The Effects of Social Networks and Digital Technology on Non-suicidal Self-Injury in Children and Adolescents: A Systematic Review

Non-suicidal self-injury (NSSI) constitutes a significant and increasingly prevalent clinical problem among children and adolescents. At the same time, social media and digital technologies have become integral to adolescents' social interaction, emotional regulation, and identity development, raising concerns about their potential contribution to NSSI risk as well as their role in prevention and intervention. This systematic review synthesizes current evidence on the relationship between digital platform use and NSSI in pediatric and adolescent populations. Thirteen studies encompassing randomized controlled trials, observational designs, and qualitative research were included. Across study types, higher levels of social media use and digital engagement were consistently associated with an increased likelihood of NSSI, self-harm behaviors, depressive symptoms, and suicidal ideation, with effects more pronounced among female adolescents. Several population-based studies demonstrated dose-response relationships, particularly for social networking platforms, suggesting that intensity and modality of use are clinically relevant. Notably, the type and purpose of digital activity appeared more informative than total screen time alone, as structured or knowledge-oriented digital engagement showed neutral or potentially protective associations. Evidence from randomized trials indicated that digitally delivered interventions targeting emotion regulation are feasible, safe, and associated with meaningful reductions in NSSI frequency, alongside improvements in psychosocial functioning and quality of life. Across study designs, emotional dysregulation emerged as a central mechanism linking digital experiences to self-injurious behavior. In summary, digital environments play a complex and multifaceted role in adolescent NSSI, functioning both as potential risk contexts and as platforms for therapeutic intervention. These findings support the need for nuanced, developmentally informed clinical assessments of digital behavior and the integration of gender-sensitive, emotion-focused digital strategies into comprehensive prevention and early intervention approaches for adolescents at risk of NSSI.