Abstract
There is evidence to suggest that both psychological characteristics and stressful life events are contributory factors in
deliberate self-harm among young people. These links, and the possibility of a dose–response relationship between self-harm
and both psychological health and life events, were investigated in the context of a seven-country school-based study. Over
30,000, mainly 15 and 16 year olds, completed anonymous questionnaires at secondary schools in Belgium, England, Hungary,
Ireland, the Netherlands, Norway and Australia. Pupils were asked to report on thoughts and episodes of self-harm, complete
scales on depression and anxiety symptoms, impulsivity and self-esteem and indicate stressful events in their lives. Level
and frequency of self-harm was judged according to whether they had thought about harming themselves or reported single or
multiple self-harm episodes. Multinomial logistic regression assessed the extent to which psychological characteristics and
stressful life events distinguished between adolescents with different self-harm histories. Increased severity of self-harm
history was associated with greater depression, anxiety and impulsivity and lower self-esteem and an increased prevalence
of all ten life event categories. Female gender, higher impulsivity and experiencing the suicide or self-harm of others, physical
or sexual abuse and worries about sexual orientation independently differentiated single-episode self-harmers from adolescents
with self-harm thoughts only. Female gender, higher depression, lower self-esteem, experiencing the suicide or self-harm of
others, and trouble with the police independently distinguished multiple- from single-episode self-harmers. The findings reinforce
the importance of psychological characteristics and stressful life events in adolescent self-harm but nonetheless suggest
that some factors are more likely than others to be implicated.
deliberate self-harm among young people. These links, and the possibility of a dose–response relationship between self-harm
and both psychological health and life events, were investigated in the context of a seven-country school-based study. Over
30,000, mainly 15 and 16 year olds, completed anonymous questionnaires at secondary schools in Belgium, England, Hungary,
Ireland, the Netherlands, Norway and Australia. Pupils were asked to report on thoughts and episodes of self-harm, complete
scales on depression and anxiety symptoms, impulsivity and self-esteem and indicate stressful events in their lives. Level
and frequency of self-harm was judged according to whether they had thought about harming themselves or reported single or
multiple self-harm episodes. Multinomial logistic regression assessed the extent to which psychological characteristics and
stressful life events distinguished between adolescents with different self-harm histories. Increased severity of self-harm
history was associated with greater depression, anxiety and impulsivity and lower self-esteem and an increased prevalence
of all ten life event categories. Female gender, higher impulsivity and experiencing the suicide or self-harm of others, physical
or sexual abuse and worries about sexual orientation independently differentiated single-episode self-harmers from adolescents
with self-harm thoughts only. Female gender, higher depression, lower self-esteem, experiencing the suicide or self-harm of
others, and trouble with the police independently distinguished multiple- from single-episode self-harmers. The findings reinforce
the importance of psychological characteristics and stressful life events in adolescent self-harm but nonetheless suggest
that some factors are more likely than others to be implicated.
- Content Type Journal Article
- Category Original Contribution
- Pages 1-10
- DOI 10.1007/s00787-011-0210-4
- Authors
- Nicola Madge, Centre for Child and Youth Research, Mary Seacole Building, Brunel University, Uxbridge, UB8 3PH UK
- Keith Hawton, Centre for Suicide Research, University of Oxford, Oxford, UK
- Elaine M. McMahon, National Suicide Research Foundation, Cork, Ireland
- Paul Corcoran, National Suicide Research Foundation, Cork, Ireland
- Diego De Leo, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Australia
- Erik Jan de Wilde, Netherlands Youth Institute, Utrecht, NL, Netherlands
- Sandor Fekete, Department of Psychiatry, University of Pécs, Pécs, Hungary
- Kees van Heeringen, Unit of Suicide Research, Ghent University, Ghent, Belgium
- Mette Ystgaard, Centre for Child & Adolescent Mental Health, Oslo, Norway
- Ella Arensman, National Suicide Research Foundation, Cork, Ireland
- Journal European Child & Adolescent Psychiatry
- Online ISSN 1435-165X
- Print ISSN 1018-8827