The present study examines reasons for adolescent deliberate self-harm. A cross-sectional survey using an anonymous self-report questionnaire was carried out in seven countries (Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway). Data on 30,477 school pupils between the ages of 14-17 were analysed. Past year and lifetime deliberate self-harm were assessed, along with the self-reported reasons for deliberate self-harm. The results showed that 'wanted to get relief from a terrible state of mind' and 'wanted to die' were most commonly reported. Principal component analysis indicated two underlying dimensions in the reasons for deliberate self-harm, i.e. a cry of pain motive and/or a cry for help motive. The majority of self-harmers reported at least one cry of pain motive ('to die', 'to punish myself', and 'to get relief from a terrible state of mind') and an additional cry for help motive ('to show how desperate I was feeling', to frighten someone', 'to get my own back on someone', 'to find out whether someone really loved me', and 'to get some attention'). Females reported more reasons than males. Only females showed an age difference, with girls aged 16-17 more frequently reporting a cry for help motive. There was considerable consistency in choice of motives across countries and genders. Systematic assessment of the reasons for deliberate self-harm can help clinicians to better understand the meaning of self harming behaviour, select appropriate treatment, suggest alternative coping strategies, and hopefully prevent future suicidal behaviour.

The present study examines the association between repetition of suicide attempts and sociodemographic and psychopathological characteristics of patients during a 5-year follow-up period. Participants were 874 suicide attempters referred to the University Hospital of Ghent, among whom 361 (41.3%) patients were available for follow-up analysis. Within 5 years, 29.2% of those admitted for an index suicide attempt repeated non-fatal suicidal behavior. Repetition of suicidal behavior was associated with high scores on measures of psychopathology. In addition, the risk of repetition was increased if the patient was female, aged between 20 and 49, and had a lower education. Multivariate analysis showed significant results for age, the Buglass & Horton Risk of Repetition Scale and for anxiety. Repetition of suicidal behavior is associated with high anxiety, severe depression, more psychiatric symptoms and is increased in young patients.

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