School- and class-level variation in self-harm, suicide ideation and suicide attempts in Danish high schools

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Abstract

AIM: Strong associations have been found between being exposed to self-harm in family and friends and own self-harm in adolescence. Therefore, self-harm and suicide behaviour might tend to cluster within school and school classes. The aim of this study was to describe the prevalence, frequency and type of self-harm, suicide ideation and suicide attempts within Danish high schools and to test whether self-harm and suicide behaviour cluster in schools and school classes.

METHODS: Data came from the Danish National Youth Study 2014, a national survey. The respective study included 66,284 high-school students nested in 117 schools and 3146 school classes. The prevalence and clustering of self-harm behaviour, ever and within the last year, type of self-harm (e.g. cutting, burning, scratching and hitting) and suicide ideation and suicide attempts were investigated. Multi-level logistic regression was applied to quantify clustering among participants within the same class and school.

RESULTS: In total, 12,960 (20%) reported self-harm ever and 5706 (8.6%) within the last year. Prevalence was higher among girls than boys. Among girls, cutting (15%) and scratching (13%) was the most common type of self-harm, whereas among boys, hitting (6.7%) was most prevalent. The degree of clustering of self-harm and suicide behaviour was low, with school-level intra-class correlation coefficients (ICC) ranging from 0.8-1.8% and school class level ICC's from 4.3-6.8%.

CONCLUSIONS: This study shows that self-harm was common, especially in girls. The degree of clustering of self-harm and suicide behaviour in school and school classes was low.

Original languageEnglish
JournalScandinavian Journal of Public Health
Volume47
Issue number2
Pages (from-to)146-156
ISSN1403-4948
DOIs
Publication statusPublished - 1. Mar 2019

Keywords

  • Clustering
  • school-level variation
  • self-harm
  • suicide attempt
  • suicide ideation
  • youth
  • Prevalence
  • Humans
  • Risk Factors
  • Male
  • Self-Injurious Behavior/epidemiology
  • Suicidal Ideation
  • Educational Status
  • Suicide, Attempted/statistics & numerical data
  • Schools/statistics & numerical data
  • Denmark/epidemiology
  • Adolescent
  • Female
  • Students/psychology
  • Surveys and Questionnaires

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