Dual-harm in adolescence and associated clinical and parenting factors

Abstract

Purpose Both aggression toward others and self peak in adolescence and interpersonal violence and suicide are among the leading causes of death in young people worldwide. Individuals who show both aggression toward others and self, i.e. dual-harm, may experience the worst outcomes. The current study investigates clinical and parenting factors associated with dual-harming in adolescence, to provide new insights for prevention and treatment. Methods In a prospective cohort of adolescents, oversampled on emotional and behavioral problems (n = 1022; aged 12–17 years), we investigated co-occurrence in harm toward others and self and presented findings in an area-proportional Euler diagram. Four harm groups (no harm, other-harm, self-harm, and dual-harm) were compared on intelligence scores, general functioning, emotional and behavioral problems, substance use, parental hostility, and harsh parenting with ANCOVAs and logistic regressions. Results In adolescents that other-harmed, the risk of self-harm was 1.9 times higher than for those who did not harm others. Dual-harm adolescents reported worse overall functioning, more emotional and behavioral problems, more parental hostility and harshness, and were more likely to use substances than those who did not engage in aggressive behaviors. No evidence of differences in intelligence scores between groups were found. Conclusion These findings highlight a vulnerable group of adolescents, at risk of future suicide, violent offending, and the development of severe psychopathology. Dual-harm is a promising marker for early intervention and referral to specialized mental health professionals. Further research is needed to examine underlying pathways and risk factors associated with persistent dual-harm trajectories into adulthood.

Probing dual harm and non‐violent misconduct among imprisoned adult men in Northern Ireland

“…speech, language, communication and learning difficulties) are understood and can express themselves can lead them to feel frustrated and lash out at themselves and others (Bryan, 2004; Houston & Butler, 2019). The finding that those who passed a higher proportion of prison drug tests were more likely to be in the ‘Self‐Harm only’ and ‘No Harm’ groups than the ‘Dual Harm’ group also corresponds to past studies linking dual harm and substance use in the general population (Durham, 2021; Richmond‐Rakerd et al, 2019; Spaan et al, 2022; Wang et al, 2022). The present study then confirms the generalisability of some of the risk factors for dual harm in prison identified in previous research to NI, as well as the relevance of some of the risk factors associated with dual harm among the general population to the prison context.…”

“…Common risk factors for dual harm compared to self‐harm only, violence only, or no harm include having more negative childhood experiences, impulsivity, poor self‐control, emotional dysregulation, genes related to dysfunctional serotongergic systems, and higher rates of substance dependence and psychotic symptoms (Durham, 2021; Richmond‐Rakerd et al, 2019; Spaan et al, 2022; Wang et al, 2022). Research also suggests that people who dual harm are more likely to experience anger, psychopathology, as well as difficulties regulating emotions and behaviours (Durham, 2021; Spaan et al, 2022; Wang et al, 2022). These characteristics may help explain why people who dual harm may be found guilty of committing more misconduct than other groups in prison.…”

Investigating dual harm and misconduct in Northern Ireland: A 1‐year follow‐up

“…In contrast, prison drug use is often attributed to a desire to ‘escape’ the monotony of prison conditions by relieving boredom, occupying time, and giving people something to do (Wakeling & Lynch, 2020). In these confrontational, challenging, distressing, and/or threatening interactions, it may not be surprising for people who dual harm to experience difficulties regulating their responses to such encounters, given past research indicating they report poorer self‐control, greater levels of impulsivity, and more emotional and behavioural dysregulation (Durham, 2021; Richmond‐Rakerd et al, 2019; Spaan et al, 2022; Wang et al, 2022). Similarly, a history of aggression and violence has been associated with maladaptive emotional regulation and poor response inhibition (Hosie et al, 2022; Roberton et al, 2014).…”

“…Slade et al (2020) suggest that people who dual harm have difficulty self‐regulating their reactive emotions towards distressing situations, contributing to their disproportionate involvement in misconduct. Studies indicate that people who dual harm have poor self‐control, report impulsivity, and experience difficulties regulating emotions and behaviours (Durham, 2021; Richmond‐Rakerd et al, 2019; Spaan et al, 2022; Wang et al, 2022). Sahlin et al (2017) propose violence towards the self or others can serve a short‐term emotional‐regulative function for these individuals by reducing unwanted experiences that may arise from internal or external threats (e.g.…”

Childhood predictors of self-harm, externalised violence and transitioning to dual harm in a cohort of adolescents and young adults

“…In general population settings, where dual harm outcomes were identified from health services and criminal justice system records, dual harm risks were higher among people whose parents had experienced social adversity, including unemployment, substance misuse, self-harm and violence (Carr et al, 2020 ). In a Dutch community-based study, which was oversampled for emotional and behavioural symptoms, young people who had engaged in dual harm reported more substance misuse, parental hostility and more emotional and behavioural problems (Spaan et al, 2022 ). In summary, a number of adverse experiences and risk factors in childhood and adolescence have been found to be linked with self-harm and violence, with some also associated with increased risks of dual harm.…”