Identifying high-risk subgroups for self-harm in adolescents and young adults: A longitudinal latent class analysis of risk factors

• Published in: Journal of affective disorders 2024-04, Vol.351, p.40-48
• Main Authors: McEvoy, David, Brannigan, Ross, Walsh, Cathal, Arensman, Ella, Clarke, Mary
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adult; Bullying; Humans; Latent Class Analysis; Risk Factors; Self-harm; Self-Injurious Behavior - diagnosis; Self-injury; Sub-groups; Substance-Related Disorders - epidemiology; Young Adult; Young adults
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2024.01.230

Self-harm is a major public health concern in young people and is governed by a complex interaction of different risk factors. While many studies have identified these risk factors, less is known about how they tend to co-occur together. A latent class analysis was conducted using risk factors for self-harm from two waves at ages 13 and 17 from the Growing Up in Ireland (GUI) study their associations with self-harm were examined longitudinally at ages 17 and 20, respectively. At age 13, there was a ‘peer problems’ group with higher probabilities of bullying, being unpopular and internalising problems and a ‘school and substance use problems’ group with higher probabilities of substance use, truancy or excessive absence from school and violence. Both of these two groups had over a two-fold risk of self-harm at age 17 in comparison to the low risk factor group. At age 17, there was a group with depression that was diagnosed by a medical professional with the highest relative risk (RR:13.9 (95 % CI 10.2–19.0)) of self-harm at age 20. Two other groups with undiagnosed depression had high probabilities of being bullied, and either high or low probabilities of substance use that had a 9.4 (95 % CI 6.8–13.1) and 7.4 (95 % CI 5.5–10.0) relative risk of self-harm at age 20, respectively. Identifying hidden sub-groups using risk factors for self-harm in young people can inform potential public health interventions by clinicians and other professionals who work with young people. •High risk subgroups for self-harm can be identified in adolescents.•Peer problems and substance use at age 13 are strong indicators of self-harm.•Adolescents with depression at age 17 are at a high risk of self-harm by age 20.•Adolescent undiagnosed depression can be identified by other risk indicators.