Non-suicidal Self-Injuries and Adolescents High Risk Behaviours: Highlights from the Portuguese HBSC Study


To analyse sex differences and associations regarding non-suicidal self-injury (NSSI) behaviour and their relationship with other health compromising behaviours. Were inquired 3262 Portuguese adolescents as participants in the context of the Health Behaviour in School-aged Children study/WHO. 20.3% of the adolescents reported at least one NSSI episode. Students from 8th grade had more NSSI than 10th grade students. Concerning sex, girls report more NSSI than boys. The occurrence of NSSI for both sexs is related to alcohol use, being bullied, being a bully, carrying weapons, and safety perception at school. Regarding boys, NSSI is also related to physical activity (PA), drugs use and school grade. For both sexs, being bullied, being a bully and carrying weapons had a positive association with the NSSI occurrence. For girls, also alcohol use had a positive association with the NSSI occurrence. Safety perception at school was negatively associated with the NSSI occurrence in girls. Regarding the 8th and 10th grade students’ being bullied and carrying weapons had a positive association with the NSSI occurrence. For the 8th grade students’ alcohol use and being a bully had also a positive association with the NSSI occurrence. Safety perception at school had a negative association with the NSSI occurrence for the 8th grade students. Specific strategies that address the NSSI occurrence in adolescents are needed for Portuguese adolescents and those needs presented age (grade) and sex specificities. Public policies must take these specificities on board while designing and implementing preventive interventions with families, in the school and in the community in order to promote a safer environment at school and adolescents’ positive development. These interventions will help adolescents to better self-regulate, seek social support, make better choices and to maintain a healthy lifestyle.

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The authors would like to thanks to Team Aventura Social for all the work and support to the HSBC 2014 in Portugal.


This work was supported by the Ministry of Health. Egrants: SFRH/BSAB/135160/2017; SFRH/BPD/110905/2015; ULisboa/BD2016/609.

Author information




All authors made substantial contributions, namely:

SUSANA GAPAR: the conception and design of the study, analysis and interpretation of data; approved the final version to be submitted.

MARTA REIS: Acquisition of data and critical for important intellectual content, approved the final version to be submitted.

DIOGO GUERREIRO: Critical review for important intellectual content; approved the final version to be submitted.

DANIEL SAMPAIO: Critical review for important intellectual content; approved the final version to be submitted.

MARGARIDA GASPAR DE MATOS: Acquisition of data and interpretation of data; critical review for important intellectual content, approved the final version to be submitted.

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Correspondence to Susana Gaspar.

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Key Points

1) The NSSI occurrence was examined in a representative sample of Portuguese adolescents;

2) NSSI prevalence is different between sexs and grades (considered as a proxy of age);

3) NSSI for girls was related to alcohol use, bullying, carrying weapons and safety perception at school;

4) For boys NSSI occurrence was related to bullying and carrying weapons.

5) Only for boys PA seems to protect from NSSI

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Gaspar, S., Reis, M., Sampaio, D. et al. Non-suicidal Self-Injuries and Adolescents High Risk Behaviours: Highlights from the Portuguese HBSC Study. Child Ind Res 12, 2137–2149 (2019).

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  • Non-suicidal self-injury
  • Adolescent health
  • Risk behaviour
  • Protective behaviour
  • Health promotion