A 6-year Longitudinal Study of Self-harm and Suicidal Behaviors among Chinese Adolescents in Hong Kong

Design: We used quantitative data from a large sample of adolescent participants. Participants initially joined this study when they were in grade 7 (wave 1), and they were followed from grade 8 (wave 2) to grade 12 (wave 6). Setting, Participants, and Interventions: The participants consisted of 2023 grade 12 students from 28 secondary schools in Hong Kong. A multistage cluster random sampling method was adopted. Main Outcome Measures: Self-harm and suicidal behaviors. Results: The trajectories of self-harm and suicidal behaviors in general declined from grade 7 to grade 12. Regarding the effect of gender, whereas adolescent girls showed a higher prevalence for self-harm and suicidal behaviors at baseline and other waves, adolescent boys showed a pronounced decline in self-harm rates. Adolescents from nonintact families were more likely to self-harm or engage in suicidal behaviors at wave 6. Economic disadvantage at wave 4 predicted higher suicidal behavior among adolescents but not self-harm at wave 6. Regarding positive youth development, several protective factors that include cognitive-behavioral competencies, prosocial attributes, general positive youth development qualities, and positive identity could help reduce self-harm and suicidal behaviors at different time points. Regarding the role of family functioning, more family conflicts predicted higher suicidality in adolescence (self-harm and suicidal behaviors), and family communication affected self-harming behaviors at wave 6. Conclusion: The trajectories of self-harm and suicidal behaviors decline from early to late adolescence among Chinese adolescents. Positive youth development and constructive family functi