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

青少年自我伤害是一个主要的和日益增长的公共卫生问题，自我伤害的年轻人未来自杀的风险要大得多（Hawton等人，2020年）。经过一段巨大的社会变革时期，以及学术压力的上升，财务不确定性和社交媒体使用的爆炸性增长，过去20年来青少年自我伤害的比率迅速增加，特别是在女孩中（Boud等人，2019; Morgan等人，2017年）。为了提供有效的早期干预以预防和减少青少年自我伤害，我们首先需要了解哪些因素会增加，更重要的是，降低来自不同背景的青少年的风险，以及相关的心理机制。来自REACH研究的数据（见下文“研究设计的关键方面”）将用于本项目。文献表明，自我伤害的原因和维持因素是广泛的，包括不良的童年经历和创伤、养育因素、社会和人际因素以及社会环境劣势（Abdelraheem等人，2019; Zetterqvist等人，2013年）。了解哪些特定的风险因素使来自不同背景的年轻人面临更大的自我伤害风险是本博士学位将解决的文献中的第一个空白。第二，这个博士学位将研究担忧和沉思作为社会环境风险和自我伤害行为之间的中介的作用。已经对其他人群的担忧和沉思进行了探索（Hirsch等人，2018; Startup等人，2013），反刍与成人的非自杀性自伤有关（霍夫和Muehlenkamp，2009; Nicolai等人，2016）。然而，对青少年人群的研究很少，这种沉思的原因也不太清楚。这个博士旨在通过研究自残的年轻人担心什么以及是否有任何基于个人，社会或环境因素的趋势来推进这一主题的知识。将通过数字日记和/或焦点小组进行经验抽样，以收集关于青年人担忧内容的数据。总之，这个博士学位将研究社会环境风险因素的影响，担忧和沉思的水平，以及自我伤害。

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.