Variables to understand self-harm in adolescents

Usually, humans understand aggressions as those behaviors referred to other people, in defensive function against the threats of others, but not as those directed towards ourselves, since it is to be supposed that the survival instinct prevails.

Thus, that self-injurious behaviors occur especially in adolescence, just when one really begins to live, constitutes a problem of growing interest, even more so at a time when suicide is one of the main causes of mortality among adolescents.

• Related article: "Mental health: definition and characteristics according to psychology"

Self-harm in adolescents: what is the prevalence and incidence?

The proportion of adolescents with self-injurious behaviors is considered to be between 6-16%, without significant differences in community samples from different countries.

The incidence is higher among adolescents diagnosed with some psychiatric pathology, specifically, depression, conduct disorders, and anxiety or anxiety-related disorder. The data, too, show that self-harm

they are more frequent in children who have gone through an adoption process, and also in those who live in large or single-parent families. Girls injure themselves more with cuts, while boys do it with burns.

What are the most important risk factors?

Between sociodemographic variables, the following stand out.

• Age: Cross-sectional studies with community samples indicate that an inverted “U” phenomenon occurs, observing a peak between 12-16 years, which is preceded by a gradual increase from 11-13 years only in women since in men, it remains relatively stable
• Sex: Self-injurious behaviors are more common among women than men.

On the other hand, the character variables to highlight are these.

• Impulsiveness: Studies on this topic suggest that among teens who self-harm, people with a high level of impulsivity are over-represented compared to the population general.
• Negative self-image: they make internal, global and relatively consistent and stable attributions about negative events in their life. In relation to this, these adolescents have lower self-esteem and a more pessimistic cognitive style than people who do not injure themselves, especially girls. For this reason, low self-esteem is considered as a predisposing and maintaining factor of self-injurious behavior.
• Problem solving ability: if it is deficient, the risk of these behaviors increases.
• Anger and hostility: these are more frequent psychological predispositions in young people who harm themselves.

On the other hand, there are also psychopathological variables.

• Substance abuse: the consumption of alcoholic beverages is statistically highly linked to self-injurious behavior.
• Depressive disorders: 67% of adolescents who take a toxic intake to attempt suicide suffer from a depressive disorder.
• Eating disorders: these young people have a more negative body image compared to girls adolescents who do not usually injure themselves, being bulimic behaviors the most prevalent because, in addition, they present greater impulsiveness.
• Conduct disorders: especially antisocial disorder.

Psychosocial factors matter too

The variables related to relationships with others, and especially with whom these young people see in their day to day, They are fundamental. Among them, we must take into account those that are described here.

• Interpersonal conflicts either in the family or school context.
• Bullying is a predisposing factor for self-harm.
• Modeling or imitation. There is a notable consensus that adolescents self-harm often have family and friends who do it, too. In addition, many of these adolescents are related through chats and forums with other self-harm, through new technologies.
• Possible presence of sexual abuse: the prevalence is higher in this population than in the general population of a way that would act as a precipitating factor and is modulated by the presence of a disorder depressant.

Regarding family characteristics, the following findings have been made:

• One in two teens who self-injure lives in single-parent households.
• Coexistence problems are statistically associated with suicide attempts in adolescents.
• Lack of warmth in dealing with other family members and dysfunctional relationships between adolescents (under 16 years of age) and their mothers have been shown to be important predictors of attempts to suicide.

How can the family deal with self-harm?

Above all, we must be aware that self-harm is an important problem and that, therefore, professional help is always required.

If she has not told you, it is because it is a behavior that is carried out with total secrecy, usually in her room, at dark or at night, but later they feel guilt, shame or fear for what you will think, for having failed you or for disappoint you. Many times, they have the fear that they will be discovered and end up in a psychiatric unit or admitted to the hospital. Therefore, you should be understanding and let your child talk to you about this behavior.

On many occasions, parents mistakenly believe that it is a wake-up call, but the fact that it remains hidden should make you suspect otherwise. Therefore, it is necessary that you become aware of gravity, but always with support and understanding. Never think that, by talking about the reasons why your daughter harms herself, this will make the situation worse but, on the contrary, it will be a way that she (or he) has to release those emotions that she has been suppressing and that they have produced that emotional pain that leads them to self-harm.

We are aware that you are going to go through periods of fear or uncertainty, but adolescents who harm themselves are not aggressive or pose a danger to others. You should tell him that you want to help him, that you are going to support him, but that you are going to do this together with his psychologist and, if necessary, with his psychiatrist.

In our Cabinet we are specialists in Clinical Psychology and Child and Adolescent Psychotherapy and we have a long experience in self-harm in adolescents. We are here to help you, as a family, and your child.

Bibliographic references

• Javierre, E, Amiguet, M., Mengual, J.M., Fuertes, A., Ruiz, P.M., García, N. (2016) Latest among adolescents. The cuts in the skin. Bowl. Pediatr. Rioj Sor, 46:35
• Frías, A., Vázquez, M., Del Real, A., Sánchez, C. Giné, E. (2012) Self-injurious behavior in adolescents: prevalence, risk factors and treatment. Journal of Psychosomatic Medicine and Liaison Psychiatry, nº 103.
• Ibañez-Aguirre, C. (2017) Psychopathological keys of self-injurious behaviors in adolescence. Journal of Clinical Psychology with Children and Adolescents, vol.4, nº1, pp. 65 - 70.