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Children with low cognitive abilities are at greater risk of being targeted by bullies, 37 as well as engaging in self harm behaviours.
Our findings add to the international debate about the extent to which these self harm behaviours represent distinct concepts or part of a continuum of suicidal behaviour.
In line with previous research, 15 we classified self harm behaviours in which there was any evidence of self reported intent to die as suicidal self harm.
The strong associations with later mental health and substance use found in this study suggest that interventions aimed at reducing self harm behaviours should also focus on treating or preventing these additional problems.
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However, the association between frequent bullying and self harm behaviour remained after we controlled for lifetime exposure to physical maltreatment (table 1).
Existing studies are often limited by cross sectional designs, the possibility that unmeasured background risk factors can lead children both to be victimised and to self harm (selection effects), and reliance on the same person to report both exposure to bullying and self harm behaviour, which may create spurious associations (reporter bias).
Current literature supports the efficacy of DBT for youth with suicidal/self-harming behaviours.
This suggests that focusing upon improving general mental health and developing positive cognitive skills is likely to have an impact on numbers engaging in self-harm behaviours.
The SHI [ 4] is a 22 item, self-report, yes/no scale that explores a broad range of self-harm behaviours (Table 1).
In a comparable epidemiological study of adolescents (age 14 - 17 years) within seven European countries, Madge et al. [ 11] found an average lifetime prevalence estimate of 17.8% and a 12-month prevalence of 11.5% for deliberate self-harm behaviours (DSH; includes self-damaging acts both with/out suicidal intention); although rates varied across countries.
Despite the contribution to our knowledge of self-harm behaviours to date, we remain unclear as to exactly why individuals engage in these behaviours and, even more importantly, we do not have in place effective methods of accurately predicting or reducing these behaviours as a consequence.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com