Of Emily Reynolds
There are several risk factors for self-harm, including a history of abuse, trauma, physical and mental illness, and bullying. Identifying these factors is an important part of prevention to ensure that those at risk receive appropriate support as early as possible. Even so, it is still difficult to predict who might end up exhibiting self-harm.
But we may be able to spot these risks sooner than we thought, a new study by a team at the University of Cambridge suggests. Stepheni Uh and colleagues report that some young people at risk could be identified ten years before self-harm – offering an “extended window” in which help and support can be offered, the team says.
Participants were part of an ongoing longitudinal study that focused on the experiences of young people in the UK; Data has been collected since participants were nine months old. At the age of 14, they reported whether they exhibited self-harming behavior and filled out a questionnaire about feelings of depression and behavior. At various times during her childhood, her caregivers had also completed a questionnaire on the child’s mental and physical health, self-esteem, sleep, their home environment, the quality of their friendships, and any negative experiences, including bullying.
The team then used a neural network to identify the risk factors for self-harm in the participants. It was also examined whether there were different subgroups with different characteristics or risk factors.
Two profiles were created. The first group of children had a long history of poor mental health, starting at the age of five, and were more likely to have caregivers who had their own mental health problems. This group had also been more likely to experience bullying before they started harming themselves and had other problems in their personal lives.
For this group, risk factors for self-harm were identifiable up to ten years before the first incident. The results could allow the development of interventions that target those at risk of self-harm much earlier than is currently the case. The work on child and adolescent mental health strongly suggests that early intervention is crucial: developing a trauma-informed environment, anti-bullying interventions, self-esteem exercises, support for those with parental illness too Do, and especially well-funded mental health services, could therefore help prevent further harm.
The second, larger group, however, did not show the same long-term risk factors. Instead, this group was characterized by impulsiveness and risk-taking that developed during the teenage years. They also tended to feel less safe with friends and family.
Because teens who fit this profile did not have the same risk factors in childhood, they may be more difficult to identify. But research still offers opportunities to help these vulnerable young people as well, says co-author Duncan Astle. “Given that they struggle with their peers and are more willing to engage in risky behaviors, access to self-help and problem-solving or conflict resolution programs can be effective.”
Crucially, the study shows that those who harm themselves are not a homogeneous group: there are many complex risk factors associated with self-harm that interact with other life experiences, personality, and more. Early responses and interventions should therefore be tailored to these individual differences rather than relying on blanket solutions.
– Two Paths to Self-Harm in Adolescence
Emily Reynolds is an associate at BPS Biomedarticles