VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Trauma Violence Abuse. 2023 Dec;24(5):2936-2952. doi: 10.1177/15248380221119513. Epub 2022 Sep 5.
Military service members and veterans (SMVs) are at risk for self-directed violence, including nonsuicidal self-injury (NSSI). While NSSI is an important construct worthy of independent study, it is understudied among SMVs and, when included in research, typically examined in the context of suicide risk. Consequently, lifetime prevalence rate estimates of NSSI among SMVs vary. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review and meta-analysis estimated the average lifetime NSSI prevalence among SMVs and explored demographic and methodological factors that may account for observed variability. Based on a search of Ovid MEDLINE, Embase, PsycINFO, and Web of Science, 47 samples from 42 articles across five countries met inclusion criteria. Results revealed an average NSSI lifetime prevalence rate of 15.76% among SMVs. Significantly higher prevalence rates were observed among clinical (28.14%) versus community (11.28%) samples and studies using interviews to assess NSSI (23.56%) versus self-report (13.44%) or chart review (7.84%). Lifetime prevalence increased as publication year increased and decreased as sample size increased. In contrast to prior literature, prevalence rates were comparable between active-duty SMVs, and studies collecting data anonymously versus those that did not. Lifetime prevalence was not moderated by age, gender, race, country, primary research focus, quality of NSSI operationalization, or whether NSSI methods were assessed. Findings suggest NSSI is a pervasive problem among military personnel, particularly within clinical settings, highlighting the need for systematic assessment of this important but understudied clinical phenomenon among SMVs. Further research is necessary to elucidate additional risk factors for NSSI among SMVs, including trauma exposure.
军人和退伍军人（SMV）有自我伤害的风险，包括非自杀性自我伤害（NSSI）。虽然 NSSI 是一个值得独立研究的重要结构，但在 SMV 中的研究较少，并且在研究中，通常在自杀风险的背景下进行检查。因此，SMV 中 NSSI 的终生患病率估计值各不相同。本项系统评价和荟萃分析的首选报告项目估计了 SMV 中 NSSI 的平均终生患病率，并探讨了可能导致观察到的变异性的人口统计学和方法学因素。根据对 Ovid MEDLINE、Embase、PsycINFO 和 Web of Science 的搜索，来自五个国家的 42 篇文章的 47 个样本符合纳入标准。结果显示，SMV 中 NSSI 的平均终生患病率为 15.76%。在临床样本（28.14%）与社区样本（11.28%）、使用访谈评估 NSSI 的研究（23.56%）与使用自我报告（13.44%）或图表审查（7.84%）的研究中，观察到显著更高的患病率。随着出版年份的增加，终生患病率增加，随着样本量的增加而减少。与先前的文献相比，现役 SMV 之间的患病率相似，收集匿名数据的研究与不收集匿名数据的研究之间的患病率相似。终生患病率不受年龄、性别、种族、国家、主要研究重点、NSSI 操作化质量或是否评估 NSSI 方法的影响。研究结果表明，NSSI 是军人中普遍存在的问题，特别是在临床环境中，这凸显了需要对 SMV 中这一重要但研究不足的临床现象进行系统评估。需要进一步研究以阐明 SMV 中 NSSI 的其他风险因素，包括创伤暴露。
