Bisexuality and Non-Suicidal Self-Injury (NSSI): a narrative synthesis of associated variables and a meta-analysis of risk.

Brendan Dunlop, Samantha Hartley, Olayinka Oladokun, Peter Taylor

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Bisexual people have been found to be at increased risk of non-suicidal self-injury (NSSI) when compared to heterosexual and gay or lesbian people. The purpose of this review was to update the estimated risk of NSSI for bisexual people and to examine variables that have been associated with NSSI in this population.

The protocol for this paper was pre-registered (CRD42019145299). An electronic search of PsycINFO, CINAHL Plus, PubMed, Ovid Online and Web of Science was undertaken from earliest available date to October 2019. Twenty-four eligible papers were identified. Meta-analyses, including moderator analysis, were conducted to ascertain NSSI risk and a narrative synthesis was undertaken of predictors and correlates. All studies were assessed for risk of bias.

Bisexual people had up to six times the odds of engaging in NSSI compared to other sexualities. Mental health variables of anxiety and depression symptoms were found to be most commonly associated with NSSI for this population. The majority of studies had moderate risk of bias. This review demonstrates that bisexual people have an elevated risk of engaging in NSSI. Increased incidence of anxiety and depression and exposure to negative life events may explain this increased risk.

Studies were found to be consistently cross-sectional in design and limited to western cultures. A limitation of this review was that only English language papers were included.

Results are clinically relevant as they suggest early identification and prevention of NSSI can be achieved. Future research should examine bisexual people independently of others.
Original languageEnglish
JournalJournal of Affective Disorders
Publication statusPublished - 21 Jul 2020


  • bisexual
  • bisexuality
  • non-suicidal self-injury
  • NSSI
  • self-injury
  • LGBT


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