This research looked at what young people report about self-harm in surveys compared with their medical records. It found that adolescents tend to under report self-harm. This supports doctors and the NHS to gain a better understanding of self-harm, informing treatment and planning decisions.

Why was this work needed?

Due to the nature of the injury, people may not see a doctor when they self-harm, and they may also under-report incidents during interviews and surveys, so understanding how common self-harm is among adolescents is challenging for health services.

What happened?

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a large study examining the influences on health and development over someone’s entire life. Over 14,500 pregnant women were recruited in the Bristol area, all expecting to give birth between April 1, 1991 and December 31, 1992. Participants and the children born during that period have been followed up during the course of their lives and their health records monitored. The children were asked for their own consent when they reached 18. At the same time as this, they were asked to agree to their responses being linked to their healthcare records.

When participants were 16, they were asked questions about self-harm as part of the study. This research involved comparing what someone says about self-harm with medically recorded incidents of self-harm.

What were the benefits?

The research found that people who did not respond or did not complete the self-harm section of the questionnaire were more likely to have medically-recorded incidents of self-harm. There were also some discrepancies between the questionnaire answers and medical reports. Approximately one fifth of the self-harm incidents recorded by hospitals were not recorded in the surveys. This suggests that self-reporting data may underestimate the number of young people who are self-harming.

These findings have the potential to inform how doctors approach the treatment of adolescent self-harm and how the NHS approaches the issue as a whole.

What type of data was involved?

This research compared data from ALSPAC with Hospital Episode Statistics (HES) records.

Participants consented to participate in ALSPAC and subsequently to linkage with their medical records.

Who funded and collaborated on this work?

This research was funded by the Medical Research Council.

Where can I go for more information?

Using Data Linkage to Investigate Inconsistent Reporting of Self-Harm and Questionnaire Non-Response