Direct and not indirect childhood abuse linked to non-suicidal self-injury in adolescents

Adolescents who were physically abused or sexually abused were more likely to engage in non-suicidal self-injury than their non-abused counterparts, according to a new study from researchers at the University of Toronto and Western University. The study appears online in the journal Child Abuse & Neglect.

"We found that about one in three adolescents with mental health problems in Ontario engaged in non-suicidal self-injury. We were surprised to find that only the experience of adversities directed towards the child (physical and sexual abuse) predicted non-suicidal self-injury and not adversities indicative of parental risk such as parental mental health issues or exposure to domestic violence" says lead author Philip Baiden, a PhD Candidate at the Factor-Inwentash Faculty of Social Work, University of Toronto. Controlling for other factors, the authors also found that adolescents who are females, had symptoms of depression, diagnosis of ADHD, and mood disorders were more likely to engage in non-suicidal self-injury. However, adolescents who have someone that they could turn to for emotional support when in crises were less likely to engage in non-suicidal self-injury.

The researchers utilized data from a representative sample of 2,038 children and adolescents aged 8-18 years referred to community and inpatient mental health settings in Ontario. The data was collected using the interRAI Child and Youth Mental Health assessment instrument.

"Depression is one indication that an individual is having difficulty coping with his/her life situation and being depressed can severely impact one's ability to regulate emotions and focus almost exclusively on the negative aspect of life. Among survivors of sexual abuse, depression can also manifest itself as emotional pain, for which non-suicidal self-injury becomes an outlet" says co-author Shannon Stewart, an interRAI Fellow and Director of Clinical Training, School and Applied Child Psychology at Western University.

Co-author Barbara Fallon, an associate professor at the Factor-Inwentash Faculty of Social Work at University of Toronto and Canada Research Chair in Child Welfare, also notes that "understanding the mechanism through which non-suicidal self-injury may occur can inform clinicians and social workers working with formerly abused children in preventing future non-suicidal self-injurious behaviours."