Department of Economics and Business Economics

Self-harm risk between adolescence and midlife in people who experienced separation from one or both parents during childhood

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  • Aske Astrup
  • ,
  • Carsten B Pedersen
  • Pearl L H Mok, Centre for Mental Health and Safety, The University of Manchester, United Kingdom.
  • ,
  • Matthew J Carr, Centre for Mental Health and Safety, The University of Manchester, United Kingdom.
  • ,
  • Roger T Webb, Centre for Mental Health and Safety, The University of Manchester, United Kingdom. Electronic address:

BACKGROUND: Experience of child-parent separation predicts adverse outcomes in later life. We conducted a detailed epidemiological examination of this complex relationship by modelling an array of separation scenarios and trajectories and subsequent risk of self-harm.

METHODS: This cohort study examined persons born in Denmark during 1971-1997. We measured child-parent separations each year from birth to 15th birthday via complete residential address records in the Civil Registration System. Self-harm episodes between 15th birthday and early middle age were ascertained through linkage to psychiatric and general hospital registers. Incidence rate ratios (IRRs) from Poisson regression models were estimated against a reference category of individuals not separated from their parents.

RESULTS: All exposure models examined indicated an association with raised self-harm risk. For example, large elevations in risk were observed in relation to separation from both parents at 15th birthday (IRR 5.50, 95% CI 5.25-5.77), experiencing five or more changes in child-parent separation status (IRR 5.24, CI 4.88-5.63), and having a shorter duration of familial cohesion during upbringing. There was no significant evidence for varying strength of association according to child's gender.

LIMITATIONS: Measuring child-parent separation according to differential residential addresses took no account of the reason for or circumstances of these separations.

CONCLUSIONS: These novel findings suggest that self-harm prevention initiatives should be tailored toward exposed persons who remain psychologically distressed into adulthood. These high-risk subgroups include individuals with little experience of familial cohesion during their upbringing, those with the most complicated trajectories who lived through multiple child-parent separation transitions, and those separated from both parents during early adolescence.

Original languageEnglish
JournalJournal of Affective Disorders
Pages (from-to)582–589
Publication statusPublished - 2017

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