Psychological characteristics, stressful life events and deliberate self-harm: findings from the Child & Adolescent Self-harm in Europe (CASE) Study

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

Biting myself so I don’t bite the dust: prevalence and predictors of deliberate self-harm and suicide ideation in Azorean youths

“…The current study showed that proximal factors such as engagement in high-risk behaviors, severe forms of self-criticism, and feelings of anger, shame, anxiety, and submissiveness explain a significant amount of variance in the alarming prevalence of NSSI behaviors in these youths, as demonstrated in previous studies. 7,14,16,17,62,64 In addition, reinforcement resulting from NSSI may act as a maintenance factor for this maladaptive behavior, rendering it more stable over time.…”

“…These motives can also co-exist. 7,8,13 Several possible risk factors have been found to be associated with NSSI, including impulsivity, self-esteem, and stress 14 ; impulsivity, anger, borderline personality disorder, depressive reactions, depression 15 ; and less adaptive coping strategies. 16 Lower levels of education, sexual and physical abuse, emotional or psychological neglect in childhood, 5,6,9 and self-criticism 17 have also been reported as risk factors for NSSI (see Fliege et al 9 for a review).…”

Mapping non suicidal self-injury in adolescence: Development and confirmatory factor analysis of the Impulse, Self-harm and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A)

“…In addition, there is evidence that many self-injurers spend less than 5 minutes contemplating a self-injurious act (Nock and Prinstein, 2005). Thus, Impulsivity is a factor often referred to as being associated with NSSI (Hawton, 2002;Claes et al, 2010;Madge et al, 2011), with individuals who self-harm reporting more impulsivity than those who do not (Janis and Nock, 2009). Also, Madge and colleagues (2011), in a study with 30.477 adolescents between 14 and 17 years old have found that the factors that independently differentiate youths with and without history of NSSI is impulsivity, suicidal experiences or self-harm of others, physical or sexual abuse, and problems with sexual orientation.…”

“…Several studies have shown that self-harming behavior is a significant problem (Madge et al, 2008(Madge et al, , 2011 in adolescence, emphasizing the relationship between self-harming behaviors and suicide ideation (Mangnall and Yurkovich, 2008;Andover and Gibb, 2010), and the importance of impulsivity to self-harm (Hawton, 2002;Claes et al, 2010;Madge et al, 2011). Despite a number of studies concerning these issues, the underlying mechanisms to these behaviors are still unclear.…”

Frecuencia de autolesiones y características clínicas asociadas en adolescentes que acudieron a un hospital psiquiátrico infantil

“…Los resultados de este estudio muestran que las autolesiones estaban relacionadas con síntomas de depresión, ansiedad e impulsividad, además de eventos estresantes. 13 Los resultados de estudios en adolescentes de muestras clínicas en varios países han replicado este hallazgo, mostrando además una asociación con los trastornos externalizados.…”