Journal of Youth and Adolescence

, Volume 47, Issue 5, pp 916–931 | Cite as

Appreciating Complexity in Adolescent Self-Harm Risk Factors: Psychological Profiling in a Longitudinal Community Sample

  • Sarah Stanford
  • Michael P. Jones
  • Jennifer L. Hudson
Empirical Research


Past research identifies a number of risk factors for adolescent self-harm, but often fails to account for overlap between these factors. This study investigated the underlying, broader concepts by identifying different psychological profiles among adolescents. We then compared new self-harm rates over a six-month period across different psychological profiles. Australian high school students (n = 326, 68.1% female) completed a questionnaire including a broad range of psychological and socioenvironmental risk and protective factors. Non-hierarchical cluster analysis produced six groups with different psychological profiles at baseline and rate of new self-harm at follow-up. The lowest rate was 1.4% in a group that appeared psychologically healthy; the highest rate was 37.5% in a group that displayed numerous psychological difficulties. Four groups with average self-harm had varied psychological profiles including low impulsivity, anxiety, impulsivity, and poor use of positive coping strategies. Identifying multiple profiles with distinct psychological characteristics can improve detection, guide prevention, and tailor treatment.


Self-harm Risk factors Adolescence Psychological profiles 


Author Contributions

S.S. participated in writing, design, and analysis, and carried out the data collection. M.J. contributed to writing, design, and analysis. J.H. provided clinical guidance and feedback on the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

Ethical Approval

The study was reviewed and approved by the Macquarie University Human Research Ethics Committee, reference number 5201400575.

Informed Consent

The project was approved by the School Principal, Executive and school counsellors in each school. Parents and students provided opt-in informed consent at the first time point; this consent covered the baseline and follow-up survey. At the follow-up, parents were provided the full study information and the opportunity to opt-out on behalf of their teen, and students again provided opt-in informed consent.


  1. Armiento, J. S., Hamza, C. A., & Willoughby, T. (2014). An examination of disclosure of nonsuicidal self-injury among university students. Journal of Community and Applied Social Psychology, 24(6), 518–533. doi:10.1002/casp.CrossRefGoogle Scholar
  2. Bagley, C., & Mallick, K. (2001). Normative data and mental health construct validity for the Rosenberg self-esteem scale in British adolescents. International Journal of Adolescence and Youth, 9(2–3), 117–126. doi:10.1080/02673843.2001.9747871.CrossRefGoogle Scholar
  3. Best, R. (2006). Deliberate self-harm in adolescence: Report of a research project in some English schools. Paper presented to the European Conference on Educational Research. European Conference on Educational Research: Geneva.
  4. Barker, E. D., Arseneault, L., Brendgen, M., Fontaine, N., & Maughan, B. (2008). Joint development of bullying and victimization in adolescence: Relations to delinquency and self-harm. Journal of the American Academy of Child & Adolescent Psychiatry, 47(9), 1030–1038.Google Scholar
  5. Bracken-Minor, K. L., McDevitt-Murphy, M. E., & Parra, G. R. (2012). Profiles of non-suicidal self-injurers and associated patterns of alcohol use. Journal of Psychopathology and Behavioral Assessment, 34(4), 552–563. doi:10.1007/s10862-012-9306-5.CrossRefGoogle Scholar
  6. Brunner, R., Kaess, M., Parzer, P., Fischer, G., Carli, V., Hoven, C. W., et al. (2014). Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 55(4), 337–348. doi:10.1111/jcpp.12166.CrossRefPubMedGoogle Scholar
  7. Booth-Kewley, S., Larson, G. E., & Miyoshi, D. K. (2007). Social desirability effects on computerized and paper-and-pencil questionnaires. Computers in Human Behavior, 23(1), 463–477. doi: 10.1016/j.chb.2004.10.020.
  8. Chisholm, K., Patterson, P., Torgerson, C., Turner, E., Jenkinson, D., & Birchwood, M. (2016). Impact of contact on adolescents’ mental health literacy and stigma: The SchoolSpace cluster randomised controlled trial. BMJ Open, 6(2), e009435 doi:10.1136/bmjopen-2015-009435.CrossRefPubMedPubMedCentralGoogle Scholar
  9. De Leo, D., & Heller, T. S. (2004). Who are the kids who self-harm? An Australian self-report school survey. Medical Journal of Australia, 181(3), 140–144.PubMedGoogle Scholar
  10. Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49(1), 71–75.CrossRefPubMedGoogle Scholar
  11. Duke, N., Ireland, M., & Borowsky, I. W. (2005). Identifying psychosocial problems among youth: Factors associated with youth agreement on a positive parent-completed PSC-17. Child: Care, Health and Development, 31(5), 563–573. doi:10.1111/j.1365-2214.2005.00551.x.Google Scholar
  12. Fliege, H., Lee, J. R., Grimm, A., & Klapp, B. F. (2009). Risk factors and correlates of deliberate self-harm behavior: A systematic review. Journal of Psychosomatic Research, 66(6), 477–493. doi:10.1016/j.jpsychores.2008.10.013.CrossRefPubMedGoogle Scholar
  13. Folkman, S., Lazarus, R., Dunkel-Schetter, C., DeLongis, A., & Gruen, R. J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50(5), 992–1003.CrossRefPubMedGoogle Scholar
  14. Fortune, S. A., & Hawton, K. (2005). Deliberate self-harm in children and adolescents: A research update. Current Opinion in Psychiatry, 18(4), 401–406. doi:10.1097/01.yco.0000172059.55778.c9.CrossRefPubMedGoogle Scholar
  15. Frost, M., Casey, L., & Rando, N. (2015). Self-injury, help-seeking, and the Internet: Informing online service provision for young people. Crisis, 37(1), 68–76. doi:10.1027/0227-5910/a000346.CrossRefPubMedGoogle Scholar
  16. Guerreiro, D. F., Figueira, M. L., Cruz, D., & Sampaio, D. (2015). Coping strategies in adolescents who self-harm. Crisis, 36(1), 31–37. doi:10.1027/0227-5910/a000289.CrossRefPubMedGoogle Scholar
  17. Haavisto, A., Sourander, A., Multimäki, P., Parkkola, K., Santalahti, P., Helenius, H., et al. (2005). Factors associated with ideation and acts of deliberate self-harm among 18-year-old boys: A prospective 10-year follow-up study. Social Psychiatry and Psychiatric Epidemiology, 40(11), 912–921. doi:10.1007/s00127-005-0966-2.CrossRefPubMedGoogle Scholar
  18. Hamza, C. A., & Willoughby, T. (2013). Nonsuicidal self-injury and suicidal behavior: A latent class analysis among young adults. Plos One, 8(3), e59955. doi: 10.1371/journal.pone.0059955.
  19. Hall, B., & Place, M. (2010). Cutting to cope—a modern adolescent phenomenon. Child: Care, Health and Development, 36(5), 623–629. doi:10.1111/j.1365-2214.2010.01095.x.Google Scholar
  20. Hasking, P., Rees, C. S., Martin, G., & Quigley, J. (2015). What happens when you tell someone you self-injure? The effects of disclosing NSSI to adults and peers. BMC Public Health, 15(1039), doi: 10.1186/s12889-015-2383-0.
  21. Hawton, K., Harriss, L., & Rodham, K. (2010). How adolescents who cut themselves differ from those who take overdoses. European Child & Adolescent Psychiatry, 19(6), 513–523. doi:10.1007/s00787-009-0065-0.CrossRefGoogle Scholar
  22. Hawton, K., Saunders, K. E., & O’Connor, R. (2012). Self-harm and suicide in adolescents. The Lancet, 379(9834), 2373–2382. doi:10.1016/S0140-6736(12)60322-5.CrossRefGoogle Scholar
  23. Hay, C., & Meldrum, R. (2010). Bullying victimization and adolescent self-harm: Testing hypotheses from general strain theory. Journal of Youth and Adolescence, 39(5), 446–459. doi:10.1007/s10964-009-9502-0.CrossRefPubMedGoogle Scholar
  24. Heerde, J. A., Toumbourou, J. W., Hemphill, S. A., Herrenkohl, T. I., Patton, G. C., & Catalano, R. F. (2015). Incidence and course of adolescent deliberate self-harm in Victoria, Australia, and Washington State. Journal of Adolescent Health, 57(5), 537–544. doi:10.1016/j.jadohealth.2015.07.017.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Heisel, M. J., & Flett, G. L. (2004). Purpose in life, satisfaction with life, and suicide ideation in a clinical sample, 26(2).Google Scholar
  26. Jacobson, C. M., & Gould, M. (2007). The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: A critical review of the literature. Archives of Suicide Research, 11(2), 129–147. doi:10.1080/13811110701247602.CrossRefPubMedGoogle Scholar
  27. Jarvi, S., Jackson, B., Swenson, L., Crawford, H. (2013). The impact of social contagion on non-suicidal self-injury: A review of the literature. Archives of Suicide Research: Official Journal of the International Academy for Suicide Research, 17(1), 1–19. doi:10.1080/13811118.2013.748404.CrossRefGoogle Scholar
  28. Jiang, Y., Perry D. K., & Hesser J. E. (2010). Suicide patterns and association with predictors among Rhode Island public high school students: A latent class analysis. American Journal of Public Health, 100(9), 1701–1707. doi: 10.2105/AJPH.2009.183483.
  29. Joiner, T. E. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.Google Scholar
  30. Juhnke, G. A., Granello, D. H., & Granello, P. F. (2011). Suicide, self-injury, and violence in the schools: Assessment, prevention, and intervention strategies. Hoboken, N.J.: Wiley.Google Scholar
  31. Juhnke, G. A., Granello, D. H., & Granello, P. F. (2012). Suicide, self-injury, and violence in the schools: Assessment, prevention, and intervention strategies. Hoboken, NJ: Wiley.Google Scholar
  32. Kaminski, J. W., Puddy, R. W., Hall, D. M., Cashman, S. Y., Crosby, A. E., & Ortega, L. A. G. (2010). The relative influence of different domains of social connectedness on self-directed violence in adolescence. Journal of Youth and Adolescence, 39(5), 460–473. doi:10.1007/s10964-009-9472-2.CrossRefPubMedGoogle Scholar
  33. Kapur, N., Cooper, J., O’Connor, R. C., & Hawton, K. (2013). Non-suicidal self-injury v. attempted suicide: New diagnosis or false dichotomy? British Journal of Psychiatry, 202(5), 326–328. doi:10.1192/bjp.bp.112.116111.CrossRefPubMedGoogle Scholar
  34. Kleiman, E. M., & Beaver, J. K. (2016). A meaningful life is worth living: Meaning in life as a suicide resiliency factor. Psychiatry Research, 210(3), 934–939. doi:10.1016/j.psychres.2013.08.002.CrossRefGoogle Scholar
  35. Klineberg, E., Kelly, M. J., Stansfeld, S. A., & Bhui, K. S. (2013). How do adolescents talk about self-harm: A qualitative study of disclosure in an ethnically diverse urban population in England. BMC Public Health, 13(572), doi: 10.1186/1471-2458-13-572.
  36. Klonsky, E. D., & Olino, T. M. (2008). Identifying clinically distinct subgroups of self-injurers among young adults: A latent class analysis. Journal of Consulting and Clinical Psychology, 76(1), 22–27. doi:10.1037/0022-006X.76.1.22.CrossRefPubMedGoogle Scholar
  37. Knightsmith, P. (2015). Self-harm and eating disorders in schools: A guide to whole-school strategies and practical support. London, Philadelphia: Jessica Kingsley Publishers.Google Scholar
  38. Kobau, R., Sniezek, J., Zack, M. M., Lucas, R. E., & Burns, A. (2010). Well-being assessment: An evaluation of well-being scales for public health and population estimates of well-being among US adults. Applied Psychology: Health and Well-Being, 2(3), 272–297. doi:10.1111/j.1758-0854.2010.01035.x.Google Scholar
  39. Kraemer, H. C., Stice, E., Kazdin, A., Offord, D., & Kupfer, D. (2001). How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. American Journal of Psychiatry, 158(6), 848–856.CrossRefPubMedGoogle Scholar
  40. LaBrie, J., Earleywine, M., Lamb, T., & Shelesky, K. (2006). Comparing electronic-keypad responses to paper-and-pencil questionnaires in group assessments of alcohol consumption and related attitudes. Addictive Behaviors, 31(12). doi: 10.1016/j.addbeh.2006.03.004.
  41. Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1994). Psychosocial risk factors for future adolescent suicide attempts. Journal of Consulting and Clinical Psychology, 62(2), 297–305.CrossRefPubMedGoogle Scholar
  42. Lloyd-Richardson, E. E., Perrine, N., Dierker, L., & Kelley, M. L. (2007). Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychological Medicine, 37(8), 1183–1192. doi:10.1017/S003329170700027X.CrossRefPubMedPubMedCentralGoogle Scholar
  43. Lofthouse, N., & Yager-Schweller, J. (2009). Nonsuicidal self-injury and suicide risk among adolescents. Current Opinion in Pediatrics, 21(5), 641–645. doi:10.1097/MOP.0b013e3283306825.CrossRefPubMedGoogle Scholar
  44. Lundh, L., Wångby-lundh, M., & Ulander, J. (2009). Emotional tone in young adolescents’ close relationships and its association with deliberate self-harm. Interpersona, 3(1), 111–138.CrossRefGoogle Scholar
  45. Madge, N., Hawton, K., McMahon, E. M., Corcoran, P., De Leo, D., De Wilde, E. J., et al. (2011). Psychological characteristics, stressful life events and deliberate self-harm: Findings from the child & adolescent self-harm in. Europe (CASE) study. European Child and Adolescent Psychiatry, 20(10), 499–508. doi:10.1007/s00787-011-0210-4.CrossRefPubMedGoogle Scholar
  46. Madge, N., Hewitt, A., Hawton, K., de Wilde, E. J., Corcoran, P., Fekete, S., et al. (2008). Deliberate self-harm within an international community sample of young people: Comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. Journal of child psychology and psychiatry, and allied disciplines, 49(6), 667–677. doi:10.1111/j.1469-7610.2008.01879.x.CrossRefPubMedGoogle Scholar
  47. Mars, B., Heron, J., Crane, C., Hawton, K., Kidger, J., Lewis, G., et al. (2014). Differences in risk factors for self-harm with and without suicidal intent: Findings from the ALSPAC cohort. Journal of Affective Disorders, 168(2014), 407–414. doi:10.1016/j.jad.2014.07.009.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Martin, J., Bureau, J. F., Yurkowski, K., Lafontaine, M. F., & Cloutier, P. (2016). Heterogeneity of relational backgrounds is associated with variation in non-suicidal self-injurious behavior. Journal of Abnormal Child Psychology, 44(3), 511–522. doi:10.1007/s10802-015-0048-1.CrossRefPubMedGoogle Scholar
  49. McVey-Noble, M. E., Khlemlani-Patel, S., & Neziroglu, F. (2006). When your child is cutting: A parent’s guide to helping children overcome self-injury. Oakland, CA: New Harbinger Publications.Google Scholar
  50. Moran, P., Coffey, C., Romaniuk, H., Olsson, C., Borschmann, R., Carlin, J. B., & Patton, G. C. (2012). The natural history of self-harm from adolescence to young adulthood: A population-based cohort study. The Lancet, 379(11), 236–243. doi:10.1016/S0140-6736(11)61141-0.CrossRefGoogle Scholar
  51. Morgan, H. G. (1979). Death wishes? The understanding and management of deliberate self-harm. Chichester: Wiley.Google Scholar
  52. Muehlenkamp, J. J., Walsh, B. W., & McDade, M. (2010). Preventing non-suicidal self-injury in adolescents: The signs of self-injury program. Journal of Youth and Adolescence, 39(3), 306–314. doi:10.1007/s10964-009-9450-8.CrossRefPubMedGoogle Scholar
  53. Neto, F. (1993). The satisfaction with life scale: Psychometric properties in an adolescent sample. Journal of Youth and Adolescence, 22(2), 125–134. doi:10.1007/BF01536648.CrossRefGoogle Scholar
  54. O’Connor, R. C., Rasmussen, S., Miles, J., & Hawton, K. (2009). Self-harm in adolescents: Self-report survey in schools in Scotland. British Journal of Psychiatry, 194(1), 68–72. doi:10.1192/bjp.bp.107.047704.CrossRefPubMedGoogle Scholar
  55. O’Donnell, L., O’Donnell, C., Wardlaw, D. M., & Stueve, A. (2004). Risk and resiliency factors influencing suicidality among urban African American and Latino youth. American Journal of Community Psychology, 33(1–2), 37–49. doi:10.1023/B:AJCP.0000014317.20704.0b.CrossRefPubMedGoogle Scholar
  56. Ougrin, D., & Boege, I. (2013). The self harm questionnaire: A new tool designed to improve identification of self harm in adolescents. Journal of Adolescence, 36(1), 221–225. doi:10.1016/j.adolescence.2012.09.006.CrossRefPubMedGoogle Scholar
  57. Owens, D., Kelley, R., Munyombwe, T., Bergen, H., Hawton, K., Cooper, J., et al. (2015). Switching methods of self-harm at repeat episodes: Findings from a multicentre cohort study. Journal of Affective Disorders, 180(2015), 44–51. doi:10.1016/j.jad.2015.03.051.CrossRefPubMedGoogle Scholar
  58. Pargament, K. I., Smith, B. W., Koenig, H. G., & Perez, L. (1998). Patterns of positive and negative religious coping with major life stressors. Journal for the Scientific Study of Religion, 37(4), 710–724. doi:10.1086/250095.CrossRefGoogle Scholar
  59. Perry, Y., Petrie, K., Buckley, H., Cavanagh, L., Clarke, D., Winslade, M., et al. (2014). Effects of a classroom-based educational resource on adolescent mental health literacy: A cluster randomised controlled trial. Journal of Adolescence, 37(7), 1143–1151. doi:10.1016/j.adolescence.2014.08.001.CrossRefPubMedGoogle Scholar
  60. Piko, B. (2001). Gender differences and similarities in adolescents’ ways of coping. The Psychological Record, 51(2), 223–235.CrossRefGoogle Scholar
  61. Plante, T. G., Vallaeys, C. L., Sherman, A. C., & Wallston, K. A. (2002). The development of a brief version of the Santa Clara strength of religious faith questionnaire. Pastoral Psychology, 50(5), 359–368. doi:10.1023/A:1014413720710.CrossRefGoogle Scholar
  62. Rigby, K., & Slee, P. T. (1993). Dimensions of interpersonal relation among Australian children and implications for psychological well-being. Journal of Chemical Information and Modeling, 133(1), 33–42. doi:10.1017/CB O9781107415324.004.Google Scholar
  63. Robinson, J., Cox, G., Malone, A., Williamson, M., Baldwin, G., Fletcher, K., & O’Brien, M. (2013). A systematic review of school-based interventions aimed at preventing, treating, and responding to suicide-related behavior in young people. Crisis, 34(3), 164–182. doi:10.1027/0227-5910/a000168.CrossRefPubMedGoogle Scholar
  64. Robinson, J., Gook, S., Yuen, H. P., McGorry, P. D., & Yung, A. R. (2008). Managing deliberate self-harm in young people: An evaluation of a training program developed for school welfare staff using a longitudinal research design. BMC Psychiatry, 8, 75. doi:10.1186/1471-244X-8-75.CrossRefPubMedPubMedCentralGoogle Scholar
  65. Robinson, J., Hetrick, S. E., & Martin, C. (2011). Preventing suicide in young people: Systematic review. Australian and New Zealand Journal of Psychiatry, 45(1), 3–26.CrossRefPubMedGoogle Scholar
  66. Robinson, J., McCutcheon, L., Browne, V., & Witt, K. (2016). Looking the other way: Young people and self-harm. Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne.Google Scholar
  67. Roffman, J. G., Pagano, M. E., & Hirsch, B. J. (2001). Youth functioning and experiences in inner-city after-school programs among age, gender, and race groups. Journal of Child and Family Studies, 10(1), 85–100. doi:10.1023/A.CrossRefPubMedPubMedCentralGoogle Scholar
  68. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
  69. Rubenstein, J. L., Halton, A., Kasten, L., Rubin, C., & Stechler, G. (1998). Suicidal behavior in adolescents: Stress and protection in different family contexts. The American Journal of Orthopsychiatry, 68(2), 274–284. doi:10.1037/h0080336.CrossRefPubMedGoogle Scholar
  70. Somer, O., Bildik, T., Kabukçu-Başay, B., Güngör, D., Başay, Ö., & Farmer, R. F. (2015). Prevalence of non-suicidal self-injury and distinct groups of self-injurers in a community sample of adolescents. Social Psychiatry and Psychiatric Epidemiology, 50(7), 1163–1171. doi:10.1007/s00127-015-1060-z.CrossRefPubMedGoogle Scholar
  71. Stallard, P., Spears, M., Montgomery, A. A., Phillips, R., & Sayal, K. (2013). Self-harm in young adolescents (12-16 years): Onset and short-term continuation in a community sample. BMC Psychiatry, 13(1), 328. doi:10.1186/1471-244X-13-328.CrossRefPubMedPubMedCentralGoogle Scholar
  72. Stanford, S., & Jones, M. P. (2010). How much detail needs to be elucidated in self-harm research?. Journal of Youth and Adolescence, 39(5), 504–513. doi:10.1007/s10964-009-9492-y.CrossRefPubMedGoogle Scholar
  73. Stanford, S., & Jones, M. P. (2012). Psychological profile in an adolescent community sample: Its relation to self-harm. In A. M. Columbia (Ed.), Advances in psychology research (pp. 77–92). New York: Nova Science Publishers.Google Scholar
  74. Stanford, S., & Jones, M. P. (2015). Finding focus in adolescent self-harm research: A literature review to guide research into risk and protective factors for self-harm. Manuscript Submitted for Publication.Google Scholar
  75. Swenson, P. L. (2003). A psychometric study of the Rosenberg Self-Esteem Scale: An investigation of gender differences. Retrieved from
  76. Taliaferro, L. A., & Muehlenkamp, J. J., (2014). Risk and protective factors that distinguish adolescents who attempt suicide from those who only consider suicide in the past year. Suicide and Life-Threatening Behavior, 44(1), 6–22. doi:10.1111/sltb.12046.CrossRefPubMedGoogle Scholar
  77. Thullen, M. J., Taliaferro, L. A., & Muehlenkamp, J. J. (2015). Suicide ideation and attempts among adolescents engaged in risk behaviors: A latent class analysis. Journal of Research on Adolescence, 26(3), 587–594. doi: 10.1111/jora.12199.
  78. Tolmunen, T., Rissanen, M.-L., Hintikka, J.,Maaranen, P., Honkalampi, K., Kylmä, J., & Laukkanen, E. (2008). Dissociation, self-cutting, and other self-harm behavior in a general population of Finnish adolescents. The Journal of Nervous and Mental Disease, 196(10), 768–771. doi:10.1097/NMD.0b013e3181879e11.CrossRefPubMedGoogle Scholar
  79. Townsend, E., Wadman, R., Sayal, K., Armstrong, M., Harroe, C., Majumder, P., et al. (2016). Uncovering key patterns in self-harm in adolescents: Sequence analysis using the Card Sort Task for Self-harm (CaTS). Journal of Affective Disorders, 206, 161–168. doi:10.1016/j.jad.2016.07.004.CrossRefPubMedPubMedCentralGoogle Scholar
  80. Vaux, A. (1988). Social Support: Theory, Research, and Intervention. New York: Praeger.Google Scholar
  81. Wadman, R., Clarke, D., Sayal, K., Vostanis, P., Armstrong, M., Harroe, C., et al. (2016). An interpretative phenomenological analysis of the experience of self-harm repetition and recovery in young adults. Journal of Health Psychology,
  82. Wasserman, D., Hoven, C. W., Wasserman, C., Wall, M., Eisenberg, R., Hadlaczky, G., et al. (2015). School-based suicide prevention programmes: The SEYLE cluster-randomised, controlled trial. The Lancet, 385(9977), 1536–1544. doi:10.1016/S0140-6736(14)61213-7.CrossRefGoogle Scholar
  83. White, D., Leach, C., Sims, R., Atkinson, M., & Cottrell, D. (1999). Validation of the hospital anxiety and depression scale for use with adolescents. British Journal of Psychiatry, 175(5), 452–454.CrossRefPubMedGoogle Scholar
  84. Whitlock, J. L., Muehlenkamp, J., & Eckenrode, J. (2008). Variation in nonsuicidal self-injury: Identification and features of latent classes in a college population of emerging adults. Journal of Clinical Child and Adolescent Psychology, 37(4), 725–735. doi: 10.1080/15374410802359734.
  85. Wilcox, H. C., Arria, A. M., Caldeira, K. M., Vincent, K. B., Pinchevsky, G. M., & O’Grady, K. E. (2012). Longitudinal predictors of past-year non-suicidal self-injury and motives among college students. Psychological Medicine, 42(4), 717–726. doi:10.1017/S0033291711001814.CrossRefPubMedGoogle Scholar
  86. Wyman, P. A., Brown, C. H., Inman, J., Cross, W., Schmeelk-Cone, K., Guo, J., & Pena, J. B. (2008). Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Journal of Consulting and Clinical Psychology, 76(1), 104–115. doi:10.1037/0022-006X.76.1.104.CrossRefPubMedPubMedCentralGoogle Scholar
  87. Yoshimasu, K., Kiyohara, C., & Miyashita, K., (2008). Suicidal risk factors and completed suicide: Meta-analyses based on psychological autopsy studies. Environmental Health and Preventive Medicine, 13(5), 243–256. doi:10.1007/s12199-008-0037-x.CrossRefPubMedPubMedCentralGoogle Scholar
  88. Zigmond, A. S., & Snaith, R. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.CrossRefPubMedGoogle Scholar

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© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Macquarie UniversityNorth RydeAustralia

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