Early predictors of deliberate self-harm among adolescents: A prospective follow-up study from age 3 to 15. Journal of Affective Disorders, 93, 87-96

University of Turku, Turku, Varsinais-Suomi, Finland
Journal of Affective Disorders (Impact Factor: 3.38). 08/2006; 93(1-3):87-96. DOI: 10.1016/j.jad.2006.02.015
Source: PubMed


To study predictors at age 3 and at age 12 for ideations and acts of deliberate self-harm at age 15 in a representative birth cohort.
Information about ideations and acts of deliberate self-harm at age 12 and at age 15 was obtained from parents and children. Information about the child's problems was obtained at age 3 using the Child Behavior Checklist 2/3 (CBCL 2/3), and at age 12 with the CBCL and Youth Self-report (YSR). Furthermore, when the child was 12, mothers and fathers gave information about their own health, well-being and mental distress, and about family functioning measured with the Family Assessment Device (FAD).
There was a significant increase in self-reported deliberate self-harm (ideations or acts) from age 12 to age 15, especially among girls (from 3% to 13%). Parent-child agreement on acts and ideations of deliberate self-harm was very low at both time-points (proportion of agreement 0.0-0.2). Self-reports of deliberate self-harm at age 12 independently predicted both acts and ideations of deliberate self-harm at age 15. Female gender, self-reports of internalizing problems and somatic complaints, parent reports of child's externalizing problems and aggressivity, mother's reports of her health problems, and living in nonintact family at age 12 independently predicted self-reported acts of deliberate self-harm 3 years later. Parent reports of child's learning difficulties, and self-reports of being bullied independently predicted ideations of deliberate self-harm at age 15. Parent reports of child's psychopathology at age 3 assessed with the CBCL 2/3 had no predictive association with ideation or acts of deliberate self-harm at age 15.
Acts of deliberate self-harm in mid-adolescence are due to an accumulation of earlier family and parental distress, and child's externalizing and internalizing problems. Information about deliberate self-harm at age 12 is an important warning sign of deliberate self-harm in mid-adolescence.

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    • "Multiple studies have investigated risk factors or correlates of DSH and have implicated a range of sociodemographic and psychosocial factors (Boxer 2010; Challis et al. 2013; Evans et al. 2004; Gratz et al. 2012; Madge et al. 2011; Scoliers et al. 2009). For instance, being female (e.g., Gratz et al. 2012; Hawton and Harriss 2007) and between the ages of 15–18 years old (Sourander et al. 2006) have been found to increase the risk of DSH. Some studies have also documented racial/ethnic variation in self-harm (Cooper et al. 2010; Gratz et al. 2012) as well as higher prevalence rates of self-harm and suicidality in youth from more socio-economically deprived backgrounds (Gratz et al. 2012; King and Merchant 2008). "
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    ABSTRACT: This paper presents the outcomes of a Dialectical Behavior Treatment (DBT) program, implemented in intensive outpatient care with two groups of adolescents (n = 55 and n = 45), ages 12-18, who engaged in deliberate self-harm (DSH) but had different insurance/funding sources and risk backgrounds. This pre-post study examined variability in clinical functioning and treatment utilization between the two groups and investigated moderating risk factors. Findings support DBT's effectiveness in improving clinical functioning for youth with DSH regardless of insurance type. However, lower rates of treatment completion among youth without private insurance call for extra engagement efforts to retain high-risk youth in DBT.
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    • "In the present study, we focused especially on mood dysregulation characterized by dysphoria, reactive anger, and suicidality. These symptoms were of particular interest, based on longitudinal research showing that negative emotional reactivity (e.g., angry outbursts and irritability) in childhood is a behavioral diathesis for later difficulty regulating anger (Crawford et al. 2009) and for aggression directed towards the self (Sourander et al. 2006). Moreover, in adolescence, dysphoric mood is linked with concurrent suicidality (Pelkonen et al. 2005) and predict later depression and suicidality (Gjerde and Westenberg 1998). "
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    ABSTRACT: To investigate the differential emergence of antisocial behaviors and mood dysregulation among children with externalizing problems, the present study prospectively followed 317 high-risk children with early externalizing problems from school entry (ages 5-7) to late adolescence (ages 17-19). Latent class analysis conducted on their conduct and mood symptoms in late adolescence revealed three distinct patterns of symptoms, characterized by: 1) criminal offenses, conduct disorder symptoms, and elevated anger ("conduct problems"), 2) elevated anger, dysphoric mood, and suicidal ideation ("mood dysregulation"), and 3) low levels of severe conduct and mood symptoms. A diathesis-stress model predicting the first two outcomes was tested. Elevated overt aggression at school entry uniquely predicted conduct problems in late adolescence, whereas elevated emotion dysregulation at school entry uniquely predicted mood dysregulation in late adolescence. Experiences of low parental warmth and peer rejection in middle childhood moderated the link between early emotion dysregulation and later mood dysregulation but did not moderate the link between early overt aggression and later conduct problems. Thus, among children with early externalizing behavior problems, increased risk for later antisocial behavior or mood dysfunction may be identifiable in early childhood based on levels of overt aggression and emotion dysregulation. For children with early emotion dysregulation, however, increased risk for mood dysregulation characterized by anger, dysphoric mood, and suicidality - possibly indicative of disruptive mood dysregulation disorder - emerges only in the presence of low parental warmth and/or peer rejection during middle childhood.
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    • "Per quanto riguarda l'esordio, l'età è generalmente stimata tra i 12 e i 14 anni per entrambi i sessi, anche se alcune ricerche hanno rilevato un'età d'insorgenza maggiormente precoce per le adolescenti femmine , tra i 10 e gli 11 anni di età (Andover, Primack, Gibb e Pepper, 2010;Hilt, Hoeksema e Cha, 2008). Viene riscontrato, poi, un incremento significativo, oltre che dei comportamenti autolesivi anche delle ideazioni suicidarie, tra i 12 e i 15 anni, in particolare per le ragazze, dal 3% al 13% (Sourander et al., 2006). Gli studi condotti in Italia sui campioni non clinici confermano le stime internazionali di incidenza del NSSI tra il 13% e il 41,5% negli adolescenti (Cerutti, Manca, Presaghi e Gratz, 2011; Di Pierro, Sarno, Perego , Gallucci e Madeddu, 2012; Giletta, Scholte, Engels, Ciairano e Prinstein, 2012) e tra il 17% e il 41% nei giovani adulti (Cerutti, Presaghi, Manca e Gratz, 2012); non vengono riscontrate differenze di genere significative sia per l'autolesività non suicidaria ripetitiva che occasionale (Manca, Presaghi e Cerutti, 2014), evidenziate invece nella popolazione clinica (Di Pierro, Sarno , Gallucci eMartorana, 2012; Salvador , Furlanetto, Jovon ePerulli, 2008). "
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