Adolescent personality traits, low self-esteem and self-harm hospitalisation: a 15-year follow-up of the Norwegian Young-HUNT1 cohort
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Affective disorders are closely related to self-harm and suicidal behaviours. Less is known about how adolescent personality traits and self-esteem influence the development of later self-harm. We examined associations between personality traits such as neuroticism, psychoticism and extroversion, and self-esteem, in adolescence, and the risk of future self-harm hospitalisation. Baseline information from 13 to 19-year-old participants in the Norwegian Young-HUNT1 study in 1995–97 (n = 8965) was linked to endpoint data recorded from participants’ hospital records, describing self-harm hospitalisation episodes within the catchment area. Crude and adjusted hazard ratios (HR) were estimated by Cox regression analyses. A one-unit increase on the 0–6 scale for neuroticism was associated with a HR of 1.29, 95% confidence interval (CI) 1.14–1.47. Corresponding HR for psychoticism was 1.30, 95% CI 1.03–1.63 per unit increase, and for extroversion risk was reduced (HR 0.89, 95% CI 0.77–1.04). Positive perception of self-esteem was more strongly associated with reduced risk of self-harm hospitalisation (HR per unit increase on the 0–12 scale was 0.74, 95% CI 0.68–0.82). Additional adjustment for alcohol use and symptoms of combined anxiety and depression symptoms attenuated effect estimates, in particular for neuroticism (HR 1.13, 95% CI 0.96–1.32) and psychoticism (HR 1.07, 95% CI 0.82–1.40). In contrast, self-esteem associations remained largely the same after adjustment. Our results indicate that brief assessments of personality and self-esteem might add additional relevant information, and could be included as a supplement to standard suicidal risk assessment in adolescents.
KeywordsSelf-harm Hospitalisation Adolescence Personality traits Self-esteem
Nord-Trøndelag Hospital Trust employees Geir Anders By Lervåg, Ingrid Lundstadsveen and Unni Veie Lynum helped with the recording of outcome data (self-harm hospitalisations). The Nord-Trøndelag Health Study (The HUNT Study) is a collaboration between HUNT Research Centre (Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology), Nord-Trøndelag County Council, Central Norway Health Authority, and the Norwegian Institute of Public Health. This was not an industry supported study. The work was supported by the Norwegian University of Science and Technology (Grant no. 2015/3436/NRS).
Compliance with ethical standards
This study was approved by the Regional Committee for Medical and Health Research Ethics (2010/1924-3). All participants gave written informed consent to use Young-HUNT1 data in medical research, including a parental consent for participants younger than 16 years.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
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