title: Immigration as risk factor for non-suicidal self-injury and suicide attempts in adolescents in Germany.
abstract: BACKGROUND
  Whereas non-suicidal self-injury (NSSI) and suicide attempts (SA) are rather common among adolescents, the description of risk factors has often failed to take migration into perspective. Our study aimed to describe immigration status in adolescents with regards to their lifetime history of NSSI and SA.
  
  
  METHODS
  We carried out a population based study in a school community of ninth-graders (N = 452, mean age 14.85, SD 0.58) in southern Germany. Data were collected via adolescent self report on sociodemographic variables and on NSSI and SA using the Self Harm Behavior Questionnaire.
  
  
  RESULTS
  Adolescents born outside Germany showed an elevated rate of a lifetime history of NSSI and SA. When compared to German adolescents without a (family) history of migration (NSSI 19.16%, SA 3.24%), adolescents who were born in another country had an elevated risk for NSSI (42.86%, OR 3.36) and SA (17.86%, OR 6.78), which was higher than the risk of adolescents who had at least one parent who had emigrated from another country (NSSI 30.08%, OR 2.46 and SA 8.94%, OR 4.45).
  
  
  CONCLUSIONS
  Our findings should inform intervention services and prevention programs for NSSI and suicidality in youth. Adopting such programs to include culturally sensible modules could improve the outcome in ethnically diverse adolescents.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Plener
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany.
authors.forename: Lara M
authors.initials: LM
authors.lastname: Munz
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Allroggen
authors.affiliation: Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Nestor D
authors.initials: ND
authors.lastname: Kapusta
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany.
authors.forename: Jörg M
authors.initials: JM
authors.lastname: Fegert
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Groschwitz
keywords: Adolescents; Immigration; Migration; NSSI; Non-suicidal self-injury; Suicide attempts