Self‐harm, substance use and psychological distress in the Australian general population

Abstract

Aims To examine predictors of self‐harm, especially substance use and psychological distress, in an Australian adult general population sample. Design Sequential‐cohort design with follow‐up every four years. Setting Australian general population. Participants A random sample of adults aged 20–24 and 40–44 years (at baseline) living in and around the Australian Capital Territory. Measurements Self‐report survey including items on four common forms of self‐harm. Psychological distress was indexed by the combined Goldberg Anxiety and Depression scale scores and alcohol problems by the Alcohol Use Disorders Identification Test (AUDIT). Findings Four thousand one hundred and sixty people (84% of baseline) were re‐interviewed at 8 years: 4126 reported their self‐harm status. Past year self‐harm was reported by 8.2% (95% CI 7.4–9.0%) of participants [males: 9.3% (8.0–10.6%), females: 7.3% (6.2–8.4%)]. Several forms of substance use—smoking (OR = 1.52), marijuana use (OR = 1.77) and drinking alcohol at a level likely to cause dependence (AUDIT score ≥ 20) (OR = 2.08)—were independently predictive of past year self‐harm. Additional key risk factors for self‐harm in the past year were childhood sexual abuse by a parent (OR = 3.07), bisexual orientation (OR = 2.65), younger age (OR = 2.23) and male gender (OR = 1.86). Other independent predictors were years of education, adverse life events, psychological distress and financial strain. Conclusions Self‐harm in young and middle‐aged adults appears to be associated with current smoking, marijuana and ‘dependent’ alcohol use. Other independent predictors include younger age, male gender, bisexual orientation, financial strain, education level, psychological distress, adverse life events and sexual abuse by a parent.

A Brief Report on Predicting Self-Harm: Is It Gender or Abuse that Matters?

“…We hypothesized that abuse history, as opposed to gender, would predict both forms of self-harm. Our results support this hypothesis and replicate other findings that suggest that abuse history is an important factor in self-harm (Boudewyn & Liem, 1995;Briere & Gil, 1998;Ford & Gómez, in press;Glassman et al, 2007;Gómez & Freyd, 2013;Gratz, 2006;Gratz et al, 2002;Hilt et al, 2008;Maniglio, 2011;Moller et al, 2013;Nock, 2012;Rabinovitch, Kerr, Leve, & Chamberlain, 2014;Swannell et al, 2012;Wedig et al, 2012;Zlotnick et al, 1996). Consistent with some other studies (e.g., Guan et al, 2012), we found that gender alone was not a predictor of selfharm.…”

“…In childhood, physical abuse, emotional abuse, sexual abuse, and peer victimization have all been associated with self-harm directly, and with difficulty in managing emotional states and social relationships that could lead to self-harm (Boudewyn & Liem, 1995;Briere & Gil, 1998;Glassman, Weierich, Hooley, Deliberto, & Nock, 2007;Gratz, 2006;Gratz, Conrad, & Roemer, 2002;Hilt, Cha, & Nolen-Hoeksema, 2008;Maniglio, 2011;Moller, Tait, & Byrne, 2013;Wedig et al, 2012;Zlotnick et al, 1996). Additionally, Swannell et al (2012) interviewed a large representative sample of adults in Australia regarding child abuse-sexual abuse, physical abuse, and neglectnonsuicidal self-injury, dissociation, and self-blame.…”

Adolescent health and subsequent risk of self-harm hospitalisation: a 15-year follow-up of the Young-HUNT cohort

“…Our results also indicated that excess alcohol use was associated with elevated risk of future self-harm hospitalisation, similar to results presented in a prospective study of Australian adults [54]. Still, even though our results do indicate an association, we cannot rule out chance as the explaining factor.…”

Profiling Hello Sunday Morning: Who are the participants?

“…AUDIT scores of HSM users were higher than both the general Australian population and other at risk groups (Islam et. al, 2013;Moller et. al, 2013;Smith et.…”