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Int. J. Environ. Res. Public Health 2012, 9(1), 178-191; doi:10.3390/ijerph9010178

Self-Harm and Suicide Attempts among High-Risk, Urban Youth in the U.S.: Shared and Unique Risk and Protective Factors

Institute of Public Health, Georgia State University, 50 Decatur Street Southeast, Atlanta, GA 30303, USA
Department of Psychiatry, University of Rochester, 400 Fort Hill Avenue, Canandaigua, Rochester, NY 14424, USA
Department of Psychology, Kent State University, 800 East Summit Street, Kent, OH 44242, USA
Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
Department of Psychology, John Carroll University, 20700 North Park Boulevard, University Height, OH 44118, USA
Author to whom correspondence should be addressed.
Received: 9 November 2011 / Revised: 13 December 2011 / Accepted: 5 January 2012 / Published: 11 January 2012
(This article belongs to the Special Issue Suicide Prevention and Public Health)
View Full-Text   |   Download PDF [291 KB, uploaded 19 June 2014]


The extent to which self-harm and suicidal behavior overlap in community samples of vulnerable youth is not well known. Secondary analyses were conducted of the “linkages study” (N = 4,131), a cross-sectional survey of students enrolled in grades 7, 9, 11/12 in a high-risk community in the U.S. in 2004. Analyses were conducted to determine the risk and protective factors (i.e., academic grades, binge drinking, illicit drug use, weapon carrying, child maltreatment, social support, depression, impulsivity, self-efficacy, parental support, and parental monitoring) associated with both self-harm and suicide attempt. Findings show that 7.5% of participants reported both self-harm and suicide attempt, 2.2% of participants reported suicide attempt only, and 12.4% of participants reported self-harm only. Shared risk factors for co-occurring self-harm and suicide attempt include depression, binge drinking, weapon carrying, child maltreatment, and impulsivity. There were also important differences by sex, grade level, and race/ethnicity that should be considered for future research. The findings show that there is significant overlap in the modifiable risk factors associated with self-harm and suicide attempt that can be targeted for future research and prevention strategies. View Full-Text
Keywords: self-harm; suicide attempt; youth; adolescents; U.S.; high-risk; school; cross-sectional self-harm; suicide attempt; youth; adolescents; U.S.; high-risk; school; cross-sectional
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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MDPI and ACS Style

Swahn, M.H.; Ali, B.; Bossarte, R.M.; Van Dulmen, M.; Crosby, A.; Jones, A.C.; Schinka, K.C. Self-Harm and Suicide Attempts among High-Risk, Urban Youth in the U.S.: Shared and Unique Risk and Protective Factors. Int. J. Environ. Res. Public Health 2012, 9, 178-191.

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