The reasons children and adolescents self-injure remain unclear, although cognitive and emotional factors have been researched. Research has shown cognitive distortions predict non-suicidal self-injury (Weismoore, & Esposito-Smythers, 2009). Moreover self-injurers report having a negative affect (Polk & Liss, 2007), and distraction from emotional pain has been identified as the most prevalent motivation for self-harm (Briere & Gil, 1998; Swannell, Martin, Scott, Gibbons, & Gifford, 2008). People that self-harm often report emotional distress, which may stem from social networks or the home environment. Research suggests intimate friendships within social networks contribute to the development of emotion regulation techniques in children (Salisch, M. von, 2001). Additionally, Polk and Liss (2007) found self-injurers might have lacked emotional nurturance, and authoritarian parenting style with strict standards predicts self-harmful behavior (Pillay & Schlebusch, 1987). Research has further shown self-injury is correlated with childhood history of severe abuse and neglect (Himber, 1994), and Carroll, Schaffer, Spensley, & Abramowitz (1980) found physical abuse in particular is related to self-injurious behavior. The current study builds on existing research to examine self-harm in late childhood and adolescence. Participants included 428 juveniles meeting the criteria for serious emotional disturbance and requiring multi-agency involvement. These juveniles ranged in age from 10.76 to 19.98 years with a mean age of 14.44 years (SD = 1.96). Of the participants, 283 were male and 139 were female. The Child and Adolescent Functional Assessment Scales (CAFAS; Hodges, 2005) were administered upon intake and six months following intake by trained staff. Domains assessed by the CAFAS include self-harmful behaviors and impairments in school/work, home, and community roles, mood/emotion, and thinking. Reports of childhood abuse and previous runaway attempts were also collected. The present study uses separate path analysis models to predict self-harmful behaviors six months post-treatment for each gender. Reported physical abuse was entered in Level 1, followed by previous runaway attempts, school/work impairment, home role impairment and community role impairment in Level 2, mood/emotional impairment and thinking impairment in Level 3, self-harmful behaviors at intake in Level 4, with self-harm at six months post-treatment as the criterion variable. Analyses reveal primary contributing factors for the male model include self-harmful behaviors at intake and community role impairment. Secondary factors include mood/emotional impairment and home role impairment contributing to self-harm at intake and previous physical abuse contributing to community role impairment. School/work impairment was a tertiary factor contributing to mood/emotional impairment. For the female model, primary contributing factors were self-harm at intake, mood/emotional impairment and thinking impairment. Secondary factors include mood/emotional impairment and home role impairment contributing to self-harm at intake, school/work impairment and home role impairment contributing to mood/emotional impairment, and school/work impairment contributing to thinking impairment. Tertiary contributors include physical abuse contributing to home role impairment, school/work impairment and home role impairment contributing to mood/emotional impairment and physical abuse contributing to home role impairment. Physical abuse was a quaternary factor contributing to home role impairment. Results of this study will guide therapists and parents in identifying youths at risk for self-harmful behaviors.
- path analysis,
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