The impact of child maltreatment on non-suicidal self-injury: data from a representative sample of the general population

Brown, Rebecca C.; Heines, Stefanie; Witt, Andreas; Bräehler, Elmar; Fegert, Jöerg M.; Harsch, Daniela; Plener, Paul L.

doi:10.1186/s12888-018-1754-3

Cited by 92 publications

(95 citation statements)

References 35 publications

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“…A third possibility is that prior studies may be detecting inflammatory consequences of self-harm as opposed to antecedents, as the act of self-harm itself will trigger an immune response and thus inflammation. Much of the evidence for the inflammation-self-harm relationship comes from crosssectional studies in adult populations, which are unable to establish the direction of association (Brundin, Erhardt, Bryleva, Achtyes, & Postolache, 2015). Our study is also novel in that we explored associations with self-harm regardless of suicidal intent, whereas prior research has focused on suicidal behaviour.…”

Section: Discussionmentioning

confidence: 94%

“…Exposure to adverse childhood experiences (ACEs) is a well-established risk factor for self-harm (Bj€ orkenstam, Kosidou, & Bj€ orkenstam, 2016;Brown et al, 2018;Cha et al, 2018;Dube et al, 2001;Hughes et al, 2017;Liu, Scopelliti, Pittman, & Zamora, 2018); however, the psychological and biological processes underlying this relationship are unclear. Inflammation has been postulated as a potential candidate mechanism, as a growing number of studies have found an association between inflammatory markers and both ACEs (Baumeister, Akhtar, Ciufolini, Pariante, & Mondelli, 2016;Coelho, Viola, Walss-Bass, Brietzke, & Grassi-Oliveira, 2014) and self-harm or suicide (Black & Miller, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Pathways between early‐life adversity and adolescent self‐harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children

Russell

Heron

Gunnell

et al. 2019

Child Psychology Psychiatry

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Background Adverse childhood experiences (ACEs) such as physical and emotional abuse are strongly associated with self‐harm, but mechanisms underlying this relationship are unclear. Inflammation has been linked to both the experience of ACEs and self‐harm or suicide in prior research. This is the first study to examine whether inflammatory markers mediate the association between exposure to ACEs and self‐harm. Methods Participants were 4,308 young people from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population‐based birth cohort in the United Kingdom. A structural equation modelling approach was used to fit a mediation model with the number of ACEs experienced between ages 0 and 9 years old (yo), levels of the inflammatory markers interleukin‐6 and C‐reactive protein measured at 9.5 yo, and self‐harm reported at 16 yo. Results The mean number of ACEs young people experienced was 1.41 (SE 0.03). Higher ACE scores were associated with an increased risk of self‐harm at 16 yo (direct effect relative risk (RR) per additional ACE 1.11, 95% CI 1.05, 1.18, p < 0.001). We did not find evidence of an indirect effect of ACEs on self‐harm via inflammation (RR 1.00, 95% CI 1.00, 1.01, p = 0.38). Conclusions Young people who have been exposed to ACEs are a group at high risk of self‐harm. The association between ACEs and self‐harm does not appear to be mediated by an inflammatory process in childhood, as indexed by peripheral levels of circulating inflammatory markers measured in childhood. Further research is needed to identify alternative psychological and biological mechanisms underlying this relationship.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Pathways between early‐life adversity and adolescent self‐harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children

Russell

Heron

Gunnell

et al. 2019

Child Psychology Psychiatry

View full text Add to dashboard Cite

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“…Self-injury is thought to be a moderately stable behavior [24], but we do not know whether patterns of recurrence change with increasing age, whether recurrence differs by sex, and what sociodemographic factors, aspects of selfinjury (e.g., age of onset, frequency), and associated mental health problems (e.g., depressive symptoms, suicidal ideation) predict recurrence of self-injury between early adolescence and early adulthood. It is well known that childhood adversity predicts adolescent self-injury, and some of these effects could be mediated by depressive and anxiety symptoms [25,26]. However, prospective studies on whether childhood internalizing symptoms increase the risk of recurrence of self-injury over prolonged periods of adolescence and until early adulthood are currently lacking.…”

Section: Age-related Course and Recurrence Of Self-injurymentioning

confidence: 99%

Self-injury from early adolescence to early adulthood: age-related course, recurrence, and services use in males and females from the community

Steinhoff

Ribeaud

Kupferschmid

et al. 2020

Eur Child Adolesc Psychiatry

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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, agerelated 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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“…The findings add to prior research, which has revealed that various forms of chronic family adversity, including child maltreatment, relational trauma, lack of support, and hostility, increase the risk of self-injury in adolescents and young adults. These effects have been found to be partially mediated by depressive symptoms, anxiety, and low self-esteem (19,23,47). Research has also shown that more sporadic events involving loss and instability in the family increase young people's risk of suicidality (28), which is a well-known correlate of self-injurious behavior (48,49).…”

Section: Contexts Of Stressful Life Eventsmentioning

confidence: 99%

Stressful Life Events in Different Social Contexts Are Associated With Self-Injury From Early Adolescence to Early Adulthood

et al. 2020

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Self-injury often arises as a maladaptive coping strategy used to alleviate distress. Past research has typically examined how chronic stressors in a specific context are associated with self-injury. Little is known about the unique and cumulative associations between acute stressful life events that occur in different social contexts and self-injury among adolescents. This is especially the case for males, for whom the etiology of self-injury is understudied. We examine the unique and cumulative contributions of stressful life events in the contexts of adolescents' school life, peer networks, intimate relationships, and family life to self-injurious behavior in males and females from the community. Our data comes from a prospective-longitudinal community-representative study, the Zurich Project on the Social Development from Childhood to Adulthood (z-proso). Our sample consists of 1,482 adolescents (52% male) assessed at ages 13, 15, 17, and 20. At each age, adolescents reported whether they had engaged in self-injury during the previous month. They also reported stressful life events in the school, peer, intimate relationships, and family contexts, typically since the last assessment. Stressful life events in the peer context were consistently associated with self-injury. In the contexts of school, intimate relationships, and family, some associations were age-or sex-specific. For example, mid-adolescent females were more likely than mid-adolescent males to use self-injury when faced with stressful events in school and intimate relationships. With respect to risk accumulation, females' risk of self-injury increased with each additional life event between the ages of 13 and 17, beginning at 2+ events. This pattern did not hold for males. In early adulthood, 4+ life events were associated with an increased risk of self-injury, which suggests that the thresholds for the number of life events needed to trigger self-injury increased from adolescence to young adulthood. Our findings suggest that reducing risk of stressful events in different social contexts, and improving young people's coping skills could help reduce their risk of self-injury. New or revised theoretical models may be needed to better understand the emergence of self-injury in males.

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The impact of child maltreatment on non-suicidal self-injury: data from a representative sample of the general population

Cited by 92 publications

References 35 publications

Pathways between early‐life adversity and adolescent self‐harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children

Pathways between early‐life adversity and adolescent self‐harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children

Self-injury from early adolescence to early adulthood: age-related course, recurrence, and services use in males and females from the community

Stressful Life Events in Different Social Contexts Are Associated With Self-Injury From Early Adolescence to Early Adulthood

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