Mechanisms of self-harm behavior in non-clinical adolescent population: the results of monitoring in Moscow schools

The behavior of self-harm is prevalent among adolescents. Most research on the topic has focused either on qualitative investigation of hospitalized teens or on quantitative research of non-clinical population. There combination of these approaches is considered very promising, yet it is extremely rare. The present article investigates the behavior of self-harm without suicidal intention in non-clinical population. The participants were 604 students of Moscow schools (7—11 grades). 22% participants reported at least 1 act of deliberate self-harm in the lifetime period (54% — single episode, 46% multiple episodes of self-harm). 100 adolescents with a history of non-suicidal self-harm were further assessed with Clinical In- ventory, which reflected the gradation of the key suicide markers. Clinical assess- ment revealed three major mechanisms of self-harm development: stressful (20%), depressive (45%), and psychopathological (35%). Further distinction among impulsive and reflective led to description of 6 groups, each having specific clini- cal picture, dynamics, motives, personal patterns and attitude towards self-harm. Understanding of leading mechanism of antivital behavior is essential for effecting crisis intervention and psychological counseling of adolescents in the aftermath of self-harm or suicidal attempts. Comparative analysis of these results with data on clinical population reveals several differences.