider the impact of self-esteem in those seeking support for NSSI. Further research should undertake longitudinal research to better understand the self-esteem and NSSI relationship.
非自杀性自伤（NSSI）是一种自我毁灭行为，给个人和社会带来了相当大的负担。低自尊可能是与非自杀性自伤相关的一个心理变量。然而，对于成年期这种关系的本质知之甚少。因此，本系统综述旨在综合现有关于自尊与非自杀性自伤之间关系的文献。
两名评审员通过检索PsycINFO、CINAHL、Medline和科学引文索引数据库独立识别文章并评估偏倚风险。纳入标准为：（1）样本平均年龄为18岁或以上；（2）有英文全文手稿；（3）对非自杀性自伤进行评估；（4）对自尊进行评估。对结果进行叙述性综合分析。还对非自杀性自伤组和非非自杀性自伤组之间自尊差异进行了随机效应荟萃分析。
共识别出17项研究，表明自尊与非自杀性自伤之间存在显著负相关。荟萃分析表明，有非自杀性自伤经历的人比没有该经历的人自尊水平更低，d = 0.59 - 1.17。结果表明，尽管低自尊与非自杀性自伤在临床和非临床人群中均有关联，但也有许多因素会影响这种关系。
缺乏纵向研究是该文献的一个主要局限性。
对于临床医生而言，在为有非自杀性自伤问题的人提供支持时考虑自尊的影响非常重要。未来的研究应开展纵向研究，以更好地理解自尊与非自杀性自伤之间的关系。
