Identifying Suicidal Behaviors in Teens Who Self-Harm

Adolescence is a time of emotional turmoil and many young people use self-injurious behaviors as a way to cope with psychological distress. However, self-harm can lead to suicide, thus increasing the importance of treating this issue in these children. “Self-harm in adolescence is a common problem with lifetime prevalence of attempted suicide of 9.7%, whereas an additional 13.2% of adolescents engage in self-harm at some point during that period,” said researchers from King’s College, London. “Self-harm is one of the strongest predictors of eventual death by suicide in adolescence, increasing the risk up to 10-fold.”

Dennis Ougrin of Kings College, along with colleagues, conducted a study to determine how therapeutic intervention affected suicidal and non-suicidal self-harm behaviors in adolescents. Research shows that most teens with these tendencies also struggle with psychological issues including depression, drug abuse, antisocial behaviors and conduct and aggression problems. Seventy adolescents were selected from the Trial of Therapeutic Assessment in London (TOTAL) for the study. Half of the participants were enrolled in a therapeutic assessment (TA) intervention which consisted of evaluation, visual involvement, pain identification, behavior modification and understanding. The control group received assessment as usual (AAU) which included a risk assessment and standard psychological evaluation.

The level and type of self-harm varied among the participants. “Fifty-six (80%) participants were young women, 28 (40%) self-harmed by self-poisoning alone, 37 (53%) self-harmed by self-injury alone, and 5 (7%) self-harmed by both self-poisoning and self-injury. Forty-one (59%) had self-harmed previously,” said the researchers. The study revealed that just as the types of injuries varied, so did the participants’ responses to treatment and only the nonsuicidal participants showed any improvement as a result of intervention. “Adolescents with nonsuicidal and suicidal self-harm differ on several important clinical and sociodemographic characteristics and may respond to treatment differently.” The researchers added, “TA may be especially important in the nonsuicidal group. Clinicians should consider suicidal intent carefully during their initial assessment.”

Ougrin, D., Zundel, T., Kyriakopoulos, M., Banarsee, R., Stahl, D., & Taylor, E. (2011, August 22). Adolescents With Suicidal and Nonsuicidal Self-Harm: Clinical Characteristics and Response to Therapeutic Assessment. Psychological Assessment. Advance online publication. doi: 10.1037/a0025043

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Chynna


    September 2nd, 2011 at 5:29 PM

    um just a little observation here- if a teen is self harming, don’t you think that this is enough proof in itself to indicate that worse things could be ahead?

  • gabriella holmes

    gabriella holmes

    September 3rd, 2011 at 7:51 PM

    Those numbers are really high. That’s very worrying indeed that almost 10% go on to attempt suicide.

    If it is truly that high, why aren’t there more discussions on how to deal with self-injury in the schools and youth organizations instead of others issues like drugs?

    Self harm is much easier to hide and participate in than drug addiction. There’s no way to tell whose ears such talks would fall upon that was already self-harming.

  • w.r.


    September 3rd, 2011 at 9:52 PM

    I have a self-harming habit myself. I only do it when people really tick me off because when you cross my threshold, I have two choices. Take it out on myself openly, or take it out on someone else. Neither of them are acceptable and I have bottled up anger to where I want to smash something but I can’t. So I self-injure and hide it. What else can I do?

  • Gina


    September 4th, 2011 at 5:18 AM

    So is the same thing as cutting and stuff like that?

  • ben


    September 4th, 2011 at 11:45 AM

    whether suicidal or not,such behavior speaks volumes about there being something wrong with the normal kid harms himself pr herself and those that do are obviously in a trouble spot and need help.

  • helenedawson


    September 4th, 2011 at 4:22 PM

    @Chynna: Not in all cases. You can have every symptom of a mental illness and turn out not have the illness itself. There are some that self-harm simply because they hear about others doing it. For them it’s pure experimentation and a one-time deal. Others do self-harm regularly because they have too much stress to cope with.

  • X.N.C.


    September 4th, 2011 at 5:49 PM

    @Gina: yes it is.

    Self-harm can be an outlet when they don’t have any other ones to take their anger out on. Bottled up emotions are not good for teenagers and they need a way to express themselves openly without retribution or punishment.

    I understand all that. But what’s a parent to do when they discover they are doing it and don’t want to involve anyone outside the family?

  • NATE


    September 4th, 2011 at 10:34 PM

    Just the mention of suicide always gives rise to this pain in me-because ending one’s own life is not something easy yet so many people go for it because they think there is no other way! I have been through painful episodes in my own life but have always figured that merely talking to a friend or someone and lettin’ out what is inside your head can get a lot of steam off and help you cope with the situation.Suicide is not a way it is the dead-end!

  • D Mask

    D Mask

    September 5th, 2011 at 1:38 PM

    Self harm is bad enough in children we don’t want suicides anymore!If they do self harm they are vulnerable and monitoring for suicidal tendencies is a good way to go about it I think.

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