Are neurocognitive factors associated with repetition of self-harm? A systematic review

•We conducted a systematic review of all studies examining neurocognition and repeat self-harm.•15 studies were included in the review.•Decision-making studies showed an association; most problem-solving studies failed to show this.•Findings were inconclusive for other factors (cognitive control, memory, emotional-processing).•Future research should consider focussing on promising areas and using neuroimaging.

BackgroundPrediction of self-harm is limited clinically. Early identification of individuals likely to repeat self-harm could improve outcomes and reduce suicide risk. Various neurocognitive deficits have been found in people who self-harm, but the ability of these to predict repetition has yet to be establishedAimsIdentify neurocognitive factors that may predict repetition of self-harm.MethodsSystematic narrative review of English language publications assessing neurocognitive functioning and self-harm repetition, searching multiple databases from inception to March 2015. Quality of studies was appraised. A narrative synthesis was performed.Results7026 unique records were identified, and 169 full-texts assessed. 15 unique studies provided data. No imaging studies could be included. Most studies assessed cognitive control or problem solving, but neither factor was consistently associated with repetition. However, specific tasks may show promise. Two studies in adolescents suggest that value-based decision-making impairments could be predictive of repetition. There were too few results for memory to draw specific conclusions.ConclusionsSelected studies suggest promise for particular neurocognitive factors and specific cognitive tasks in terms of repetition of self-harm.