Rebecca L Forrester1, Hayley Slater2, Khowla Jomar3, Susan Mitzman4, Peter James Taylor5. 1. Institute of Psychology Health and Society, University of Liverpool, Liverpool, England L69 3GB, United Kingdom. Electronic address: rebecca.forrester@ggc.scot.nhs.uk. 2. Division of Health Research, University of Lancaster, Lancaster, England LA1 4YG, United Kingdom. 3. Institute of Psychology Health and Society, University of Liverpool, Liverpool, England L69 3GB, United Kingdom. 4. Instiute of Learning and Teaching, University of Liverpool, Liverpool, England L69 3GB, United Kingdom. 5. Division of Psychology & Mental Health, University of Manchester, Manchester, England M13 9PL, United Kingdom.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. LIMITATIONS: The absence of longitudinal research is a major limitation of this literature. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. LIMITATIONS: The absence of longitudinal research is a major limitation of this literature. CONCLUSIONS: 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.