Wednesday, 21 March 2018

Self-harm in adolescence

Self-harm is an intentional injury to one’s own body resulting in tissue damage. Self-harm can include a wider range of self-harming behaviours such as cutting, burning, biting oneself and ingesting toxic substances (Bifulco et al., 2014; Claes et al., 2015).

Around 13%-18% of adolescents in the world experience a lifetime risk of self-harm. Self-harm becomes increasingly common between the ages of 12 and 15 years, at which stage rates among adolescent girls are higher than boys. Over the past decade, rates of self-harm have been increasing among adolescents (Burton, 2014; Hawton, 2012).

Recent findings from the Health Behaviour in School-aged Children (HBSC) study showed that 22% of young people in England aged 15 have experienced self-harming behaviour in their lives. Nearly three times as many girls as boys reported that they had self-harmed, 11% of boys compared to 32% of girls (Brooks et al., 2015). Most of those young people who were self-harming reported engaging in self-harm once a month or more.

Self-harming behaviour is more often seen among young people living in one parent households and is more common in young people from lower family affluence. Young people receiving free school meals were more likely to report self-harming behaviour; 29% girls and 21% boys who were in receipt of free school meals reported ever having self-harmed (Brooks et al., 2017).

Self-harm in adolescence is usually associated with emotional distress and adolescents usually describe it as being accompanied by negative feelings, such as self-loathing, disgust and shame. Young people who reported ever self-harming had lower life satisfaction compared to those who reported never having self-harmed (Brooks et al., 2017).

Adolescents who experience self-harming behaviour in their life are more likely to be at risk of developing mental illness in their later life; also, they are at higher risk to be engaged in risky behaviours in late adolescence and young adulthood; including increased likelihood of suicidal thoughts.

Recent findings showed that adolescents who have a positive relationship and open communication with their parents, sense of belonging and connectedness to school and the wider neighbourhood, are less likely to be engaged in self-harming behaviour (Klemera et al., 2016). These findings suggest that having easy and open communication with parents could be even more protective for young people than communication with their peers. Quality parenting seems to be very valuable for the promotion and maintenance of emotional well-being and health during adolescence.

The school environment is strongly associated with adolescents’ health and emotional wellbeing; recent HBSC findings showed that young people who reported ever self-harming were less likely to trust their teachers, feel safe, and feel like they belong in their school.

The community environment where young people live can also have a significant impact on health and wellbeing, as according to the HBSC England study young people with a positive perception of their neighbourhood (including issues relating to feeling safe in their community, having positive relationships with neighbours and having good places for young people to go in their community) were less likely to report having self-harmed compared with those who held negative opinions about how supportive and safe they perceived their community to be (Brooks et al., 2017).

The protective nature of adolescents’ multiple environments (the family, the learning environment and the wider community) can help adolescents develop coping strategies to prevent self-harming behaviour among adolescents.

Bifulco A, Schimmenti A, Moran P et al (2014) Problem parental care and teenage deliberate self-harm in young community adults. Bull Menninger Clin 78(2):95–114. doi: 10.1521/bumc.2014.78.2.95

Brooks F, Magnusson J, Klemera E et al (2015) Health Behaviour in School Aged Children, HBSC England National Report: Findings from the 2014 HBSC Study for England. Hatfield, University of Hertfordshire.

Brooks, F., Chester, K., Klemera, E., & Magnusson, J. (2017). Intentional self-harm in adolescence: An analysis of data from the Health Behaviour in School-aged Children (HBSC) survey for England, 2014.

Burton M (2014) Self-harm: working with vulnerable adolescents. Pract Nurs 25(5):245–251. doi: 10.12968/pnur.2014.25.5.245

Claes L, Luyckx K, Baetens I et al (2015) Bullying and Victimization, Depressive Mood, and Non-Suicidal Self-Injury in Adolescents: The Moderating Role of Parental Support. J Child Fam Stud 24(11):3363–3371. doi: 10.1007/s10826-015-0138-2

Hawton K, Saunders KEA, O’Connor RC (2012) Self-harm and suicide in adolescents. The Lancet. 379(9834):2373–2382. doi: 10.1016/S0140-6736(12)60322-5

Klemera, E., Brooks, F. M., Chester, K. L., Magnusson, J., & Spencer, N. (2017). Self-harm in adolescence: protective health assets in the family, school and community. International journal of public health62(6), 631-638.

Tuesday, 13 March 2018

Don’t forget the “hidden” forms of bullying

Bullying is a widespread concern across schools, with around 1 in 3 young people being victimised1. It is widely viewed as a public health issue. Longitudinal research has shown the detrimental and long lasting effects of bullying on young people’s health and wellbeing2, with negative outcomes reported for both the victim and the perpetrator3.

Bullying behaviours can be broadly broken down into physical, verbal, cyber and relational bullying. Relational bullying behaviours upset the victim by damaging their peer relationships, friendships and social status4. Sometimes it is described as “indirect bullying” and can include actions which are harder to spot like social exclusion and the spreading of rumours.

The study of relational bullying specifically is warranted because it is the least understood form of bullying, and has seen little attention in a UK context. Also, teachers have been shown to respond with less empathy and concern to instances of relational bullying among students5.

The study examined the association between relational bullying specifically and adolescent health related quality of life, whilst controlling for the effect of demographic variables and other forms of bullying. Health related quality of life was measured with KIDSCREEN-10 – a measure created for young people which provides an overall score.

Young people who experienced relational bullying had lower KIDSCREEN-10 scores than those who were not bullied. Interestingly, the decrease in score which was linked to relational bullying was larger than the decrease for physical or verbal bullying.

The full paper can be found by clicking here. If you are interested in the topic of bullying you may also like to read our publications on cyberbullying and cross-national trends in bullying victimisation.

1.       Chester KL, Callaghan M, Cosma A, et al. Cross-national time trends in bullying victimization in 33 countries among children aged 11, 13 and 15 from 2002 to 2010. Eur J Public Health. 2015;25(suppl 2):61-64. doi:10.1093/eurpub/ckv029.
2.       Bowes L, Joinson C, Wolke D, Lewis G. Peer victimisation during adolescence and its impact on depression in early adulthood: prospective cohort study in the United Kingdom. BMJ. 2015;350(January 2016):h2469. doi:10.1136/bmj.h2469.
3.       Wolke D, Copeland WE, Angold A, Costello EJ. Impact of bullying in childhood on adult health, wealth, crime, and social outcomes. Psychol Sci. 2013;24:1958-70. doi:10.1177/0956797613481608.
4.       Crick NR. The role of overt aggression, relational aggression, and prosocial behavior in the prediction of children’s future social adjustment. Child Dev. 1996;67(5):2317-2327. doi:10.2307/1131625.
5.       Kahn JH, Jones JL, Wieland AL. Preservice teachers’ coping styles and their responses to bullying. Psychol Sch. 2012;49(8):784-793. doi:10.1002/pits.21632.


Next week (18-24 March) is Teen Health Week!!!

Teen Health Week is an initiative to raise awareness of the unique health issues facing teenagers. 2018 marks the first year of this initiative going global - bringing together young people across the world to increase recognition of the health and wellbeing concerns of teenagers today. 

During Teen Health Week each day has a specific theme:
Sunday, March 18: Violence Prevention
Monday, March 19: Preventive Care and Vaccines
Tuesday, March 20: Healthy Diet and Exercise
Wednesday, March 21: Mental Health
Thursday, March 22: Sexual Development and Health
Friday, March 23: Substance Use and Abuse
Saturday, March 24: Oral Health 

The HBSC England team will be raising awareness of Teen Health Week with lots of tweeting and blogging! We will be sharing data and key findings from the latest HBSC survey carried out in England. We will also share key messages from other projects within our department, including The Teacher Connectedness Project and Beyond the School Gate, which focus on teen health.

We hope Teen Health Week will help raise the profile of adolescent health!

Remember to follow us on twitter @HBSCEngland, and join the conversation using #2018TeenHealth.