title: Psychological subtyping finds pathological, impulsive, and 'normal' groups among adolescents who self-harm.
abstract: BACKGROUND
  Research to date suggests that as many as 12-15% of young people engage in self-harm behaviour; however, the current understanding of the psychological basis of adolescent self-harm is limited. The objective was to determine whether adolescents who self-harm are a psychologically homogenous group. It was hypothesised that psychological subtypes would exist and these groups would report different rates of self-harm.
  
  
  METHODS
  Nine hundred and forty-four school students aged 11 to 19 and 166 first-year psychology students aged 21 or younger completed a self-report questionnaire. Participants were aged 11 to 21 (mean = 15.4, SD = 2.1). Sixty-two percent of the sample were female (n = 692). Students were allocated to psychologically distinct groups. Rates of self-harm were compared for the psychological subtypes of self-harmers.
  
  
  RESULTS
  Two hundred and thirty-four participants reported lifetime self-harm (21.1%; 95% CI 19-23%) and 78 reported recent self-harm (7.0%; 95% CI 6.7-7.3%). The present study identified three psychologically quite distinct groups of adolescents within those who reported self-harm - a psychologically pathological group, a psychologically 'normal' group, and an impulsive group. The pathological group reported the highest rate of recent self-harm (50.9%); the psychologically 'normal' and impulsive groups reported similar rates of self-harm (28.7% and 24.6%, respectively).
  
  
  CONCLUSIONS
  Adolescents who self-harm are not a psychologically homogenous group. One pathological subtype of self-harmers appears to most closely reflect a number of the psychological and social factors previously associated with self-harm. However, a large proportion of the sample was allocated the psychologically 'normal' subtype. This finding highlights the importance of psychological screening of adolescents presenting for treatment for self-harm as subtypes of self-harmers may require disparate strategies for intervention. Further research is required in order to identify appropriate treatment strategies for each subtype.
authors.affiliation: Standord University, Stanford, CA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Stanford
authors.forename: Michael P
authors.initials: MP
authors.lastname: Jones
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D001315:Australia; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012649:Self Concept; D012650:Self Disclosure; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult