title: The influence of personality disorder on outcome in adolescent self-harm.
abstract: BACKGROUND
  Little is currently known about the presence and impact of personality disorder in adolescents who self-harm.
  
  
  OBJECTIVE
  To evaluate personality disorder in repeated self-harm in adolescence and its impact on self-harm psychopathology and adaptation outcomes over 1 year.
  
  
  METHODS
  A clinical referral sample (n = 366) of adolescents presenting with repeated self-harm aged 12-17 years, as part of a randomised controlled trial (Assessment of Treatment in Suicidal Teenagers study, ASSIST). Personality disorder was assessed using the Structured Clinical Interview for DSM-IV Axis II (SCID-II). One-year outcomes included frequency and severity of repeat self-harm, self-reported suicidality, mood and functional impairment.
  
  
  RESULTS
  About 60% of the referred adolescents showed one or more forms of personality disorder. Personality disorder was associated with significantly greater severity of self-harm, overall psychopathology and impairment. There was a complex association with treatment adherence. Personality disorder predicted worse 1-year outcomes in relation to self-harm frequency and severity, as well as impairment, suicidality and depressive symptoms.
  
  
  CONCLUSIONS
  Personality disorder can be reliably measured in adolescence and showed high prevalence in this clinical self-harm sample. Controlling for other variables, it showed a strong independent association with self-harm severity at referral and predicted adherence to treatment and clinical outcomes (independent of treatment) over 1 year. Consideration of personality disorder diagnosis is indicated in the assessment and management of adolescents who repeatedly self-harm.
authors.affiliation: Eunice Ayodeji, PhD, Lecturer, School of Nursing, Midwifery and Social Work, University of Salford, Salford; Jonathan Green, FRCPsych, Professor, Chris Roberts, PhD, Professor, Community Based Medicine, University of Manchester, Manchester; Gemma Trainor, PhD, Nurse Consultant, Greater Manchester West, Manchester; Justine Rothwell, PhD, Research Associate, Adrine Woodham, MA, Research Assistant, Community Based Medicine, University of Manchester, Manchester; Alison Wood, MRCPsych, Consultant, Pennine Care NHS Foundation Trust, UK e.ayodeji@salford.ac.uk.
authors.forename: Eunice
authors.initials: E
authors.lastname: Ayodeji
authors.affiliation: Eunice Ayodeji, PhD, Lecturer, School of Nursing, Midwifery and Social Work, University of Salford, Salford; Jonathan Green, FRCPsych, Professor, Chris Roberts, PhD, Professor, Community Based Medicine, University of Manchester, Manchester; Gemma Trainor, PhD, Nurse Consultant, Greater Manchester West, Manchester; Justine Rothwell, PhD, Research Associate, Adrine Woodham, MA, Research Assistant, Community Based Medicine, University of Manchester, Manchester; Alison Wood, MRCPsych, Consultant, Pennine Care NHS Foundation Trust, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Green
authors.affiliation: Eunice Ayodeji, PhD, Lecturer, School of Nursing, Midwifery and Social Work, University of Salford, Salford; Jonathan Green, FRCPsych, Professor, Chris Roberts, PhD, Professor, Community Based Medicine, University of Manchester, Manchester; Gemma Trainor, PhD, Nurse Consultant, Greater Manchester West, Manchester; Justine Rothwell, PhD, Research Associate, Adrine Woodham, MA, Research Assistant, Community Based Medicine, University of Manchester, Manchester; Alison Wood, MRCPsych, Consultant, Pennine Care NHS Foundation Trust, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Roberts
authors.affiliation: Eunice Ayodeji, PhD, Lecturer, School of Nursing, Midwifery and Social Work, University of Salford, Salford; Jonathan Green, FRCPsych, Professor, Chris Roberts, PhD, Professor, Community Based Medicine, University of Manchester, Manchester; Gemma Trainor, PhD, Nurse Consultant, Greater Manchester West, Manchester; Justine Rothwell, PhD, Research Associate, Adrine Woodham, MA, Research Assistant, Community Based Medicine, University of Manchester, Manchester; Alison Wood, MRCPsych, Consultant, Pennine Care NHS Foundation Trust, UK.
authors.forename: Gemma
authors.initials: G
authors.lastname: Trainor
authors.affiliation: Eunice Ayodeji, PhD, Lecturer, School of Nursing, Midwifery and Social Work, University of Salford, Salford; Jonathan Green, FRCPsych, Professor, Chris Roberts, PhD, Professor, Community Based Medicine, University of Manchester, Manchester; Gemma Trainor, PhD, Nurse Consultant, Greater Manchester West, Manchester; Justine Rothwell, PhD, Research Associate, Adrine Woodham, MA, Research Assistant, Community Based Medicine, University of Manchester, Manchester; Alison Wood, MRCPsych, Consultant, Pennine Care NHS Foundation Trust, UK.
authors.forename: Justine
authors.initials: J
authors.lastname: Rothwell
authors.affiliation: Eunice Ayodeji, PhD, Lecturer, School of Nursing, Midwifery and Social Work, University of Salford, Salford; Jonathan Green, FRCPsych, Professor, Chris Roberts, PhD, Professor, Community Based Medicine, University of Manchester, Manchester; Gemma Trainor, PhD, Nurse Consultant, Greater Manchester West, Manchester; Justine Rothwell, PhD, Research Associate, Adrine Woodham, MA, Research Assistant, Community Based Medicine, University of Manchester, Manchester; Alison Wood, MRCPsych, Consultant, Pennine Care NHS Foundation Trust, UK.
authors.forename: Adrine
authors.initials: A
authors.lastname: Woodham
authors.affiliation: Eunice Ayodeji, PhD, Lecturer, School of Nursing, Midwifery and Social Work, University of Salford, Salford; Jonathan Green, FRCPsych, Professor, Chris Roberts, PhD, Professor, Community Based Medicine, University of Manchester, Manchester; Gemma Trainor, PhD, Nurse Consultant, Greater Manchester West, Manchester; Justine Rothwell, PhD, Research Associate, Adrine Woodham, MA, Research Assistant, Community Based Medicine, University of Manchester, Manchester; Alison Wood, MRCPsych, Consultant, Pennine Care NHS Foundation Trust, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D003863:Depression; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010554:Personality Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D011569:Psychiatric Status Rating Scales; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000628:therapy; D013405:Suicide; D011795:Surveys and Questionnaires; D016896:Treatment Outcome