Impulsivity as a predictor of self-harm onset and maintenance in young adolescents: a longitudinal prospective study

Lockwood, Joanna; Townsend, Ellen; Daley, David; Sayal, Kapil

Abstract

Background
Rates of self-harm in young adolescents are increasing and self-harm typically emerges at this developmental stage. Greater specificity of impulsivity as a multifaceted construct is enabling investigation of links between individual impulsivity facets and self-harm outcomes. However, studies have yet to adequately explore these associations in young adolescents, and prospective relationships between multidimensional impulsivity and self-harm in younger adolescents remain untested. This study investigates unidimensional facets of impulsivity as risk-factors for the emergence and maintenance of self-harm, specifically within young community-based adolescents.
Methods
A school-based sample of 594 adolescents (aged 13-15 years) provided data at two time points, 12 weeks apart. Logistic regression analyses determined associations between impulsivity-related facets (as delineated by the UPPS-P scale) and self-harm outcomes over time.
Results
Overall, 23.6% of young people reported lifetime self-harm. A higher tendency towards Sensation Seeking was associated with self-harm onset over the study-period (OR 1.19, 95% CI 1.017-1.401). Deficits in Premeditation predicted maintained (versus remitted) self-harm behaviour during this time (OR 1.16, 95% CI 1.013-1.328). Negative Urgency was a significant cross-sectional correlate, but did not offer prospective predictive utility.
Limitations
The study relied on self-report. Interpretations are cautious given low incidence of self-harm outcomes over the course of the study.
Conclusions
Separate pathways to impulsive behaviour describe the psychological context in which self-harm starts and develops in young people. Findings support differential treatment targets and developmentally-focused early intervention. The predictive utility of impulsivity was inconsistent between cross-sectional and longitudinal analyses, underlining the role for temporality in the establishment of risk of self-harm.

Citation

Lockwood, J., Townsend, E., Daley, D., & Sayal, K. (2020). Impulsivity as a predictor of self-harm onset and maintenance in young adolescents: a longitudinal prospective study. Journal of Affective Disorders, 274, 583-592. https://doi.org/10.1016/j.jad.2020.05.021

• Journal Article Type: Article
• Acceptance Date: May 10, 2020
• Online Publication Date: May 26, 2020
• Publication Date: Sep 1, 2020
• Deposit Date: May 28, 2020
• Publicly Available Date: May 28, 2020
• Journal: Journal of Affective Disorders
• Print ISSN: 0165-0327
• Electronic ISSN: 1573-2517
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 274
• Pages: 583-592
• DOI: https://doi.org/10.1016/j.jad.2020.05.021
• Keywords: Clinical Psychology; Psychiatry and Mental health
• Public URL: https://nottingham-repository.worktribe.com/output/4524988
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0165032719319706?dgcid=rss_sd_all
• Additional Information: This article is maintained by: Elsevier; Article Title: Impulsivity as a predictor of self-harm onset and maintenance in young adolescents: a longitudinal prospective study; Journal Title: Journal of Affective Disorders; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.jad.2020.05.021; Content Type: article; Copyright: © 2020 The Authors. Published by Elsevier B.V.