self-harm and suicide attempts

Common health concerns for adolescents include self-harm and suicide attempts. While studies of these phenomena had been undertaken in Western populations, researchers in Taiwan sought to provide data from an Asian perspective, in addition to a better understanding of factors that predict these behaviors.


For front-line professionals and policy-makers working with adolescents, prevention of suicide and self-harm is an important part of maintaining good physical and mental health. Studies in Europe and North America have examined self-harm and suicide attempts, and researchers in Taiwan hoped to assess the prevalence of these incidents within their own culture. In a one-year study, they surveyed thousands of high school students to find out the frequency of direct self-harm (DSH) and suicide attempts (SAs), as well as, common characteristics among adolescents involved in these incidents.

Researchers administered two surveys a year apart from one another, allowing them to track the same group of students over time. Initially, 5879 participants completed surveys, but only 73.67% of these were available for the second phase of the study. The average age of participants was 16, and 56.73% of the students were female. Students were asked a variety of questions about their home life, the social support available to them, and whether they used substances such as tobacco or alcohol. They were also asked questions designed to assess their mental health, particularly measuring their impulsiveness and level of depressive symptoms. Participants self-reported any incidents where they had attempted suicide, or attempted to deliberately harm themselves with or without the intention to end their lives. SAs were defined as an intentional action to kill themselves, while incidents of DSH involved participants who had harmed themselves with or without suicidal intent. Variables such as gender and socioeconomic status were taken into account when analyzing the results.

Researchers found that the rate of DSH was 25.04% for the first phase of the study, and the rate during the year between the two surveys was 4.04%. The rate of SA assessed during the first survey was 3.50%, and 1.53% over the next year. Of the 4331 participants involved in both phases of the study, 131 reported no history of DSH during the first survey, but did report DSH incidents during the year between the two surveys. The number of students with no history of SA who reported SA during the second phase was 64. Participants who reported DSH were likely to experience depressive symptoms at the onset of the study, as well as having a high level of perceived family discord. Participants who reported SA were likely to have more depressive symptoms, to use tobacco, and to have lifetime suicidal ideation. For students who reported self-harm incidents between the two surveys, depressive symptoms both contributed to and resulted from these incidents. While the incidents of DSH and SA were similar to those recorded in Western countries, the predictors differed slightly, allowing researchers to determine which warning signs are most relevant to their population.

The participants were a good representative sample of the adolescent population in Taiwan, with both urban, suburban and rural schools participating. One problem for the researchers was the number of participants unavailable for the study’s second phase, making it hard to tell whether the rate of incidents for the year between the two surveys accurately reflected the actual rate. The results are considered very helpful overall, and the authors hope an understanding of the factors contributing to self-harm and suicide attempts will allow professionals to intervene with the appropriate resources as early as possible.


Written By: Ashley Shaw

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