Self-harm among adolescents in Iceland: Prevalence and risk factors

Abstract

Self-harm behaviour among adolescents has emerged as a serious public health concern in recent decades. International studies indicate that self-harm is the third leading cause of disability-adjusted life years (DALYs) lost, which is a measure of overall disease burden, representing a year lost due to ill-health, disability or early death. It is also one of the five most common causes of death among young people in Europe. Typically, self-injurious behaviour arises from intense psychological distress and difficulties with emotional regulation and is often a manifestation of underlying mental health conditions. With rising rates of distress among young people – both globally and in Iceland – there is a pressing need to understand better both the risk and protective factors associated with self-harm. This research had two main aims: (1) to examine the prevalence of self-harm among 15-year-olds in Iceland and how it has developed over a three-year period from 2023 to 2025 and (2) to investigate the extent to which adolescents’ social skills, self-efficacy in problem solving, relationships with their parents and sleep predict the likelihood of engaging in self-harm behaviour, after controlling for anxiety and depression. It draws on data from the Icelandic Youth Study, a large-scale, population-based survey administered annually to students in grades 4–10. The present sample comprised 10th-grade students (approximately 15 years of age), with response rates exceeding 90%. Given the scope, representativeness and repeated design of the data collection, the findings provide valuable insight into national trends in adolescents’ wellbeing. The findings show that across the three-year study period, the overall prevalence remained relatively stable over time. Around 16% of 10th-grade students reported having engaged in intentional self-harm on one or more occasions during the past 12 months. Girls were approximately 50% more likely than boys to report self-harm behaviour (20% vs. 10% respectively). Furthermore, significant associations were found between self-harm behaviour and social skills, adolescents’ self-efficacy in problem solving and sleep. Self-harm behaviour was also associated with adolescents’ perceptions of their 19 Netla – Veftímarit um uppeldi og menntun: Sérrit 2025 – Íslenska æskulýðsrannsóknin I relationships with their parents. After controlling for anxiety and depression, the strength of these associations decreased to varying degrees, indicating that anxiety and depression partially accounted for the relations between these factors and self-harm. The findings suggest that effective prevention efforts should focus on strengthening adolescents’ social skills, self-efficacy in problem solving and promoting healthy sleep patterns. In addition, they underscore the important role parents and other caregivers play in the lives of their children and how their support can strengthen young people’s well-being. Parents should be offered education on how to recognise early signs of distress and be provided with access to specialist support services for their children, such as psychologists and psychiatrists, particularly when adolescents experience severe distress or engage in self-harm. Early intervention should be prioritised, and adolescents should be provided with timely information about where to turn when they experience psychological distress, as well as access to support services and guidance on positive coping strategies. Self-harm should not be understood solely as an individual concern but rather as a reflection of broader societal, relational and emotional contexts that shape young people’s wellbeing. Aligned with the aims of the Icelandic Prosperity Act, effective prevention and early interventions require comprehensive, child-centred, structured support systems, emphasising integrated, cross-sectoral collaboration that extends beyond the individual to include families, schools, welfare services and communities. Adolescents should also have a voice in shaping these processes as well as the prevention strategies and services designed to support them. When interpreting the findings, it should be noted that this was a cross-sectional study and that the relationships examined are correlational in nature. The study design therefore limits causal inference. Accordingly, the results were interpreted with appropriate caution. However, the repeated 12-month prevalence data collected over three consecutive years (2023–2025) provide a robust basis for assessing stability and trends in self-harm behaviour among adolescents in Iceland. Self-harm among adolescents has been under-researched in Iceland, particularly in community-based samples drawn from the school system. The present study helps address this gap, building on data from the Icelandic Youth Study. There remains a clear need for further research examining self-harm in both clinical and community samples, in order to develop a more comprehensive understanding of the challenges faced by young people. Moreover, relatively few studies have examined self-harm over extended time periods, underscoring the importance of continued longitudinal and mixed-methods research in this area.