Other risky behaviors and coping skills of adolescent patients who apply to the pediatric emergency department with self-harm

Introduction and Purpose: During adolescence, rapid changes occur in physical, cognitive, and psychosocial domains. Adolescents become susceptible to risky behaviors based on factors such as personality traits, psychiatric conditions, family dynamics, academic status, and cognitive development. Examples of risky behaviors include smoking, alcohol and substance abuse, school dropout, suicidal tendencies, antisocial behaviors, early sexual activity, and unhealthy eating habits. The coping mechanisms chosen by adolescents to deal with stress are crucial, as inappropriate coping methods may trigger risky behaviors like smoking, alcohol, and substance use. On the other hand, healthy coping methods contribute to the development of self-confidence and a sense of adequacy in adolescents. The aim of this study is to examine adolescents between the ages of 12 and 18 who applied to the Pediatric Emergency Department with self-harm behavior in terms of other risky behaviors and coping methods. Materials and Methods: This prospective study included adolescents aged 12- 18 who presented to the Pediatric Emergency Department of Ankara Bilkent City Hospital between July 15, 2022, and July 15, 2023. A data form including sociodemographic and clinical characteristics, the Risky Behavior Scale (RBS), and the Coping Scale for Children and Adolescents (CSCA) were administered to the adolescents. Results: Out of 156 adolescents presenting with self-harm behavior to the Pediatric Emergency Department, 127 (81.4%) had taken medication, 29 (18.6%) had consumed alcohol, and 6 (3.8%) had used substances. The total RBS score was higher in the study group, and other risky behaviors were more common in adolescents engaging in self-harm behavior. Subgroup analysis of RBS, including antisocial behaviors, alcohol use, tobacco use, suicidal tendencies, unhealthy eating behavior, and school dropout, revealed higher scores in the study group. Although the difference in the total CSCA score was not significant, the help-seeking and problem-solving methods were more prevalent in the control group, while cognitive avoidance and behavioral avoidance methods were more common in the study group. Suicidal tendencies were more prevalent in females, while problem-solving was more common in males among coping methods. Patients with repeated admissions had higher RBS scores and more frequent risky behaviors. Comparisons between those with and without family conflicts showed a higher prevalence of risky behaviors in both the study and control groups. Searching for information about self-harm on the internet was associated with risky behaviors in both groups. As age increased, total RBS, alcohol use, and tobacco use scores also increased in adolescents. Conclusion: This study demonstrates that adolescents engaging in self-harm behavior may also exhibit other risky behaviors and may not effectively utilize coping methods. Adolescents presenting with self-harm behavior in emergency departments should be carefully assessed and referred for psychological support to prevent mortality and morbidity.