Research Review: Sex differences in the clinical correlates of nonsuicidal self‐injury in adolescents – a systematic review
Bibliographic record
Abstract
BACKGROUND: Nonsuicidal self-injury (NSSI), or 'the deliberate, self-inflicted destruction of body tissue…without suicidal intent and for purposes not culturally sanctioned', is a robust predictor of future suicide-related behavior and therefore a modifiable target for suicide prevention. The prevalence of NSSI is rising in adolescents, particularly among females; however, it is unknown whether sex differences also exist in the clinical and psychosocial factors associated with NSSI. Understanding how the correlates of NSSI differ by sex is important for developing tailored treatments. This study systematically reviews sex differences in the clinical and psychosocial correlates of NSSI among adolescents. METHODS: MEDLINE and PsycINFO were searched using the keywords 'adolescents', 'self-injury', and 'sex factors' and synonyms for English-language articles published between January 1, 2000 and May 10, 2022. We included studies that presented original data on NSSI, included adolescents ages 10-19, reported sex differences, and explicitly defined self-injury as that done without suicidal intent. Fifty-seven studies containing 54 unique samples were included. Data were summarized by sex and recorded by: (a) characteristics of NSSI, (b) clinical and psychosocial correlates of NSSI, and (c) associations with suicide. RESULTS: We used data on NSSI from 54 unique samples of adolescents worldwide. Males more commonly used violent methods of NSSI, such as burning, and were more likely to be physically aggressive and experience substance abuse. Females more commonly self-injured by cutting, and their NSSI was more likely to be repetitive and associated with emotional distress. In both sexes, NSSI was associated with adverse childhood experiences (ACEs) such as sexual abuse/violence and bullying. NSSI was predictive of suicide in females but not males. CONCLUSIONS: Data from 22 countries and 352,516 participants suggest important sex differences in the clinical and psychosocial factors associated with NSSI among adolescents that future assessment and treatment strategies ought to consider.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.031 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.009 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".