Comportamentos autolesivos na adolescência: um estudo transversal

Autores

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v33.i1.29618

Palavras-chave:

adolescente, comportamento autolesivo, fator de risco

Resumo

Introdução: A elevada prevalência de comportamentos autolesivos (CAL) e a sua forte associação ao suicídio tornam estes comportamentos um alvo natural de intervenção, de forma a prevenir consequências nefastas nos adolescentes. O objetivo deste estudo foi determinar a prevalência e caracterizar os padrões de CAL e potenciais fatores de risco associados numa amostra de adolescentes.
Metodologia: Foi realizado um estudo transversal através da aplicação de um questionário baseado no “Lifestyle and Coping Questionnaire”. Foram convidados a participar adolescentes dos 12 aos 17 anos de idade que recorreram a um hospital de nível II. Os dados foram analisados através de análise descritiva, bivariada e de regressão utilizando o software SPSS v.25.
Resultados: Foram incluídos 159 questionários de jovens com uma média de 15 anos de idade. Entre os adolescentes, 25,8% afirmaram já ter realizado CAL, sendo que a maioria (61%) fê-lo mais do que uma vez e a mesma percentagem não procurou ajuda. Foi encontrada uma relação estatisticamente significativa entre a apresentação de CAL e dificuldade em fazer amigos, história de bullying e realização de pesquisa online sobre formas de autolesão. Foi detetado um aumento significativo do risco de CAL nos adolescentes que tinham passado por múltiplos eventos de vida negativos (odds ratio ajustado [ORa] 1,47, intervalo de confiança [IC] 1,231-1,1763; p<0,01), enquanto a ausência de problemas de saúde (ORa 0,356, IC 0,13-0,969; p=0,04) e a não utilização de drogas (ORa 0,087, IC 0,012-0,633; p=0,016) foram identificados como fatores protetores.
Conclusão: Os CAL são um problema de saúde pública e, na maior parte das vezes, não são evidentes. Os resultados deste estudo evidenciam a necessidade de uma abordagem holística dos adolescentes, de forma a identificar precocemente CAL e fatores de risco associados.

Downloads

Não há dados estatísticos.

Referências

Brown RC, Plener PL. Non-suicidal Self-Injury in Adolescence. Curr Psychiatry Rep. 2017;19(3):1–8. https://doi.org/10.1007/s11920-017-0767-9.

Guerreiro DF, Sampaio D. Comportamentos autolesivos em adolescentes: uma revisão da literatura com foco na investigação em língua portuguesa. Rev Port Saúde Pública. 2013;31(2):213–22. http://doi.org/10.1016/j.rpsp.2013.05.001.

Victor SE, Hipwell AE, Stepp SD, Scott LN. Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset. Child Adolesc Psychiatry Ment Health. 2019;13(1):1–13. https://doi.org/10.1186/s13034-018-0261-0.

Vega D, Sintes A, Fernández M, Puntí J, Soler J, Santamarina P, et al. Revisión y actualización de la autolesión no suicida: ¿quién, cómo y por qué? Actas Españolas Psiquiatr. 2018;46(4):155. https://bit.ly/3p0IVH5.

Halicka J, Kiejna A. Non-suicidal self-injury (NSSI) and suicidal: Criteria differentiation. Adv Clin Exp Med. 2018;27(2):257–61. https://doi.org/10.17219/acem/66353.

Esposito C, Bacchini D, Affuso G. Adolescent non-suicidal self-injury and its relationships with school bullying and peer rejection. Psychiatry Res. 2019;274:1–6. https://doi.org/10.1016/j.psychres.2019.02.018.

Carballo JJ, Llorente C, Kehrmann L, Flamarique I, Zuddas A, Purper-Ouakil D, et al. Psychosocial risk factors for suicidality in children and adolescents. Eur Child Adolesc Psychiatry. 2020;29(6):759–76. https://doi.org/10.1007/s00787-018-01270-9.

Palmer C, Connor C, Channa S, Lavis A, Leung N, Parsons N, et al. The Development of First-Episode Direct Self-Injurious Behavior and Association with Difficulties in Emotional Regulation in Adolescence. Suicide Life-Threatening Behav. 2019;49(5):1266–80. https://doi.org/10.1111/sltb.12512.

Lim KS, Wong CH, McIntyre RS, Wang J, Zhang Z, Tran BX, et al. Global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents between 1989 and 2018: A meta-analysis. Int J Environ Res Public Health. 2019;16(22). https://doi.org/10.3390/ijerph16224581.

Matos M. A Saúde dos Adolescentes Portugueses Após a Recessão. Heal Behav Sch - Aged Child. 2018;62. http://aventurasocial.com/publicacoes/publicacao_1545534554.pdf.

Gillies D, Christou MA, Dixon AC, Featherston OJ, Rapti I, Garcia-Anguita A, et al. Prevalence and Characteristics of Self-Harm in Adolescents: Meta-Analyses of Community-Based Studies 1990–2015. J Am Acad Child Adolesc Psychiatry. 2018;57(10):733–741. https://doi.org/10.1016/j.jaac.2018.06.018.

Kiekens G, Hasking P, Boyes M, Claes L, Mortier P, Auerbach RP, et al. The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviors. J Affect Disord. 2018;239:171–179. https://doi.org/10.1016/j.jad.2018.06.033.

Agüero G, Medina V, Obradovich G, Berner E. Self-injurious behaviors among adolescents. A qualitative study of characteristics, meanings, and contexts. Arch Argent Pediatr. 2018;116(6):394–401. https://doi.org/10.5546/aap.2018.eng.394.

Bježančević M, Groznica Hržić I, Dodig-Ćurković K. Self-Injury in Adolescents: A Five-Year Study of Characteristics and Trends. Psychiatr Danub. 2019;31(4):413–20. https://doi.org/10.24869/psyd.2019.413.

World Health Organization. Suicide [Fact sheets]. 2019. https://www.who.int/news-room/fact-sheets/detail/suicide.

Calati R, Ferrari C, Brittner M, Oasi O, Olié E, Carvalho AF, et al. Suicidal thoughts and behaviors and social isolation: A narrative review of the literature. J Affect Disord. 2019;245:653–67. https://doi.org/10.1016/j.jad.2018.11.022.

Plener PL, Kaess M, Schmahl C, Pollak S, Fegert JM, Brown RC. Non-suicidal self-injury in adolescents. Dtsch Arztebl Int. 2018;115(3):23–30. https://doi.org/10.3238/arztebl.2018.0023.

Cullen KR, Schreiner MW, Klimes-Dougan B. The Neural Basis of Social Evaluation in Adolescents with Non-Suicidal Self-Injury. EClinicalMedicine. 2019;13:6–7. https://doi.org/10.1016/j.eclinm.2019.08.002.

Belfort EL, Miller L. Relationship Between Adolescent Suicidality, Self-Injury, and Media Habits. Child Adolesc Psychiatr Clin N Am. 2018;27(2):159–69. https://doi.org/10.1016/j.chc.2017.11.004.

Marchant A, Hawton K, Stewart A, Montgomery P, Singaravelu V, Lloyd K, et al. A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown. PLoS One. 2017;12(8):1–26. https://doi.org/10.1371/journal.pone.0181722.

Yaacob SN, Yuin FJ, Hasbullah M, Arshat Z, Juhari R. Negative life events and mental health problem: The importance of coping strategy. Pertanika J Soc Sci Humanit. 2019;27(S1):77–87.

Macrynikola N, Miranda R, Soffer A. Social connectedness, stressful life events, and self-injurious thoughts and behaviors among young adults. Compr Psychiatry. 2018;80:140–9. http://doi.org/10.1016/j.comppsych.2017.09.008.

Clarke S, Allerhand LA, Berk MS. Recent advances in understanding and managing self-harm in adolescents. F1000Research. 2019;8:1–12. https://doi.org/10.12688/f1000research.19868.1.

Madge N, Hewitt A, Hawton K, Wilde EJ De, Corcoran P, Fekete S, et al. Deliberate self-harm within an international community sample of young people: Comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psychiatry Allied Discip. 2008;49(6):667–77. https://doi.org/10.1111/j.1469-7610.2008.01879.x.

Psychiatric Research Unit. The World Health Organisation - Five Well-Being Index (WHO-5). 1998. https://www.psykiatri-regionh.dk/who-5/Documents/WHO5_Portuguese.pdf.

Brunner R, Kaess M, Parzer P, Fischer G, Carli V, Hoven CW, et al. Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries. J Child Psychol Psychiatry Allied Discip. 2014;55(4):337–48. https://doi.org/10.1111/jcpp.12166.

Guerreiro DF, Sampaio D, Figueira ML, Madge N. Self-Harm in Adolescents: A Self-Report Survey in Schools from Lisbon, Portugal. Arch Suicide Res. 2017;21(1):83–99. https://doi.org/10.1080/13811118.2015.1004480.

Muehlenkamp JJ, Xhunga N, Brausch AM. Self-injury Age of Onset: A Risk Factor for NSSI Severity and Suicidal Behavior. Arch Suicide Res. 2019;23(4):551–63. https://doi.org/10.1080/13811118.2018.1486252.

Monto MA, McRee N, Deryck FS. Nonsuicidal self-Injury among a representative sample of US adolescents, 2015. Am J Public Health. 2018;108(8):1042–8. https://doi.org/10.2105/AJPH.2018.304470.

Olfson M, Wall M, Wang S, Crystal S, Bridge JA, Liu SM, et al. Suicide after deliberate self-harm in adolescents and young adults. Pediatrics. 2018;141(4). https://doi.org/10.1542/peds.2017-3517.

O’Connor RC, Rasmussen S, Miles J, Hawton K. Self-harm in adolescents: Self-report survey in schools in Scotland. Br J Psychiatry. 2009;194(1):68–72. https://doi.org/10.1192/bjp.bp.107.047704.

Crouch W, Wright J. Deliberate Self-Harm at an Adolescent Unit: A Qualitative Investigation. Clin Child Psychol Psychiatry. 2004;9(2):185–204. https://doi.org/10.1177/1359104504041918.

Martínez-Ferrer B, Stattin H. Self-harm, depressive mood, and belonging to a subculture in adolescence. J Adolesc. 2019;76:12-9. https://doi.org/10.1016/j.adolescence.2019.08.003.

Shen Y, Hu Y, Zhou Y, Fan X. Non-suicidal self-injury function: prevalence in adolescents with depression and its associations with non-suicidal self-injury severity, duration and suicide. Front Psychiatry. 2023;14(June):1–9. https://doi.org/10.3389/fpsyt.2023.1188327.

Ghinea D, Koenig J, Parzer P, Brunner R, Carli V, Hoven CW, et al. Longitudinal development of risk-taking and self-injurious behavior in association with late adolescent borderline personality disorder symptoms. Psychiatry Res. 2019;273:127–33. https://doi.org/10.1016/j.psychres.2019.01.010.

World Health Organization. Adolescent DALYs – top 20 causes (global and regions) [Data portal]. (n.d.). https://www.who.int/data/maternal-newborn-child-adolescent-ageing/indicator-explorer-new/mca/adolescent-dalys---top-20-causes-(global-and-regions).

Zhu J, Chen Y, Su B. Non-suicidal self-injury in adolescence: Longitudinal evidence of recursive associations with adolescent depression and parental rejection. J Adolesc. 2020;84:36-44. https://doi.org/10.1016/j.adolescence.2020.08.002.

Waals L, Baetens I, Rober P, Lewis S, Van Parys H, Goethals ER, et al. The NSSI Family Distress Cascade Theory. Child Adolesc Psychiatry Ment Health. 2018;12:52. https://doi.org/10.1186/s13034-018-0259-7.

Ross-Reed DE, Reno J, Peñaloza L, Green D, FitzGerald C. Family, School, and Peer Support Are Associated With Rates of Violence Victimization and Self-Harm Among Gender Minority and Cisgender Youth. J Adolesc Heal. 2019;65(6):776–83. https://doi.org/10.1016/j.jadohealth.2019.07.013.

Nguyen HTL, Nakamura K, Seino K, Vo VT. Relationships among cyberbullying, parental attitudes, self-harm and suicidal behavior among adolescents: Results from a school-based survey in Vietnam. BMC Public Health. 2020;20(1):1–9. https://doi.org/10.1186/s12889-020-08500-3.

Martins MV, Formiga A, Santos C, Sousa D, Resende C, Campos R, et al. Adolescent internet addiction – role of parental control and adolescent behaviours. Int J Pediatr Adolesc Med. 2020;7(3):116–20. https://doi.org/10.1016/j.ijpam.2019.12.003.

Downloads

Publicado

2024-04-05

Como Citar

1.
Mendes J, Vieira Martins M, Azevedo I, Patrício P, Ferreira S. Comportamentos autolesivos na adolescência: um estudo transversal. REVNEC [Internet]. 5 de Abril de 2024 [citado 4 de Julho de 2024];33(1):12-20. Disponível em: https://revistas.rcaap.pt/nascercrescer/article/view/29618

Edição

Secção

Artigos Originais

Artigos mais lidos do(s) mesmo(s) autor(es)