Correlates and predictors of self-harm in a prospective sample of sexually assaulted adolescents

Sexual assault of adolescents is associated with negative mental health outcomes, including self-harm. Little is known about correlates and predictors of self-harm after sexual assault. We hypothesized that pre-assault vulnerabilities and post-assault psychological distress would be associated with self-harm after experiencing a recent sexual assault.

The sample was recruited from adolescents aged 13 to 17 years accessing sexual assault centers and it included 98 females. Longitudinal data were collected at T₀ (3.9 weeks on average post-assault) and T₁ (21.8 weeks on average post-assault). Bivariate analysis and hierarchical binary logistic regressions were performed.

The rate of self-harm was 38.1% before the assault and 37.8% after the assault (T₁). History of family dysfunction (OR 3.60 (1.30, 10.01)), depressive symptoms at T₀ (OR 5.83 (2.35, 14.43)) or T₁ (OR 2.79 (1.20, 6.50), and posttraumatic stress symptoms at T₁ (OR 3.21 (1.36, 7.58)) predicted self-harm at T₁. These effects were attenuated when adjusting for confounders, except for depressive symptoms at T₀ (OR 4.21 (1.57, 11.28)).

Clinical implications for the prevention of onset or continuation of self-harm following adolescent sexual assault are discussed. Future studies should replicate these findings in a larger sample and consider different trajectories of self-harm.