Change in prevalence of self-harm from 2002 to 2018 among Norwegian adolescents

Abstract

Background Self-harm is prevalent among adolescents and associated with mental health problems and negative life-events. Few studies have examined changes in its prevalence related to these factors. This study explored whether changes in prevalence of self-harm among adolescents had occurred, and to what extent changes in associated factors may have contributed. Methods Two cross-sectional school-based surveys among adolescents (grades 8–10) in Norway were conducted in 2002 (N = 5842) and in 2017/18 (N = 29 063). Past year prevalence of self-harm and identical variables on risk factors was analyzed in hierarchical logistic regression to examine whether and to what extent changes in self-harm correlates could explain periodical change in prevalence of self-harm. Results An increase from 4.1% to 16.2% in self-harm prevalence was observed from 2002 to 2017/18. The increase was relatively larger among girls compared to boys and among 8th graders compared to 10th graders. Among the assessed risk factors for self-harm, depressive symptoms increased, while anti-social behavior, exposure to violent acts and drinking to intoxication decreased. The increase in depressive symptoms contributed to explain increase in self-harm. This contribution was outweighed by the decrease in other risk factors. Conclusions Self-harm prevalence increased 4-fold among Norwegian adolescents over a 15-year period. While exposure to several risk factors for self-harm changed substantially in this period, these risk factors could in sum not explain any of the increase in self-harm.

The psychometric properties and clinical utility of the Norwegian versions of the deliberate self-harm inventory and the inventory of statements about self-injury

“…Rates of DSH varied to some degree across age groups, with reported rates of DSH being significantly higher in the two youngest age groups (25 and younger, and 26-35), relative to the older age groups. This finding is consistent with previous research suggesting a rising trend in DSH behavior among young people (Boudewyn & Liem, 1995;Klonsky, 2007;Tørmoen et al, 2020). The vast majority of participants with a history of DSH reported having engaged in DSH more than once, with 58%-68% reporting more than 10 lifetime episodes of DSH.…”

“…Deliberate self-harm (DSH), also referred to as non-suicidal self-injury, is defined as direct self-destruction or alternation of body tissue without conscious suicidal intent, but resulting in injuries severe enough for tissue damage to occur (American Psychiatric Association, 2013;Favazza, 1998). DSH is a major public health problem with increasing prevalence in adolescent and young adult populations (Madge et al, 2011;Tørmoen, Myhre, Walby, Grøholt, & Rossow, 2020). This behavior often remains undetected in clinical and school settings unless directly assessed.…”

“…The most common forms of DSH include skin cutting, carving, severe scratching, burning, needle sticking, and interfering with wound healing (American Psychiatric Association, 2013;Favazza, 1998;Zanarini et al, 2008). Given both the serious consequences of DSH and the evidence that this behavior is increasing in prevalence among adolescents (Madge et al, 2011;Tørmoen et al, 2020), there is a pressing need for empirically validated measures assessing the presence, features, and functions of DSH across countries and languages. Such measures would be useful in both clinical and nonclinical settings in order to screen for the presence of DSH, track the prevalence of this behavior in various populations, and assess the utility of interventions aimed at reducing DSH.…”

The Relationship between Self-harm and Bullying Behavior: Results from a Population based-study of Adolescents

“…Nonetheless, 15% reported having engaged in self-harm in the previous 12 months, which is consistent with earlier studies nding the 12-month prevalence rate to be between 10 to 19% around the world (3)(4)(5).…”

Suicidality, function and associated negative life events in an adolescent psychiatric population at 3-year follow-up

“…Suicidal symptoms increase during this developmental period [ 4 – 6 ], with a rapid shift from suicidal ideation to suicidal behavior [ 5 , 7 , 8 ], and an estimated lifetime prevalence of suicidal ideation and suicide attempts of 12.1–33% and 4.1–9.3%, respectively [ 5 , 9 ]. The prevalence of self-harm, defined broadly regardless of motivation and intention to die, has increased among Norwegian adolescents from 4.1 to 16.2% between 2002 and 2018 [ 10 ]. Second to road injury, suicide is the most common cause of death among young people worldwide, uncommon before 15 years of age but the frequency increases through adolescence [ 6 , 11 – 13 ].…”