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Abstract

Objective:

Self-harm is associated with violent offending. However, little is known about young people who engage in “dual-harm” behavior. The authors investigated antecedents, clinical features, and life characteristics distinguishing dual-harming adolescents from those who self-harm only.

Methods:

Participants were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative U.K. cohort of 2,232 twins born in 1994 and 1995. Self-harm in adolescence was assessed through interviews at age 18. Violent offending was assessed using a computer questionnaire at age 18 and police records through age 22. Risk factors were assessed between ages 5 and 12. Adolescent mental health, victimization, personality functioning, and use of support services were measured at age 18.

Results:

Self-harm was associated with violent crime (odds ratio=3.50, 95% CI=2.61–4.70), even after accounting for familial risk factors. Dual harmers had been victims of violence from childhood and exhibited lower childhood self-control and lower childhood IQ than self-only harmers. Dual harmers experienced higher rates of concurrent psychotic symptoms and substance dependence. They also exhibited distinct personality styles characterized by resistance to change and by emotional and interpersonal lability. However, dual harmers were not more likely than self-only harmers to have contact with mental health services.

Conclusions:

Dual harmers have self-control difficulties and are immersed in violence from a young age. A treatment- rather than punishment-oriented approach is indicated to meet these individuals’ needs. Connecting self-harming adolescents with delinquency-reduction programs and transdiagnostic approaches that target self-regulation may reduce harmful behaviors. Preventing childhood maltreatment and implementing strategies to reduce victimization exposure could mitigate risk for both internalized and externalized violence.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 186 - 195
PubMed: 30606048

History

Received: 25 June 2018
Revision received: 12 August 2018
Revision received: 13 September 2018
Accepted: 20 September 2018
Published online: 4 January 2019
Published in print: March 01, 2019

Keywords

  1. Self-harm
  2. Violence/Aggression
  3. Adolescents
  4. Risk Factors
  5. Longitudinal

Authors

Details

Leah S. Richmond-Rakerd, Ph.D. [email protected]
The Department of Psychology and Neuroscience, Duke University, Durham, N.C. (Richmond-Rakerd, Caspi, Houts, Wertz, Moffitt); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham (Caspi, Moffitt); the Center for Genomic and Computational Biology, Duke University, Durham (Caspi, Moffitt); the Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Caspi, Arseneault, Baldwin, Danese, Matthews, Moffitt); the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Danese); and the National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London (Danese).
Avshalom Caspi, Ph.D.
The Department of Psychology and Neuroscience, Duke University, Durham, N.C. (Richmond-Rakerd, Caspi, Houts, Wertz, Moffitt); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham (Caspi, Moffitt); the Center for Genomic and Computational Biology, Duke University, Durham (Caspi, Moffitt); the Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Caspi, Arseneault, Baldwin, Danese, Matthews, Moffitt); the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Danese); and the National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London (Danese).
Louise Arseneault, Ph.D.
The Department of Psychology and Neuroscience, Duke University, Durham, N.C. (Richmond-Rakerd, Caspi, Houts, Wertz, Moffitt); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham (Caspi, Moffitt); the Center for Genomic and Computational Biology, Duke University, Durham (Caspi, Moffitt); the Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Caspi, Arseneault, Baldwin, Danese, Matthews, Moffitt); the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Danese); and the National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London (Danese).
Jessie R. Baldwin, Ph.D.
The Department of Psychology and Neuroscience, Duke University, Durham, N.C. (Richmond-Rakerd, Caspi, Houts, Wertz, Moffitt); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham (Caspi, Moffitt); the Center for Genomic and Computational Biology, Duke University, Durham (Caspi, Moffitt); the Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Caspi, Arseneault, Baldwin, Danese, Matthews, Moffitt); the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Danese); and the National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London (Danese).
Andrea Danese, M.D., Ph.D.
The Department of Psychology and Neuroscience, Duke University, Durham, N.C. (Richmond-Rakerd, Caspi, Houts, Wertz, Moffitt); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham (Caspi, Moffitt); the Center for Genomic and Computational Biology, Duke University, Durham (Caspi, Moffitt); the Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Caspi, Arseneault, Baldwin, Danese, Matthews, Moffitt); the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Danese); and the National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London (Danese).
Renate M. Houts, Ph.D.
The Department of Psychology and Neuroscience, Duke University, Durham, N.C. (Richmond-Rakerd, Caspi, Houts, Wertz, Moffitt); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham (Caspi, Moffitt); the Center for Genomic and Computational Biology, Duke University, Durham (Caspi, Moffitt); the Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Caspi, Arseneault, Baldwin, Danese, Matthews, Moffitt); the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Danese); and the National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London (Danese).
Timothy Matthews, Ph.D.
The Department of Psychology and Neuroscience, Duke University, Durham, N.C. (Richmond-Rakerd, Caspi, Houts, Wertz, Moffitt); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham (Caspi, Moffitt); the Center for Genomic and Computational Biology, Duke University, Durham (Caspi, Moffitt); the Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Caspi, Arseneault, Baldwin, Danese, Matthews, Moffitt); the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Danese); and the National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London (Danese).
Jasmin Wertz, Ph.D.
The Department of Psychology and Neuroscience, Duke University, Durham, N.C. (Richmond-Rakerd, Caspi, Houts, Wertz, Moffitt); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham (Caspi, Moffitt); the Center for Genomic and Computational Biology, Duke University, Durham (Caspi, Moffitt); the Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Caspi, Arseneault, Baldwin, Danese, Matthews, Moffitt); the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Danese); and the National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London (Danese).
Terrie E. Moffitt, Ph.D.
The Department of Psychology and Neuroscience, Duke University, Durham, N.C. (Richmond-Rakerd, Caspi, Houts, Wertz, Moffitt); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham (Caspi, Moffitt); the Center for Genomic and Computational Biology, Duke University, Durham (Caspi, Moffitt); the Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Caspi, Arseneault, Baldwin, Danese, Matthews, Moffitt); the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Danese); and the National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London (Danese).

Notes

Send correspondence to Dr. Richmond-Rakerd ([email protected]).
Presented as a poster at the annual meeting of the American Psychopathological Association, New York, March 1–3, 2018.

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

Jacobs Foundation10.13039/501100003986:
Medical Research Council10.13039/501100000265: G1002190
Eunice Kennedy Shriver National Institute of Child Health and Human Development10.13039/100009633: HD007376, HD077482
Avielle Foundation: HD007376, HD077482
The E-Risk Study is funded by the Medical Research Council (grant G1002190). Additional support was provided by National Institute of Child Health and Development (NICHD) grant HD077482, the Jacobs Foundation, and the Avielle Foundation. Dr. Richmond-Rakerd was supported by a postdoctoral fellowship from NICHD (T32-HD007376) through the Center for Developmental Science at the University of North Carolina at Chapel Hill.

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