title: Predicting repeat self-harm in children--how accurate can we expect to be?
abstract: The main objective of the study was to find which variables predict repetition of deliberate self-harm in children. The study is based on a group of children who took part in a randomized control trial investigating the effects of a home-based family intervention for children who had deliberately poisoned themselves. These children had a range of baseline and outcome measures collected on two occasions (two and six months follow-up). Outcome data were collected from 149 (92 %) of the initial 162 children over the six months. Twenty-three children made a further deliberate self-harm attempt within the follow-up period. A number of variables at baseline were found to be significantly associated with repeat self-harm. Parental mental health and a history of previous attempts were the strongest predictors. A model of prediction of further deliberate self-harm combining these significant individual variables produced a high positive predictive value (86 %) but had low sensitivity (28 %). Predicting repeat self-harm in children is difficult, even with a comprehensive series of assessments over multiple time points, and we need to adapt services with this in mind. We propose a model of service provision which takes these findings into account.
authors.affiliation: The University Department of Child and Adolescent Psychiatry, Central Manchester and Manchester Children's University Hospitals, Hospital Road, Pendlebury, Manchester, M27 4HA, UK.
authors.forename: Prathiba
authors.initials: P
authors.lastname: Chitsabesan
authors.forename: Richard
authors.initials: R
authors.lastname: Harrington
authors.forename: Valerie
authors.initials: V
authors.lastname: Harrington
authors.forename: Barbara
authors.initials: B
authors.lastname: Tomenson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010287:Parent-Child Relations; D011237:Predictive Value of Tests; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology*