Repeat self-harm among Chinese adolescents: 1-year incidence and psychosocial predictors

• Published in: Social Psychiatry and Psychiatric Epidemiology 2021-11, Vol.56 (11), p.1979-1992
• Main Authors: Liu, Xianchen, Liu, Zhen-Zhen, Jia, Cun-Xian
• Format: Article
• Language: English
• Subjects: Alcohol use; Analysis; Epidemiology; Medicine; Medicine & Public Health; Mental health; Original Paper; Psychiatry; Psychological aspects; Self destructive behavior; Stress (Psychology); Suicide; Surveys; Teenagers; Youth
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-021-02085-x

Purpose Self-harm in adolescents is prevalent and is the most significant predictor of future self-harm and suicide. Longitudinal data on the incidence and predictors of repeat self-harm in the general population of adolescents are limited. This study investigated 1-year incidence and psychosocial predictors of repeat self-harm in Chinese adolescents. Methods Shandong Adolescent Behavior and Health Cohort is a longitudinal study of behavior and health in adolescents in Shandong Province, China. Of 7072 participants who were assessed in 2015 and again 1 year later in 2016, 1879 reported a history of self-harm at the baseline survey and were included for this analysis. A self-administered structured questionnaire was used to assess behavioral and emotional problems, sleep, life stress, previous history of self-harm and suicidal thought, and family factors at baseline and self-harm at 1-year follow-up. Results Mean age of the sample was 14.86 (SD 1.36) years and 54.6% were female. At 1-year follow-up, 22.1% participants engaged in repeat self-harm. Multiple logistic regression analyses showed that female gender (OR 1.45, 95% CI 1.11–1.89), alcohol use (OR 1.95, 95% CI 1.48–2.57), frequent nightmares (OR 1.61, 95% CI 1.14–2.28), elevated depression score (OR 1.59, 95% CI 1.05–2.42), and prior suicidal thought (OR 1.79, 95% CI 1.37–2.34) were independently and significantly associated with an increased risk of repeat self-harm. Conclusion More than one in five Chinese adolescents who had a history of self-harm engaged in self-harm at 1-year follow-up. Multiple psychosocial factors including female gender, alcohol use, frequent nightmares, depression, and prior suicidal thought appeared to be significant predictors of repeat self-harm. Our findings highlight the importance of comprehensive psychosocial assessment and intervention of repeat self-harm in adolescents.