The inter-connections between self-harm and aggressive behaviours: A general network analysis study of dual harm

Abstract

Dual harm is the co-occurrence of self-harm and aggression during an individual’s lifetime. This behaviour is especially prevalent within criminal justice and forensic settings. The forms of aggression that should be included in the definition of dual harm have not yet been established. This study aimed to use network analysis to inform an evidence-based definition of dual harm by assessing the relationship between self-harm and different forms of aggressive behaviour in young people (N = 3,579). We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Results revealed low correlations between the variables, leading to sparse network models with weak connections. We found that when separated into their distinct forms, aggressive acts and self-harm are only weakly correlated. Our work provides preliminary evidence to assist in understanding and managing dual harm within clinical and forensic settings and informs recommendations for future research.

A systematic review of the co-occurrence of self-harm and aggression: Is dual harm a unique behavioural construct?

“…In light of such findings, it is important to adopt an interdisciplinary perspective that expands on existing theories and considers the myriad of psychological, social and environmental factors that may contribute to dual harm. For instance, Shafti et al’s ( 15 , 30 ) cognitive-emotional model adopts numerous existing theoretical frameworks, such as the general aggression model and diathesis-stress theories, in order to explain how various evidence-based risk factors of self-harm and aggression, including psychological factors, may interact to lead to dual harm. Findings from the present review that antisocial/impulsive related personality factors are associated with dual harm offer support to the cognitive emotional model of dual harm ( 15 ).…”

“…There was variability in the definitions and measurements of harmful behaviours across the included research, reflected by the inconsistent terms used to refer to dual harm. A lack of agreed and empirically tested definition for dual harm is a major weakness of the literature, leading to variability in how this behaviour is conceptualised and assessed ( 30 ). For example, it has been debated whether it is clinically meaningful to consider a behaviour as dual harm if the self-harm and aggressive act co-occur at any point in time, or whether it is more appropriate to establish a restricted time-period ( 15 ).…”

“…To the best of our knowledge Shafti et al’s cognitive-emotional model ( 15 , 30 ) provides the only comprehensive framework that accounts for how various factors may interact to lead to dual harm and the function of this behaviour. Self-harm and aggression are suggested to not only share a causal pathway, but also serve the same purpose in those who dual harm.…”