@article{ref1,
title="Self-harm risk between adolescence and midlife in people who experienced separation from one or both parents during childhood",
journal="Journal of affective disorders",
year="2016",
author="Astrup, Aske and Pedersen, Carsten B. and Mok, Pearl L. H. and Carr, Matthew J. and Webb, Roger T.",
volume="208",
number="",
pages="582-589",
abstract="BACKGROUND: Experience of child-parent separation predicts adverse outcomes in later life. We conducted a detailed epidemiological examination of this complex relationship by modelling an array of separation scenarios and trajectories and subsequent risk of self-harm. <br><br>METHODS: This cohort study examined persons born in Denmark during 1971-1997. We measured child-parent separations each year from birth to 15th birthday via complete residential address records in the Civil Registration System. Self-harm episodes between 15th birthday and early middle age were ascertained through linkage to psychiatric and general hospital registers. Incidence rate ratios (IRRs) from Poisson regression models were estimated against a reference category of individuals not separated from their parents. <br><br>RESULTS: All exposure models examined indicated an association with raised self-harm risk. For example, large elevations in risk were observed in relation to separation from both parents at 15th birthday (IRR 5.50, 95% CI 5.25-5.77), experiencing five or more changes in child-parent separation status (IRR 5.24, CI 4.88-5.63), and having a shorter duration of familial cohesion during upbringing. There was no significant evidence for varying strength of association according to child's gender. LIMITATIONS: Measuring child-parent separation according to differential residential addresses took no account of the reason for or circumstances of these separations. <br><br>CONCLUSIONS: These novel findings suggest that self-harm prevention initiatives should be tailored toward exposed persons who remain psychologically distressed into adulthood. These high-risk subgroups include individuals with little experience of familial cohesion during their upbringing, those with the most complicated trajectories who lived through multiple child-parent separation transitions, and those separated from both parents during early adolescence.<br><br>Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2016.10.023",
url="http://dx.doi.org/10.1016/j.jad.2016.10.023"
}