Experiential avoidance in non-suicidal self-injury and suicide experiences: A systematic review and meta-analaysis.

Abstract
Introduction: This systematic review and meta-analysis aimed to (i) examine the associations between experiential avoidance (EA), non-suicidal self-injury (NSSI), and
suicide experiences, and (ii) identify sample- and methodological-related variables
affecting the strength of these associations.
Method: Medline, Embase, PsychINFO, Web of Science, and CINAHL were
searched until April 2020. Random-effect meta-analyses were applied. The I
2
statistic and the Egger’s test assessed heterogeneity and publication bias. Meta-regression
analyses were used to evaluate the impact of moderator variables on the strength of
these associations.
Results: Data from 19 independent studies based on n = 9900 participants were
pooled. The analyses demonstrated a weak but significant association between EA
and NSSI. None of the examined moderator variables influenced the strength of this
relationship. There was an indication of publication bias, suggesting that this association may have been inflated. The associations between EA, and suicide ideation and
behaviors were moderate to strong.
Discussion: The current study concluded that (i) the EA model for NSSI should be
revised by incorporating new evidence implicating feelings of relief in NSSI, and (ii)
future studies should examine interactive factors between EA and key psychological
components in the pathways to suicide experiences because these findings have direct
clinical implications.