The prevalence of dual harm, or co-occurring self-harm and violence against others, was found to double from 16 years of age to 22 years of age, according to results of a study published in Psychological Medicine.
Investigators from the University of Manchester in the United Kingdom sourced data for this study from the Avon Longitudinal Study of Parents and Children (ALSPAC) which is an ongoing cohort study initiated in 1991 and focused on health and development throughout life. For this study, predictors for engaging in self-harm and/or violence towards others at the ages of 16 and 22 years were evaluated.
The study cohort comprised 4,176 adolescents and young adults, among whom 18.1% engaged in self-harm, 21.1% violence towards others, and 3.7% dual harm at 16 years of age and 24.2%, 25.8%, and 6.8% at 22 years of age, respectively. The study participants comprised 56.5% of girls and 23.1% had a low socioeconomic status.
Compared with individuals who did not engage in any violence, among the 16 predictors, the strongest for self-harm included a close friend self-harming (relative risk ratio [RRR], 6.44), a family member self-harming (RRR, 4.29), and drug use in the past year (RRR, 3.60). Predictors for violence towards others included drug use in the past year (RRR, 5.63), being hit with an object by a family member before 11 years of age (RRR, 3.00), and being hit by a family member before 11 years of age (RRR, 2.76). Dual harm was predicted by drug use in the past year (RRR, 10.48), a close friend’s self-harming (RRR, 8.36), and a family member’s self-harming (RRR, 4.22).
Risk factors for violent outcomes for those aged 16 years were broadly similar to risks for those aged 22 years.
Among the adolescents who reported engaging in either self-harm or violence towards others at 16 years of age, 10.2% progressed to dual harm at 22 years of age. The strongest predictors for progression to dual harm included a close friend self-harming (risk ratio [RR], 5.74), drug use at 15 years of age (RR, 3.56), being hit by friends at 12 years of age (RR, 3.52), ever witnessing parental violence (RR, 3.42), and being hit by a family member before 11 years of age (RR, 3.41).
Risk for engaging in violent outcomes at both 16 and 22 years of age increased with the number of predictors present. For example, the highest risk for dual harm was observed among individuals with 5 or more predictors at 16 (adjusted RRR [aRRR], 28.99) and 22 (aRRR, 23.94) years of age.
The findings in this study may have been biased, as there were no measures about the frequency or intensity of predictors or outcomes.
Study authors concluded, “We identified several childhood experiences associated specifically with dual harm at age 16 [years] and with the transition to dual harm by age 22 [years]. Findings provide evidence supporting emerging novel models for dual harm and could help inform the development of interventions.”
This article originally appeared on Psychiatry Advisor
Steeg S, Farooq B, Taylor P, et al. Childhood predictors of self-harm, externalized violence and transitioning to dual harm in a cohort of adolescents and young adults. Psychol Med. 2023;1-11. doi: 10.1017/S0033291723000557