Clinical Profiles Associated With Deliberate Self-Harm in Preadolescent Children.

Objective: Children who self-harm are at high risk for suicide attempts later in life, yet little is known about the clinical profiles of young children who self-harm. The primary aim of this study is to characterize clinical profiles associated with self-harm in preadolescent children to inform risk recognition and prevention efforts. Method: A retrospective, population-based cohort analysis of children aged 5 to 11 years who presented with self-harm in a medical setting from 2010 to 2020 (N = 878) was conducted using Ohio Medicaid data. Children were followed for 1 year after the initial self-harm event to determine subsequent self-harm events. Results: Of the 878 children with initial self-harm, 116 children (13%) self-harmed again within the following year. Latent class analyses revealed 3 distinct clinical profiles. Children in class 1 tended to be male, typically presented in mental health settings with both externalizing and internalizing disorders, and commonly reported suicidal ideation. Children in class 2 were largely female, presented with internalizing disorders, and often expressed suicidal ideation. Children in class 2 were less likely than those in class 1 to have a history of mental health treatment but were equally at risk for repetitive self-harming behaviors. Children in class 3 tended to be younger and from non-metropolitan areas, with fewer known mental health conditions. Conclusion: Study findings show that children who self-harm have distinct clinical profiles that are associated with elevated risk of future self-harm. Findings underscore the importance of comprehensive risk assessment to guide clinical decision making for young children who self-harm.