Baldwin, J. R. et al. | 2018| Adolescent Victimization and Self-Injurious Thoughts and Behaviors: A Genetically Sensitive Cohort Study| Journal of the American Academy of Child & Adolescent Psychiatry | Vol.0 |Issue 0| DOI: https://doi.org/10.1016/j.jaac.2018.07.903
Children and young people that are victimised have double the likelihood of self-harm and their risk of suicide is trebled compared to non-victimised peers according to researchers at King’s College London. The study looked at over 2000 twins born in England and Wales between 1994-95. They studied different forms of adolescent victimisation- including maltreatment, neglect, bullying, crime, sexual victimisation, and family violence- which were identified in interviews with the participants when they turned 18. Among their findings was that over a third of the sample had experienced one severe form of victimisation during their adolescence and 7 per cent had experienced at least three or more severe types of victimisation. Almost 20 per cent (18.9%) had had some form of self-injurious thoughts and behaviours. Victimized adolescents had an increased risk of suicidal ideation and over a quarter had atempted suicide.
Victimized adolescents have elevated risk of self-injurious thoughts and behaviors. However, poor understanding of causal and non-causal mechanisms underlying this observed risk limits the development of interventions to prevent premature death among adolescents. We tested whether pre-existing family-wide and individual vulnerabilities account for victimized adolescents’ elevated risk of self-injurious thoughts and behaviors.
Participants were 2,232 British children followed from birth to age 18 as part of the Environmental Risk (E-Risk) Longitudinal Twin Study. Adolescent victimization (maltreatment, neglect, sexual victimization, family violence, peer/sibling victimization, cyber-victimization, and crime victimization) was assessed through interviews with participants and co-informant questionnaires at the age 18 assessment. Suicidal ideation, self-harm, and suicide attempt in adolescence were assessed through interviews with participants at age 18.
Victimized adolescents had an increased risk of suicidal ideation, self-harm, and suicide attempt. Co-twin control and propensity-score matching analyses showed that these associations were largely accounted for pre-existing familial and individual vulnerabilities, respectively. Over and above their prior vulnerabilities, victimized adolescents still showed a modest elevation in risk for suicidal ideation.
Risk for self-injurious thoughts and behaviors in victimized adolescents is only partly explained by the experience of victimization. Pre-existing vulnerabilities account for a large proportion of the risk. Therefore, effective interventions to prevent premature death in victimized adolescents should not only target the experience of victimization but also address pre-existing vulnerabilities.
The article is in press but may be requested through interlibrary loan by Rotherham NHS staff
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