Background
The prevalence of SH
The relationship between childhood adversity and SH among adolescents
Methods
Study design and participants
Procedure
Ethical approval
Measurements
Childhood adversity
Reliability and validity of the measurements
Statistical analysis
Results
The prevalence of each SH subtype
Variables | n (%) | Highly lethal self-harm | Less lethal self-harm with visible tissue damage | Self-harm without visible tissue damage | Self-harmful behaviors with latency damage | Psychological self-harm |
---|---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | n (%) | ||
Gender | ||||||
Female | 2878 (50.3) | 197 (6.8) | 763 (26.5) | 972 (33.8) | 600 (20.8) | 749 (26.0) |
Male | 2848 (49.7) | 152 (5.3) | 405 (14.2) | 862 (30.3) | 545 (19.1) | 567 (19.9) |
Age | ||||||
12 years | 876 (15.3) | 28 (3.2) | 133 (15.2) | 217 (24.8) | 91 (10.4) | 119 (13.6) |
13 years | 919 (16.0) | 59 (6.4) | 191 (20.8) | 297 (32.3) | 170 (18.5) | 200 (21.8) |
14 years | 842 (14.7) | 56 (6.7) | 180 (21.4) | 239 (28.4) | 156 (18.5) | 165 (19.6) |
15 years | 803 (14.0) | 56 (7.0) | 174 (21.7) | 234 (29.1) | 170 (21.2) | 185 (23.0) |
16 years | 892 (15.6) | 63 (7.1) | 178 (20.0) | 302 (33.9) | 187 (21.0) | 234 (26.2) |
17 years | 996 (17.4) | 62 (6.2) | 226 (22.7) | 382 (38.4) | 267 (26.8) | 295 (29.6) |
18 years | 398 (7.0) | 25 (6.3) | 86 (21.6) | 163 (41.0) | 104 (26.1) | 118 (29.6) |
Self-perceived family status | ||||||
Bad | 800 (14.0) | 57 (7.1) | 183 (22.9) | 304 (38.0) | 187 (23.4) | 227 (28.4) |
General | 4377 (76.4) | 256 (5.8) | 877 (20.0) | 1370 (31.3) | 846 (19.3) | 967 (22.1) |
Good | 549 (9.6) | 36 (6.6) | 108 (19.7) | 160 (29.1) | 112 (20.4) | 122 (22.2) |
Relationship with mother | ||||||
Good | 4373 (76.4) | 227 (5.2) | 843 (19.3) | 1358 (31.1) | 795 (18.2) | 927 (21.2) |
Poor | 1353 (23.6) | 122 (9.0) | 325 (24.0) | 476 (35.2) | 350 (25.9) | 389 (28.8) |
Relationship with father | ||||||
Good | 3815 (66.6) | 191 (5.0) | 700 (18.3) | 1135 (29.8) | 666 (17.5) | 779 (20.4) |
Poor | 1911 (33.4) | 158 (8.3) | 468 (24.5) | 699 (36.6) | 479 (25.1) | 537 (28.1) |
Only child | ||||||
Yes | 2469 (43.1) | 113 (4.6) | 399 (16.2) | 711 (28.8) | 435 (17.6) | 481 (19.5) |
No | 3257 (56.9) | 236 (7.2) | 769 (23.6) | 1123 (34.5) | 710 (21.8) | 835 (25.6) |
Family structure | ||||||
Nuclear family | 3792 (66.2) | 225 (5.9) | 765 (20.2) | 1190 (31.4) | 761 (20.1) | 867 (22.9) |
Lager family | 1353 (23.6) | 91 (6.7) | 276 (20.4) | 447 (33.0) | 256 (18.9) | 310 (22.9) |
Single-parent family | 469 (8.2) | 26 (5.5) | 99 (21.1) | 152 (32.4) | 99 (21.1) | 112 (23.9) |
Other | 112 (2.0) | 7 (6.3) | 28 (25.0) | 45 (40.2) | 29 (25.9) | 27 (24.1) |
Childhood physical peer victimization | ||||||
Yes | 4494 (78.5) | 213 (4.7) | 778 (17.3) | 1264 (28.1) | 761 (16.9) | 879 (19.6) |
No | 1232 (21.5) | 136 (11.0) | 390 (31.7) | 570 (46.3) | 384 (31.2) | 437 (35.5) |
Childhood verbal peer victimization | ||||||
Yes | 3325 (58.1) | 152 (4.6) | 525 (15.8) | 832 (25.0) | 522 (15.7) | 552 (16.6) |
No | 2401 (41.9) | 197 (8.2) | 643 (26.8) | 1002 (41.7) | 623 (25.9) | 764 (31.8) |
Childhood relational peer victimization | ||||||
Yes | 4143 (72.4) | 175 (4.2) | 615 (14.8) | 1039 (25.1) | 578 (14.0) | 674 (16.3) |
No | 1583 (27.6) | 174 (11.0) | 553 (34.9) | 795 (50.2) | 567 (35.8) | 642 (40.6) |
Physical abuse | ||||||
Yes | 425 (7.4) | 71 (16.7) | 155 (36.5) | 236 (55.5) | 171 (40.2) | 205 (48.2) |
No | 5301 (92.6) | 278 (5.2) | 1013 (19.1) | 1598 (30.1) | 974 (18.4) | 1111 (21.0) |
Emotional abuse | ||||||
Yes | 632 (11.0) | 112 (17.7) | 263 (41.6) | 356 (56.3) | 257 (40.7) | 308 (48.7) |
No | 5094 (89.0) | 237 (4.7) | 905 (17.8) | 1478 (29.0) | 888 (17.4) | 1008 (19.8) |
Sexual abuse | ||||||
Yes | 499 (8.7) | 88 (17.6) | 206 (41.3) | 268 (53.7) | 210 (42.1) | 220 (44.1) |
No | 5227 (91.3) | 261 (5.0) | 962 (18.4) | 1566 (30.0) | 935 (17.9) | 1096 (21.0) |
Physical neglect | ||||||
Yes | 379 (6.6) | 77 (20.3) | 166 (43.8) | 229 (60.4) | 179 (47.2) | 198 (52.2) |
No | 5347 (93.4) | 272 (5.1) | 1002 (18.7) | 1605 (30.0) | 966 (18.1) | 1118 (20.9) |
Emotional neglect | ||||||
Yes | 228 (4.0) | 63 (27.6) | 111 (48.7) | 144 (63.2) | 116 (50.9) | 124 (54.4) |
No | 5498 (96.0) | 286 (5.2) | 1057 (19.2) | 1690 (30.7) | 1029 (18.7) | 1192 (21.7) |
Family life stress event scores | ||||||
0 | 2049 (35.8) | 95 (4.6) | 239 (11.7) | 417 (20.4) | 258 (12.6) | 255 (12.4) |
1–2 | 2337 (40.8) | 144 (6.2) | 514 (22.0) | 805 (34.4) | 484 (20.7) | 588 (25.2) |
3–10 | 1340 (23.4) | 110 (8.2) | 415 (31.0) | 612 (45.7) | 403 (30.1) | 473 (35.3) |
Depression | ||||||
Yes | 3711 (64.8) | 301 (8.1) | 891 (24.0) | 1341 (36.1) | 896 (24.1) | 1023 (27.6) |
No | 2015 (35.2) | 48 (2.4) | 277 (13.7) | 493 (24.5) | 249 (12.4) | 293 (14.5) |
Univariate logistic regression analyses
Highly lethal self-harm | Less lethal self-harm with visible tissue damage | Self-harm without visible tissue damage | Self-harmful behaviors with latency damage | Psychological self-harm | ||
---|---|---|---|---|---|---|
Gender | Female: Male | 1.30 (1.05, 1.62)* | 2.18 (1.90, 2.49)*** | 1.18 (1.05, 1.31)** | 1.11 (0.98, 1.27) | 1.42 (1.25, 1.60)*** |
Age | 1.07 (1.02, 1.34)* | 1.06 (1.02, 1.09)*** | 1.11 (1.08, 1.14)*** | 1.17 (1.13, 1.21)*** | 1.16 (1.12, 1.20)*** | |
Self-perceived family status | Ref: Bad | |||||
General | 0.81 (0.60, 1.09) | 0.85 (0.71, 1.01) | 0.74 (0.64, 0.87)*** | 0.79 (0.66, 0.94)** | 0.72 (0.60, 0.85)*** | |
Good | 0.92 (0.59, 1.41) | 0.83 (0.63, 1.08) | 0.67 (0.53, 0.85)*** | 0.84 (0.65, 1.09) | 0.72 (0.56, 0.93)* | |
Relationship with mother | Good: Poor | 0.55 (0.44, 0.70)*** | 0.76 (0.65, 0.87)*** | 0.83 (0.73, 0.94)** | 0.64 (0.55, 0.74)*** | 0.67 (0.58, 0.77)*** |
Relationship with father | Good: Poor | 0.59 (0.47, 0.73)*** | 0.69 (0.61, 0.79)*** | 0.73 (0.65, 0.83)*** | 0.63 (0.55, 0.72)*** | 0.66 (0.58, 0.75)*** |
Only child | Yes: No | 0.61 (0.49, 0.77)*** | 0.62 (0.55, 0.71)*** | 0.77 (0.69, 0.86)*** | 0.77 (0.67, 0.87)*** | 0.70 (0.62, 0.80)*** |
Family structure | Ref: Nuclear Family | |||||
Lager family | 1.14 (0.89, 1.47) | 1.01 (0.87, 1.18) | 1.08 (0.95, 1.23) | 0.93 (0.79, 1.09) | 1.01 (0.87, 1.16) | |
Single-parent Family | 0.93 (0.61, 1.41) | 1.06 (0.84, 1.34) | 1.05 (0.85, 1.29) | 1.07 (0.84, 1.35) | 1.06 (0.85, 1.33) | |
Other | 1.06 (0.49, 2.30) | 1.32 (0.85, 2.04) | 1.47 (0.99, 2.16) | 1.40 (0.91, 2.14) | 1.07 (0.70, 1.66) | |
Childhood physical peer victimization | Yes: No | 2.49 (1.99, 3.12)*** | 2.21 (1.92, 2.55)*** | 2.20 (1.93, 2.50)*** | 2.22 (1.92, 2.56)*** | 2.26 (1.97, 2.60)*** |
Childhood verbal peer victimization | Yes: No | 1.87 (1.50, 2.32)*** | 1.95 (1.71, 2.22)*** | 2.15 (1.92, 2.40)*** | 1.88 (1.65, 2.14)*** | 2.35 (2.07, 2.66)*** |
Childhood relational peer victimization | Yes: No | 2.80 (2.25, 3.48)*** | 3.08 (2.69, 3.52)*** | 3.01 (2.67, 3.40)*** | 3.44 (3.01, 3.94)*** | 3,51 (3.08, 4.00)*** |
Physical abuse | Yes: No | 3.62 (2.73, 4.81)*** | 2.43 (1.97, 3.00)*** | 2.89 (2.37, 3.54)*** | 2.99 (2.43, 3.68)*** | 3.51 (2.87, 4.30)*** |
Emotional abuse | Yes: No | 4.41 (3.46, 5.62)*** | 3.30 (2.77, 3.93)*** | 3.16 (2.67, 3.74)*** | 3.25 (2.73, 3.87)*** | 3.85 (3.25, 4.57)*** |
Sexual abuse | Yes: No | 4.07 (3.14, 5.29)*** | 3.12 (2.57, 3.78)*** | 2.71 (2.25, 3.27)*** | 3.34 (2.76, 4.04)*** | 2.97 (2.46, 3.59)*** |
Physical neglect | Yes: No | 4.76 (3.60, 6.28)*** | 3.38 (2.73, 4.19)*** | 3.56 (2.87, 4.41)*** | 4.06 (3.28, 5.02)*** | 4.14 (3.35, 5.12)*** |
Emotional neglect | Yes: No | 6.96 (5.08, 9.52)*** | 3.99 (3.05, 5.21)*** | 3.86 (2.93, 5.09)*** | 4.50 (3.44, 5.88)*** | 4.31 (3.29, 5.63)*** |
Family life stress event scores | Ref: 0 | |||||
1–2 | 1.35 (1.04, 1.76)* | 2.14 (1.81, 2.52)*** | 2.06 (1.79, 2.36)*** | 1.81 (1.54, 2.14)*** | 2.37 (2.01, 2.78)*** | |
3–10 | 1.84 (1.39, 2.44)*** | 3.40 (2.84, 4.06)*** | 3.29 (2.83, 3.83)*** | 2.99 (2.51, 3.56)*** | 3.84 (3.23, 4.56)*** | |
Depression | Yes: No | 3.62 (2.65, 4.93)*** | 1.98 (1.71, 2.30)*** | 1.75 (1.55, 1.97)*** | 2.26 (1.94, 2.63)*** | 2.24 (1.94, 2.58)*** |
The association between each type of childhood adversity and each SH subtype
Highly lethal self-harma | Less lethal self-harm with visible tissue damageb | Self-harm without visible tissue damagec | Self-harmful behaviors with latency damaged | Psychological self-harme | ||
---|---|---|---|---|---|---|
Childhood physical peer victimization | Yes: No | 1.48 (1.11, 1.97)** | 1.52 (1.28, 1.82)*** | 1.27 (1.08, 1.48)** | 1.27 (1.06, 1.51)** | 1.23 (1.03, 1.46)* |
Childhood verbal peer victimization | Yes: No | 1.11 (0.85, 1.44) | 1.25 (1.07, 1.45)** | 1.42 (1.24, 1.61)*** | 1.15 (0.99, 1.34) | 1.52 (1.31, 1.76)*** |
Childhood relational peer victimization | Yes: No | 1.17 (0.86, 1.58) | 1.69 (1.42, 2.00)*** | 1.87 (1.61, 2.18)*** | 2.24 (1.89, 2.65)*** | 1.90 (1.61, 2.25)*** |
Physical abuse | Yes: No | 0.98 (0.66, 1.45) | 0.96 (0.73, 1.26) | 1.24 (0.97, 1.59) | 1.09 (0.83, 1.42) | 1.45 (1.12, 1.88)** |
Emotional abuse | Yes: No | 1.58 (1.09, 2.30)* | 1.14 (0.90, 1.46) | 1.06 (0.84, 1.33) | 0.90 (0.70, 1.15) | 1.15 (0.90, 1.46) |
Sexual abuse | Yes: No | 1.76 (1.27, 2.45)*** | 1.67 (1.33, 2.10)*** | 1.33 (1.07, 1.65)* | 1.61 (1.28, 2.03)*** | 1.30 (1.03, 1.63)* |
Physical neglect | Yes: No | 1.43 (0.97, 2.11) | 1.30 (0.98, 1.71) | 1.32 (1.01, 1.72)* | 1.40 (1.07, 1.85)* | 1.39 (1.06, 1.83)* |
Emotional neglect | Yes: No | 1.79 (1.16, 2.76)** | 1.17 (0.82, 1.65) | 1.07 (0.76, 1.51) | 1.15 (0.81, 1.62) | 0.92 (0.65, 1.30) |
Family life stress event scores | Ref: 0 | |||||
1–2 | 0.99 (0.75, 1.32) | 1.63 (1.37, 1.95)*** | 1.67 (1.44, 1.93)*** | 1.45 (1.22, 1.73)*** | 1.85 (1.55, 2.20)*** | |
3–10 | 0.84 (0.60, 1.16) | 1.97 (1.61, 2.41)*** | 2.02 (1.70, 2.41)*** | 1.72 (1.40, 2.10)*** | 2.13 (1.75, 2.59)*** |