Rahman Farhan, Webb Roger T, Wittkowski Anja
School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), UK.
School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), UK; NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK.
Clin Psychol Rev. 2021 Aug;88:102048. doi: 10.1016/j.cpr.2021.102048. Epub 2021 May 29.
Self-harm behavior can begin in early adolescence, with the highest rates of self-harm, between 1990 and 2000 in England, being among adolescents aged 16 to 24 years and there being considerable risk of fatal and non-fatal repetition. Previous systematic reviews have identified risk factors for self-harm in adolescents, but not for the repetition of this behavior. The aim of this review was to synthesise the psychological, psychosocial and sociodemographic risk factors for self-harm repetition in adolescents. By searching four databases, 27 studies were identified and included in the review. Several psychological (e.g., psychiatric morbidity, features of previous self-harm, psychological distress), psychosocial (e.g., alcohol misuse, poor family and peer relationships) and sociodemographic (e.g., age, gender and ethnicity) risk factors were identified for self-harm repetition in adolescents. Several risk factors across all categories for self-harm overlapped with that of self-harm repetition, such as depression, alcohol misuse and female gender. The clinical implications of these findings for practitioners were discussed. As was the case with prior reviews in this area, comparability between studies was limited and a meta-analysis was not possible due to considerable heterogeneity in outcome definitions, measures and methodologies.
自我伤害行为可能始于青春期早期，在英国，1990年至2000年间自我伤害发生率最高的人群是16至24岁的青少年，且存在致命和非致命重复行为的重大风险。以往的系统评价已经确定了青少年自我伤害的风险因素，但未涉及这种行为重复发生的风险因素。本评价的目的是综合青少年自我伤害行为重复发生的心理、心理社会和社会人口学风险因素。通过检索四个数据库，共识别出27项研究并纳入本评价。确定了青少年自我伤害行为重复发生的若干心理（如精神疾病、既往自我伤害特征、心理困扰）、心理社会（如酒精滥用、不良的家庭和同伴关系）和社会人口学（如年龄、性别和种族）风险因素。自我伤害所有类别中的若干风险因素与自我伤害行为重复发生的风险因素重叠，如抑郁、酒精滥用和女性性别。讨论了这些发现对从业者的临床意义。与该领域以往的评价一样，研究之间的可比性有限，由于结果定义、测量方法和研究方法存在相当大的异质性，无法进行荟萃分析。
