Problem parental care and teenage deliberate self-harm in young community adults

Deliberate self-harm (DSH) in young people is a clinical and social problem related to early maltreatment but with little specificity in type of care or abuse determined. A community sample of 160 high-risk young people (aged 16-30) were the offspring of mothers' previously interviewed as vulnerable to major depression. The youth were interviewed to determine DSH (both suicidal and nonsuicidal), childhood maltreatment (using the Childhood Experience of Care and Abuse interview) and major depression (using SCID for DSM-IV) before age 17. Around one fifth reported DSH; equal proportions were suicidal and nonsuicidal with a fourth of these with both. DSH was highly related to family context (single mother upbringing and family discord) and poor parental care (including antipathy, neglect, inadequate supervision, and role reversal). Highest odds ratios were for role reversal (OR = 17) and neglect (OR = 11). DSH was unrelated to any type of abuse. Logistic regression showed that role reversal, inadequate supervision, and teenage depression all modeled DSH. There was some specificity, with single mother upbringing, role reversal, and inadequate supervision predicting nonsuicidal DSH, and neglect and role reversal alone predicting suicidal DSH. Role reversal remained a key predictor for both types of DSH when controls were applied. Poor childhood care, which has implications for problematic emotion regulation and empoverished social development, needs to be understood to improve interventions and treatment for DSH in young people.