Nonsuicidal Self-Injury in Adolescents Placed in Youth Welfare and Juvenile Justice Group Homes: Associations with Mental Disorders and Suicidality

Abstract

Nonsuicidal self-injury (NSSI) is a frequent phenomenon in adolescents, however there is a lack of studies on the prevalence of NSSI in adolescents placed in youth welfare and juvenile justice group homes. The goal of the present study is to investigate the prevalence rates of NSSI and mental disorders in adolescents living in the youth welfare system, as well as how occasional and repetitive NSSI differ with respect to mental disorders, suicidality, and gender. The sample consisted of 397 adolescents aged 12 to19 years (mean age = 15.98, SD = 1.77, 65.7% male) placed in youth welfare and juvenile justice group homes. NSSI, suicidality, and mental disorders were assessed using the Kiddie-Schedule of Affective Disorders and Schizophrenia (K-SADS-PL). Lifetime prevalence rates of occasional and repetitive NSSI were 21.9% and 18.4%, respectively and 85.6% of the sample endorsed a lifetime mental disorder. Occasional and repetitive NSSI were significantly associated with depressive, conduct, and substance use disorders (d = 0.50-0.67) among both genders. Prevalence rates of repetitive NSSI in youth welfare and juvenile justice institutions are higher than in the general population and males who engage in NSSI are at particularly high risk of suicidality. Due to the high prevalence of NSSI and its related problems, NSSI should be routinely assessed in this vulnerable population and staff should be trained in recognizing and handling NSSI as well as supporting adolescents in improving their emotion regulation skills.

Depressive symptoms and self-harm among youngsters referred to child welfare: The role of trust in caregiver support and communication

“…Furthermore, almost twice as many CWS youngsters of the current sample engaged in lifetime NSSI (32.7%) compared to normal population youngsters (13.71% in Baetens, Claes, Muehlenkamp, Grietens, & Onghena, 2011;18% in Muehlenkamp, Claes, Havertape, & Plener, 2012), and also suicidal ideation rates during the past six months in the current sample of CWS adolescents are remarkably high (41.8%) compared to the lifetime prevalence of suicidal ideation in nonclinical adolescents (29.9%; Evans, Hawton, Rodham, & Deeks, 2005). The current study's high prevalence of depressive symptoms and self-harm confirms previous findings that a large number of CWS youngsters suffers from severe and disabling depressive symptoms and engages in self-harm (Janssens & Deboutte, 2010;Katz et al, 2011;Lüdtke et al, 2017). This suggests that the current CWS sample is relevant and valid to study the research questions regarding mechanisms and moderators that may help understand depressive symptoms and selfharm within CWS youngsters.…”

“…The role of trust in caregiver support and communication Youngsters involved in the Child Welfare System (CWS) are characterized by high rates of mental health problems (Blower, Addo, Hodgson, Lamington, & Towlson, 2004). Especially the high rates of depressive symptoms, non-suicidal self-injurious behavior (NSSI) and suicidal ideation (SI) in CWS youngsters are of great concern to CWS workers and policy makers (Lüdtke et al, 2017). NSSI and SI can be situated on a spectrum of self-harm behaviors (Claes & Muehlenkamp, 2014).…”

Differential Experiences of Mental Health among Transgender and Gender-Diverse Youth in Colorado

“…Young women, especially those who are White and heterosexual, are more likely to self-harm [12][13][14][15][16][17][18]. While NSSI is associated with suicide attempts for women [19], men with NSSI are at even higher risk for suicide attempts [20]. Some studies indicate that young people with NSSI who have attempted suicide are more likely to have a substance use disorder than those with only NSSI and those with NSSI and suicidal ideation [18].…”

The Stress of Caring—Resilience and HPA-Axis Activity in Hair Samples of Youth Residential Caregivers

“…Professional caregivers in youth residential care are exposed to chronic stressors and aggression resulting from their work with a highly troubled clientele. Most children and adolescents in the youth welfare system grew up in highly disrupted families, were exposed to multiple traumatic stressors or were victims of child maltreatment, and thus have an increased risk to develop mental health problems such as anxiety, depression, externalizing disorders, substance abuse, and suicidal ideation (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Beyond the impact on mental health, adverse and traumatic experiences might lead to long-lasting impacts on the development of one's self-concept and identity development, inhibitory control, relationships and attachment to others, including caregivers (20)(21)(22)(23)(24).…”