Exploring gender differences in risk factors for self-harm in adolescents using data from the Millennium Cohort Study

Background Self-harm is common in young people and girls have consistently higher rates of self-harm than boys. Differences in exposure and reactions to risk and protective factors, adverse events and problematic interpersonal relationships, and levels of wellbeing could contribute to the gender difference. This study aims to explore gender differences in risk factors associated with self-harm, to provide the foundation for developing more gender-sensitive approaches to self-harm management.

Methods Data were analysed from 11,196 young people recruited to the Millennium Cohort Study, surveyed around age 14. We examined gender differences in the prevalence of key psychological and social risk factors for self-harm, including family and peer relationships, emotional wellbeing, and bullying and victimisation. We utilised modified Poisson regression to estimate gender-specific risks.

Results At age 14 self-harm prevalence was 15.4 % with a ratio of 2.6 females to 1 male. Differential exposure to recorded psychosocial risk factors explained a third of the gender difference in risk of self-harm. Intense social media use and not confiding in family members were associated with a greater likelihood of self-harm in girls than boys. Bullying others and same-sex attraction were more strongly associated with self-harm in boys than girls.

Limitations Self-harm data were obtained by self-report therefore subject to misclassification. The cross-sectional design does not enable us to establish causation.

Conclusions Unhappiness and dissatisfaction are common in adolescence. Our findings suggest the need for further research into young people's experiences to explore why rates differ and inform the development of gender-specific approaches to self-harm management.