Self-harm is a major public health concern associated with suicide risk and significant psychological distress. Theories suggest that aversive emotional states are an important process that drives self-harm. Shame and guilt may, in particular, be important emotions in self-harm. This review therefore sought to provide a systematic review and meta-analysis of the relationship between shame, guilt, and self-harm. A systematic search of electronic databases (PsycINFO; Medline; CINAHL Plus; Web of Science and ProQuest) was undertaken to identify studies measuring shame, guilt and self-harm (including suicidal and non-suicidal behaviour). Meta-analysis was undertaken where papers focused on the same subtype of shame or guilt and shared a common outcome. Thirty studies were identified for inclusion. Most forms of shame were associated with non-suicidal self-injury (NSSI), but research was sparse concerning suicidal behaviour. Fewer studies examined guilt and findings were more varied. Methodological issues included a paucity of longitudinal designs and lack of justification for sample sizes. Results of this review support the link between shame and self-harm, particularly NSSI. The direction of this relationship is yet to be established. Clinically, consideration should be given to the role of shame amongst individuals who present with NSSI. This review was pre-registered on PROSPERO (CRD42017056165).

自残是一个与自杀风险和严重心理困扰相关的主要公共卫生问题。理论表明，厌恶情绪状态是导致自残的重要过程。羞耻和内疚可能是自残中特别重要的情绪。因此，本综述旨在对羞耻、内疚和自残之间的关系进行系统回顾和荟萃分析。对电子数据库（PsycINFO；Medline；CINAHL Plus；Web of Science 和 ProQuest）进行了系统检索，以确定衡量羞耻、内疚和自残（包括自杀和非自杀行为）的研究。进行荟萃分析时，论文关注相同的羞耻或内疚亚型，并具有共同的结果。确定纳入三十项研究。大多数形式的羞耻都与非自杀性自伤（NSSI）有关，但有关自杀行为的研究很少。调查内疚感的研究较少，而且研究结果也更加多样化。方法论问题包括缺乏纵向设计和缺乏样本量的合理性。本次审查的结果支持羞耻感与自残之间的联系，尤其是 NSSI。这种关系的方向尚未确定。临床上，应考虑羞耻感在 NSSI 患者中的作用。该评论已在 PROSPERO 上预注册 (CRD42017056165)。