Psychosocial factors associated with non-suicidal self-injury in Iranian adolescents and young adults: a scoping review protocol

BMJ Open. 2026 May 3;16(4):e115300. doi: 10.1136/bmjopen-2025-115300.

ABSTRACT

INTRODUCTION: Non-suicidal self-injury (NSSI) is defined as the deliberate harm to one’s body without suicidal intent. Although individuals engaging in NSSI do not intend to die, repetitive self-injury may increase the risk of future suicidal behaviour through reduced fear of death and increased pain tolerance. Global lifetime prevalence estimates of NSSI range from 4.2% in adults to 15.4% in adolescents, with an observed increase during the COVID-19 pandemic. In Iran, the reported prevalence of NSSI among adolescents and young adults is approximately 22%; however, comprehensive and culturally contextualised evidence remains limited. Psychosocial, interpersonal and ecological factors contribute to NSSI, yet no prior study has systematically mapped these determinants within an integrated, multilevel framework in the Iranian context.

OBJECTIVE: This scoping review aims to identify and map intrapersonal, interpersonal and ecological psychosocial factors associated with NSSI among Iranian adolescents and young adults, summarising quantitative and qualitative evidence and highlighting gaps for future research and intervention planning.

METHODS AND ANALYSIS: Following Arksey and O’Malley’s six-stage framework, with enhancements from the Joanna Briggs Institute guidelines, a comprehensive search was conducted across international (PubMed, Scopus, Web of Science, PsycINFO, Embase) and national (SID, Magiran, Noormags) databases. Two reviewers will independently conduct screening, data extraction and thematic coding. A third reviewer will resolve any discrepancies. Findings will be synthesised using a directed narrative synthesis combined with integrative thematic analysis. Psychosocial factors will be mapped to an integrated framework combining Nock’s functional model and Bronfenbrenner’s ecological systems theory. Methodological quality will be appraised using the Mixed Methods Appraisal Tool.

ETHICS AND DISSEMINATION: This scoping review will be conducted based on published and publicly available literature; therefore, no individual informed consent is required. Ethical approval has been obtained from the Ethics Committee of Ferdowsi University of Mashhad (Approval code: IR.UM.REC.1404.282). The findings will be disseminated through publication in a peer-reviewed journal, conference presentations and academic workshops to inform researchers, clinicians and policymakers about the factors associated with NSSI among Iranian adolescents and young adults.

PMID:42082246 | DOI:10.1136/bmjopen-2025-115300