The role of socio-environmental risks and worry in the prediction of self-harm among adolescents

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Adolescent self-harm is a major and growing public health concern, and young people who self-harm are at a considerably greater risk of future suicide (Hawton et al., 2020). Through a period of great social change as well as a rise in academic pressures, financial uncertainties and explosion in social media use, rates of adolescent self-harm in the past 20 years have increased rapidly, particularly among girls (Bould et al., 2019; Morgan et al., 2017). To inform effective early intervention to prevent and reduce adolescent self-harm, we first need to understand which factors increase and, importantly, decrease risk among adolescents from diverse backgrounds, and the associated psychological mechanisms. Data from the REACH study (see 'Key Aspects of Study Design', below) will be used for this project. The literature suggests that the causes and maintaining factors of self-harm are wide-ranging, including adverse childhood experiences and trauma, parenting factors, social and interpersonal factors and socio-environmental disadvantage (Abdelraheem et al., 2019; Zetterqvist et al., 2013). Understanding which specific risk factors place young people from diverse backgrounds at greater risk of self-harm is the first gap in the literature this PhD will address. Second, this PhD will look at the role of worry and rumination as a mediator between socio-environmental risks and self-harming behaviours. Worry and rumination has been explored for other population groups (Hirsch et al., 2018; Startup et al., 2013), with rumination linked to nonsuicidal self-injury in adults (Hoff & Muehlenkamp, 2009; Nicolai et al., 2016). However, research among adolescent populations is scarce and the causes of this rumination are less known. This PhD aims to advance the knowledge on this topic by looking at what young people who self-harm worry about and whether there are any trends based on individual, social or environmental factors. Experience sampling through digital diaries and/or focus groups would be used to collect data on the content of young people's worries. In summary, this PhD will look at the impact of socio-environmental risk factors, levels of worry and rumination, and self-harm.