Mediating effects of coping style on associations between mental health factors and self-harm among adolescents.

BACKGROUND There is evidence for an association between suicidal behavior and coping style among adolescents. AIMS The aims of this study were to examine associations between coping style, mental health factors, and self-harm thoughts and acts among Irish adolescents, and to investigate whether coping style mediates associations between mental health factors (depression, anxiety, and self-esteem) and self-harm. METHOD A cross-sectional school-based survey was carried out. Information was obtained on history of self-harm, life events, and demographic, psychological, and lifestyle factors. RESULTS Emotion-oriented coping was strongly associated with poorer mental health and self-harm thoughts and acts. Problem-Oriented Coping was associated with better mental health. Mediating effects of Emotion-Oriented Coping on associations between mental health factors and deliberate self-harm (DSH) was found for both genders and between Problem-Oriented Coping and mental health factors for girls. Similar mediating effects of coping style were found when risk of self-harm thoughts was examined. LIMITATIONS Since the methodology used was cross-sectional, it is impossible to draw conclusions regarding causal relationships between coping style and associated factors. The coping measure used was brief. CONCLUSIONS Promotion of positive coping skills and reduction of emotion-focused approaches may build resilience to self-harm thoughts and acts among adolescents experiencing mental health problems.