title: Reasons for adolescent deliberate self-harm: a cry of pain and/or a cry for help? Findings from the child and adolescent self-harm in Europe (CASE) study.
abstract: The present study examines reasons for adolescent deliberate self-harm. A cross-sectional survey using an anonymous self-report questionnaire was carried out in seven countries (Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway). Data on 30,477 school pupils between the ages of 14-17 were analysed. Past year and lifetime deliberate self-harm were assessed, along with the self-reported reasons for deliberate self-harm. The results showed that 'wanted to get relief from a terrible state of mind' and 'wanted to die' were most commonly reported. Principal component analysis indicated two underlying dimensions in the reasons for deliberate self-harm, i.e. a cry of pain motive and/or a cry for help motive. The majority of self-harmers reported at least one cry of pain motive ('to die', 'to punish myself', and 'to get relief from a terrible state of mind') and an additional cry for help motive ('to show how desperate I was feeling', to frighten someone', 'to get my own back on someone', 'to find out whether someone really loved me', and 'to get some attention'). Females reported more reasons than males. Only females showed an age difference, with girls aged 16-17 more frequently reporting a cry for help motive. There was considerable consistency in choice of motives across countries and genders. Systematic assessment of the reasons for deliberate self-harm can help clinicians to better understand the meaning of self harming behaviour, select appropriate treatment, suggest alternative coping strategies, and hopefully prevent future suicidal behaviour.
authors.affiliation: Unit for Suicide Research, Dept. of Psychiatry and Medical Psychology, University of Ghent, UZ Gent 1K12F, De Pintelaan 185, 9000 Ghent, Belgium. gerrit.scoliers@telenet.be
authors.forename: Gerrit
authors.initials: G
authors.lastname: Scoliers
authors.forename: Gwendolyn
authors.initials: G
authors.lastname: Portzky
authors.forename: Nicola
authors.initials: N
authors.lastname: Madge
authors.forename: Anthea
authors.initials: A
authors.lastname: Hewitt
authors.forename: Keith
authors.initials: K
authors.lastname: Hawton
authors.forename: Erik Jan
authors.initials: EJ
authors.lastname: de Wilde
authors.forename: Mette
authors.initials: M
authors.lastname: Ystgaard
authors.forename: Ella
authors.initials: E
authors.lastname: Arensman
authors.forename: Diego
authors.initials: D
authors.lastname: De Leo
authors.forename: Sandor
authors.initials: S
authors.lastname: Fekete
authors.forename: Kees
authors.initials: K
authors.lastname: van Heeringen
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology*; D012737:Sex Factors; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires