Preventing suicide and involuntary care in youth: identifying and targeting risk factors for self-harm

Suicide is the leading cause of death for ages 10-19-years in Sweden. The most reliable predictor of suicide is self-harm (including suicide attempts).

Decades of research have failed to produce reliable assessments of risk factors for self-harm that could be applied with confidence in the clinic. Further, few evidence-based out-patient treatments for self-harm exist to date.

Instead, involuntary care is increasingly used in this population, despite evidence indicating that it may worsen prognosis. Two studies will be conducted.

Study 1 aims to identify clinically applicable risk factors of self-harm and Study 2 is a randomized clinical trial for youth who self-harm.

Study 1 will for the first time assess youth at risk of self-harm prospectively (aged 12 to 14-years) at two timepoints: pre onset of self-harm and at follow-up.

Participants will be assessed using a range of psychophysiological, cognitive, and psychosocial measures, with a particular focus on pain-sensitivity.

Identified individuals with self-harm will be included in a parallel randomized controlled trial (total N=200) of a cognitive behavioral family treatment targeting risk factors for self-harm and suicide, compared to an active control group.

By identifying clinically applicable risk factors and evaluating a potentially effective out-patient intervention, this project aims to reduce the need for involuntary care and prevent suicide in youth.