Dual-harm in adolescence and associated clinical and parenting factors

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)
17 Downloads (Pure)


PURPOSE: Both aggression toward others and self peak in adolescence and interpersonal violence and suicide are among the leading causes of death in young people worldwide. Individuals who show both aggression toward others and self, i.e. dual-harm, may experience the worst outcomes. The current study investigates clinical and parenting factors associated with dual-harming in adolescence, to provide new insights for prevention and treatment.

METHODS: In a prospective cohort of adolescents, oversampled on emotional and behavioral problems (n = 1022; aged 12-17 years), we investigated co-occurrence in harm toward others and self and presented findings in an area-proportional Euler diagram. Four harm groups (no harm, other-harm, self-harm, and dual-harm) were compared on intelligence scores, general functioning, emotional and behavioral problems, substance use, parental hostility, and harsh parenting with ANCOVAs and logistic regressions.

RESULTS: In adolescents that other-harmed, the risk of self-harm was 1.9 times higher than for those who did not harm others. Dual-harm adolescents reported worse overall functioning, more emotional and behavioral problems, more parental hostility and harshness, and were more likely to use substances than those who did not engage in aggressive behaviors. No evidence of differences in intelligence scores between groups were found.

CONCLUSION: These findings highlight a vulnerable group of adolescents, at risk of future suicide, violent offending, and the development of severe psychopathology. Dual-harm is a promising marker for early intervention and referral to specialized mental health professionals. Further research is needed to examine underlying pathways and risk factors associated with persistent dual-harm trajectories into adulthood.

Original languageEnglish
Pages (from-to)1615-1626
Number of pages12
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number8
Early online date29 Mar 2022
Publication statusPublished - Aug 2022

Bibliographical note

Funding Information:
The iBerry Study is funded by the Erasmus University Medical Center and the following mental healthcare institutes: Parnassia Psychiatric Institute Antes, GGz Breburg, GGz Delfland, GGz Westelijk Noord-Brabant and Yulius. All funding organizations participate in the Epidemiological and Social Psychiatric Research Institute (ESPRi), a consortium of academic and non-academic research groups.

Publisher Copyright:
© 2022, The Author(s).


Dive into the research topics of 'Dual-harm in adolescence and associated clinical and parenting factors'. Together they form a unique fingerprint.

Cite this