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Deliberate self-harm increases risk for violent crime

Individuals who deliberately self-harmed were more likely to commit violent crime, suggesting a link between the two.

“Several psychiatric disorders have been associated with an increased risk of violent crime (eg, bipolar disorder, borderline personality disorder, antisocial personality disorder). However, not all phenotypes within and between psychiatric disorders may be associated with an increased risk of violence,” Hanna Sahlin, MSc, of Karolinska Institutet, Stockholm, and colleagues wrote. “Because self-harm occurs in the context of many different psychiatric disorders, it could be used as a behavioral marker of an underlying vulnerability of emotional and behavioral dysregulation relevant to violent crime (eg, impulsive aggression and emotion regulation) across diagnoses.”

To examine associations between nonfatal self-harm and violent crime, researchers conducted a population-based longitudinal cohort study among all Swedish citizens aged 15 years and older (n = 1,850,252). Mean follow-up time was 8.1 years.

During follow-up, 3% of the cohort received clinical care for self-harm.

Participants exposed to self-harm had increased risk for violent crime (HR = 4.9; 95% CI, 4.8-5), compared with unexposed participants.

Women who self-harmed had significantly high risk for expressing violent behaviors, according to researchers.

When adjusting for psychiatric comorbidities and socioeconomic status, risk for violent crime was almost double among participants exposed to self-harm (HR = 1.8; 95% CI, 1.8-1.9).

“In the assessment and treatment of individuals who self-harm, impulsive aggression and emotion regulation difficulties should be investigated and addressed, regardless of sex and co-occurring diagnoses. In addition, assessment of [deliberate self-harm] in aggressive or antisocial individuals should affect clinical work and treatment guidelines in both sexes,” the researchers wrote. – by Amanda Oldt

Disclosure: Sahlin reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.