Self-harm in adolescence and the influence of gender and peer networks
Lead Research Organisation:
King's College London
Department Name: Health Service and Population Research
Abstract
Self-harm in adolescence is a growing public health concern both in the UK and internationally. Self-harm is the leading risk factor for later suicide, and suicide is the second leading cause of death before the age of 25. Self-harm is more commonly reported in women and a 68% increase in self-harm incidence was observed among girls aged 13-16 between 2011 and 2014 in the UK compared with boys of the same age. While both boys and girls engage in self-harm, self-harm among adolescent boys is receiving growing attention.
Self-harm among adolescents is a concerning phenomenon. There is evidence to suggest that boys and girls differ in the ways they self-harm and their risk factors for it. We do not have a clear understanding about if self-harm means the same thing in adolescent girls and boys and what the processes, risks and protective factors are between them. It is important to investigate perceptions and interpretations of self-harm in adolescents, determine the specific factors that precipitate it for an individual and identify factors that could increase and decrease the likelihood of self-harm.
The aim of this PhD project is to examine questions on the gender differences in adolescents who self-harm. The main research questions are: 1. Are the rates of self-harm different in adolescent boys and girls and do boys and girls self-harm in different ways? 2. Does self-harm spread differently across social networks in boys and girls and why is this? Do girls seek help for self-harm more than boys? Is self-harm more hidden among boys? 3. Does self-harm mean the same thing to both boys and girls? 4. What do boys understand self-harm to mean? These questions will be addressed through (i) a systematic review on gender differences in self-harm; (ii) utilising longitudinal data from the Resilience, Ethnicity and Adolescent Mental Health (REACH) cohort in south London (UK) to conduct quantitative and social network analyses; and (iii) conducting semi-structured qualitative interviews with 15-20 adolescent boys from the REACH cohort.
Self-harm among adolescents is a concerning phenomenon. There is evidence to suggest that boys and girls differ in the ways they self-harm and their risk factors for it. We do not have a clear understanding about if self-harm means the same thing in adolescent girls and boys and what the processes, risks and protective factors are between them. It is important to investigate perceptions and interpretations of self-harm in adolescents, determine the specific factors that precipitate it for an individual and identify factors that could increase and decrease the likelihood of self-harm.
The aim of this PhD project is to examine questions on the gender differences in adolescents who self-harm. The main research questions are: 1. Are the rates of self-harm different in adolescent boys and girls and do boys and girls self-harm in different ways? 2. Does self-harm spread differently across social networks in boys and girls and why is this? Do girls seek help for self-harm more than boys? Is self-harm more hidden among boys? 3. Does self-harm mean the same thing to both boys and girls? 4. What do boys understand self-harm to mean? These questions will be addressed through (i) a systematic review on gender differences in self-harm; (ii) utilising longitudinal data from the Resilience, Ethnicity and Adolescent Mental Health (REACH) cohort in south London (UK) to conduct quantitative and social network analyses; and (iii) conducting semi-structured qualitative interviews with 15-20 adolescent boys from the REACH cohort.
Organisations
Studentship Projects
| Project Reference | Relationship | Related To | Start | End | Student Name |
|---|---|---|---|---|---|
| ES/P000703/1 | 01/10/2017 | 30/09/2027 | |||
| 2466069 | Studentship | ES/P000703/1 | 01/10/2020 | 30/11/2023 | Holly Crudgington |
| Description | Magazine article: NICE guidelines for self-harm: a new school of thought |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Article/blog published about NICE guidelines in the Association for Child and Adolescent Mental Health (ACAMH)'s magazine 'The Bridge' which shares the latest clinically relevant child and adolescent mental health research, best practice, and policy. Email from Editor on 5th May to say "It launched on 31 March and has been referenced across social media, and our e-newsletter and has had nearly 5,000 views on our webpage. This represents 3% of all the site visits in this period. Which is extremely good for a blog. It has a comparable bounce rate to our other blogs, but importantly it has an extremely high dwell time of 4m 20secs, indicating people are reading the whole article. It has been our most popular single piece of content (blog, podcast, recorded talk, online event) in this time, which is a great effort." Audience - professionals, schools, general public, Impact arisen - developed this into a workshop for young people (see other output on adolescent self-harm workshop) |
| Year(s) Of Engagement Activity | 2022 |
| URL | http://www.acamh.org/blog/nice-guidelines-for-self-harm-a-new-school-of-thought |
| Description | Mental Elf Blog 1: Blue Whale Challenge and suicide contagion |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | I reviewed a qualitative study that examines the self-harm and suicide contagion effects of the Blue Whale Challenge on YouTube and Twitter for Mental Elf. Intended purpose: to review academic research in the field of self-harm and suicide and communicate it in an engaging way for the audience of the Mental Elf. The Mental Elf initiative involves mental health experts posting blogs with short and snappy summaries that highlight evidence-based publications relevant to mental health practice in the UK and further afield. Audience/purpose: to facilitate a democratic conversation between patients, clinicians, researchers, carers, policy-makers, health and social care professionals and others in a public space. |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://www.nationalelfservice.net/mental-health/suicide/blue-whale-challenge-suicide-contagion/ |
| Description | Mental Elf Blog 3: Risk factors for suicide in men: new review highlights substance misuse, marital status and depression |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | "Holly Crudgington summarises a recent systematic review and narrative synthesis of risk factors for suicidal behaviour in men, which finds that substance misuse, marital status and depression are the strongest risk factors." Intended purpose: to review academic research in the field of self-harm and suicide and communicate it in an engaging way for the audience of the Mental Elf. The Mental Elf initiative involves mental health experts posting blogs with short and snappy summaries that highlight evidence-based publications relevant to mental health practice in the UK and further afield. Audience/purpose: to facilitate a democratic conversation between patients, clinicians, researchers, carers, policy-makers, health and social care professionals and others in a public space. |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://www.nationalelfservice.net/mental-health/suicide/risk-factors-suicide-men/ |
| Description | Mental Elf Blog 4: Harm minimisation for self-harm: mixed-method analysis of electronic health care records finds it can be helpful |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | "Holly Crudgington reviews a mixed-methods analysis of electronic health records in secondary mental healthcare on harm minimisation for the management of self-harm". Intended purpose: to review academic research in the field of self-harm and suicide and communicate it in an engaging way for the audience of the Mental Elf. The Mental Elf initiative involves mental health experts posting blogs with short and snappy summaries that highlight evidence-based publications relevant to mental health practice in the UK and further afield. Audience/purpose: to facilitate a democratic conversation between patients, clinicians, researchers, carers, policy-makers, health and social care professionals and others in a public space. |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://www.nationalelfservice.net/mental-health/self-harm/harm-minimisation-self-harm/ |
| Description | Mental Elf Blog 5: Cyber-victimisation may be associated with self-injurious thoughts and behaviours |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | "Holly Crudgington looks at a systematic review exploring the links between social media, cyberbullying, suicide and self-harm, which identifies a link between being victimised online and suicidal behaviour, thoughts and self-harm." Intended purpose: to review academic research in the field of self-harm and suicide and communicate it in an engaging way for the audience of the Mental Elf. The Mental Elf initiative involves mental health experts posting blogs with short and snappy summaries that highlight evidence-based publications relevant to mental health practice in the UK and further afield. Audience/purpose: to facilitate a democratic conversation between patients, clinicians, researchers, carers, policy-makers, health and social care professionals and others in a public space. |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://www.nationalelfservice.net/mental-health/self-harm/cyber-victimisation-self-injurious-though... |
| Description | Mental Elf blog 2: Disclosing self-harm history: people's attributes and risk factors |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | "Holly Crudgington reviews a recent study from Manchester, which explores characteristics and risk of repetition in people who fail to report previous hospital presentations for self-harm". Intended purpose: to review academic research in the field of self-harm and suicide and communicate it in an engaging way for the audience of the Mental Elf. The Mental Elf initiative involves mental health experts posting blogs with short and snappy summaries that highlight evidence-based publications relevant to mental health practice in the UK and further afield. Audience/purpose: to facilitate a democratic conversation between patients, clinicians, researchers, carers, policy-makers, health and social care professionals and others in a public space. |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://www.nationalelfservice.net/mental-health/self-harm/disclosing-self-harm-history/ |
| Description | Rapid-fire presentation at the European Psychiatric Association (EPA) Section of Epidemiology + Social Psychiatry Conference |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Other audiences |
| Results and Impact | Presented a 4-minute rapid fire talk about my recently published systematic review on peer-friendship networks and self-harm at the EPA conference in Cambridge, UK. Audience: Room (30+ people), academic audience. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Workshop with school students about adolescent self-harm guidelines for schools |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Schools |
| Results and Impact | 30 students from a secondary school in south London attended a workshop that I set up. I discussed my article about the new NICE guidelines for self-harm which includes schools for the first time What happened: 10 mins introduction, 20 mins - we presented the evidence on self-harm in schools (e.g., how common it is, which things increase or decrease risk of self-harm, differences between genders, etc.), 30-40 mins small group work - students were invited to break into groups and brainstorm ideas for what schools (and peer groups) could do about this issue, 20-30 mins for the groups to feedback and discuss their ideas with the whole group, and to compare their ideas with the recommendations soon to be released by NICE (and generally to reflect on the recommendations, e.g., whether they agree, potential barriers, etc.). Most significant outcome - tailored recommendations for schools |
| Year(s) Of Engagement Activity | 2022 |