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Reasons for adolescent deliberate self-harm: a cry of pain and/or a cry for help?

Findings from the child and adolescent self-harm in Europe (CASE) study

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Abstract

The present study examines reasons for adolescent deliberate self-harm. A cross-sectional survey using an anonymous self-report questionnaire was carried out in seven countries (Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway). Data on 30,477 school pupils between the ages of 14–17 were analysed. Past year and lifetime deliberate self-harm were assessed, along with the self-reported reasons for deliberate self-harm. The results showed that ‘wanted to get relief from a terrible state of mind’ and ‘wanted to die’ were most commonly reported. Principal component analysis indicated two underlying dimensions in the reasons for deliberate self-harm, i.e. a cry of pain motive and/or a cry for help motive. The majority of self-harmers reported at least one cry of pain motive (‘to die’, ‘to punish myself’, and ‘to get relief from a terrible state of mind’) and an additional cry for help motive (‘to show how desperate I was feeling’, to frighten someone’, ‘to get my own back on someone’, ‘to find out whether someone really loved me’, and ‘to get some attention’). Females reported more reasons than males. Only females showed an age difference, with girls aged 16–17 more frequently reporting a cry for help motive. There was considerable consistency in choice of motives across countries and genders. Systematic assessment of the reasons for deliberate self-harm can help clinicians to better understand the meaning of self harming behaviour, select appropriate treatment, suggest alternative coping strategies, and hopefully prevent future suicidal behaviour.

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Authors and Affiliations

  1. Unit for Suicide Research, Dept. of Psychiatry and Medical Psychology, University of Ghent, UZ Gent 1K12F, De Pintelaan 185, 9000, Ghent, Belgium

    Gerrit Scoliers MA, Gwendolyn Portzky PhD & Kees van Heeringen MD, PhD

  2. School of Health Sciences and Social Care, Brunel University Uxbridge, London, UK

    Nicola Madge PhD & Anthea Hewitt PhD

  3. Centre for Suicide Research, University of Oxford, Oxford, UK

    Keith Hawton MD, DSc

  4. Netherlands Youth Institute, Utrecht, The Netherlands

    Erik Jan de Wilde MD, PhD

  5. Centre for Child and Adolescent Mental Health, Oslo, Norway

    Mette Ystgaard MD, PhD

  6. National Suicide Research Foundation, Cork, Ireland

    Ella Arensman PhD

  7. Australian Institute for Suicide Research and Prevention, Griffith University Gold Coast, Brisbane, QLD, Australia

    Diego De Leo MD, PhD

  8. Dept. of Psychiatry, University of Pecs, Pecs, Hungary

    Sandor Fekete MD, PhD

Authors
  1. Gerrit Scoliers MA
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  2. Gwendolyn Portzky PhD
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  3. Nicola Madge PhD
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  4. Anthea Hewitt PhD
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  5. Keith Hawton MD, DSc
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  6. Erik Jan de Wilde MD, PhD
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  7. Mette Ystgaard MD, PhD
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  8. Ella Arensman PhD
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  9. Diego De Leo MD, PhD
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  10. Sandor Fekete MD, PhD
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  11. Kees van Heeringen MD, PhD
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Correspondence to Gerrit Scoliers MA.

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Scoliers, G., Portzky, G., Madge, N. et al. Reasons for adolescent deliberate self-harm: a cry of pain and/or a cry for help?. Soc Psychiat Epidemiol 44, 601–607 (2009). https://doi.org/10.1007/s00127-008-0469-z

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  • DOI: https://doi.org/10.1007/s00127-008-0469-z

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