Examining school attendance as a predictor of self-harm in adolescents: A series of longitudinal studies using linked mental health and education data

检查学校出勤率作为青少年自残的预测因素：使用相关心理健康和教育数据进行的一系列纵向研究

• 批准号: MR/T001437/1
• 负责人: Sophie Epstein
• 金额: $ 33.74万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT001437%2F1
• 关键词: Examining; attendance; predictor; self; harm

Self-harm is when a person hurts themselves on purpose in any way. More than 1 in 10 young people harm themselves before they turn 18. Self-harm with or without suicidal intent, is a major concern, as it is a sign of distress and a strong predictor of later suicide. Many young people have had problems for some time before they start to self-harm but do not feel able to seek help. To prevent self-harm, we need to find ways to identify those at risk as early as possible so that the right help can be provided.A good place to identify problems early is in school. However, schools have limited resources so cannot regularly ask their students how well they are coping. Schools do however keep records of all students' attendance and so information about poor attendance, which is one way that young people begin to show signs of problems, can be gathered.I have reviewed existing studies which suggest that poor school attendance increases the risk of self-harm but these studies lack quality and are inconclusive. However, previous research does suggest that a link between attendance and later self-harm could be possible for a number of reasons. Poor school attendance could increase social isolation and loneliness which are known to increase the risk of self-harm. Also poor attendance could result from hidden problems that a young person is encountering such as bullying or having an unwell parent, which can also increase the risk of self-harm. My research will explore whether poor school attendance can provide an "early warning sign" that young people are at risk of self-harm. I will also explore why those with poor attendance might be at higher risk, to help understand what type of support is needed. Whatever the reason, if this research shows that poor attendance is a sign of higher risk then it will inform schools and policy-makers that this group requires extra support in order to prevent self-harm.I also will explore whether school attendance patterns in young people who have known mental health problems could give mental health professionals extra information about whether a young person is at increased risk for severe self-harm. Things which increase the risk of self-harm in the general population may be different to those which increase the risk in young people who are already vulnerable due to having mental health problems or suicidal thoughts. An understanding of this would provide information to improve clinical practice.My research will consist of two studies. In one study, I will examine anonymised mental health records linked to education records for three groups of 11-17 year-olds to explore whether school attendance can predict who is more likely to present to Accident and Emergency (A&E) with self-harm and what may explain this. The three groups are: a) Young people in 4 boroughs of South London, b) Those who have attended Child and Adolescent Mental Health Services (CAMHS), c) Those who have reported suicidal thoughts to CAMHS. In another study, I will use data from the Resilience, Ethnicity and Adolescent Mental Health (REACH) study, which includes 11-14 year-olds in 12 schools in South London who may never have sought help for their problems. Here, I will explore whether school attendance can predict who is more likely to self-harm, this time according to young people's own reports rather than only those who present to A&E. The methods used in these studies provide an important example of using information which is routinely collected by schools and health services to understand which young people may be at risk of problems in future. Similar methods could be used to identify other signs of risk and to help predict other problems. The findings of my studies will provide information to help clinicians, education professionals and policy-makers understand which young people may be at higher risk of self-harm, and could contribute to the development of self-harm prevention strategies.

自我伤害是指一个人以任何方式故意伤害自己。超过十分之一的年轻人在18岁之前伤害自己。有或没有自杀意图的自我伤害是一个主要问题，因为它是痛苦的迹象，也是后来自杀的有力预测因素。许多年轻人在开始自残之前已经有一段时间的问题了，但他们觉得无法寻求帮助。为了防止自我伤害，我们需要找到方法，尽早识别那些有风险的人，以便提供正确的帮助。然而，学校的资源有限，因此不能定期询问学生的应对情况。然而，学校确实保留了所有学生的出勤记录，因此可以收集有关出勤率低的信息，这是年轻人开始出现问题的一种方式。我回顾了现有的研究，这些研究表明，出勤率低会增加自残的风险，但这些研究缺乏质量，也没有结论。然而，先前的研究确实表明，出席和后来的自我伤害之间的联系可能有多种原因。低出勤率可能会增加社会孤立和孤独感，这会增加自我伤害的风险。出勤率低也可能是年轻人遇到的隐藏问题造成的，比如欺凌或父母身体不适，这也会增加自我伤害的风险。我的研究将探讨低出勤率是否可以提供一个“早期预警信号”，即年轻人有自残的风险。我还将探讨为什么出勤率低的人可能面临更高的风险，以帮助了解需要什么类型的支持。不管是什么原因，如果这项研究表明，出勤率低是高风险的标志，那么它将告知学校和政策制定者，这一群体需要额外的支持，以防止自我伤害。我还将探讨是否上学的模式在年轻人谁知道心理健康问题可以给心理健康专业人员额外的信息，一个年轻人是否在严重的自我伤害的风险增加。增加一般人群自我伤害风险的事情可能与增加由于心理健康问题或自杀想法而已经脆弱的年轻人的风险不同。了解这一点将提供信息，以改善临床实践。我的研究将包括两个研究。在一项研究中，我将检查与三组11-17岁青少年的教育记录相关的匿名心理健康记录，以探讨上学是否可以预测谁更有可能出现自我伤害的事故和紧急情况（A&E），以及什么可以解释这一点。这三组是：a）南伦敦4个区的年轻人，B）参加过儿童和青少年心理健康服务（CAMHS）的人，c）向CAMHS报告过自杀想法的人。在另一项研究中，我将使用弹性，种族和青少年心理健康（REACH）研究的数据，该研究包括伦敦南部12所学校的11-14岁儿童，他们可能从未寻求过他们的问题的帮助。在这里，我将探讨学校出勤率是否可以预测谁更有可能自残，这一次是根据年轻人自己的报告，而不仅仅是那些到A&E的人。这些研究中使用的方法提供了一个重要的例子，说明如何利用学校和卫生服务部门定期收集的信息来了解哪些年轻人将来可能面临问题。类似的方法可用于识别其他风险迹象并帮助预测其他问题。我的研究结果将提供信息，帮助临床医生，教育专业人员和政策制定者了解哪些年轻人可能处于自我伤害的较高风险，并有助于制定自我伤害预防策略。

项目成果

Additional file 3 of Autism spectrum disorders as a risk factor for adolescent self-harm: a retrospective cohort study of 113,286 young people in the UK

自闭症谱系障碍作为青少年自残危险因素的附加文件 3：一项针对英国 113,286 名年轻人的回顾性队列研究

• DOI: 10.6084/m9.figshare.19681660
• 发表时间: 2022
• 作者: Widnall E

Risk and protective factors for self-harm and suicide in children and adolescents: a systematic review and meta-analysis protocol.

• DOI: 10.1136/bmjopen-2021-058297
• 发表时间: 2022-11-25
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: Farbstein, Dan;Lukito, Steve;Yorke, Isabel;Wilson, Emma;Crudgington, Holly;El-Aalem, Omar;Cliffe, Charlotte;Bergou, Nicol;Itani, Lynn;Owusu, Andy;Sedgwick, Rosemary;Singh, Nidhita;Tarasenko, Anna;Tucker, Gavin;Woodhouse, Emma;Suzuki, Mimi;Myerscough, Anna Louise;Lopez Chemas, Natalia;Abdel-Halim, Nadia;Del Giovane, Cinzia;Epstein, Sophie;Ougrin, Dennis
• 通讯作者: Ougrin, Dennis

Additional file 1 of Autism spectrum disorders as a risk factor for adolescent self-harm: a retrospective cohort study of 113,286 young people in the UK

自闭症谱系障碍作为青少年自残危险因素的附加文件 1：一项针对英国 113,286 名年轻人的回顾性队列研究

• DOI: 10.6084/m9.figshare.19681654
• 发表时间: 2022
• 作者: Widnall E

Additional file 2 of Autism spectrum disorders as a risk factor for adolescent self-harm: a retrospective cohort study of 113,286 young people in the UK

自闭症谱系障碍作为青少年自残危险因素的附加文件 2：一项针对英国 113,286 名年轻人的回顾性队列研究

• DOI: 10.6084/m9.figshare.19681657
• 发表时间: 2022
• 作者: Widnall E

Examining the acceptability of actigraphic devices in children using qualitative and quantitative approaches: protocol for a systematic review and meta-analysis.

• DOI: 10.1136/bmjopen-2022-070597
• 发表时间: 2023-03-01
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: Morris, Anna Charlotte;Telesia, Laurence;Wickersham, Alice;Epstein, Sophie;Matcham, Faith;Sonuga-Barke, Edmund;Downs, Johnny
• 通讯作者: Downs, Johnny