Adolescent self-harm and suicidal thoughts in the ALSPAC cohort: a self-report survey in England
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BACKGROUND: Substantial numbers of adolescents self-harm, but the majority of cases do not reach the attention of medical services, making community studies essential. The prevalence of suicidal thoughts and plans at this age, and the inter-relationships between suicidal thoughts, plans and self-harm remain largely unexplored. METHOD: Cross-sectional analysis of self-reported questionnaire data collected from members of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, England. Respondents (n = 4810) were aged 16-17 years old and have been followed up since birth. RESULTS: Altogether 905 (18.8%) respondents had ever self-harmed. The prevalence of lifetime self-harm was higher in females (25.6%) than males (9.1%). The most commonly used method was self-cutting: this was used alone or in combination in 73.5% of episodes, compared to 10.0% who took overdoses alone or in combination with other methods. Of those who reported self-harm, 25.3% wanted to die during the most recent episode. Concurrent depression was associated with a greatly increased risk of self-harm (OR 5.43). Only 12.4% of participants sought medical help following their most recent episode of self-harm, although this figure was higher (30.1%) where self-harm was carried out with desire to die. Of the whole sample, 15.8% had ever thought of killing themselves, and 4.3% had ever made plans to kill themselves. Compared to those who had never self-harmed, those who had self-harmed but not wanted to die during the most recent episode were at increased risk of ever having had suicidal thoughts (37.6% compared to 7.8% χ2 =102.3, p < 0.001) and ever making suicidal plans (8.7% compared to 0.7%, χ2 =166.9, p < 0.001). As the frequency of self-harm increased, so did the risk of suicidal thoughts and plans. CONCLUSIONS: Self-harm and suicidal thoughts are common among 16/17 year olds. Although the majority of self-harm behaviour is not accompanied by a desire to die, all self-harm regardless of motivation is associated with increased risk of suicidal thoughts and plans, particularly when it is carried out repeatedly.
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Many of those who go on to die by suicide will not have interacted with mental health services.
“However, it is challenging to detect and intervene early, as many of those who go on to die by suicide will not have interacted with mental health services [2].”
From Social media, internet use and suicide attempts in adolescents (2019) · cites this paper as [2]
The Discussion (Main findings; page unavailable) reports that only one third of adolescents who self-harmed with a desire to die sought medical help afterward, suggesting that many such episodes remain hidden from medical services. The study does not establish whether people who later die by suicide had previously interacted with mental health services; its outcome is self-reported self-harm, not subsequent suicide deaths. (LLM, conf=0.87)
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References 38 · Cited by 148
- Authors
- Kidger, J., Heron, J., Lewis, G., Evans, J., & Gunnell, D.
- Affiliations
- University of Bristol (GB)
- Corresponding author
- Kidger, Judi
- Venue
- BMC Psychiatry
- Published
- 2012-06-27
- Volume
- 12
- Issue
- 1
- Pages
- 69-69
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC3439325
- OpenAlex
- W2158399066
- Cited by
- 148
- References
- 38
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 18 · 2023: 11 · 2022: 6 · 2021: 17 · 2020: 11 · 2019: 11 · 2018: 14 · 2017: 7 · 2016: 12 · 2015: 9 · 2014: 14 · 2013: 6
- FWCI
- 10.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Explore Bristol Research (submittedVersion)
- Funders
- Wellcome Trust (092731)
- National Institute for Health and Care Research
- University of Bristol (092731)
- Medical Research Council (092731)
- 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
- adolescent self-harm, suicidal ideation, suicide planning, self-cutting, depression, desire for death, gender differences, ALSPAC birth cohort, adolescents
- MeSH terms
- Adolescent, Adolescent Behavior, Cross-Sectional Studies, England, Female, Humans, Longitudinal Studies, Male, Motivation, Surveys and Questionnaires, Risk Factors, Sex Factors, Suicide, Attempted, Prevalence, Self-Injurious Behavior, Self Report, Suicidal Ideation
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