Characteristics and Risk Factors of Non-Suicidal Self-Injury Behaviors in Children and Adolescents with Depression at Lamphun Hospital
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Abstract
Objective: To study the characteristics and risk factors of non-suicidal self-injury behaviors in children and adolescents with depression at Lamphun Hospital, and to examine the differences in non-suicidal self-injury behaviors and risk factors between patients younger than 15 years and those aged 15 years and older.
Methods: A cross-sectional study was conducted among 80 patients aged 11 - 18 years diagnosed with depression according to DSM-5 criteria, with a history of at least one self-injury incident between January and December 2022. Data were collected using the Thai version of the Brief Non-Suicidal Self-Injury Assessment Tool (BNSSI-AT) and a risk factor questionnaire. Descriptive statistics, Fisher’s exact test, and t-test were used for analysis.
Results: Among 80 children and adolescents with depression who engaged in self-injury at Lamphun Hospital, the mean age was 14.9 years, with 88.7% being female. The mean age of first self-injury was 13.1 years. The average frequency of NSSI was 25 times per year. 56.3% used 5 or more different methods, and 87.3% used wrist cutting. 58.7% showed likelihood of repeated self-injury. The most common reasons for NSSI were to relieve stress and pressure and to manage uncomfortable feelings. Most patients were aware that they needed to fight against feelings of wanting to harm themselves and viewed self-injury as a life problem 53.8% perceived that self-injury affected their self-worth and self-esteem. Patients aged 15 years and older significantly viewed self-injury as affecting their clothing choices more than younger patients (p = 0.039), while patients younger than 15 years significantly viewed self-injury as less disruptive to their lives (p = 0.035). The most common risk factors for NSSI were bullying by peers and criticism by family members.
Conclusion: Among children and adolescents with depression at Lamphun Hospital, the most common method of self-harm was cutting the arms. The main reasons for self-harm were to relieve stress and emotional pressure. The most frequently reported risk factors were being bullied by peers and being criticized by family members. Factors that increased patients’ awareness included struggling with urges to self-harm and recognizing that self-harm negatively affects their self-worth and self-esteem.
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