Protective Factors Against Self-Harm and Suicidality Among Australian Indigenous Adolescents: A Strengths-Based Analysis of the Longitudinal Study of Indigenous Children

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2022 Jul 28

PMID 35897497

Authors

Md Irteja Islam

Lisa Sharwood

Verity Chadwick

Tuguy Esgin

Alexandra Martiniuk

Affiliations

Soon will be listed here.

Abstract

Background: Understanding and encouraging social and emotional well-being (SEWB) among Indigenous adolescents is vital in countering the impacts of colonisation and intergenerational trauma. As self-harm and suicidality are considered markers of poor SEWB among Indigenous communities, we aimed to identify the individual-level and community-level factors protecting Indigenous adolescents from self-harm and suicidality. Methods: Data came from Footprints in Time—The Longitudinal Study of Indigenous Children (waves 10 and 11), conducted among Indigenous families across Australia. A strengths-based analysis fitted multilevel logistic regression to explore associations with factors proposed as protective against self-reported self-harm and suicidality among Indigenous adolescents. Results: Our study cohort included 365 adolescents with complete data for the variables of interest. Adolescents had a mean (SD) age of 14.04 (0.45) years and a sex ratio of almost 1:1, and most were attending school (96.2%). Previous self-harm was reported by 8.2% (n = 30); previous suicidality was reported by 4.1% (n = 15). Individual-level factors protecting against self-harm and suicidality were being male, living in a cohesive family, and having low total Strengths and Difficulty Questionnaire scores (p < 0.05 for all). Residing in major cities compared with regional/remote areas was protective against self-harm (OR 5.94, 95% CI 1.31−26.81). Strong cultural identity was not found to be a protective factor against self-harm and/or suicidality in the sample. Conclusions: This study identified key individual- and community-level factors that can protect Australian Indigenous adolescents against self-harm and suicidality, particularly family cohesion. Identifying strengths for this at-risk population can inform prevention strategies, particularly for rural living adolescents with high distress.

Citing Articles

Thriving Beyond Adversity: A Prospective Longitudinal Cohort Study Using a Strength-Based Approach Depicts Indigenous Adolescents with Less Adverse Childhood Experiences (ACEs) Had Fewer Neurodevelopmental Disorders (NDDs).

Islam M, Lam B, Esgin T, Martiniuk A Behav Sci (Basel). 2024; 14(11).

PMID: 39594347 PMC: 11591513. DOI: 10.3390/bs14111047.

Impact of healthy pregnancy and lifestyle in mothers on developmental delay in their offspring: a strength-based analysis of a longitudinal study among indigenous children in Australia.

Islam M, Stubbs T, Esgin T, Martiniuk A BMC Pregnancy Childbirth. 2024; 24(1):776.

PMID: 39580390 PMC: 11585953. DOI: 10.1186/s12884-024-06990-2.

References

Chandler M, Proulx T . Changing selves in changing worlds: youth suicide on the fault-lines of colliding cultures. Arch Suicide Res. 2006; 10(2):125-40. DOI: 10.1080/13811110600556707. View

Madge N, Hewitt A, Hawton K, de Wilde E, Corcoran P, Fekete S . 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. 2008; 49(6):667-77. DOI: 10.1111/j.1469-7610.2008.01879.x. View

Rivera F, Guarnaccia P, Mulvaney-Day N, Lin J, Torres M, Alegria M . Family Cohesion and its Relationship to Psychological Distress among Latino Groups. Hisp J Behav Sci. 2011; 30(3):357-378. PMC: 2681258. DOI: 10.1177/0739986308318713. View

Ridani R, Shand F, Christensen H, McKay K, Tighe J, Burns J . Suicide prevention in Australian Aboriginal communities: a review of past and present programs. Suicide Life Threat Behav. 2014; 45(1):111-40. DOI: 10.1111/sltb.12121. View

Glascoe F . Screening for developmental and behavioral problems. Ment Retard Dev Disabil Res Rev. 2005; 11(3):173-9. DOI: 10.1002/mrdd.20068. View

Page A, Morrell S, Taylor R, Dudley M, Carter G . Further increases in rural suicide in young Australian adults: secular trends, 1979-2003. Soc Sci Med. 2007; 65(3):442-53. DOI: 10.1016/j.socscimed.2007.03.029. View

Zubrick S, Ward K, Silburn S, Lawrence D, Williams A, Blair E . Prevention of child behavior problems through universal implementation of a group behavioral family intervention. Prev Sci. 2005; 6(4):287-304. DOI: 10.1007/s11121-005-0013-2. View

De Leo D, Heller T . Who are the kids who self-harm? An Australian self-report school survey. Med J Aust. 2004; 181(3):140-4. DOI: 10.5694/j.1326-5377.2004.tb06204.x. View

Anderson I, Crengle S, Kamaka M, Chen T, Palafox N, Jackson-Pulver L . Indigenous health in Australia, New Zealand, and the Pacific. Lancet. 2006; 367(9524):1775-85. DOI: 10.1016/S0140-6736(06)68773-4. View

10.

Merlo J, Chaix B, Ohlsson H, Beckman A, Johnell K, Hjerpe P . A brief conceptual tutorial of multilevel analysis in social epidemiology: using measures of clustering in multilevel logistic regression to investigate contextual phenomena. J Epidemiol Community Health. 2006; 60(4):290-7. PMC: 2566165. DOI: 10.1136/jech.2004.029454. View

11.

Theall K, Scribner R, Broyles S, Yu Q, Chotalia J, Simonsen N . Impact of small group size on neighbourhood influences in multilevel models. J Epidemiol Community Health. 2010; 65(8):688-95. PMC: 3706628. DOI: 10.1136/jech.2009.097956. View

12.

Gupta H, Tari-Keresztes N, Stephens D, Smith J, Sultan E, Lloyd S . A scoping review about social and emotional wellbeing programs and services targeting Aboriginal and Torres Strait Islander young people in Australia: understanding the principles guiding promising practice. BMC Public Health. 2020; 20(1):1625. PMC: 7596979. DOI: 10.1186/s12889-020-09730-1. View

13.

Perera J, Wand T, Bein K, Chalkley D, Ivers R, Steinbeck K . Presentations to NSW emergency departments with self-harm, suicidal ideation, or intentional poisoning, 2010-2014. Med J Aust. 2018; 208(8):348-353. DOI: 10.5694/mja17.00589. View

14.

Johnson J, Cohen P, Gould M, Kasen S, Brown J, Brook J . Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Arch Gen Psychiatry. 2002; 59(8):741-9. DOI: 10.1001/archpsyc.59.8.741. View

15.

Dudley M, Kelk N, Florio T, Waters B, Howard J, Taylor D . Coroners' records of rural and non-rural cases of youth suicide in New South Wales. Aust N Z J Psychiatry. 1998; 32(2):242-51. DOI: 10.3109/00048679809062735. View

16.

Soole R, Kolves K, De Leo D . Suicides in Aboriginal and Torres Strait Islander children: analysis of Queensland Suicide Register. Aust N Z J Public Health. 2014; 38(6):574-8. DOI: 10.1111/1753-6405.12259. View

17.

Rigby C, Rosen A, Berry H, Hart C . If the land's sick, we're sick:* the impact of prolonged drought on the social and emotional well-being of Aboriginal communities in rural New South Wales. Aust J Rural Health. 2011; 19(5):249-54. DOI: 10.1111/j.1440-1584.2011.01223.x. View

18.

Salmon M, Skelton F, Thurber K, Bennetts Kneebone L, Gosling J, Lovett R . Intergenerational and early life influences on the well-being of Australian Aboriginal and Torres Strait Islander children: overview and selected findings from Footprints in Time, the Longitudinal Study of Indigenous Children. J Dev Orig Health Dis. 2018; 10(1):17-23. DOI: 10.1017/S204017441800017X. View

19.

Kleiman E, Liu R . Social support as a protective factor in suicide: findings from two nationally representative samples. J Affect Disord. 2013; 150(2):540-5. PMC: 3683363. DOI: 10.1016/j.jad.2013.01.033. View

20.

Thurber K, Banks E, Banwell C . Cohort Profile: Footprints in Time, the Australian Longitudinal Study of Indigenous Children. Int J Epidemiol. 2014; 44(3):789-800. PMC: 4521121. DOI: 10.1093/ije/dyu122. View