Table 4 Associates, Risk and Protective Factors of Self-Harm (by year of publication)
Author (year) Country | Associates / Risk Factors | Study quality | ||||
|---|---|---|---|---|---|---|
Personal a | Family b | School c | Interpersonal d | Abuse and violence e | ||
Cummins & Allwood (1984) [83] South Africa | ▪ Psychiatric disturbance | ▪ Family dysfunction (including divorce) ▪ Family psychiatric illness | ▪ School problems | ▪ Socialisation problems | – | 3/5 |
Pillay (1987) [85] South Africa | ▪ Medical/psychiatric illness | ▪ Problems with Parents ▪ Problems with siblings ▪ Marital problems | ▪ School problems | ▪ Problems with boyfriend or girlfriend | – | 3/5 |
Sefa-Dedeh & Canetto (1992) [22] Ghana | – | ▪ Family harassment and dispute ▪ Failed sense of autonomy in the family | – | – | – | 4/5 |
Kebede & Ketsela (1993) [35] Ethiopia | ▪ Hopelessness ▪ Heavy alcohol intake | – | ▪ Lower school grade | – | – | 5/5 |
Pillay & Wassenaar (1997) [95] South Africa | ▪ Depression | ▪ Lower family adaptability ▪ Low family cohesion ▪ Low family satisfaction ▪ Hopelessness ▪ Psychiatric disturbances. | ▪ Problems at school | ▪ Romantic relationship problems | – | 5/5 |
Wassenaar et al. (1998) [23] South Africa | ▪ Hopelessness | ▪ Family communication breakdown ▪ Conflict with parents ▪ Authoritarian patriarchy. | – | – | – | 4/5 |
Mhlongo & Peltzer (1999) [88] South Africa | ▪ AIDS phobia ▪ Teenage pregnancy ▪ Mental illness ▪ Unemployment ▪ Financial problems | ▪ Problem with parents | ▪ Academic failure | ▪ Romantic relationship problems | – | 3/5 |
Peltzer et al. (2000) [36] South Africa | ▪ Suicidal ideation ▪ Suicide intent | ▪ History of family suicide ▪ Parental divorced ▪ Large family size | – | ▪ History of suicide by friend | – | 3/5 |
Madu & Matla (2004) [96] South Africa | – | ▪ Family conflict | – | – | – | 4/5 |
Wild et al. (2004) [38] South Africa | ▪ Depression ▪ Poor global self-worth ▪ Poor body image ▪ Female sex | – | ▪ Poor schoolwork | ▪ Problems with peers | – | 4/5 |
Sommer (2005) [39] South Africa | ▪ Female sex ▪ Previous psychiatric contact | ▪ Perceived lack of family support ▪ Suicide attempt in the family | – | ▪ Death of a friend | – | 2/5 |
Shiferaw et al. (2006) [41] Ethiopia | ▪ Being sexually active ▪ Female sex ▪ Unwanted pregnancy ▪ Boredom ▪ HIV/AIDS positive status | ▪ Family member attempted suicide ▪ Lack of family support ▪ Living with both biological parents | ▪ Academic under-achievement | ▪ Friend suicide attempt ▪ Romantic relationship problems | – | 2/5 |
Omigbodun et al. (2008) [20] Nigeria | ▪ Drinking alcohol ▪ Having to go hungry | ▪ Unstable family life ▪ Having a mother who had been married more than once ▪ Living in urban location | – | – | ▪ Sexual abuse ▪ Physical attack ▪ Physical fights | 4/5 |
Yéo-Tenena et al. (2010) [89] Ivory Coast | ▪ Psychiatric problems (depression, substance addiction) ▪ Previous suicide attempt ▪ Emotional problems | ▪ Familial conflict | ▪ School failure | ▪ Unwanted pregnancy | ▪ Sexual abuse | 4/5 |
Beekrum et al. (2011) [24] South Africa | â–ª Hopelessness and despair | â–ª Previous suicide or attempted suicide by a close family member â–ª Conflictual, disengaged or over-protective family relationships â–ª Strained adolescent-parent communication â–ª Conflicting social roles and values in the context of contemporary acculturation pressures | â–ª Academic failure | â–ª Breakup â–ª Lack of social support | â–ª Physical and emotional abuse in the family | 5/5 |
Okoko et al. (2011) [90] The Congo | â–ª Previous suicide attempt â–ª Psychosis â–ª Alcohol abuse â–ª Drugs abuse â–ª Emotional breakdown | â–ª Conflict with parents â–ª Difficulty with family communication â–ª Parental divorce â–ª Parental death â–ª Kinship fostering â–ª Living in a stepfamily | â–ª School problems | â–ª Breakup | â–ª Domestic violence victimisation â–ª Sexual abuse â–ª Neglect â–ª Incest | 4/5 |
Pretorius (2011) [29] South Africa | ▪ Personal history of suicide attempts suicide; ▪ Previous diagnosis of mood disorders (i.e., major depression, and bipolar disorder) | ▪ Experience of human trafficking before removal from parental care ▪ Dysfunctional parenting (unavailability, conflict, or alcoholism) before removal from parental care ▪ Family history of attempted suicide | – | ▪ Observation of the self-harm of another adolescent at the same children’s home | ▪ Abuse (i.e., physical, sexual, and emotional abuse) before removal from parental care. | 3/5 |
Campbell (2012) [45] South Africa | ▪ Female sex; ▪ Coloured race; | ▪ Stressful relationships with parents and extended family ▪ Financial hardship | – | ▪ Stressful romantic relationship ▪ Negative life events | – | 3/5 |
Shilubane et al. (2012) [32] South Africa | ▪ Perceived accusations of negative behaviour ▪ Feelings of physical rejection ▪ Acute negative mood (e.g., depression, anger, hopelessness) ▪ Being unaware of community-support resources ▪ Personal history of attempted suicide | ▪ Conflictual and strained family relationships ▪ Lack of family support ▪ Family member HIV positive status ▪ Death of close family member ▪ Family history of attempted suicide ▪ Family poverty | – | ▪ Lack of trusted peer support ▪ Peer suicide attempt | – | 4/5 |
Swahn et al. (2012) [30] Uganda | ▪ Sadness ▪ Expectations of dying prior to age 30 | ▪ Parental neglect due to alcohol use | – | – | – | 4/5 |
Vawda (2012) [47] South Africa | – | ▪ Family member suicide | – | – | – | 3/5 |
Gage (2013) [25] Ethiopia | ▪ Currently employed ▪ Lost much sleep over worry ▪ Depression | ▪ Receiving marriage request ▪ Both parents deceased | – | ▪ Community involvement in child marriage prevention | ▪ Sexual violence victimisation | 4/5 |
Muula et al. (2013) [48] Zambia | ▪ Female sex ▪ Aged ≤14 yrs. ▪ Loneliness ▪ Sleeplessness due to worry ▪ Hopelessness ▪ Suicidal ideation ▪ Marijuana use ▪ Drunkenness | – | – | – | ▪ Use of dagga | 5/5 |
Shilubane et al. (2013) [49] South Africa | ▪ Female sex ▪ Hopelessness ▪ Feeling unsafe ▪ Substance use ▪ Having unsafe sex ▪ Older adolescence ▪ Body dissatisfaction. | – | ▪ Lower grade | – | ▪ Violence | 5/5 |
Chinawa et al. (2014) [51] Nigeria | ▪ Depression ▪ Alcohol and drug use | – | – | – | – | 2/5 |
Penning & Collings (2014) [53] South Africa | ▪ Female sex | ▪ Domestic injury | – | – | ▪ Domestic assault ▪ Rape ▪ Emotional abuse ▪ Negative child sexual abuse appraisals | 5/5 |
Randall et al. (2014) [54] Benin | ▪ Male sex ▪ Anxiety ▪ Loneliness ▪ Substance use | – | – | – | ▪ Being attacked | 5/5 |
Lippi (2014) [52] South Africa | ▪ Severe depression | – | – | – |  | 3/5 |
Cluver et al. (2015) [56] South Africa | ▪ Older adolescence ▪ Female sex ▪ Orphanhood by AIDS, ▪ Previous suicide attempt | ▪ Parental AIDS-illness ▪ Food insecurity | – | – | ▪ Severe physical abuse ▪ Severe emotional abuse ▪ Sexual abuse or rape ▪ Community violence ▪ Domestic violence ▪ Orphanhood by homicide | 4/5 |
Ng et al. (2015) [57] Rwanda | ▪ Child mental health symptoms (i.e., Depression above diagnostic threshold; conduct problems). | ▪ Parenting style | – | – | – | 5/5 |
Giru (2016) [58] Ethiopia | ▪ Family history of suicide ▪ Loneliness ▪ Hopelessness ▪ Mental illness ▪ Financial loss | ▪ Family conflict ▪ Death in family | ▪ Academic failure | ▪ Lack of social support | – | 3/5 |
Shaikh et al. (2016) [59] Malawi | ▪ Female sex ▪ Early sexual debut ▪ Serious injury ▪ Loneliness ▪ Anxiety ▪ Suicide ideation ▪ Suicide planning ▪ Alcohol use | ▪ Parental tobacco use | – | ▪ Lifetime sexual partners ▪ Number of days people smoked in presence weekly ▪ Having many close friends | ▪ Bullied ▪ Physical fight ▪ Physically attacked ▪ Physically bullied | 5/5 |
Asante et al. (2017) [62] Ghana | ▪ Anxiety ▪ Loneliness | ▪ Parental understanding | – | ▪ Food insecurity ▪ Having many close friends | ▪ Bullied ▪ Being attacked ▪ Fighting | 5/5 |
Asante & Meyer-Weitz (2017) [31] Ghana | ▪ Female sex ▪ Aged 15 years or older ▪ Smoking ▪ Past alcohol use ▪ Present alcohol use ▪ Marijuana use ▪ Survival sex | – | – | – | ▪ Assaulted with a weapon ▪ Having been robbed | 4/5 |
Peltzer & Pengpid (2017) [65] Namibia | ▪ Health risk behaviours ▪ Hunger ▪ Parental support | – | – | – | – | 4/5 |
Amare et al. (2018) [67] Ethiopia | ▪ Living alone ▪ Loneliness ▪ Hopelessness ▪ Sleep disturbance worries ▪ Being physically hurt | – | ▪ Truancy | ▪ Poor social support | – | 5/5 |
Khuzwayo et al. (2018) [68] South Africa | ▪ Aged 16 years and above ▪ Female sex ▪ Cannabis use | – | – | – | ▪ Threatened in school with a weapon ▪ Bullied in school ▪ Dating violence victimisation ▪ Cyber bullying | 3/5 |
Kritzinger (2018) [26] South Africa | ▪ Anger ▪ Low mood ▪ Suicidal ideation ▪ Previous suicide attempt ▪ Impulsivity ▪ Unemployment | ▪ Conflict with parents | – | ▪ Breakup ▪ Loss of significant other | ▪ Domestic abuse victimisation | 5/5 |
van der Wal & George (2018) [70] South Africa | ▪ Emotional reactivity ▪ Tension-reduction coping | – | – | ▪ Social support | – | 3/5 |
Baiden et al. (2019) [71] Ghana | ▪ Anxiety ▪ Illicit substance use ▪ Physical activity | – | – | ▪ Having a close friend | ▪ Bullying victimisation | 5/5 |
Carvalho et al. (2019) [97] Cross-national study (Benin, Ghana, Mozambique, Namibia, & Tanzania). | ▪ Cannabis use | – | – | – | – | 5/5 |
Darré et al. (2019) [73] Togo | ▪ Female sex ▪ Being aged > 18 ▪ Sentimental problems ▪ Health problems ▪ Loneliness ▪ Unwanted pregnancy ▪ Distaste of life ▪ Abstinence | ▪ Family history of suicide ▪ Financial problems ▪ Family problems ▪ Absence of parents | – | ▪ Living as a couple ▪ Death of a loved one | – | 3/5 |
Koyanagi, Oh et al. (2019) [74] Cross-national study (Benin, Ghana, Malawi, Mauritania, Mozambique, Namibia, Seychelles, Swaziland, & Tanzania). | – | – | – | – | ▪ Bullying victimisation | 5/5 |
Koyanagi, Stubbs, et al. (2019) [75] Cross-national (Benin, Ghana, Mauritania, Mozambique, Namibia, Seychelles, Swaziland, & Tanzania). | – | ▪ Children and adolescent food insecurity | – | – | – | 5/5 |
Nguyen et al. (2019) [76] Cross-national (Nigeria, Uganda, & Zambia). | – | ▪ Orphanhood prior to age 18 | – | – | ▪ Coerced/forced sexual initiation | 5/5 |
Shayo & Lawala (2019) [78] Tanzania | ▪ Loneliness ▪ Anxiety ▪ Younger age | ▪ Food insecurity ▪ Parental care | – | – | – | 5/5 |
Thornton et al. (2019) [79] Cross-national (South Africa & Guyana) | – | – | – | ▪ Social stress | – | 2/5 |
Vancampfort et al. (2019) [82] Cross-national (Benin, Ghana, Mauritania, Mozambique, Namibia, Seychelles, & Tanzania) | ▪ Sedentary leisure-time | – | – | – | – | 5/5 |