DELIBERATE SELF-HARM AMONG THAI ADOLESCENTS: AN EMPIRICAL TEST OF A CAUSAL MODEL

Abstract

Deliberate self-harm [DSH] is an intentional behavior of direct destruction of body tissues which causes non-fatal physical trauma to the extent that bleeding occurs or causes a bruise to appear and without conscious suicidal intent, such as cutting, punching, etc. Adolescents’ DSH is an important issue in mental health work because of its high prevalence in Thailand. A model-testing, cross-sectional study was conducted to test a causal model of DSH in Thai adolescents. A multi-stage random sampling was used to recruit participants of 360 adolescents aged 10-19 years studying in high schools in the north of Thailand in 2019. Data collection was carried out from July 2019 to January 2020. Six self-report instruments included the family relationship questionnaire, the Student-School Connectedness scale, the Resilience Factors scale for Thai adolescents, the self-control questionnaire, the Thai version of Perceived Stress Scale-10 and the Deliberated Self-Harm Inventory. Their consistency reliability ranged from 0.81-0.89. Data were analyzed by using descriptive statistics and Structural Equation Modeling.

The results revealed the prevalence of DSH behaviors among participants who are Thai adolescents were 45.9%, and can be classified by sex were approximately equal percentage between boys (47%) and girls (44.7%). The modification of the hypothesized model fit the data well (c2 = 333.35, p = .078, df = 298, CMIN/ df = 1.119, GFI = .952, AGFI = .900, and RMSEA = .018). Sex, resilience, stress, and school connectedness had direct effects on DSH (β = -0.139, β = -0.266, β = 0.163, and β = -0.671, respectively). Resilience and stress also mediated the link between sex (girl), family relationship, school connectedness, and DSH. Sex, stress, resilience, family relationship, and school connectedness accounted for 65.20% of variance in prediction of DSH in Thai adolescents. These findings suggested that this causal model of DSH is fit the empirical data. The prevalence of DSH among Thai adolescents is high. An intervention to strengthen and enhance the school connectedness, family relationship, and resilience as well as to reduce stress among Thai adolescent for DSH prevention should be developed and implemented in both sexes, specifically in boys.

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