Impulsivity as a predictor of self-harm onset and maintenance in young adolescents: a longitudinal prospective study

Joanna Lockwood · Ellen Townsend · David Daley · Kapil S. Sayal

54 citations0/0 files storedJournal of Affective Disorders

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Suicide and Self-Harm Studies Personality Disorders and Psychopathology Mental Health Research Topics

Abstract

BACKGROUND: Rates of self-harm in young adolescents are increasing and self-harm typically emerges at this developmental stage. Greater specificity of impulsivity as a multifaceted construct is enabling investigation of links between individual impulsivity facets and self-harm outcomes. However, studies have yet to adequately explore these associations in young adolescents, and prospective relationships between multidimensional impulsivity and self-harm in younger adolescents remain untested. This study investigates unidimensional facets of impulsivity as risk-factors for the emergence and maintenance of self-harm, specifically within young community-based adolescents. METHODS: A school-based sample of 594 adolescents (aged 13-15 years) provided data at two time points, 12 weeks apart. Logistic regression analyses determined associations between impulsivity-related facets (as delineated by the UPPS-P scale) and self-harm outcomes over time. RESULTS: Overall, 23.6% of young people reported lifetime self-harm. A higher tendency towards Sensation Seeking was associated with self-harm onset over the study-period (OR 1.19, 95% CI 1.017-1.401). Deficits in Premeditation predicted maintained (versus remitted) self-harm behaviour during this time (OR 1.16, 95% CI 1.013-1.328). Negative Urgency was a significant cross-sectional correlate, but did not offer prospective predictive utility. LIMITATIONS: The study relied on self-report. Interpretations are cautious given low incidence of self-harm outcomes over the course of the study. CONCLUSIONS: Separate pathways to impulsive behaviour describe the psychological context in which self-harm starts and develops in young people. Findings support differential treatment targets and developmentally-focused early intervention. The predictive utility of impulsivity was inconsistent between cross-sectional and longitudinal analyses, underlining the role for temporality in the establishment of risk of self-harm.

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1983The Hospital Anxiety and Depression Scale 2003Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale 1980Unrealistic optimism about future life events.2001The Five Factor Model and impulsivity: using a structural model of personality to understand impulsivity 2016Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research.2007Development and Validation of an Internationally Reliable Short-Form of the Positive and Negative Affect Schedule (PANAS)2010Self-Injury 2014Prevalence of Nonsuicidal Self‐Injury in Nonclinical Samples: Systematic Review, Meta‐Analysis and Meta‐Regression

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