Vulnerability or resilience? Psycho-social factors associated with deliberate self-harm among adolescents
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Date
2012-08
Authors
McMahon, Elaine M.
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
Background: Deliberate self-harm (DSH) is common among adolescents in Ireland and internationally.
Psychological factors, negative life events and lifestyle factors have been found to be associated
with self-harm in this group. However, large scale population-based studies of adolescent selfharm
and its correlates have been lacking, and internationally a standardised methodology was
needed to facilitate comparative studies. The focus on vulnerability which has been prevalent in
this field has meant that research has failed to examine resilient adaptation among at-risk
adolescents.
Method: Data were obtained from a cross-sectional school-based study conducted in Ireland and in each
of the six other centres which participated in the Child and Adolescent Self-harm in Europe
(CASE) study. In Ireland, 3,881 adolescents in 39 schools in completing the anonymous
questionnaire, while across all 7 centres, over 30,000 young people participated. Data were
gathered on health and lifestyle, self-harm thoughts and behaviour, a wide range of life events,
psychological characteristics (anxiety and depressive symptoms, self-esteem, impulsivity and
coping style), and support available to young people.
Results: This thesis reports the findings of the Irish CASE centre as well as one international study. The
factors associated with DSH among Irish adolescents differed by gender, but among both
genders drug use and knowing a friend who had engaged in self-harm were associated with DSH.
Among Irish boys, strong associations were found between bullying and poor mental health and
DSH. Among boys who had been bullied, psychological and school factors were associated
with DSH, while family support was protective.
Links between stressful life events, psychological characteristics and DSH within the
international CASE sample were examined. Increased history of self-harm thoughts and acts
was associated with greater depression, anxiety and impulsivity, lower self esteem and an
increased prevalence of ten different negative life events, supporting the hypothesis of a “dose-response”
relationship between these risk factors and the self-harm process.
Associations between coping style, mental health factors (depressive symptoms, anxiety and
self-esteem) and self-harm were examined among Irish adolescents. Emotion-oriented coping
was strongly associated with poorer mental health and self-harm thoughts and acts. A mediating
effect of emotion-oriented coping on associations between mental health factors and DSH was
found for both genders and between problem-oriented coping and mental health factors for
girls. Similar mediating effects of coping style were found when risk of self-harm thoughts was
examined.
Resilient adaptation among adolescents exposed to suicidal behaviour of others was examined.
Self-harm thoughts were common in these adolescents. Among those exposed to suicidal
behaviour of others, vulnerability factors were drug use and higher levels of anxiety among
boys, while for girls drug use, bullying and abuse were vulnerability factors, while resilience
was associated with higher self-esteem and use of problem-oriented coping.
Conclusion: These findings can aid in the identification of young people at risk of self-harm in the school
setting and highlight the importance of mental health, peer-related and lifestyle factors in the
development of DSH. High-risk groups of young people such as bullying victims and those
exposed to suicidal behaviour of others have distinctive profiles of risk factors which differ
from those of their peers. Findings relating to the importance of positive coping skills can
inform positive mental health programmes, many of which aim to enhance life skills and build resilience among young people. Knowledge of the factors associated with positive adaptation
among at-risk adolescents can inform prevention efforts among this group.
Description
Keywords
Deliberate self-harm (DSH) , Adolescence , Vulnerability , Resilience , Child and Adolescent Self-harm Europe (CASE) Study , Ireland , Europe
Citation
McMahon, E. 2012. Vulnerability or resilience? Psycho-social factors associated with deliberate self-harm among adolescents. PhD Thesis, University College Cork.