Family Risk and Protective Factors Associated with Non-Suicidal Self-Injury in Male Adolescents: A Systematic Review

Abstract

Background Non-suicidal self-injury (NSSI) is a growing mental health concern among adolescents, with increasing prevalence reported globally. While existing research has identified multiple individual and social risk factors, the role of family-related variables, particularly among male adolescents, remains less clearly synthesized.

Objective The present study aimed to systematically identify and synthesize family-related factors associated with NSSI among male adolescents.

Methods A systematic review design was employed following PRISMA guidelines. A comprehensive literature search was conducted across multiple electronic databases, including PubMed, Scopus, Web of Science, EMBASE, PsycARTICLES, and Google Scholar. Studies were included if they examined NSSI among adolescents and reported family-related variables such as parenting practices, family functioning, attachment, family conflict, or socioeconomic status. A total of 17 studies published between 2017 and 2025 met the inclusion criteria and were included in the qualitative synthesis. Data were extracted and analyzed using a narrative synthesis approach.

Results The findings indicate that multiple family-related factors are associated with NSSI among adolescents. Poor family functioning, low cohesion, and reduced adaptability were frequently reported across studies. Negative parenting practices, including harsh parenting, parental rejection, and lack of emotional warmth, were also consistently associated with NSSI, while positive parenting behaviors and emotional warmth were negatively associated. Additionally, inter-parental conflict, parent–child separation, and insecure attachment were identified as relevant correlates. Structural factors such as socioeconomic status and family structure were also examined. Most studies employed cross-sectional designs and were conducted in China, with fewer studies utilizing longitudinal, experimental, or qualitative approaches.

Conclusion

The review highlights the importance of family-related variables in the context of adolescent NSSI and provides a structured synthesis of existing evidence. The findings underscore the need for further research focusing specifically on male adolescents, as well as studies employing longitudinal and culturally diverse approaches. Family-focused assessment and intervention strategies may be relevant in addressing NSSI among adolescents.