Association of direct and indirect aggression and victimization with self-harm in young adolescents: A person-oriented approach.

We sought to determine which patterns of direct and indirect aggression and victimization are most clearly associated with self-harm in adolescent girls and boys cross-sectionally at two time points, as well as prospectively over one year. A cluster analysis using the LICUR procedure (Bergman, 1998) was employed to identify stable patterns of aggression and victimization in a community cohort of 883 Swedish adolescents (51% girls; mean age 14.5). The results showed that a pattern combining high aggression with high victimization was consistently associated with high levels of self-harm in both genders, both cross-sectionally and prospectively. Additionally, this pattern of aggressive victims was a clear risk factor for the development of repetitive self-harm over a one-year period in both girls (odds ratio 13.58) and boys (odds ratio 5.72). We also found several gender differences: In girls, subgroups characterized by high victimization (aggressive victims and non-aggressive victims) had the highest levels of self-harm, whereas in boys the patterns characterized by high aggression (aggressive victims and aggressive non-victims) seemed more relevant. The findings concerning the aggressive victim cluster are clear warning signs of severe psychopathology and possible psychiatric diagnosis in this subgroup of girls and boys.