Title: Association of problematic Internet, mobile phone, or gaming use or addiction with non-suicidal self-injury: a meta-analysis

Objective This study aims to systematically explore the association between problematic internet/mobile/game use or internet/mobile/game addiction and non-suicidal self-injury (NSSI) through a meta-analysis, and to provide scientific evidence for future prevention and intervention strategies for NSSI and problematic internet/mobile/game use or addiction.Methods Six databases were searched for relative articles up to June 23, 2024. Before pooling the odds ratios (ORs) between problematic internet/mobile/game use or addiction and NSSI, the quality of the included studies was assessed. Additionally, the heterogeneity among the included studies were evaluated, and publication bias detection, sensitivity analysis, and subgroup analysis were conducted.Results Globally, individuals with problematic internet/mobile/game use or internet/mobile/game addiction have an increased risk of NSSI (OR = 2.47, 95% confidence interval = 2.22–2.76). After controlling for confounding factors, the combined adjusted OR validated these results. Both problematic internet use/internet addiction and problematic mobile use/mobile addiction were associated with increased NSSI risk. Both university students and primary/middle/high school students with problematic internet/mobile/game use or internet/mobile/game addiction have an increased risk of NSSI. Additionally, among primary/middle/high school students, both problematic internet use/internet addiction and problematic mobile use/mobile addiction are associated with increased NSSI risk. Findings in the Chinese population were consistent with global findings.Conclusion Problematic internet/mobile/game use or addiction is associated with NSSI. Preventive and intervention measures should be developed based on this association.