Self-harm and Suicide Attempts Among Young Chinese Adolescents in Hong Kong: Prevalence, Correlates, and Changes

Objective: To examine the prevalence of and changes in self-harm and suicide attempts and to predict these behaviors in relation to family functioning and positive youth development.

Design: We used quantitative data based on a large sample of adolescent participants. Participants had joined this study in a previous year when they were in Grade 7 (Wave 1). The present study focused on Wave 2 data and the comparison with Wave 1 data.

Setting And Participants: The participants consisted of 2,579 Grade 8 students from 28 secondary schools in Hong Kong. A multi-stage cluster random sampling was adopted.

Main Outcome Measure: Self-harm behavior, suicide attempt, the Chinese Family Assessment Instrument, the Chinese Positive Youth Development Scale.

Results: Approximately 23.5% of Grade 8 students had engaged in self-harm behavior in the preceding 12 months. Girls showed more self-harm behavior compared with the boys. Nearly 4.0% of adolescents attempted suicide in the preceding 12 months. Perceived family functioning and positive youth development predicted self-harm and suicidal ideation. Among the 4 second-order positive youth development qualities, the construct "general positive youth development qualities" was the strongest predictor of self-harm and suicide attempts. Compared with the Wave 1 data, more suicidal symptoms were observed in Wave 2, although the prevalence of self-harm behavior was similar across time.

Conclusions: The prevalence of self-harm behavior among Chinese adolescents was high, but the level of suicidal behavior was low. Perceived family functioning and positive youth development can be regarded as protective factors for adolescents against self-harm and suicidal behaviors. General positive youth development quality is most important among the 4 second-order positive youth development qualities.