ABSTRACT Background Self‐harm is a worldwide public health concern with negative long‐term consequences. In recent years, a growing body of research has highlighted the role of cognitive vulnerability in the development of self‐harm behaviours. Emerging evidence indicates that an early maladaptive schema (EMS) developed during childhood is associated with self‐harm behaviours. Understanding the complex role of EMS in the development and maintenance of self‐harm is essential for early identification and targeted preventive strategies. Aim This systematic review aimed to investigate the influence of EMS on self‐harm. Methods Guided by the PRISMA framework, research published between 2020 and 2025 was determined through a systematic search of Scopus and Web of Science. Following rigorous screening and eligibility procedures, ten studies were selected for qualitative analysis. Results The review demonstrated that individuals with self‐harm behaviour consistently reported significantly elevated EMS scores compared to those without such a history. Rumination, depression and emotional dysregulation mediate the association between EMS and self‐harm behaviour. This review also suggests incorporating schema strategies, mindfulness and cognitive restructuring into self‐harm interventions to address cognitive vulnerabilities effectively. Discussion & Conclusion These findings highlight the importance of targeting EMS to mitigate self‐harm behaviours, particularly in early identification and preventive intervention.
Tan et al. (2026) studied this question.