Self-injury from early adolescence to early adulthood: Age-related course, recurrence, and services use in males and females from the community
Open accessAbstract
Adolescent self-injury is a widespread public health problem, but long-term longitudinal studies from European countries are rare. Self-injury in males and sex differences are poorly understood. This study describes the prevalence, frequency, age-related course, and recurrence of, and mental health services use related to adolescent self-injury. Data came from a Swiss prospective-longitudinal cohort study (N = 1482). Adolescents (52% male) reported frequency of self-injury and mental health services use (including reasons for and types of services use, hospitalizations) at ages 13, 15, 17, and 20. Between ages 13-20, 27% of adolescents reported self-injury at least once. In males, prevalence decreased from 12 to 5%; in females self-injury peaked at age 15 (16%) and then decreased (11% at age 20). In males, recurrence of self-injury increased after age 15 (from odds ratio [OR] < 3 to OR > 10); in females, recurrence was high from age 13 onwards (OR > 5). Predictors of recurrence included childhood/early adolescent internalizing symptoms and early self-injury onset. Typically, less than half of adolescents with self-injury used mental health services. Males with self-injury used services mainly for externalizing problems, learning difficulties, and attention/concentration problems; females for depression or self-injury, family problems, and victimization. Types of services used changed with age, and adolescents with self-injury had increased rates of hospitalization. There are notable sex differences in the longitudinal course of self-injury and reasons for related mental health services use. Treating early internalizing symptoms could be a promising target for preventing recurrent self-injury. Males are at particular risk of not receiving adequate treatment for self-injury.
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Adolescents are severely negatively affected on their mental health development and growth due to destructive experiential avoidance behaviors.
“Furthermore, adolescents are severely negatively affected on their mental health development and growth due to DEA behaviors [13].”
From Acceptance and Commitment Therapy for Destructive Experiential Avoidance (ACT-DEA): A Feasibility Study (2022) · cites this paper as [13]
The Discussion describes potential long-term negative consequences of adolescent self-injury and says early self-injury can be followed by long-term psychiatric impairments. It does not identify self-injury as “destructive experiential avoidance” or establish that such behaviors cause severe harm to adolescents’ mental health development and growth generally. (LLM, conf=0.84)
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Missing data: our view of the state of the art
Schafer, J. L., & Graham, J. W. (2002) · Psychological Methods · doi:10.1037/1082-989x.7.2.147 · Cited by 11,638 · see citing works
(1993) · Cited by 7,136 · see citing works
(2010) · Cited by 7,034 · see citing works
Cognitive-Behavioral Treatment of Borderline Personality Disorder
Cary, G. L. (1994) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1994.48.1.155 · Cited by 6,300 · see citing works
A standard international socio-economic index of occupational status
Ganzeboom, H. B. G., de Graaf, P. M., & Treiman, D. J. (1992) · Social Science Research · doi:10.1016/0049-089x(92)90017-b · Cited by 3,171 · see citing works
Salk, R. H., Hyde, J. S., & Abramson, L. Y. (2017) · Psychological Bulletin · doi:10.1037/bul0000102 · Cited by 2,622 · cited 1× · see citing works
“Adolescent depression—which has risen in the past decade [5] and is comorbid with self-injury in a significant group of young people [20]—follows a dramatically sex-differentiated course, with female adolescents exhibiting more depressive symptoms than males, particularly during early and mid-adolescence [21].”
BackgroundSelf-harm and suicide in adolescents
Hawton, K., Saunders, K. E., & O'Connor, R. C. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60322-5 · Cited by 2,306 · see citing works
Swannell, S. V., Martin, G. E., Page, A., Hasking, P., & St John, N. J. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12070 · Cited by 1,624 · see citing works
Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts
NOCK, M., JOINERJR, T., GORDON, K., LLOYDRICHARDSON, E., & PRINSTEIN, M. (2006) · Psychiatry Research · doi:10.1016/j.psychres.2006.05.010 · Cited by 1,617 · see citing works
Merikangas, K. R., He, J.-P., Burstein, M., Swendsen, J., Avenevoli, S., Case, B., Georgiades, K., Heaton, L., Swanson, S., & Olfson, M. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.10.006 · Cited by 1,579 · see citing works
Nock, M. K. (2010) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.121208.131258 · Cited by 1,550 · see citing works
Why Do People Hurt Themselves?
Nock, M. K. (2009) · Current Directions in Psychological Science · doi:10.1111/j.1467-8721.2009.01613.x · Cited by 1,245 · see citing works
International prevalence of adolescent non-suicidal self-injury and deliberate self-harm
Muehlenkamp, J. J., Claes, L., Havertape, L., & Plener, P. L. (2012) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-6-10 · Cited by 1,166 · see citing works
Twenge, J. M., & Nolen-Hoeksema, S. (2002) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.111.4.578 · Cited by 1,080 · see citing works
Moffitt, T. E., Caspi, A., Taylor, A., Kokaua, J., Milne, B. J., Polanczyk, G., & Poulton, R. (2010) · Psychological Medicine · doi:10.1017/s0033291709991036 · Cited by 938 · see citing works
Gender differences in emotional responses to interpersonal stress during adolescence
Rudolph, K. D. (2002) · Journal of Adolescent Health · doi:10.1016/s1054-139x(01)00383-4 · Cited by 785 · see citing works
Twenge, J. M., & Nolen–Hoeksema, S. (2002) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.111.4.578 · Cited by 758 · see citing works
Madge, N., Hewitt, A., Hawton, K., Wilde, E. J. D., Corcoran, P., Fekete, S., Heeringen, K. V., Leo, D. D., & Ystgaard, M. (2008) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2008.01879.x · Cited by 750 · see citing works
Nonsuicidal Self-Harm Among Community Adolescents: Understanding the “Whats” and “Whys” of Self-Harm
Laye-Gindhu, A., & Schonert-Reichl, K. A. (2005) · Journal of Youth and Adolescence · doi:10.1007/s10964-005-7262-z · Cited by 746 · see citing works
Plener, P. L., Schumacher, T. S., Munz, L. M., & Groschwitz, R. C. (2015) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-014-0024-3 · Cited by 704 · see citing works
Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis
Bresin, K., & Schoenleber, M. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.02.009 · Cited by 678 · see citing works
Moran, P., Coffey, C., Romaniuk, H., Olsson, C., Borschmann, R., Carlin, J. B., & Patton, G. C. (2012) · The Lancet · doi:10.1016/s0140-6736(11)61141-0 · Cited by 607 · see citing works
Duffy, M. E., Twenge, J. M., & Joiner, T. E. (2019) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2019.04.033 · Cited by 579 · see citing works
Tremblay, R. E., Loeber, R., Gagnon, C., Charlebois, P., Larivée, S. J., & Blanc, M. L. (1991) · Research on Child and Adolescent Psychopathology · doi:10.1007/bf00911232 · Cited by 493 · see citing works
Recent increases in depressive symptoms among US adolescents: trends from 1991 to 2018
Keyes, K. M., Gary, D., O’Malley, P. M., Hamilton, A., & Schulenberg, J. (2019) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-019-01697-8 · Cited by 465 · see citing works
Child maltreatment, non-suicidal self-injury, and the mediating role of self-criticism
Glassman, L. H., Weierich, M. R., Hooley, J. M., Deliberto, T. L., & Nock, M. K. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.04.002 · Cited by 447 · see citing works
The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviors
Kiekens, G., Hasking, P. A., Boyes, M. E., Claes, L., Mortier, P., Auerbach, R. P., Cuijpers, P. J., Demyttenaere, K., Green, J. G., Kessler, R. C., et al. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.06.033 · Cited by 428 · see citing works
Depression scale scores in 8–17‐year‐olds: effects of age and gender
Angold, A. C., Erkanli, A., Silberg, J. L., Eaves, L. J., & Costello, E. J. (2002) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00232 · Cited by 418 · see citing works
Stigma starts early: Gender differences in teen willingness to use mental health services
CHANDRA, A., & Minkovitz, C. S. (2006) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2005.08.011 · Cited by 404 · see citing works
Longitudinal analysis of adolescent NSSI: The role of intrapersonal and interpersonal factors
Tatnell, R., Kelada, L., Hasking, P., & Martin, G. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9837-6 · Cited by 363 · see citing works
The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature
Zetterqvist, M. (2015) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-015-0062-7 · Cited by 360 · see citing works
Why Do People Hurt Themselves? A New Conceptual Model of Nonsuicidal Self-Injury
Hooley, J., & Franklin, J. (2018) · Clinical Psychological Science · doi:10.1177/2167702617745641 · Cited by 357 · see citing works
Hankin, B. L., & Abela, J. R. Z. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2010.07.056 · Cited by 341 · see citing works
Nonsuicidal Self-Injury Disorder: An Empirical Investigation in Adolescent Psychiatric Patients
Glenn, C. R., & Klonsky, E. D. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.794699 · Cited by 337 · see citing works
Patalay, P., & Gage, S. H. (2019) · International Journal of Epidemiology · doi:10.1093/ije/dyz006 · Cited by 335 · see citing works
Burgess, P. M., Pirkis, J. E., Slade, T. N., Johnston, A. K., Meadows, G. N., & Gunn, J. M. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670902970858 · Cited by 318 · see citing works
School Mental Health Resources and Adolescent Mental Health Service Use
Green, J. G., McLaughlin, K. A., Alegria, M. M., Costello, E. J., Gruber, M. J., Hoagwood, K., Leaf, P. J., Olin, S.-C. S., Sampson, N. A., & Kessler, R. C. (2013) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.03.002 · Cited by 288 · see citing works
The Danish 22q11 research initiative
Schmock, H., Vangkilde, A., Larsen, K. M., Fischer, E., Birknow, M. R., Jepsen, J. R. M., Olesen, C., Skovby, F., Plessen, K. J., Mørup, M., et al. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0594-7 · Cited by 286 · see citing works
Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample
Barrocas, A. L., Hankin, B. L., Young, J. F., & Abela, J. R. Z. (2012) · PEDIATRICS · doi:10.1542/peds.2011-2094 · Cited by 272 · see citing works
Nonsuicidal Self‐Injury and Gender: Patterns of Prevalence, Methods, and Locations among Adolescents
Sornberger, M. J., Heath, N. L., Toste, J. R., & McLouth, R. (2012) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2012.0088.x · Cited by 228 · see citing works
Rickwood, D., Mazzer, K., & Telford, N. R. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0429-6 · Cited by 206 · see citing works
Nonsuicidal Self-Injury Among a Representative Sample of US Adolescents, 2015
Monto, M. A., McRee, N., & Deryck, F. S. (2018) · American Journal of Public Health · doi:10.2105/ajph.2018.304470 · Cited by 185 · see citing works
The Relationship Between Nonsuicidal Self‐Injury Age of Onset and Severity of Self‐Harm
Ammerman, B. A., Jacobucci, R., Kleiman, E. M., Uyeji, L. L., & McCloskey, M. S. (2017) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12330 · Cited by 139 · see citing works
Brown, R. C., Heines, S., Witt, A., Brähler, E., Fegert, J. M., Harsch, D., & Plener, P. L. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1754-3 · Cited by 136 · see citing works
20-year outcomes in adolescents who self-harm: a population-based cohort study
Borschmann, R., Becker, D., Coffey, C., Spry, E., Moreno-Betancur, M., Moran, P., & Patton, G. C. (2017) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(17)30007-x · Cited by 135 · see citing works
The structure of adolescent psychopathology: a symptom-level analysis
Carragher, N., Teesson, M., Sunderland, M., Newton, N. C., Krueger, R. F., Conrod, P., Barrett, E. L., Champion, K. E., Nair, N. K., & Slade, T. N. (2015) · Psychological Medicine · doi:10.1017/s0033291715002470 · Cited by 126 · see citing works
Eisner, N. L., Murray, A. L., Eisner, M., & Ribeaud, D. (2019) · International Journal of Behavioral Development · doi:10.1177/0165025418797004 · Cited by 117 · see citing works
Self-citationThe situation of former adolescent self-injurers as young adults: a follow-up study
Groschwitz, R. C., Plener, P. L., Kaess, M., Schumacher, T. S., Stoehr, R., & Boege, I. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0555-1 · Cited by 114 · see citing works
Baetens, I., Claes, L., Onghena, P., Grietens, H. W. E., Leeuwen, K. G. V., Pieters, C., Wiersema, J. R., & Griffith, J. W. (2014) · Journal of Adolescence · doi:10.1016/j.adolescence.2014.05.010 · Cited by 114 · see citing works
Iyengar, U., Snowden, N., Asarnow, J. R., Moran, P., Tranah, T., & Ougrin, D. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00583 · Cited by 111 · see citing works
Ougrin, D., Corrigall, R., Poole, J., Zundel, T., Sarhane, M., Slater, V., Stahl, D., Reavey, P., Byford, S., Heslin, M., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30129-9 · Cited by 101 · see citing works
Evans, R., & Hurrell, C. (2016) · BMC Public Health · doi:10.1186/s12889-016-3065-2 · Cited by 99 · see citing works
Psychological treatment of self‐injury among adolescents
Nock, M. K., Teper, R., & Hollander, M. (2007) · Journal of Clinical Psychology · doi:10.1002/jclp.20415 · Cited by 90 · see citing works
The Role of Exposure to Self-Injury Among Peers in Predicting Later Self-Injury
Hasking, P. A., Andrews, T., & Martin, G. (2013) · Journal of Youth and Adolescence · doi:10.1007/s10964-013-9931-7 · Cited by 84 · see citing works
Voon, D., Hasking, P. A., & Martin, G. (2014) · Journal of Abnormal Psychology · doi:10.1037/a0037024 · Cited by 79 · see citing works
Robinson, K., Garisch, J. A., Kingi, T., Brocklesby, M., O’Connell, A., Langlands, R. L., Russell, L., & Wilson, M. S. (2018) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-018-0450-6 · Cited by 79 · see citing works
Suicide in Children and Adolescents
Greydanus, D. E., & Calles, J. L. (2007) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2007.04.013 · Cited by 73 · see citing works
Reavey, P., Poole, J., Corrigall, R. J., Zundel, T., Byford, S., Sarhane, M., Taylor, E. A., Ivens, J., & Ougrin, D. (2017) · Health & Place · doi:10.1016/j.healthplace.2017.05.008 · Cited by 52 · see citing works
Young Men, Masculinities, and Suicide
Rasmussen, M. L., Haavind, H., & Dieserud, G. (2017) · Archives of Suicide Research · doi:10.1080/13811118.2017.1340855 · Cited by 50 · see citing works
The Association Between Masculinity and Nonsuicidal Self-Injury
Green, J. D., Kearns, J. C., Ledoux, A. M., Addis, M. E., & Marx, B. P. (2015) · American Journal of Men s Health · doi:10.1177/1557988315624508 · Cited by 31 · see citing works
Goldman-Mellor, S. J., Phillips, D., Brown, P., Gruenewald, P. J., Cerdá, M., & Wiebe, D. J. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201900153 · Cited by 21 · see citing works
Sijbrandij, M., Farooq, S., Bryant, R. A., Dawson, K. S., Hamdani, S. U., Chiumento, A., Minhas, F., Saeed, K., Rahman, A., & van Ommeren, M. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1922-5 · Cited by 14 · see citing works
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Na, E., Lee, K., Jeon, B.-H., Jo, C., Kwak, U.-H., Jeon, Y., Yang, K., Lee, E. J., & Jeong, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192416434 · Cited by 21 · see citing works
“Furthermore, adolescents are severely negatively affected on their mental health development and growth due to DEA behaviors [13].”
Background
- Authors
- Steinhoff, A., Ribeaud, D., Kupferschmid, S., Raible-Destan, N., Quednow, B. B., Hepp, U., Eisner, M., & Shanahan, L.
- Affiliations
- University of Zurich (CH)
- Integrierte Psychiatrie Winterthur (CH)
- Corresponding author
- Steinhoff, Annekatrin
- ORCID
- Venue
- European Child & Adolescent Psychiatry
- Published
- 2020-06-22
- Volume
- 30
- Issue
- 6
- Pages
- 937-951
- ISSN
- 1018-8827 (ISSN-L)
- 1435-165X
- PMC
- PMC8140957
- OpenAlex
- W3036694008
- Cited by
- 100
- References
- 62
- Citations by year
- 2026: 16 · 2025: 16 · 2024: 18 · 2023: 17 · 2022: 24 · 2021: 8 · 2020: 1
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Child & Adolescent Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Repository for Publications and Research Data (ETH Zurich) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- Apollo (cc-by)
- Apollo
- ETH Zürich Research Collection (cc-by)
- Funders
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (100014_132124, 100014_149979, 10FI14_170409)
- Jacobs Foundation (2010-888, 2013-1081-1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Keywords
- self-harm, adolescent self-injury, early adulthood, sex differences, recurrence, mental health service utilization, hospitalization, internalizing problems, externalizing problems, community adolescents
- MeSH terms
- Adolescent, Adult, Age Factors, Female, Humans, Longitudinal Studies, Male, Prospective Studies, Recurrence, Cohort Studies, Self-Injurious Behavior, Young Adult
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