Social Psychiatry and Psychiatric Epidemiology

, Volume 44, Issue 8, pp 601–607 | Cite as

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
  • Gerrit ScoliersEmail author
  • Gwendolyn Portzky
  • Nicola Madge
  • Anthea Hewitt
  • Keith Hawton
  • Erik Jan de Wilde
  • Mette Ystgaard
  • Ella Arensman
  • Diego De Leo
  • Sandor Fekete
  • Kees van Heeringen


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.


deliberate self-harm adolescence reasons cry of pain cry for help 


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Copyright information

© Steinkopff Verlag Darmstadt 2008

Authors and Affiliations

  • Gerrit Scoliers
    • 1
    Email author
  • Gwendolyn Portzky
    • 1
  • Nicola Madge
    • 2
  • Anthea Hewitt
    • 2
  • Keith Hawton
    • 3
  • Erik Jan de Wilde
    • 4
  • Mette Ystgaard
    • 5
  • Ella Arensman
    • 6
  • Diego De Leo
    • 7
  • Sandor Fekete
    • 8
  • Kees van Heeringen
    • 1
  1. 1.Unit for Suicide Research, Dept. of Psychiatry and Medical PsychologyUniversity of GhentGhentBelgium
  2. 2.School of Health Sciences and Social CareBrunel University UxbridgeLondonUK
  3. 3.Centre for Suicide ResearchUniversity of OxfordOxfordUK
  4. 4.Netherlands Youth InstituteUtrechtThe Netherlands
  5. 5.Centre for Child and Adolescent Mental HealthOsloNorway
  6. 6.National Suicide Research FoundationCorkIreland
  7. 7.Australian Institute for Suicide Research and PreventionGriffith University Gold CoastBrisbaneAustralia
  8. 8.Dept. of PsychiatryUniversity of PecsPecsHungary

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