Parenting style and deliberate self-harm among children and adolescents: A hospital-based case-control study in Japan

Although inappropriate parenting styles have been shown to be associated with deliberate self-harm (DSH), few studies have assessed parenting styles from both the perspectives of patients and their parents.

We conducted a hospital-based case-control study at a psychiatric ward in Japan, including patients aged 7-20 years. Histories of DSH were collected from electronic health records in the hospital. Parenting styles were assessed using the Family Diagnostic Test (FDT), which evaluates parenting style from both the patients' and parents' perspectives. Multivariable logistic regression was performed to estimate odds ratios (ORs) of DSH by 10 % increase of FDT score, adjusting for age, sex, primary diagnosis, history of abuse, school refusal, the number of previous hospitalizations, and family structure.

Of the 272 patients (mean age, 15.2 [SD, 2.4] years; 57.4 % female), 115 (42.3 %) had a history of DSH. Patients who felt rejection from their mothers, avoided contact with their mothers, and felt less attached to their mothers were more likely to have histories of DSH, independent of covariates (sense of rejection, OR = 1.15 [95 %CI, 1.01-1.30]; active avoidance, OR = 1.14 [95 %CI, 1.00-1.29]; emotional closeness, OR = 0.89 [95 % CI, 0.79-1.00]; In contrast, parents' self-assessments of their parenting style were not significantly associated with DSH.

Our findings underscore the importance of patient-reported perceptions for revealing the underlying mechanisms linking parenting style and DSH.