Year: 2014
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To investigate the mental health, substance use, educational, and occupational outcomes of adolescents who self harm in a general population sample, and to examine whether these outcomes differ according to self reported suicidal intent. DESIGN: Population based birth cohort study. SETTING: Avon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of children born in 1991-92. PARTICIPANTS: Data on lifetime history of self harm with and without suicidal intent were available for 4799 respondents who completed a detailed self harm questionnaire at age 16 years. Multiple imputation was used to account for missing data. MAIN OUTCOME MEASURES: Mental health problems (depression and anxiety disorder), assessed using the clinical interview schedule-revised at age 18 years, self reported substance use (alcohol, cannabis, cigarette smoking, and illicit drugs) at age 18 years, educational attainment at age 16 and 19 years, occupational outcomes at age 19 years, and self harm at age 21 years. RESULTS: Participants who self harmed with and without suicidal intent at age 16 years were at increased risk of developing mental health problems, future self harm, and problem substance misuse, with stronger associations for suicidal self harm than for non-suicidal self harm. For example, in models adjusted for confounders the odds ratio for depression at age 18 years was 2.21 (95% confidence interval 1.55 to 3.15) in participants who had self harmed without suicidal intent at age 16 years and 3.94 (2.67 to 5.83) in those who had self harmed with suicidal intent. Suicidal self harm, but not self harm without suicidal intent, was also associated with poorer educational and employment outcomes. CONCLUSIONS: Adolescents who self harm seem to be vulnerable to a range of adverse outcomes in early adulthood. Risks were generally stronger in those who had self harmed with suicidal intent, but outcomes were also poor among those who had self harmed without suicidal intent. These findings emphasise the need for early identification and treatment of adolescents who self harm.
Source: BMJ
DOI: 10.1136/bmj.g5954
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $4,244
Awards: NIHR Senior Investigator Award, Self-harm with and without suicidal intent in adolescence: causes and consequences in the ALSPAC cohort, DECIPHer: Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, G4182683118, The Avon Longitudinal Study for Parents and Children: An international resource for population genomic and lifecourse epidemiology. Core programme support 2014-2019., The Avon Longitudinal Study of Parents and Children: An international resource for population
genomics and lifecourse epidemiology. Core Programme Support 2011-2015 and Core programme support 2014-2019, The Avon Longitudinal Study of Parents and Children: An international resource for population genomics and lifecourse epidemiology. Core Programme Support 2011-2013., MICA: Centre for the Improvement of Population Health through E-health Research (CIPHER), Promoting mental health and building resilience in adolescence: Investigating mindfulness and attentional control., G6737906592, NIHR Senior Investigator Award
OpenAlex ID: W2169077504