Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
PLoS One. 2020 Nov 30;15(11):e0242802. doi: 10.1371/journal.pone.0242802. eCollection 2020.
No prospective studies have examined the prevalence, antecedents or concurrent characteristics associated with self-harm in non-treatment-seeking primary school-aged children.
In this cohort study from Melbourne, Australia we assessed 1239 children annually from age 8-9 years (wave 1) to 11-12 years (wave 4) on a range of health, social, educational and family measures. Past-year self-harm was assessed at wave 4. We estimated the prevalence of self-harm and used multivariable logistic regression to examine associations with concurrent and antecedent factors.
28 participants (3% of the 1059 with self-harm data; 18 girls [3%], 10 boys [2%]) reported self-harm at age 11-12 years. Antecedent (waves 1-3) predictors of self-harm were: persistent symptoms of depression (sex-age-socioeconomic status adjusted odds ratio [aOR]: 7.8; 95% confidence intervals [CI] 2.6 to 24) or anxiety (aOR: 5.1; 95%CI 2.1 to 12), frequent bullying victimisation (aOR: 24.6; 95%CI 3.8 to 158), and recent alcohol consumption (aOR: 2.9; 95%CI 1.2 to 7.1). Concurrent (wave 4) associations with self-harm were: having few friends (aOR: 8.7; 95%CI 3.2 to 24), poor emotional control (aOR: 4.2; 95%CI 1.9 to 9.6), antisocial behaviour (theft-aOR: 3.1; 95%CI 1.2 to 7.9; carrying a weapon-aOR: 6.9; 95%CI 3.1 to 15), and being in mid-puberty (aOR: 6.5; 95%CI 1.5 to 28) or late/post-puberty (aOR: 14.4; 95%CI 2.9 to 70).
The focus of intervention efforts aimed at preventing and reducing adolescent self-harm should extend to primary school-aged children, with a focus on mental health and peer relationships during the pubertal transition.
尚无前瞻性研究探讨非治疗寻求的小学年龄儿童中与自我伤害相关的流行率、前兆或并存特征。
在这项来自澳大利亚墨尔本的队列研究中，我们每年评估 1239 名 8-9 岁（第 1 波）至 11-12 岁（第 4 波）儿童的一系列健康、社会、教育和家庭指标。在第 4 波评估过去一年的自我伤害情况。我们估计了自我伤害的流行率，并使用多变量逻辑回归来检查与并存和前兆因素的关联。
28 名参与者（有自我伤害数据的 1059 名参与者中的 3%；18 名女孩[3%]，10 名男孩[2%]）报告在 11-12 岁时有自我伤害。自我伤害的前兆（第 1-3 波）预测因素为：持续的抑郁症状（经性别-年龄-社会经济地位调整后的优势比[aOR]：7.8；95%置信区间[CI] 2.6 至 24）或焦虑（aOR：5.1；95%CI 2.1 至 12）、频繁被欺凌（aOR：24.6；95%CI 3.8 至 158）和近期饮酒（aOR：2.9；95%CI 1.2 至 7.1）。与自我伤害相关的并存（第 4 波）因素为：朋友少（aOR：8.7；95%CI 3.2 至 24）、情绪控制能力差（aOR：4.2；95%CI 1.9 至 9.6）、反社会行为（盗窃-aOR：3.1；95%CI 1.2 至 7.9；携带武器-aOR：6.9；95%CI 3.1 至 15）和处于青春期中期（aOR：6.5；95%CI 1.5 至 28）或青春期后期/后期（aOR：14.4；95%CI 2.9 至 70）。
旨在预防和减少青少年自我伤害的干预措施的重点应扩展到小学年龄的儿童，重点关注青春期过渡期间的心理健康和同伴关系。
