Self-harm in adolescence and the influence of gender and peer networks

在英国和国际上，青春期的自我伤害是一个日益增长的公共卫生问题。自我伤害是后来自杀的主要危险因素，自杀是25岁之前死亡的第二大原因。自我伤害在女性中更常见，2011年至2014年期间，英国13-16岁的女孩与同龄男孩相比，自我伤害发生率增加了68%。虽然男孩和女孩都有自残行为，但青春期男孩的自残行为正受到越来越多的关注。青少年的自我伤害是一个令人担忧的现象。有证据表明，男孩和女孩在自我伤害的方式和风险因素方面存在差异。我们不清楚自我伤害在青春期女孩和男孩中是否意味着同样的事情，以及他们之间的过程，风险和保护因素是什么。重要的是要调查青少年自我伤害的看法和解释，确定具体的因素，沉淀它为个人，并确定因素，可以增加和减少自我伤害的可能性。这个博士项目的目的是研究自我伤害青少年的性别差异问题。主要研究问题有：1.青春期男孩和女孩的自残率是否不同？男孩和女孩的自残方式是否不同？2.男孩和女孩在社交网络中自残的传播方式是否不同？为什么？女孩是否比男孩更愿意寻求帮助？自残在男孩中更隐蔽吗？3.自我伤害对男孩和女孩来说是一样的吗？4.男孩们对自残的理解是什么？这些问题将通过以下方式解决：（i）对自我伤害的性别差异进行系统性审查;（ii）利用来自伦敦南部（英国）弹性，种族和青少年心理健康（REACH）队列的纵向数据进行定量和社会网络分析;以及（iii）对来自REACH队列的15-20名青少年男孩进行半结构化定性访谈。

Self-harm in adolescence is a growing public health concern both in the UK and internationally. Self-harm is the leading risk factor for later suicide, and suicide is the second leading cause of death before the age of 25. Self-harm is more commonly reported in women and a 68% increase in self-harm incidence was observed among girls aged 13-16 between 2011 and 2014 in the UK compared with boys of the same age. While both boys and girls engage in self-harm, self-harm among adolescent boys is receiving growing attention. Self-harm among adolescents is a concerning phenomenon. There is evidence to suggest that boys and girls differ in the ways they self-harm and their risk factors for it. We do not have a clear understanding about if self-harm means the same thing in adolescent girls and boys and what the processes, risks and protective factors are between them. It is important to investigate perceptions and interpretations of self-harm in adolescents, determine the specific factors that precipitate it for an individual and identify factors that could increase and decrease the likelihood of self-harm. The aim of this PhD project is to examine questions on the gender differences in adolescents who self-harm. The main research questions are: 1. Are the rates of self-harm different in adolescent boys and girls and do boys and girls self-harm in different ways? 2. Does self-harm spread differently across social networks in boys and girls and why is this? Do girls seek help for self-harm more than boys? Is self-harm more hidden among boys? 3. Does self-harm mean the same thing to both boys and girls? 4. What do boys understand self-harm to mean? These questions will be addressed through (i) a systematic review on gender differences in self-harm; (ii) utilising longitudinal data from the Resilience, Ethnicity and Adolescent Mental Health (REACH) cohort in south London (UK) to conduct quantitative and social network analyses; and (iii) conducting semi-structured qualitative interviews with 15-20 adolescent boys from the REACH cohort.