Could a brief assessment of negative emotions and self-esteem identify adolescents at current and future risk of self-harm in the community? A prospective cohort analysis

Abstract

BackgroundSelf-harm is common in adolescents, but it is often unreported and undetected. Available screening tools typically ask directly about self-harm and suicidal ideation. Although in an ideal world, direct enquiry and open discussion around self-harm would be advocated, non-psychiatric professionals in community settings are often reluctant to ask about this directly and disclosure can be met with feeling of intense anxiety. Training non-specialist staff to directly ask about self-harm has limited effects suggesting that alternative approaches are required. This study investigated whether a targeted analysis of negative emotions and self-esteem could identify young adolescents at risk of self-harm in community settings.MethodsData were collected as part of a clinical trial from young people in school years 8–11 (aged 12–16) at eight UK secondary schools (N = 4503 at baseline, N = 3263 in prospective analysis). The Short Mood and Feelings Questionnaire, Revised Child Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, personal failure (Children’s Automatic Thoughts Scale), and two items on self-harm were completed at baseline, 6 and 12 months.ResultsFollowing a process of Principal Components Analysis, item reduction, and logistic regression analysis, three internally reliable factors were identified from the original measures that were independently associated with current and future self-harm; personal failure (3 items), physical symptoms of depression/anxiety (6 items), positive self-esteem (5 items). The summed score of these 14 items had good accuracy in identifying current self-harm (AUC 0.87 girls, 0.81 boys) and at six months for girls (0.81), and fair accuracy at six months for boys (AUC 0.74) and 12 months for girls (AUC 0.77).ConclusionsA brief and targeted assessment of negative emotions and self-esteem, focusing on factors that are strongly associated with current and future self-harm, could potentially be used to help identify adolescents who are at risk in community settings. Further research should assess the psychometric properties of the items identified and test this approach in more diverse community contexts.

Lesbian and Heterosexual Two-Parent Families: Adolescent–Parent Relationship Quality and Adolescent Well-Being

“…The RSES consists of 10 statements (e.g., ''I have a positive attitude towards myself'') answered on a 4-point Likert scale, ranging from 1 (strongly disagree) to 4 (strongly agree). The RSES has demonstrated good reliability and validity across different sample groups and has been validated for use with adolescents (Blascovich and Tomaka 1991;Hagborg 1993;Philips et al 2013;Rosenberg 1989). Cronbach's alphas were .85 for the adolescents with lesbian mothers and .80 for the comparison group.…”

Cluster‐randomised controlled trial of an occupational therapy intervention for children aged 11–13 years, designed to increase participation to prevent symptoms of mental illness

“…The RSES has good test-retest reliability after 1-week (r = .82, p < .001), 2-weeks (r = .85-.87), 7 months (r = .63-.74) and several assessment points over a period of 4 years (r = .69) (Fleming & Courtney, 1984;Revenson, Wollman, & Felton, 1983;Robins et al, 2001;Silber & Tippett, 1965;Torrey, Mueser, McHugo, & Drake, 2000;Wylie, 1989). Several of the RSES items were found to be predictive of self-harm in the future, however, evidence it is sensitive to change in children, following interventions, is limited (Blascovich & Tomaka, 1991;Bowling, 1991;Phillips et al, 2013). The SISES is more reliable when used as a parent, than a child report measure (a = .84 and .77 respectively) (Robins et al, 2001).…”

“…Early intervention is fundamental to achieving better mental health outcomes for children and communities in the future, with childhood mental illness shown to precede and predict mood disorders in adulthood (Kohlboeck, Quadflieg, & Fichter, 2011;Zahn-Waxler, Klimes-Dougan, & Slattery, 2000). The prevalence of specific mental health disorders in children world-wide include anxiety disorders at 6.5% and depression at 2.6% (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015).…”

“…There is a clear need to prioritise children's mental health and wellbeing to reduce the long-term burden on health care services internationally (Friedberg, Crosby, & Friedberg, 2000;Polanczyk et al, 2015). To meet the needs of children clinically impaired by mental health conditions, including those who go undiagnosed and untreated, health services would need to support up to the top 3% (Mental Health Commission, 2012), so an alternative is to offer preventative interventions.…”

Nasilenie osobowościowych przejawów schizotypii wśród osób zdrowych a wartościowanie siebie i świata w kontekście zdrowia psychicznego. Próba walidacji skróconej skali schizotypii Oxford–Liverpool Inventory of Feelings and Experiences w warunkach polskich

“…Samoocena i pozytywne nastawienie odgrywają niewątpliwie znaczącą rolę w ogólnym samopoczuciu tak osób zdrowych, jak i pacjentów cierpią-cych z powodu chorób psychicznych oraz fizycznych. W grupie młodych zdrowych ludzi negatywne wartościowanie własnej osoby i swojego miejsca w świecie fizycznym i społecznym było wyraźnym czynnikiem podnoszącym ryzyko podejmowania zachowań nakierowanych na wyrządzenie krzywdy samemu sobie [19]. Przeprowadzone badanie wykazało spadek samooceny i pozytywnego nastawienia towarzyszący wzrostowi wszystkich przejawów cech schizotypowych.…”