The Epidemiology of Self-Harm in the Romanian Juvenile Prison System: A Two-Year Cohort Study

Background: There is no extensive literature on social predictors of self-harm in the juvenile justice system, over the time of a prisoner’s sentence. Self-harm behavior displays a higher prevalence in prison, 11 to 14 times greater than in the general population. Our study extended the current research in self-harm by examining dynamic factors of self-harm in adolescents over their sentence in the Romanian juvenile prison system. Method: The present research examined longitudinal predictors of self-harm behaviors in 439 adolescent inmates (Mage = 16.21; 5.2% female, 94.8% male), enrolled in prison during 2011-2012, following them for two years. A series of time-to-event analyses were applied to start from the time of the subject’s internment in the juvenile prison system. Results: Findings from the multivariate survival analyses show that adherence to self-harm conduct in prison was consistently influenced by family factors and prison contexts; although low ability to cope with frustration, sensitivity and emotion dysregulation also mattered. Keeping the other covariates invariant, serving a prison sentence in a closed regime reduces the probability of remaining free of self-harm events, increasing the monthly hazard of self-harm by a factor of 5.26 on average (HR = 5.26, 95% CI = 2.37 - 11.64) compared to the open regime. Conclusion: A greater focus on longitudinal studies may help improve the screening process and also follow the progress of each juvenile to warrant the efficacy of preventive programs in self-harm, according to their emerging needs.