Correlates and prospective predictors of adolescent self-harm in community and sexually assaulted samples
- Autores: Fátima Valencia Agudo
- Directores de la Tesis: Lourdes Ezpeleta (dir. tes.)
- Lectura: En la Universitat Autònoma de Barcelona ( España ) en 2019
- Idioma: español
- Materias:
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- Resumen
Self-harm in adolescence is a focus of concern given its increasing frequency and its association with future attempted and complete suicide. The main objective of this thesis is to review correlates and predictors of this behaviour in different samples of adolescents. The aims of this work are: 1) to systematically review the existing literature about prospective predictors, mediators and moderators of Nonsuicidal Self-injury (NSSI) in community adolescents, 2) to examine correlates and predictors of self-harm after experiencing sexual assault in adolescence, 3) to explore the protective role of self-perceived strengths on self-harm occurrence after sexual assault in adolescence.
Three studies were carried out. Study 1 was a systematic review of longitudinal predictors of NSSI in community adolescents. Two members of the team carried out an independent search in four databases: Medline, PsycInfo, Embase and Web of Science. Quality of the studies was assessed by means of the New Castle Ottawa Quality Assessment Scale. Study 2 was a prospective study conducted in a consecutive sample of sexually assaulted adolescents who sought help at the Havens (Multiagency Sexual Assault Centres in London) over a period of two years. One hundred and forty-one young people were recruited at baseline and females who completed self-harm information were included in the study (n = 98). There was data collection at T0 (4 weeks on average post-assault) and T1 (22 weeks on average post-assault). Information was gathered by means of a semi-structured interview and validated questionnaires. Bivariate analyses and binary logistic regressions were conducted to ascertain correlates and predictors of self-harm. Study 3 was conducted in the same sample as Study 2, with those females who completed self-harm information at T0 and T1 the Youth Strengths Inventory at T1 to assess perceived strengths (n = 63). A logistic regression model was tested, controlling for other relevant variables.
In Study 1, 39 studies were found matching inclusion criteria. The following variables were shown to prospectively predict NSSI: female gender, family-related variables, peer victimisation, depression, history of NSSI and self-concept. Studies analysing mediators and moderators, as well as protective factors, were scarce. Study 2 showed a high rate of self-harm both before (38.1%) and after (37.8%) sexual assault. History of family dysfunction [OR 3.60 (1.30, 10.01)], depressive symptoms at T0 [OR 5.83 (2.35, 14.43)] or T1 [OR 2.79 (1.20, 6.50)] and posttraumatic stress symptoms at T1 [OR 3.21 (1.36, 7.58)] were associated with self-harm at T1. These effects were attenuated when adjusting for confounders, except for depressive symptoms at T0 [OR 4.21 (1.57, 11.28)]. In Study 3, perceived strengths at T1 were associated with less likelihood of engaging in self-harm after the assault [OR .89 (.80, .99)], after controlling for concurrent depressive and PTSD symptoms and history of self-harm.
Results point out to specific risk factors that should be assessed to detect the most at risk individuals both in community and assaulted samples of adolescents. Study 3 indicates the potential protective role of perceived strengths. Correlates of self-harm (e.g. psychopathology, family dysfunction, self-esteem) should be tackled in intervention programs to prevent chronic engagement in the behaviour.
