Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
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The association between adverse childhood experiences and self-harm among South Korean children and adolescents: a cross-sectional study

  • Scott Seung W. Choi (Department of Nursing, Inha University) ;
  • Jeong-Kyu Sakong (Department of Psychiatry, Dongkuk University) ;
  • Hyo Ju Woo (Department of Nursing, Inha University) ;
  • Sang-Kyu Lee (Department of Psychiatry, Hallym University) ;
  • Boung Chul Lee (Department of Psychiatry, Hallym University) ;
  • Hyung-Jun Yoon (Department of Psychiatry, College of Medicine, Chosun University) ;
  • Jong-Chul Yang (Department of Psychiatry, Jeonbuk National University) ;
  • Min Sohn (Department of Nursing, Inha University)
  • Received : 2023.07.31
  • Accepted : 2023.09.19
  • Published : 2023.10.31
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Abstract

Purpose: Adolescent self-harm is a public health problem. Research suggests a link between adverse childhood experiences (ACEs) and self-destructive behaviors. Few studies, however, have examined the effects of ACEs on self-harm among Asian adolescents. This study explored the association between lifetime ACEs and a history of self-harm among Korean children and adolescents in elementary, middle, and high schools. Methods: A cross-sectional, retrospective medical record review was conducted on a dataset of a national psychiatrist advisory service for school counselors who participated in the Wee Doctor Service from January 1 to December 31, 2020. The data were analyzed using multiple logistic regression to predict self-harm. Results: Student cases (n=171) were referred to psychiatrists by school counselors for remote consultation. Multiple logistic regression analyses revealed that the odds of self-harm were higher among high school students (adjusted odds ratio [aOR]=4.97; 95% confidence interval [CI]=1.94-12.76), those with two or more ACEs (aOR=3.27; 95% CI=1.43-7.47), and those with depression (aOR=3.06; 95% CI=1.32-7.10). Conclusion: The study's findings provide compelling evidence that exposure to ACEs can increase vulnerability to self-harm among Korean students. Students with a history of ACEs and depression, as well as high school students, require increased attention during counseling. School counselors can benefit from incorporating screening assessment tools that include questions related to ACEs and depression. Establishing a systematic referral system to connect students with experts can enhance the likelihood of identifying self-harm tendencies and offering the essential support to prevent self-harm.

Keywords

Acknowledgement

This study was supported by the Inha University Research Grant.

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