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are prominent risk factors for suicidal phenomena, including self-injury.However, in studies of risk factors of self-assessed self-injury in young people, death of a parent is indistinguishable from categories broadly labeled as “not living with both parents,” In preparatory semistructured interviews, self-injuring and other self-destructive behavior in bereaved children were described by widowed fathers and parentally bereaved young adults.

Initially, 16 cancer-bereaved youth were interviewed. The consequently formulated questions and response options were then tested for face validity by 15 bereaved and 2 nonbereaved young adults.

Conclusions One-fifth of cancer-bereaved youth reported self-injury, representing twice the odds for self-injury in their nonbereaved peers, regardless of any of the adjustments we made.

Raised awareness on a broad basis in health care and allied disciplines would enable identification and support provision to this vulnerable group.

Author Affiliations: Departments of Oncology and Pathology (Ms Bylund Grenklo, Mr Nyberg, and Drs Steineck and Fürst) and Women's and Children's Health (Dr Kreicbergs), Karolinska Institutet, Stockholm, Sweden; Stockholm Sjukhem Foundation, Research and Development (Ms Bylund Grenklo and Dr Fürst), and Sophiahemmet University College (Dr Kreicbergs), Stockholm, Sweden; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík (Drs Hauksdóttir and Valdimarsdóttir); and Division of Clinical Cancer Epidemiology, Department of Oncology, The Sahlgrenska Academy, Gothenburg, Sweden (Drs Steineck and Hauksdóttir).

Objective To investigate the risk of self-injury in parentally cancer-bereaved youth compared with their nonbereaved peers.

After controlling for potential confounding factors in childhood (eg, having engaged in self-destructive behavior, having been bullied, having been sexually or physically abused, having no one to share joys and sorrows with, and sex), the adjusted OR was 2.3 (95% CI, 1.4-3.7).

The OR for suicide attempts was 1.6 (95% CI, 0.8-3.0).

indicate that bereaved youth are at increased risk for completed suicide and registered suicide attempt.

Teenagers and young adults in the community (ie, nonpatients) are high-risk populations for self-injury.

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Design Population-based study of cancer-bereaved youth and a random sample of matched population controls. Participants A total of 952 youth (74.8%) confirmed to be eligible for the study returned the questionnaire: 622 (73.1%) of 851 eligible young adults who lost a parent to cancer between the ages of 13 and 16 years, in 2000 to 2003, and 330 (78.4%) of 451 nonbereaved peers.

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