Marzecki Filip, Ahmadzadeh Yasmin I, Oginni Olakunle A, Pingault Jean-Baptiste, McAdams Thomas A, Zavos Helena M S
Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
The Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK.
J Child Psychol Psychiatry. 2025 Jun;66(6):857-867. doi: 10.1111/jcpp.14096. Epub 2024 Dec 13.
Almost one in five (18.8%) UK adolescents are estimated to self-harm and many young people initiate self-harm early (average age 13 years). Prevention of self-harm should be informed by knowledge about risk factors (e.g. socio-demographic indices), characteristics (i.e. motivation for self-harm and help-seeking behaviours), as well as relative aetiological genetic and environmental processes. Previous twin studies evidence both genetic and environmental influences on self-harm. However, to date, there has been no genetically informed research on self-harm aetiology across development, nor studies identifying risk factors for initiating self-harm at a younger age.
We examined self-harm in the Twins Early Development Study, a birth cohort twin study. Using clustered regression models, we tested associations of socio-demographic factors and victimisation with lifetime self-harm and age of self-harm initiation, both reported at 21. To investigate stability and/or change in genetic and environmental influences on self-harm we interpreted a multivariate Cholesky decomposition across ages ≤16, 21, and 26.
Self-harm was more common in adolescence than early adulthood, and the incidence of self-harm in early adulthood was low (1.4%). The most common motivation for self-harm was 'to get relief from a terrible state of mind' (83.4%). Independent predictors of self-harm and earlier initiation of self-harm were being female, belonging to a gender and/or sexual minority group, and experience of bullying victimisation. Sexual minority status was still significantly associated with self-harm after controlling for familial factors in co-twin control analyses. The Cholesky decomposition showed stability in genetic influences and innovation in non-shared environmental influences on self-harm.
Adolescence should be a key period for self-harm interventions. Women, sexual, and gender minorities, and those experiencing victimisation may need targeted support early in adolescence. Furthermore, it should be acknowledged that different individuals can be at risk at different stages as environmental factors influencing self-harm change across time.
据估计，英国近五分之一（18.8%）的青少年存在自我伤害行为，许多年轻人在早期（平均年龄13岁）就开始自我伤害。自我伤害的预防应基于对风险因素（如社会人口统计学指标）、特征（即自我伤害的动机和寻求帮助的行为）以及相关病因学上的遗传和环境过程的了解。先前的双胞胎研究证明了遗传和环境对自我伤害均有影响。然而，迄今为止，尚无关于自我伤害病因在整个发育过程中的遗传学研究，也没有研究确定在较年轻时开始自我伤害的风险因素。
我们在双胞胎早期发育研究（一项出生队列双胞胎研究）中对自我伤害进行了研究。使用聚类回归模型，我们测试了社会人口统计学因素和受侵害情况与终生自我伤害及自我伤害开始年龄之间的关联，这些数据均在21岁时报告。为了研究遗传和环境对自我伤害影响的稳定性和/或变化，我们对年龄≤16岁、21岁和26岁的多变量进行了Cholesky分解。
自我伤害在青少年期比成年早期更为常见，成年早期自我伤害的发生率较低（1.4%）。自我伤害最常见的动机是“从糟糕的心理状态中解脱出来”（83.4%）。自我伤害和较早开始自我伤害的独立预测因素包括女性、属于性别和/或性少数群体以及受欺凌的经历。在双胞胎对照分析中控制家族因素后，性少数群体身份仍与自我伤害显著相关。Cholesky分解显示了遗传影响的稳定性以及非共享环境对自我伤害影响的创新性。
青少年期应是自我伤害干预的关键时期。女性、性少数群体和性别少数群体以及那些遭受侵害的人在青少年早期可能需要有针对性的支持。此外，应该认识到，由于影响自我伤害的环境因素随时间变化，不同个体在不同阶段可能面临风险。
