Boys Who Don't Feel Accepted at Greater Risk of Self-Harm

New research suggests that when boys feel they are not accepted by peers or family they are at high risk for committing future harm or suicide.

Brown University researchers studied 99 teens hospitalized out of concern for suicide risk and found that a high perception of family invalidation, or a lack of acceptance, predicted future suicide events among boys.

Researchers also discovered that peer invalidation predicted future self-harm, such as cutting, among the teens in general.

Investigators discovered that the perception of invalidation is an independent risk factor for determining whether teens will try to harm themselves or even attempt suicide.

In some cases, as with peers, that sense of invalidation could come from being bullied, but it could also be more subtle.

“In the case of family, for example, a teen who is gay may feel a strong degree of invalidation if he or she perceives that parents would either disapprove or be disappointed upon finding out,” said study lead author Shirley Yen, Ph.D.

In the study, Yen and her colleagues followed a group of 99 teens, each admitted to a psychiatric facility because they had tried to kill themselves or presented a serious risk of doing so, for six months of follow-up.

Along the way they assessed the teens’ sense of family and peer invalidation as well as other demographic and psychiatric data.

They also tracked whether the teens (or their parents) reported new suicide attempts or related events by the teen, or whether the teen was engaging in cutting or other forms of self-harm.

The study is published online in the Journal of Child and Adolescent Psychopharmacology.

Researchers assessed family invalidation by asking questions such as, “Were there times when you did not feel accepted by your family? Or that you could not express your true thoughts and feelings? Or that if you did express your thoughts and feelings that you would be dismissed, punished, ignored or made fun of?”

There were similar questions about the perception of peer invalidation.

The researchers assessed invalidation upon hospital admission. Then, at the six-month mark, the teens were asked to recall the degree of such feelings anchored in notable events. Ratings were assigned for each week of that past half-year.

After statistically accounting for other known risk factors such as low positive affect or high levels of aggression, Yen found that a moderate to high perception of family invalidation proved a statistically significant predictor of a later suicide event among boys. A strong degree of peer invalidation, meanwhile, predicted engagement in self-harm behaviors in the overall group (boys and girls).

“What this points to is the importance of assessing for the teen’s individual feelings of invalidation,” Yen said. “This is different than a lack of social support.”

Yen said doctors and psychologists may find the measure of invalidation especially helpful in the context seen in the study: identifying a distinctly higher suicide or self-mutilation risk within a group of teens already understood to be very troubled.

Yen has worked for years to understand the different risk factors of suicide and self-mutilation among troubled youths. Her goal is to understand the key risk factors, such as family and peer invalidation, well enough to produce new, effective clinical interventions or inform existing ones.

Source: Brown University