Self-injurious thoughts and behaviors (SITBs) are major public health concerns impacting a wide range of individuals and communities. Despite major efforts to develop and refine treatments to reduce SITBs, the efficacy of SITB interventions remains unclear. To provide a comprehensive summary of SITB treatment efficacy, we conducted a meta-analysis of published randomized controlled trials (RCTs) that have attempted to reduce SITBs. A total of 591 published articles from 1,125 unique RCTs with 3,458 effect sizes from the past 50 years were included. The random-effects meta-analysis yielded surprising findings: The overall intervention effects were small across all SITB outcomes; despite a near-exponential increase in the number of RCTs across five decades, intervention efficacy has not improved; all SITB interventions produced similarly small effects, and no intervention appeared significantly and consistently stronger than others; the overall small intervention effects were largely maintained at follow-up assessments; efficacy was similar across age groups, though effects were slightly weaker for child/adolescent populations and few studies focused on older adults; and major sample and study characteristics (e.g., control group type, treatment target, sample size, intervention length) did not consistently moderate treatment efficacy. This meta-analysis suggests that fundamental changes are needed to facilitate progress in SITB intervention efficacy. In particular, powerful interventions target the necessary causes of pathology, but little is known about SITB causes (vs. SITB correlates and risk factors). The field would accordingly benefit from the prioritization of research that aims to identify and target common necessary causes of SITBs. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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自杀和自我伤害的干预措施：一项针对近50年研究的随机对照试验的荟萃分析。

自伤性思想和行为（SITB）是主要的公共健康问题，影响着广泛的个人和社区。尽管为开发和完善减少SITB的治疗方法做出了巨大努力，但SITB干预的效果仍不清楚。为了提供SITB治疗功效的全面总结，我们对已尝试降低SITB的已发表的随机对照试验（RCT）进行了荟萃分析。纳入了过去50年中来自1,125个独特RCT的591篇发表的文章，其效应大小为3,458。荟萃分析的随机效果得出了令人惊讶的发现：在所有SITB结果中，总体干预效果均很小。尽管在过去的五十年中，随机对照试验的数量几乎呈指数增长，但干预效果并未提高。所有SITB干预措施都产生了类似的小影响，并且没有任何干预措施比其他干预措施显着且持续地强大。总体的小规模干预效果在后续评估中基本保持不变；各个年龄组的疗效相似，尽管对儿童/青少年人群的影响稍弱，并且很少有针对老年人的研究。主要样本和研究特征（例如，对照组类型，治疗目标，样本量，干预时间）并不能持续降低治疗效果。这项荟萃分析表明，需要进行根本性的改变以促进SITB干预疗效的进展。特别是，有力的干预措施针对的是病理的必要原因，但对SITB的原因知之甚少（相对于SITB的相关性和危险因素）。因此，该领域将从优先确定旨在确定和确定SITB的常见必要原因的研究中受益。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。