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Poor psychological health and stressful-life events are more common in adolescents with self-harm thoughts or episodes

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Are there associations between psychological characteristics, life event and self-harm history among teenagers?


30 447 adolescents (14 to 17 years old) participating in the Child & Adolescent Self-harm in Europe (CASE) study. Adolescents attended secondary schools that were selected to be locally and nationally representative. Response rate varied from 81% to 91% in the participating countries.


Belgium, England, Hungary, Ireland, The Netherlands, Norway and Australia; time period not stated.


Anonymous school-based survey, including questions on self-harm, psychological characteristics and stressful-life events. Self-harm was defined as deliberate actions intended to cause self-harm that were non-fatal, regardless of motivation. Four psychological characteristics were measured: anxiety and depression (Hospital Anxiety and Depression scale), impulsivity (six item scale) and self-esteem (eight item abbreviated Robson self-concept scale). There were 10 categories of stressful-life events, which were categorised as occurring in the past 12 months and/or prior to this.


Thoughts and episodes of self-harm.



Cross-sectional study.

Main results

Over the past year, 14.6% of participants had self-harm thoughts without an …

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  • Sources of funding European Commission Daphne Programme, Community Fund in England, Irish National Suicide Review Group, National Office for Suicide Prevention and the Ireland Funds, QLD-Health and the Commonwealth of Australia, Department of Health and Aging and Norwegian Foundation for Health and Rehabilitation.


  • Competing interests None.

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