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Self-harm risk between adolescence and midlife in people who experienced separation from one or both parents during childhood. / Astrup, Aske; Pedersen, Carsten B; Mok, Pearl L H; Carr, Matthew J; Webb, Roger T.
In: Journal of Affective Disorders, Vol. 208, 2017, p. 582–589.Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
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TY - JOUR
T1 - Self-harm risk between adolescence and midlife in people who experienced separation from one or both parents during childhood
AU - Astrup, Aske
AU - Pedersen, Carsten B
AU - Mok, Pearl L H
AU - Carr, Matthew J
AU - Webb, Roger T
N1 - Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
U2 - 10.1016/j.jad.2016.10.023
DO - 10.1016/j.jad.2016.10.023
M3 - Journal article
C2 - 27802894
VL - 208
SP - 582
EP - 589
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -