The development and validation of an instrument to identify risk of self-harm in children

Agni Angelkovska

Research output: ThesisDoctoral Thesis

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Abstract

[Truncated abstract]The overall aim of the research reported in this thesis was to develop and validate an instrument that would identify children among the general population at risk of self-harm. To achieve this, four separate yet interrelated studies were conducted. Study One, which sought to explore the risk factors of self-harm in children comprised a series of focus interviews with three paediatricians and 24 mothers of children who had self-harmed or who had verbalized self-harm ideation. The findings revealed that prior to the onset of self-harming or self-harm ideation these children reportedly manifested other problem behaviours that prompted their mothers to seek specialist advice from a paediatrician. The majority of these problem behaviours were characteristic of externalizing problems, either in the form of conduct problems, aggressive behaviours or impulsiveness. Conversely, some problem behaviours were characteristic of internalizing problems such as anxiety and depression. These findings provided valuable information which in addition to the current literature created the conceptual framework for the subsequent studies. Study Two incorporated the information obtained from Study One, along with that obtained from a review of existing instruments that measure self-harm or suicide, to develop a new instrument specifically designed to assess the risk of children in the general population developing self-harming behaviours. Initially, 159 items were generated and using the extant knowledge regarding the risk factors of self-harm as a guide, the items were categorized into risk factors of anxiety, depression, low self- ii worth, social difficulty, social withdrawal, helplessness, hopelessness, atypical cognition, emotional lability, impulsivity, self-harming ideation and self-harm. ... Study Four comprised four interrelated investigations, the purposes of which were to (i) examine the prevalence rates of self-harming ideation and self-harm among young school aged children in the general population; (ii) investigate differences of risk of self-harm between the referred group and community comparison group; (iii) examine the relationship between impulsivity and risk of self-harm in these children and, (iv) examine the relationship between executive function and risk of self-harm among these children. The results from these investigations revealed that approximately 3.5% of children aged between 6 to12 years in the general population manifest self-harming ideations and approximately 2.5% actually self-harm. No significant age or gender differences were found. Children that presented with a higher level of risk of self-harm also presented with a complex array of internalizing and externalizing problem behaviours. Furthermore, children who displayed significantly higher levels of hyperactive-impulsive symptomatology scored higher on the SHRAC instrument, as did the children who had higher levels of executive functioning impairment. The findings are discussed and interpreted in line with the current research literature and are used to make suggestions for future research.
Original languageEnglish
QualificationDoctor of Philosophy
Publication statusUnpublished - 2007

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