Rethinking pathology in adolescent self-harm: Towards a more complex understanding of risk factors

- Past research has identified self-harm risk and protective factors including depression, anxiety and low self-esteem.
- This study identified five distinct psychological profiles among adolescents with recent self-harm.
- Profiles with psychological difficulties included: Anxiety symptoms; Impulsive; Pathological; and Pathological-Impulsive.
- One group of adolescents with recent self-harm appeared psychologically 'normal' on the domains measured.
- Adolescents with different risk factors may require disparate strategies for treatment.

Researchers have begun to consider whether there may be more than one psychological profile to describe adolescents who engage in self-harm. Limited past research suggests multiple different profiles. Australian high school students (n = 1,521, age 11-19, 56.4% female) completed an online questionnaire reporting risk and protective factors and self-harm frequency. Non-hierarchical cluster analysis allocated 256 students who reported 6-month self-harm to mutually exclusive profiles based on psychological similarity. Five distinct psychological profiles were identified: 1) Psychologically 'normal'; 2) Anxiety symptoms; 3) Impulsive; 4) Pathological; and 5) Pathological-Impulsive. The proportion of adolescents that reported 11 or more episodes of self-harm varied from 5.7% in the psychologically 'Normal' group to 27.7% in the 'Pathological- Impulsive' group. These results indicate that multiple psychological profiles exist. Adolescents with different risk factors may require disparate strategies for treatment and prevention. Given the variability in profiles, screening may assist in detecting adolescents who self-harm.