Weedage Daphne, Kool-Goudzwaard Nienke, Meijnckens Dwayne, Vermeiren Robert R J M, Boonmann Cyril
Department of Child and Adolescent Psychiatry (LUMC Curium), Leiden University Medical Center, Endegeesterstraatweg 27, 2342 AK Oegstgeest, Postbus 15 - 2300 AA, Leiden, The Netherlands.
Intensive Treatment Centre and Parnassia Academy, Parnassia Groep, The Hague, The Netherlands.
BMC Psychiatry. 2025 May 7;25(1):463. doi: 10.1186/s12888-025-06868-3.
The aim of the current study is to examine the relationship between nonsuicidal self-injury (NSSI) and resilience. Resilience has been identified as a critical area for further investigation in the context of NSSI. Resilience has been conceptualized in different ways over the years, from psychological resilience, with a focus on the individual's problem/deficiency, into a dynamic, cultural, interactive process in which people's biological, psychological, social, and ecological systems work together to help them cope with challenges and maintain or improve their mental well-being.
For this systematic review was searched within PubMed, PsycINFO, the Cochrane Library, and Web of Science for currently published studies on the relationship between NSSI and resilience to provide a summary, following the Preferred Reporting Items for Meta-analysis and Meta-Analysis. Second, it determines the magnitude of this relationship by calculating a random effects size, using the meta-package of R.
Included were 17 studies with a total sample size of 12,273 participants (M = 17.56, range: 12.93-27.50, SD = 3.95; female: 59.5%) and a NSSI sample size of 4,767 (38.8%). The pooled results indicate a small to moderate relationship between resilience and NSSI, with a random effects model effect size of 0.28 (95% CI: 0.10; 0.47), with higher levels or the presence of NSSI associated with lower levels of resilience. Most studies measured psychological resilience. Several reporting the moderator and mediator function of resilience, whereby higher resilience reduces the odds of developing NSSI in the case of stressful or traumatic events. A minority of studies reported effect sizes per resilience factor. Of which problem solving/coping and emotional reactivity were predominantly reported.
Resilience is related to NSSI. However, it also shows that resilience is mostly measured as a psychological and individual concept. This is contrary to the multimodal perspective of resilience as well as the multimodal and non-linear nature of the recovery process of NSSI. Therefor this review highlights the need for a holistic approach with a shift in focus to a multimodal perspective. More research is needed to understand the role of resilience within the nonlinear recovery process. This research should include the voices of people with lived experience.
本研究旨在探讨非自杀性自伤（NSSI）与心理韧性之间的关系。心理韧性已被确定为在NSSI背景下需要进一步研究的关键领域。多年来，心理韧性的概念化方式各不相同，从关注个体问题/缺陷的心理韧性，发展到一个动态、文化、互动的过程，在这个过程中，人们的生物、心理、社会和生态系统共同发挥作用，帮助他们应对挑战并维持或改善心理健康。
为进行这项系统评价，我们在PubMed、PsycINFO、Cochrane图书馆和科学网中检索了当前发表的关于NSSI与心理韧性关系的研究，以按照Meta分析和系统评价的首选报告项目提供综述。其次，我们使用R语言的meta包，通过计算随机效应量来确定这种关系的大小。
纳入了17项研究，总样本量为12273名参与者（M = 17.56，范围：12.93 - 27.50，标准差 = 3.95；女性：59.5%），NSSI样本量为4767（38.8%）。汇总结果表明心理韧性与NSSI之间存在小到中等程度的关系，随机效应模型效应量为0.28（95%置信区间：0.10；0.47），NSSI水平越高或存在NSSI与心理韧性水平越低相关。大多数研究测量了心理韧性。有几项研究报告了心理韧性的调节和中介功能，即在压力或创伤事件的情况下，较高的心理韧性会降低发生NSSI的几率。少数研究报告了每个心理韧性因素的效应量。其中主要报告了问题解决/应对和情绪反应性。
心理韧性与NSSI有关。然而，这也表明心理韧性大多被测量为一个心理和个体概念。这与心理韧性的多模式观点以及NSSI恢复过程的多模式和非线性性质相反。因此，本综述强调需要一种整体方法，将重点转向多模式视角。需要更多研究来了解心理韧性在非线性恢复过程中的作用。这项研究应纳入有实际经历者的声音。
