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Predicting repeat self-harm in children--how accurate can we expect to be?
Prathiba Chitsabesan1, Richard Harrington, Valerie Harrington
1The University Department of Child and Adolescent Psychiatry, Central Manchester and Manchester Children's University Hospitals, Hospital Road, Pendlebury, Manchester, M27 4HA, UK.
European Child & Adolescent Psychiatry
|February 26, 2003
Summary
Predicting repeat self-harm in children is challenging. Parental mental health and prior attempts are key predictors, but a predictive model showed low sensitivity for identifying at-risk youth.
Area of Science:
- Child and Adolescent Psychiatry
- Public Health
- Clinical Psychology
Background:
- Deliberate self-harm in children is a significant concern.
- Understanding predictors of repetition is crucial for intervention.
- Previous research highlights various risk factors.
Purpose of the Study:
- To identify variables that predict the repetition of deliberate self-harm in children.
- To evaluate the predictive accuracy of a model combining key variables.
- To inform service provision for at-risk youth.
Main Methods:
- Analysis of data from a randomized control trial involving children with deliberate self-poisoning.
- Collection of baseline and follow-up (2 and 6 months) outcome measures.
- Statistical modeling to identify predictors of repeat self-harm.
Main Results:
- Parental mental health and a history of previous self-harm attempts were the strongest predictors.
- A predictive model achieved high positive predictive value (86%) but low sensitivity (28%).
- Twenty-three out of 149 children (15.4%) repeated self-harm within the follow-up period.
Conclusions:
- Predicting repeat self-harm in children remains difficult despite comprehensive assessments.
- Current predictive models have limitations in sensitivity.
- Services need adaptation to account for the complexities of predicting repeat self-harm.