Doktorarbeit

Adverse childhood experiences, parental socioeconomic resources and hospital-presenting self-harm in adolescence and young adulthood

Abstract

Self-harming behaviours in adolescence and young adulthood have far-reaching consequences, both to the individuals who self-harm and to their families and friends. For self-harm prevention, it is important to understand the processes underlying the behaviour. A substantial body of literature has documented a large variety of determinants of self-harm, including both individual-level factors, such as psychiatric disorders and certain psychological characteristics, and environmental factors, such as adverse
childhood experiences and low childhood socioeconomic position. However, the interplays between these various determinants are still less understood.
This study set out to explore the associations between adverse childhood experiences, parental socioeconomic resources and hospital-presenting self-harm in adolescence and young adulthood. First, the thesis examined the role of multiple adverse childhood experiences in the risk of self-harm. The experiences assessed included treated maternal and paternal psychiatric and
substance use disorders, crime related to substance use, other parental crime, and hospitalisations due to interpersonal violence or self-harm. Second, the association between low childhood income and self-harm in young adulthood was examined, and the mediating contribution of adolescent risk markers in this association assessed. The mediating risk markers included in the study were a diverse set of different health and behavioural problems and social risk markers, such as diagnosed psychiatric
disorders, out-of-home placements, and police-reported violent crime. Third, interaction between adverse experiences and low income was explored. Finally, the study analysed socioeconomic differences in psychiatric treatment use before and after an episode of hospital-presenting self-harm, both among the young persons who self-harmed and their parents.