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.


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