Deliberate self harm in adolescents: self report survey in schools in England
Open accessAbstract
Objective: To determine the prevalence of deliberate self harm in adolescents and the factors associated with it. Design: Cross sectional survey using anonymous self report questionnaire. Setting: 41 schools in England. Participants: 6020 pupils aged 15 and 16 years. Main outcome measure: Deliberate self harm. Results: 398 (6.9%) participants reported an act of deliberate self harm in the previous year that met study criteria. Only 12.6% of episodes had resulted in presentation to hospital. Deliberate self harm was more common in females than it was in males (11.2% v 3.2%; odds ratio 3.9, 95% confidence interval 3.1 to 4.9). In females the factors included in a multivariate logistic regression for deliberate self harm were recent self harm by friends, self harm by family members, drug misuse, depression, anxiety, impulsivity, and low self esteem. In males the factors were suicidal behaviour in friends and family members, drug use, and low self esteem. Conclusions: Deliberate self harm is common in adolescents, especially females. School based mental health initiatives are needed. These could include approaches aimed at educating school pupils about mental health problems and screening for those at risk. What is already known on this topic: Deliberate self harm is a common reason for presentation of adolescents to hospital Community studies from outside the United Kingdom have shown much greater prevalence of self harm in adolescents than hospital based studies What this study adds: Deliberate self harm defined according to strict criteria is common in adolescents, especially females Associated factors include recent awareness of self harm in peers, self harm by family members, drug misuse, depression, anxiety, impulsivity, and low self esteem
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The data corroborates the association between depression, anxiety and self-injury.
“the data corroborates the association between depression, anxiety and self-injury [73, 93–101]”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [94]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Youth Risk Behavior Surveillance — United States, 1999
Kann, L. K., Kinchen, S. A., Williams, B. I., Ross, J. G., Lowry, R., Grunbaum, J. A., & Kolbe, L. J. (2000) · Journal of School Health · doi:10.1111/j.1746-1561.2000.tb07252.x · Cited by 1,633 · see citing works
Psychiatric Diagnosis in Child and Adolescent Suicide
Shaffer, D. (1996) · Archives of General Psychiatry · doi:10.1001/archpsyc.1996.01830040075012 · Cited by 1,250 · see citing works
Psychiatric Risk Factors for Adolescent Suicide: A Case-Control Study
Brent, D. A., Perper, J. A., MORITZ, G., ALLMAN, C., FRIEND, A., ROTH, C., SCHWEERS, J., BALACH, L., & BAUGHER, M. (1993) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199305000-00006 · Cited by 863 · see citing works
Suicidal Behavior Runs in Families: A Controlled Family Study of Adolescent Suicide Victims
Brent, D. A. (1996) · Archives of General Psychiatry · doi:10.1001/archpsyc.1996.01830120085015 · Cited by 516 · see citing works
A User's Guide to MLwiN version 2.0
Rasbash, J., Steele, F., Browne, W. J., & Goldstein, H. (2004) · Bristol Research (University of Bristol) · Cited by 457 · see citing works
Biological and chemical terrorism: strategic plan for preparedness and response.
Groseclose, S. L., Gray, E. K., Gunter, E. W., Johnson, A. B., Wilson, A. L., Ashford, D. A., Craven, R. B., Gaynes, R. P., Morse, S., Peters, C. J., et al. (2000) · MMWR Morbidity and Mortality Weekly Report · Cited by 355 · see citing works
Validation of the Hospital Anxiety and Depression Scale for use with adolescents
White, D., Leach, C., Sims, R., Atkinson, M. A., & Cottrell, D. J. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.5.452 · Cited by 352 · see citing works
British Educational Research Association
Stones, E. (1975) · Journal of Education for Teaching International Research and Pedagogy · doi:10.1080/0260747750010113 · Cited by 334 · see citing works
Development of a new self-report questionnaire to measure self esteem
Robson, P. (1989) · Psychological Medicine · doi:10.1017/s003329170001254x · Cited by 232 · see citing works
Deliberate self-harm in adolescents in Oxford, 1985–1995
Hawton, K., Fagg, J., Simkin, S., Bale, E., & Bond, A. (2000) · Journal of Adolescence · doi:10.1006/jado.1999.0290 · Cited by 150 · see citing works
Self-citationHawton, K., Fagg, J., & Simkin, S. (1996) · British Journal of Psychiatry · doi:10.1192/bjp.169.2.202 · Cited by 150 · see citing works
Self-citationSuicide clusters: A critical review
Gould, M. S., Wallenstein, S., & Davidson, L. (1989) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1989.tb00363.x · Cited by 142 · see citing works
Hawtdn, K., Houston, K., & Shepperd, R. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.3.271 · Cited by 142 · see citing works
Correlates and Short-Term Course of Self-Poisoning in Adolescents
Kerfoot, M., Dyer, E. J., Harrington, V., Woodham, A., & Harrington, R. (1996) · The British Journal of Psychiatry · doi:10.1192/bjp.168.1.38 · Cited by 132 · see citing works
Plutchik, R., van Praag, H. M., Picard, S., Conte, H. R., & Korn, M. L. (1989) · Psychiatry Research · doi:10.1016/0165-1781(89)90011-5 · Cited by 104 · see citing works
Adolescents : enquête nationale
Choquet, M., & Ledoux, S. (1994) · INSERM eBooks · Cited by 103 · see citing works
Manifest Predictors of Past Suicide Attempts in a Population of Icelandic Adolescents
Bjarnason, T., & Thorlindsson, T. (1994) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1994.tb00815.x · Cited by 69 · see citing works
Attempted Suicide Among High School Students—United States, 1990
(1991) · JAMA · doi:10.1001/jama.1991.03470140023008 · Cited by 64 · see citing works
Shaffer, D., & Gould, M. S. (2000) · doi:10.1002/9780470698976.ch37 · Cited by 36 · see citing works
Suicide Attempts in Adolescence—“Self-Report” and “Other-Report”
de Wilde, E. J., & Kienhorst, I. (1995) · Crisis · doi:10.1027/0227-5910.16.2.59 · Cited by 35 · see citing works
Postvention after teenage suicide: an Australian experience
Hazell, P. (1991) · Journal of Adolescence · doi:10.1016/0140-1971(91)90002-9 · Cited by 32 · see citing works
A symbiosis of paper and electronic publishing, serving the interests of the Journal's readers
Chalmers, I. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.1.1 · Cited by 13 · see citing works
Flagged first, then by citations
2 of the 25 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Dean AG, Dean JA, Coulombier D, Brendel KA, Smith DC, Burton AH, et al. EpiInfo version 6: a word processing database and statistics program for epidemiology on microcomputers. Atlanta, GA: Centers for Disease Control and Prevention, 1994. 15 SPSS. SPSS base 9.0 users' guide. New Jersey: Prentice Hall, 1999.
Cited by
Sorted by citations
Self-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
Self-citationSwannell, 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
Almeida, J., Johnson, R. M., Corliss, H. L., Molnar, B. E., & Azrael, D. R. (2009) · Journal of Youth and Adolescence · doi:10.1007/s10964-009-9397-9 · Cited by 968 · see citing works
“Self-harm —which includes self-inflicted painful acts such as cutting or burning oneself—is increasingly recognized as a strong risk factor for suicide and suicide attempts, and is also a symptom of depression (Hawton et al. 2002, 2003).”
BackgroundCharacteristics and functions of non-suicidal self-injury in a community sample of adolescents
Lloyd‐Richardson, E. E., Perrine, N., Dierker, L., & Kelley, M. L. (2007) · Psychological Medicine · doi:10.1017/s003329170700027x · Cited by 929 · see citing works
“Hawton et al. (2002) reported that 6.9% (n=398) of their sample of adolescents recruited in the UK engaged in NSSI within the previous year.”
BackgroundInfluentialSelf-injurious behaviors in a college population
Whitlock, J., Eckenrode, J., & Silverman, D. (2006) · PEDIATRICS · doi:10.1542/peds.2005-2543 · Cited by 874 · see citing works
Klonsky, E. D., May, A. M., & Glenn, C. R. (2013) · Journal of Abnormal Psychology · doi:10.1037/a0030278 · Cited by 692 · see citing works
“The PHQ-A has demonstrated excellent correspondence with structured interview measures of Axis I disorders (Johnson et al., 2002).”
MethodJacobson, C. M., & Gould, M. S. (2007) · Archives of Suicide Research · doi:10.1080/13811110701247602 · Cited by 694 · see citing works
“Further, many research studies have failed to separate acts of non-suicidal self-injury and suicidal behaviors, ie, behaviors engaged in with the intent to die as a result of the act (eg, Hawton, Rodham, Evens et al, 2002 ; Hawton, Sumkin, Bale et al, 2004 ; Hurry, 2000 ).”
BackgroundSex differences in impulsivity: A meta-analysis.
Cross, C. P., Copping, L. T., & Campbell, A. (2011) · Psychological Bulletin · doi:10.1037/a0021591 · Cited by 866 · see citing works
Skegg, K. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67600-3 · Cited by 630 · see citing works
Mehlum, L., Tørmoen, A. J., Ramberg, M., Haga, E., Diep, L. M., Laberg, S., Larsson, B. S., Stanley, B. H., Miller, A. L., Sund, A. M., et al. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2014.07.003 · Cited by 616 · 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
“10,11 Injury to the skin through cutting and burning was the commonest method of self-harm during adolescence, although by young adulthood no one form of self-harm predominated.”
BackgroundMadge, 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
Self-citationLim, K.-S., Wong, C. H. J., McIntyre, R. S., Wang, J., Zhang, Z., Tran, B. X., Tan, W., Ho, C. S. H., & Ho, R. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16224581 · Cited by 594 · see citing works
“083 NA NA Hawton [61] 2002 United Kingdom 5801 NA 0.”
BackgroundInfluentialThe Prevalence of Suicidal Phenomena in Adolescents: A Systematic Review of Population‐Based Studies
Evans, E., Hawton, K. E., Rodham, K., Psychol, C., & Deeks, J. J. (2005) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2005.35.3.239 · Cited by 552 · see citing works
Self-citationNonsuicidal Self-injury in a College Population: General Trends and Sex Differences
Whitlock, J. L., Muehlenkamp, J. J., Purington, A., Eckenrode, J. J., Barreira, P. J., Abrams, G. B., Marchell, T. C., Kress, V. E. W., Girard, K., Chin, C., et al. (2011) · Journal of American College Health · doi:10.1080/07448481.2010.529626 · Cited by 434 · see citing works
Brunner, R. M., Kaess, M., Parzer, P., Fischer, G., Carli, V., Hoven, C. W., Wasserman, C., Sarchiapone, M., Resch, F., Apter, A. S., et al. (2013) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12166 · Cited by 433 · see citing works
Risk factors and correlates of deliberate self-harm behavior: A systematic review
Fliege, H., Lee, J.-R., Grimm, A., & Klapp, B. F. (2009) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2008.10.013 · Cited by 428 · see citing works
“In adolescents, six studies found higher self-harm rates for females [45,87,92,93,102,109].”
BackgroundInfluentialBrunner, R. M., Parzer, P., Haffner, J., Steen, R., Roos, J., Klett, M., & Resch, F. (2007) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.161.7.641 · Cited by 415 · see citing works
Evans, E., Hawton, K., & Rodham, K. (2004) · Clinical Psychology Review · doi:10.1016/j.cpr.2004.04.005 · Cited by 541 · see citing works
Self-citationDaine, K., Hawton, K. E., Singaravelu, V., Stewart, A., Simkin, S., & Montgomery, P. (2013) · PLoS ONE · doi:10.1371/journal.pone.0077555 · Cited by 369 · see citing works
“This is particularly important given evidence that exposure to others who are self-harming is a major risk factor for self-harm [36,37,38], the fact that such exposure may occur through the internet, and that exposure to self-harm and suicide on the internet may be associated with potentially more dangerous methods of…”
BackgroundSelf-citationRodham, K., Hawton, K. E., & Evans, E. (2004) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200401000-00017 · Cited by 352 · see citing works
Self-citationPlener, P. L., Libal, G., Keller, F., Fegert, J. M., & Muehlenkamp, J. J. (2009) · Psychological Medicine · doi:10.1017/s0033291708005114 · Cited by 336 · see citing works
“Although there are plenty of study-specific data on the prevalence of NSSI in adolescents from the USA, Canada, Australia and the UK (Patton et al. 1997; Hawton et al. 2002 ; Muehlenkamp & Gutierrez, 2004 ; NadaRaja et al. 2004 ; Skegg et al. 2004 ; Laye-Gindhu & Schonert-Reichel, 2005), data on adolescent NSSI are sc…”
BackgroundClinical and social outcomes of adolescent self harm: population based birth cohort study
Mars, B., Heron, J., Crane, C., Hawton, K., Lewis, G., Macleod, J., Tilling, K., & Gunnell, D. (2014) · BMJ · doi:10.1136/bmj.g5954 · Cited by 311 · see citing works
Self-citationHawton, K., Bergen, H. A., Kapur, N., Cooper, J., Steeg, S., Ness, J., & Waters, K. (2012) · Journal of Child Psychology and Psychiatry and Allied Disciplines · doi:10.1111/j.1469-7610.2012.02559.x · Cited by 307 · see citing works
Self-citationSuicide and deliberate self harm in young people
Hawton, K., & James, A. (2005) · BMJ · doi:10.1136/bmj.330.7496.891 · Cited by 309 · see citing works
Self-citationThe relationship between self-injurious behavior and suicide in a young adult population.
Whitlock, J., & Knox, K. (2007) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.161.7.634 · Cited by 308 · see citing works
Geulayov, G., Casey, D., McDonald, K. C., Foster, P., Pritchard, K., Wells, C., Clements, C., Kapur, N., Ness, J., Waters, K., et al. (2017) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30478-9 · Cited by 299 · see citing works
Self-citationDeliberate self‐harm in adolescents: a study of characteristics and trends in Oxford, 1990–2000
Hawton, K. E., Hall, S., Simkin, S., Bale, L., Bond, A., Codd, S., & Stewart, A. (2003) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00200 · Cited by 295 · see citing works
Self-citationWho are the kids who self‐harm? An Australian self‐report school survey
Leo, D. D., & Heller, T. (2004) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2004.tb06204.x · Cited by 287 · see citing works
Robinson, J., Cox, G., Malone, A., Williamson, M. K., Baldwin, G., Fletcher, K., & O’Brien, M. (2012) · Crisis · doi:10.1027/0227-5910/a000168 · Cited by 286 · see citing works
Nonsuicidal self-harm in youth: a population-based survey
Nixon, M. K., Cloutier, P., & Jansson, S. M. (2007) · Canadian Medical Association Journal · doi:10.1503/cmaj.061693 · Cited by 283 · see citing works
“Impulsive behaviour has been noted to be strongly associated with nonsuicidal self-harm.(4,7) We found that slightly more than half of youth who reported ever self-harming had sought help for this behaviour.”
BackgroundResultInfluentialEvans, E., Hawton, K. E., & Rodham, K. (2005) · Journal of Adolescence · doi:10.1016/j.adolescence.2004.11.001 · Cited by 274 · see citing works
Self-citationA multimethod analysis of impulsivity in nonsuicidal self-injury.
Glenn, C. R., & Klonsky, E. D. (2010) · Personality Disorders Theory Research and Treatment · doi:10.1037/a0017427 · Cited by 273 · see citing works
“In addition, consistent with previous research that self-injurers exhibit poorer planning than noninjurers (Evans et al., 1996; Hawton et al., 2002; Herpertz et al., 1997), it is predicted that self-injurers will exhibit less Premeditation than noninjurers.”
BackgroundResultInfluentialKokkevi, A., Rotsika, V., Arapaki, A., & Richardson, C. (2011) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2011.02457.x · Cited by 272 · see citing works
“Suicide ideation and attempts might also be the expression of depressive disorder (Hacker et al., 2006; Hawton et al., 2002; Kandel, Raveis, & Davies, 1991; Laukkanen et al., 2009; Rey Gex et al., 1998), or of low impulse control or some other mental disorder (Gould et al., 1998; Haw & Hawton,…”
BackgroundAn Examination of Nonsuicidal Self-Injury Among College Students
Heath, N. L., Toste, J. R., Nedecheva, T., & Charlebois, A. (2008) · Journal of Mental Health Counseling · doi:10.17744/mehc.30.2.8p879p3443514678 · Cited by 271 · see citing works
Interventions for self-harm in children and adolescents
Hawton, K., Witt, K. G., Taylor Salisbury, T. L., Arensman, E., Gunnell, D., Townsend, E., van Heeringen, K., & Hazell, P. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012013 · Cited by 261 · see citing works
Self-citationLundh, L., KARIM, J., & Quilisch, E. (2007) · Scandinavian Journal of Psychology · doi:10.1111/j.1467-9450.2007.00567.x · Cited by 258 · see citing works
Mehlum, L. I., Ramberg, M., Tørmoen, A. J., Haga, E., Diep, L. M., Stanley, B., Miller, A. L., Sund, A. M., & Grøholt, B. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2016.01.005 · Cited by 253 · see citing works
O’Connor, R. C., Rasmussen, S. A., & Hawton, K. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.09.008 · Cited by 237 · see citing works
“6% for Scotland and England, respectively) using the same methodology (Hawton et al., 2002; O’Connor, Fraser, et al., 2009; O’Connor, Rasmussen, & Hawton, 2009; O’Connor, Rasmussen, Miles, et al., 2009).”
BackgroundMethodInfluentialSelf-citationGiletta, M., Scholte, R. H. J., Engels, R. C. M. E., Ciairano, S., & Prinstein, M. J. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.02.009 · Cited by 228 · see citing works
“*Corresponding author at: Department of Psychology, University of Torino, via Verdi 10, 10124, Torino, Italy.”
BackgroundResultHawton, K., & Harriss, L. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n1017 · Cited by 226 · see citing works
Self-citationSelf-harm in adolescents: self-report survey in schools in Scotland
O’Connor, R. C., Rasmussen, S. A., Miles, J., & Hawton, K. E. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.047704 · Cited by 224 · see citing works
Self-citationMicali, N., Solmi, F., Horton, N. J., Crosby, R. D., Eddy, K. T., Calzo, J. P., Sonneville, K. R., Swanson, S. A., & Field, A. E. (2015) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2015.05.009 · Cited by 248 · see citing works
Geulayov, G., Kapur, N., Turnbull, P., Clements, C., Waters, K., Ness, J., Townsend, E., & Hawton, K. E. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010538 · Cited by 213 · see citing works
Self-citationImpulsivity and self-harm in adolescence: a systematic review
Lockwood, J., Daley, D., Townsend, E., & Sayal, K. S. (2016) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-016-0915-5 · Cited by 213 · see citing works
Griffin, E., McMahon, E. M., McNicholas, F., Corcoran, P. E., Perry, I. J., & Arensman, E. (2018) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-018-1522-1 · Cited by 212 · see citing works
Distinguishing adolescents who think about self-harm from those who engage in self-harm
O'Connor, R. C., Rasmussen, S., & Hawton, K. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.bp.111.097808 · Cited by 192 · see citing works
Self-citationHelp-seeking before and after episodes of self-harm: a descriptive study in school pupils in England
Fortune, S. A., Sinclair, J., & Hawton, K. E. (2008) · BMC Public Health · doi:10.1186/1471-2458-8-369 · Cited by 208 · see citing works
“Full details of the method have been provided elsewhere [5,10].”
BackgroundMethodResultInfluentialSelf-citationDaukantaité, D., Lundh, L., Wångby‐Lundh, M., Claréus, B., Bjärehed, J., Zhou, Y., & Liljedahl, S. I. (2020) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-020-01533-4 · Cited by 210 · see citing works
Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose
Hawton, K., Bergen, H., Simkin, S., Cooper, J., Waters, K., Gunnell, D., & Kapur, N. (2010) · British Journal of Psychiatry · doi:10.1192/bjp.bp.109.070219 · Cited by 192 · see citing works
Self-citationHawton, K. E., Bale, L., Brand, F., Townsend, E., Ness, J., Waters, K., Clements, C., Kapur, N., & Geulayov, G. (2020) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(19)30373-6 · Cited by 192 · see citing works
Self-citationValencia‐Agudo, F., Burcher, G. C., Ezpeleta, L., & Kramer, T. (2018) · Journal of Adolescence · doi:10.1016/j.adolescence.2018.02.012 · Cited by 193 · see citing works
Suicidal phenomena and abuse in adolescents: a review of epidemiological studies
Evans, E., Hawton, K. E., & Rodham, K. (2005) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2004.06.014 · Cited by 189 · see citing works
Self-citationMars, B., Heron, J., Crane, C., Hawton, K. E., Kidger, J., Lewis, G., Macleod, J., Tilling, K. M., & Gunnell, D. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.07.009 · Cited by 189 · see citing works
Self-citationBjärehed, J., & Lundh, L. (2008) · Cognitive Behaviour Therapy · doi:10.1080/16506070701778951 · Cited by 183 · see citing works
“Large-scale survey studies of DSH (e.g. De Leo & Heller, 2004; Hawton et al., 2002; Patton et al., 1997) generally rely on self-report questionnaires consisting”
BackgroundPrevalence of nonsuicidal self-injury in chinese middle school and high school students
Lang, J., & Yao, Y. (2018) · Medicine · doi:10.1097/md.0000000000012916 · Cited by 176 · see citing works
Carter, G., Page, A., Large, M., Hetrick, S., Milner, A. J., Bendit, N., Walton, C., Draper, B., Hazell, P., Fortune, S., et al. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416661039 · Cited by 167 · see citing works
“Among adolescents with hospital-treated DSH, taking an overdose was the method reported in the majority of cases (Hawton et al., 2002).”
BackgroundMethodInfluentialClaes, L., Houben, A., Vandereycken, W., Bijttebier, P., & Muehlenkamp, J. J. (2009) · Journal of Adolescence · doi:10.1016/j.adolescence.2009.10.012 · Cited by 165 · see citing works
Xing, X., Tao, F., Wan, Y., Xing, C., Qi, X., Hao, J., Su, P., Pan, H., & Huang, L. (2010) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2009.12.006 · Cited by 160 · see citing works
Internet Pathways in Suicidality: A Review of the Evidence
Durkee, T., Hadlaczky, G., Westerlund, M., & Carli, V. (2011) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph8103938 · Cited by 160 · see citing works
“NSSI rates appear to be higher among females than males [11].”
BackgroundSelf-harm in older adults: systematic review
Troya, M. I., Babatunde, O. O., Polidano, K., Bartlam, B., McCloskey, E., Dikomitis, L., & Chew-Graham, C. A. (2019) · The British Journal of Psychiatry · doi:10.1192/bjp.2019.11 · Cited by 159 · see citing works
“Despite sharing some characteristics of self-harm with younger populations (e.g. higher percentage in women, those with psychiatric history and those with a previous episode(s) of self-harm), 12,59 there is an increased risk of repetition and suicide in older adults.”
BackgroundDirect and indirect forms of non-suicidal self-injury: Evidence for a distinction
Germain, S. A. S., & Hooley, J. M. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.12.050 · Cited by 158 · see citing works
“They also have decreased self-esteem (Boudewyn and Liem, 1995; Hawton et al., 2002; Lundh et al., 2007; Claes et al., 2010) and higher levels of aggression (Simeon and Favazza, 2001; Brown and Williams, 2007; Brunner et al.”
BackgroundBeing Bullied During Childhood and the Prospective Pathways to Self-Harm in Late Adolescence
Lereya, S. T., Winsper, C., Heron, J., Lewis, G., Gunnell, D., Fisher, H. L., & Dieter Wolke, C. (2013) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.03.012 · Cited by 156 · see citing works
Self-harm, suicidal ideation and suicide attempts among college students.
Toprak, S., Cetin, I., Guven, T., Can, G., & Demircan, C. (2011) · Psychiatry Research · doi:10.1016/j.psychres.2010.09.009 · Cited by 158 · see citing works
“The required sample size for expected lifetime prevalence of self-harm was 10% (Hawton et al., 2002) ±2% error with a 95% confidence interval.”
BackgroundLilley, R., Owens, D., Horrocks, J. A., House, A. O., Noble, R., Bergen, H. A., Hawton, K. E., Casey, D., Simkin, S., Murphy, E., et al. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.043380 · Cited by 153 · see citing works
Self-citationCerutti, R., Manca, M., Presaghi, F., & Gratz, K. L. (2010) · Journal of Adolescence · doi:10.1016/j.adolescence.2010.04.004 · Cited by 152 · see citing works
Pubertal stage and deliberate self-harm in adolescents
PATTON, G. C., HEMPHILL, S. A., BEYERS, J. M., BOND, L., TOUMBOUROU, J. W., McMORRIS, B. J., & CATALANO, R. F. (2007) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e31803065c7 · Cited by 148 · see citing works
“7%, which is slightly lower than previous adolescent surveys (Hawton et al., 2002; Safer, 1997).”
BackgroundAdolescent self-harm and suicidal thoughts in the ALSPAC cohort: a self-report survey in England
Kidger, J., Heron, J., Lewis, G., Evans, J., & Gunnell, D. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-69 · Cited by 148 · see citing works
“The only previous community-based study of teenage self-harm in England was conducted eight years before the present study [4].”
BackgroundResultInfluentialAggarwal, S., Patton, G., Reavley, N., Sreenivasan, S. A., & Berk, M. (2017) · International Journal of Social Psychiatry · doi:10.1177/0020764017700175 · Cited by 147 · see citing works
Adolescent self-harm: A school-based study in Northern Ireland
O׳Connor, R. C., Rasmussen, S., & Hawton, K. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.02.015 · Cited by 138 · see citing works
“%) as had previously been reported in England (13.2%, Hawton et al., 2002).”
BackgroundResultInfluentialSelf-citationMehlum, L., Ramleth, R., Tørmoen, A. J., Haga, E., Diep, L. M., Stanley, B. H., Miller, A. L., Larsson, B., Sund, A. M., & Grøholt, B. (2019) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13077 · Cited by 144 · see citing works
Reasons for adolescent deliberate self-harm: a cry of pain and/or a cry for help?
Scoliers, G., Portzky, G., Madge, N. J. H., Hewitt, A., Hawton, K. E., de Wilde, E. J., Ystgaard, M., Arensman, E., Leo, D. D., Fekete, S., et al. (2008) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-008-0469-z · Cited by 143 · see citing works
Self-citationThe co-occurrence of aggression and self-harm: Systematic literature review
O’Donnell, O., House, A. O., & Waterman, M. G. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.12.051 · Cited by 141 · see citing works
“Given that many episodes of self-harm do not lead to healthcare presentation, these figures are likely to be underestimates (Kapur et al., 1998; Hawton et al., 2002; Rodham et al., 2005; Taylor and Cameron, 1998).”
BackgroundThe association between internet addiction and self-injurious behaviour among adolescents
Lam, L. T.-M., Peng, Z., Mai, J., & Jing, J. (2009) · Injury Prevention · doi:10.1136/ip.2009.021949 · Cited by 140 · see citing works
“It has been reported that the population-based prevalence of teenage self-injurious behaviour in the UK is among the highest in Europe with a self-reported lifetime prevalence ranging from 2% to 9%.”
BackgroundLang, C. M., & Sharma-Patel, K. (2011) · Trauma Violence & Abuse · doi:10.1177/1524838010386975 · Cited by 151 · see citing works
Badoud, D., Luyten, P., Fonseca‐Pedrero, E., D, S. E. M., Fonagy, P., & Debbané, M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0145892 · Cited by 142 · see citing works
Poor sleep quality and nightmares are associated with non-suicidal self-injury in adolescents
Liu, X., Chen, H., Bo, Q.-G., Fan, F., & Jia, C.-X. (2016) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-016-0885-7 · Cited by 139 · see citing works
“In addition, given that many NSSI adolescents may never come to medical attention or result in hospitalization, selfreport measures remains a valuable source of information [48, 49].”
BackgroundSinclair, J., & Green, J. (2005) · BMJ · doi:10.1136/bmj.38441.503333.8f · Cited by 135 · see citing works
Kaess, M., Parzer, P., Haffner, J., Steen, R., Roos, J., Klett, M., Brunner, R. M., & Resch, F. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-597 · Cited by 137 · see citing works
“This is consistent with findings from many other studies that reported emotional and behavioural problems to be strongly associated with suicidal behaviour and gave evidence for a correlation of suicidal thoughts and suicide attempts with both internalizing and externalizing problems [20,38-42].”
ResultOutcomes of public concern in schizophrenia
Kooyman, I., Dean, K., Harvey, S. B., & Walsh, E. (2007) · The British Journal of Psychiatry · doi:10.1192/bjp.191.50.s29 · Cited by 138 · see citing works
Adolescents’ views on preventing self-harm
Fortune, S. A., Sinclair, J., & Hawton, K. E. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0273-1 · Cited by 136 · see citing works
“Two recent large-scale community-based surveys of self-harm in adolescents in England have shown that the prevalence of selfharm is much higher than indicated by hospital presentation alone [17, 19].”
BackgroundInfluentialSelf-citationBehind impulsive suicide attempts: Indications from a community study
Wyder, M., & De Leo, D. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.02.015 · Cited by 132 · see citing works
“73) (De Leo and Heller, 2004; Hawton et al., 2002; Kingsbury et al., 1999; Plutchik and Van Praag, 1989; Ystgaard et al., 2003).”
WILSTRAND, C., Lindgren, B., Gilje, F., & Olofsson, B. (2007) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2007.01045.x · Cited by 133 · see citing works
The Nature and Extent of Non-Suicidal Self-Injury in a Non-Clinical Sample of Young Adults
Hasking, P. A., Momeni, R., Swannell, S., & Chia, S. (2008) · Archives of Suicide Research · doi:10.1080/13811110802100957 · Cited by 132 · see citing works
The impact of self-harm by young people on parents and families: a qualitative study
Ferrey, A. E., Hughes, N. D., Simkin, S., Locock, L., Stewart, A., Kapur, N., Gunnell, D., & Hawton, K. E. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-009631 · Cited by 132 · see citing works
Self-citationMars, B., Heron, J., Biddle, L., Donovan, J., Holley, R., Piper, M., Potokar, J. P., Wyllie, C., & Gunnell, D. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.06.001 · Cited by 131 · see citing works
“The prevalence of self-harm in ALSPAC is somewhat higher than other population-based studies that have investigated selfharm (Evans et al., 2005; Hawton et al., 2002).”
BackgroundParents' perspectives on adolescent self-harm: Qualitative study
Oldershaw, A., Richards, C., Simic, M., & Schmidt, U. H. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.045930 · Cited by 131 · see citing works
Epidemiology and phenomenology of nonsuicidal self-injury.
Rodham, K., & Hawton, K. E. (2009) · American Psychological Association eBooks · doi:10.1037/11875-003 · Cited by 130 · see citing works
Self-citationStallard, P. N., Spears, M. R., Montgomery, A. A., Phillips, R., & Sayal, K. S. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-328 · Cited by 130 · see citing works
“; licensee BioMed Central Commons Attribution License (http://creativec reproduction in any medium, provided the or 9-14% [1-6].”
Decision making and problem solving in adolescents who deliberately self-harm
Oldershaw, A., Grima, E., Jollant, F., Richards, C., Simic, M., Taylor, L. M. W., & Schmidt, U. H. (2008) · Psychological Medicine · doi:10.1017/s0033291708003693 · Cited by 127 · see citing works
“The majority of the SH participants in our community sample were self-cutters and female, which reflects previous demographic observations of this group (Hawton et al. 2002) and supports the notion that these findings may be generalized.”
ResultYstgaard, M., Arensman, E., Hawton, K., Madge, N., van Heeringen, K., Hewitt, A., Jan de Wilde, E., De Leo, D., & Fekete, S. (2009) · Journal of Adolescence · doi:10.1016/j.adolescence.2008.10.010 · Cited by 127 · see citing works
“Findings from population-based studies indicate that some 10e20% of teenagers who engage in deliberate self-harm present to hospital as a result of this act (Hawton et al., 2002; Pages et al., 2004; Ystgaard et al., 2003).”
InfluentialSelf-citationThe risk-taking and self-harm inventory for adolescents: Development and psychometric evaluation.
Vrouva, I., Fonagy, P., Fearon, P. R. M., & Roussow, T. (2010) · Psychological Assessment · doi:10.1037/a0020583 · Cited by 129 · see citing works
“This is in accordance with literature in which SH is defined at the behavioral level with no reference to intent (Hawton et al., 2002), because suicidal acts and self-destructive behavior may often be interchangeable in nature.”
ResultBaetens, I., Claes, L., Hasking, P., Smits, D., Grietens, H., Onghena, P., & Martin, G. (2015) · Journal of Child and Family Studies · doi:10.1007/s10826-013-9861-8 · Cited by 122 · see citing works
“In line with Heath et al. (2009), we found no gender differences in the prevalence of NSSI although, consistent with earlier research (e.”
ResultHawton, K. E., & Harriss, L. (2008) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2008.38.6.650 · Cited by 123 · see citing works
Self-citationSocial context during non-suicidal self-injury indicates suicide risk
Glenn, C. R., & Klonsky, E. D. (2008) · Personality and Individual Differences · doi:10.1016/j.paid.2008.08.020 · Cited by 124 · see citing works
Bhui, K. S., McKenzie, K. J., & Rasul, F. (2007) · BMC Public Health · doi:10.1186/1471-2458-7-336 · Cited by 120 · see citing works
“There were only two national studies; one investigated adult admissions for self poisoning in England, Scotland and Wales [25]; the other was a self report school based study of adolescents [19].”
BackgroundMethodResultInfluentialDigital Self-Harm Among Adolescents
Patchin, J. W., & Hinduja, S. (2017) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2017.06.012 · Cited by 120 · see citing works
Personality and misconduct correlates of body modification and other cultural deviance markers
Nathanson, C., Paulhus, D. L., & Williams, K. M. (2005) · Journal of Research in Personality · doi:10.1016/j.jrp.2005.09.002 · Cited by 118 · see citing works
James, A. C., Taylor, A., Winmill, L., & Alfoadari, K. (2008) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2007.00470.x · Cited by 114 · see citing works
“To be included in the study subjects had to have a history of more than six months of severe and persistent DSH, defined after Hawton et al. (2002) as: an act with a non-fatal outcome in which an individual deliberately did one or more of the following: self cutting; jumping from a height which…”
BackgroundRobinson, J., Hetrick, S., Cox, G., Bendall, S., Yuen, H. P., Yung, A., & Pirkis, J. (2016) · Early Intervention in Psychiatry · doi:10.1111/eip.12137 · Cited by 108 · see citing works
- Authors
- Hawton, K., Rodham, K., Evans, E., & Weatherall, R.
- Affiliations
- Warneford Hospital (GB)
- University of Oxford (GB)
- Corresponding author
- Hawton, Keith
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2002-11-23
- Volume
- 325
- Issue
- 7374
- Pages
- 1207-1211
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC135492
- OpenAlex
- W2123869797
- Cited by
- 1,008
- References
- 25
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 19 · 2023: 25 · 2022: 29 · 2021: 37 · 2020: 51 · 2019: 28 · 2018: 53 · 2017: 53 · 2016: 65 · 2015: 63 · 2014: 77 · 2013: 54 · 2012: 62
- FWCI
- 26.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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, adolescents, prevalence, risk factors, sex differences, peer influence, drug abuse, depression, anxiety, impulsivity, low self-esteem, suicidal behavior, school mental health, hospital presentations
- MeSH terms
- Adolescent, Cross-Sectional Studies, England, Female, Humans, Male, Risk Factors, Prevalence, Multivariate Analysis, Self-Injurious Behavior, Sex Distribution
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
