Autism, ADHD, school absenteeism are risk factors for self-harm and discover new research

Conversation between Emily Vidonal and Johnny Downs,

Self-harm (injuring the body) is common among young people and affects about 1 in 5 teens by the age of 18.

In the emergency department of the hospital, only about one-eighth of the episodes of self-harm in teens are seen. However, going to the hospital for self-harm is one of the strongest risk factors for future suicide.

A newly published study combines information from hospital assessments with other sources of information such as school attendance, special educational needs, and the status of free school meals to identify some of the risk factors for self-harm. I have identified. Collecting information sources related to the same individual in this way is called data linkage. This is a powerful tool for maximizing the value of public health data.

Girls are at higher risk

Self-harm refers to self-harm performed by a person regardless of motive. This usually includes self-harm due to drug poisoning or amputation.

Our findings show that the risk of self-harm was almost three times higher than in boys without autism spectrum disorders (ASD). ASD was not a significant risk of girl self-harm, but this could be due to an underdiagnosis of the girl’s ASD.

However, in general, the risk of self-harm is higher in girls (1.5%) than in boys (0.3%), consistent with previous studies.

Evidence suggests that ASD is a risk factor for adult self-harm, but far fewer studies have been conducted on the risk of teenagers. Existing studies often include small, selective studies using clinical samples rather than population-wide samples.

In contrast, data linkage allowed us to study vast amounts of information. We evaluated data on more than 113,000 young people aged 11 to 17 years from four districts in southern London, collected between 2009 and 2013. Therefore, our finding that boys with ASD are at increased risk of self-harm is important in addressing the gap in this study.

We also found that Attention Deficit Hyperactivity Disorder (ADHD) is a powerful predictor of self-harm for both boys and girls. Young people with ADHD were about four times more likely to self-harm than young people without ADHD.

Adolescents who had previously participated in ADHD mental health services were at four times the risk of self-harm than adolescents who did not participate in ADHD services. These are important discoveries due to the gap in evidence. Few UK studies have investigated the association between ADHD and self-harm, especially in girls.

Socio-economic risk factors

We also found that young people who leave school and spend time either excluded or absent are at increased risk of self-harm. For people with attendance below 80%, the risk of injuring themselves was three times higher than for people with attendance above 80%.

These findings do not show that school absenteeism causes self-harm. However, they suggest that this is an important group of young people targeted for preventive intervention.

Previous studies examining socio-economic risk factors for self-harm have shown that girls who receive the status of free school meals are also very likely to engage in self-harm. Similarly, caring children have been shown to be at high risk.

Our research has also led to some unexpected discoveries. Having English as a second language seemed to act as a protective factor for self-harm. However, this is probably due to adolescents using English as a second language not presented to mental health services. Previous research has shown that language barriers are an important cause of disparities in access to services.

In addition, there was an association between the status of free meals and self-harm, but no association between neighborhood deprivation and self-harm. This is incompatible with previous studies, but our findings include recent studies showing low rates of self-harm in some poor urban areas, such as parts of London. I support it.

Factors that may explain this are, on the one hand, community solidarity, what researchers call a culture of independence, and, on the other hand, a collective sense that it is dangerous to be identified as having a mental illness. Includes-Mental health services are intrusive and compulsory.

Data linkage allows you to study the entire population. It’s less disturbing than asking people to complete the investigation. You can also include people in your study who may not be able to actively participate in traditional studies. We were also able to identify the most vulnerable groups by focusing on the risk factors behind youth self-harm.

These findings are an important step in developing strategies to demonstrate the power of data links to prevent self-harm and address public health issues.

(The author is Senior Research Associate, Artificial Health Sciences, University of Bristol. King’s College London Senior Clinical Lecture)

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