Tang S, Hoye A, Slade A, Tang B, Holmes G, Fujimoto H, Zheng W-Y, Ravindra S, Christensen H, Calear A L
Black Dog Institute, UNSW Sydney, Sydney, NSW, Australia.
Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia.
Clin Child Fam Psychol Rev. 2025 Mar;28(1):171-208. doi: 10.1007/s10567-024-00511-5. Epub 2025 Jan 29.
Self-harm in young people is associated with increased risk of suicide and other negative long-term outcomes. Understanding the motivations driving self-harm behaviours among young people can help to inform the development of preventative and treatment interventions. Self-harm rates have been rising, but reviews of the recent quantitative literature have not been undertaken. PsycInfo, Embase and Medline were systematically searched in September 2024 for studies published in the past ten years. Quantitative studies that examined motivations for self-harm (including prevalence and/or correlates) among young people (aged 10 to 24 years) with a history of self-harm were included in the review. The review was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD42023429568). One hundred and seventeen studies met inclusion criteria. Intrapersonal motivations for self-harm (particularly emotion regulation, anti-dissociation and self-punishment) were more common than interpersonal motivations (e.g. peer bonding, communication). Intrapersonal motivations correlated with female gender, higher self-harm severity, current, repetitive and persistent self-harm, suicidality, poorer mental health and poorer emotion regulation. There was evidence to suggest that interpersonal motives are associated with younger age and some mental health difficulties (e.g. anxiety). Young people predominantly self-harm for intrapersonal reasons. Given that self-harm for intrapersonal reasons is associated with greater self-harm severity, suicidality and poor mental health, steps should be taken to prevent and reduce self-harm. Interventions for self-harm require a multifaceted approach that not only provides young people with alternate ways of regulating their emotions, but also targets risk factors that contribute to self-harm.
青少年自我伤害与自杀风险及其他长期负面后果的增加有关。了解青少年自我伤害行为背后的动机有助于为预防和治疗干预措施的制定提供依据。自我伤害率一直在上升，但尚未对近期的定量文献进行综述。2024年9月，我们系统检索了PsycInfo、Embase和Medline数据库，以查找过去十年发表的研究。本综述纳入了对有自我伤害史的青少年（10至24岁）自我伤害动机（包括患病率和/或相关因素）进行研究的定量研究。本综述按照PRISMA指南进行，并在PROSPERO（CRD42023429568）上进行了注册。117项研究符合纳入标准。自我伤害的个人内部动机（特别是情绪调节、抗解离和自我惩罚）比人际动机（如同伴联系、沟通）更为常见。个人内部动机与女性性别、更高的自我伤害严重程度、当前的、重复的和持续的自我伤害、自杀倾向、较差的心理健康和较差的情绪调节相关。有证据表明人际动机与年龄较小和一些心理健康问题（如焦虑）有关。青少年主要出于个人内部原因进行自我伤害。鉴于出于个人内部原因的自我伤害与更高的自我伤害严重程度、自杀倾向和心理健康不佳有关，应采取措施预防和减少自我伤害。针对自我伤害的干预措施需要采取多方面的方法，不仅要为青少年提供调节情绪的替代方式，还要针对导致自我伤害的风险因素。
