Psychological subtyping finds pathological, impulsive, and ‘normal’ groups among adolescents who self‐harm

Background: Research to date suggests that as many as 12–15% of young people engage in self‐harm behaviour; however, the current understanding of the psychological basis of adolescent self‐harm is limited. The objective was to determine whether adolescents who self‐harm are a psychologically homogenous group. It was hypothesised that psychological subtypes would exist and these groups would report different rates of self‐harm. Method: Nine hundred and forty‐four school students aged 11 to 19 and 166 first‐year psychology students aged 21 or younger completed a self‐report questionnaire. Participants were aged 11 to 21 (mean = 15.4, SD = 2.1). Sixty‐two percent of the sample were female ( n = 692). Students were allocated to psychologically distinct groups. Rates of self‐harm were compared for the psychological subtypes of self‐harmers. Results: Two hundred and thirty‐four participants reported lifetime self‐harm (21.1%; 95% CI 19–23%) and 78 reported recent self‐harm (7.0%; 95% CI 6.7–7.3%). The present study identified three psychologically quite distinct groups of adolescents within those who reported self‐harm – a psychologically pathological group, a psychologically ‘normal’ group, and an impulsive group. The pathological group reported the highest rate of recent self‐harm (50.9%); the psychologically ‘normal’ and impulsive groups reported similar rates of self‐harm (28.7% and 24.6%, respectively). Conclusions: Adolescents who self‐harm are not a psychologically homogenous group. One pathological subtype of self‐harmers appears to most closely reflect a number of the psychological and social factors previously associated with self‐harm. However, a large proportion of the sample was allocated the psychologically ‘normal’ subtype. This finding highlights the importance of psychological screening of adolescents presenting for treatment for self‐harm as subtypes of self‐harmers may require disparate strategies for intervention. Further research is required in order to identify appropriate treatment strategies for each subtype.