Teens most at risk for self-harm could be identified almost a decade earlier – ScienceDaily
Researchers have identified two subgroups of adolescents who self-harm and have shown that it is possible to predict those most at risk almost a decade before they start to self-harm.
The team, based at Cambridge University’s MRC’s Cognitive and Brain Sciences Unit, found that while sleep problems and low self-esteem were common risk factors, there were two distinct profiles of young people who self-injure – one with behavioral problems and a second group without these difficulties, but with different risk factors.
Between one in five and one in seven adolescents in England self-injure, for example by deliberately cutting themselves. Although self-harm is a significant risk factor for subsequent suicide attempts, many do not intend to kill themselves but face other adverse consequences, including repeated self-harm, poor mental health and risky behaviors such as drug addiction. Despite its prevalence and lifelong consequences, there has been little progress in the accurate prediction of self-injury.
The Cambridge team identified adolescents who reported self-harm at age 14, from a representative UK birth cohort of around 11,000 people. They then used machine learning analysis to identify if there were distinct profiles of young people who self-harm, with different emotional and behavioral characteristics. They used this information to identify early and middle childhood risk factors. The results are published in the Journal of the American Academy of Child and Adolescent Psychiatry.
Because the data followed participants over time, the researchers were able to distinguish factors that appear alongside reported self-injurious behaviors, such as low self-esteem, from those that precede them, such as intimidation.
The team identified two distinct subgroups among young people who self-harm, with significant risk factors present as early as age five, almost a decade before they reported self-harm. While both groups were likely to experience difficulty sleeping and reported low self-esteem by age 14, other risk factors differed between the two groups.
The first group showed a long history of poor mental health, as well as bullying before self-harm. Their caregivers were more likely to have mental health problems themselves.
For the second group, however, their self-injurious behavior was more difficult to predict in early childhood. One of the key signs was a greater willingness to engage in risky behaviors, which are linked to impulsivity. Other research suggests that these tendencies may predispose the individual to spend less time considering other coping methods and the consequences of self-harm. Factors related to their relationships with their peers were also important for this subgroup, including feeling less secure with friends and family at age 14 and a greater concern about the feelings of others as a risk factor to 11 years old.
Stepheni Uh, Gates Cambridge Fellow and lead author of the study, said: “Self-injury is a significant problem in adolescents, so it is essential that we understand the nuanced nature of self-injury, especially when it comes to self-injury. the different profiles of young people who self-injure and their potentially different risk factors.
“We found two distinct subgroups of young people who self-harm. The first was quite as expected – young people who show symptoms of depression and low self-esteem, face issues with their families and their families. friends and are bullied. The second, a much larger group was much more surprising as they lack the usual traits associated with self-harm. “
The researchers say their results suggest that it may be possible to predict which people are most at risk for self-harm up to a decade in advance, providing a window to intervene.
Dr Duncan Astle said: “The current approach to supporting youth mental health is to wait until the problems get worse. Instead, we need a much better database so that we can identify who is most at risk for mental health problems in the future, and This gives us the opportunity to be proactive and minimize difficulties before they start.
“Our results suggest that boosting the self-esteem of young children, making sure schools implement anti-bullying measures, and providing advice on sleep training, could all help reduce levels of self-harm. years later.
“Our research offers us potential ways to help this newly identified second subgroup. Since they experience difficulties with their peers and are more willing to engage in risky behaviors, then providing access to self-help and problem-solving or conflict resolution programs can be effective. “
Professor Tamsin Ford of the Department of Psychiatry added, “We could also help at-risk adolescents by targeting interventions to mental health officials and school mental health teams. Teachers are often the first to hear about self-harm, but some lack self-confidence. in the way of reacting. Providing them with training could make a big difference.