The influence of personality disorder on outcome in adolescent self-harm

Ayodeji, E

Abstract

Background:
Little is currently known about the presence and impact
of personality disorder in adolescents who self-harm.

Aims:
To evaluate personality disorder in repeated self-harm in
adolescence and its impact on self-harm psychopathology
and adaptation outcomes over 1 year.

Method:
A clinical referral sample (n = 366) of adolescents presenting
with repeated self-harm aged 12–17 years, as part of a
randomised controlled trial (Assessment of Treatment in
Suicidal Teenagers study, ASSIST). Personality disorder was
assessed using the Structured Clinical Interview for DSM-IV
Axis II (SCID-II). One-year outcomes included frequency and
severity of repeat self-harm, self-reported suicidality, mood
and functional impairment.

Results:
About 60% of the referred adolescents showed one or more
forms of personality disorder. Personality disorder was
associated with significantly greater severity of self-harm,
overall psychopathology and impairment. There was a
complex association with treatment adherence. Personality
disorder predicted worse 1-year outcomes in relation to
self-harm frequency and severity, as well as impairment,
suicidality and depressive symptoms.

Conclusions:
Personality disorder can be reliably measured in adolescence
and showed high prevalence in this clinical self-harm
sample. Controlling for other variables, it showed a
strong independent association with self-harm severity at
referral and predicted adherence to treatment and clinical
outcomes (independent of treatment) over 1 year.
Consideration of personality disorder diagnosis is indicated
in the assessment and management of adolescents who
repeatedly self-harm.

Citation

Ayodeji, E. (2015). The influence of personality disorder on outcome in adolescent self-harm. British Journal of Psychiatry, 207(4), 313-319. https://doi.org/10.1192/bjp.bp.113.138941

• Journal Article Type: Article
• Acceptance Date: Mar 1, 2015
• Online Publication Date: Jan 2, 2018
• Publication Date: Oct 1, 2015
• Deposit Date: Dec 1, 2015
• Journal: British Journal of Psychiatry
• Print ISSN: 0007-1250
• Electronic ISSN: 1472-1465
• Publisher: Royal College of Psychiatrists
• Volume: 207
• Issue: 4
• Pages: 313-319
• DOI: https://doi.org/10.1192/bjp.bp.113.138941
• Publisher URL: http://dx.doi.org/10.1192/bjp.bp.113.138941
• Related Public URLs: http://www.maneyonline.com/loi/bjp