Psychological characteristics associated with self-harm ideation in adolescents and young adults with hip conditions

Aaron Blom; Lauren Vande Kamp; Taylor Murray; Yumeng Gao; Ashley Kochuyt; Courtney Seffker; Jenna Jensen; Robert Westermann; Michael Willey

doi:10.1093/jhps/hnag046

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Psychological characteristics associated with self-harm ideation in adolescents and young adults with hip conditions

Journal article

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Psychological characteristics associated with self-harm ideation in adolescents and young adults with hip conditions

Aaron Blom, Lauren Vande Kamp, Taylor Murray, Yumeng Gao, Ashley Kochuyt, Courtney Seffker, Jenna Jensen, Robert Westermann and Michael Willey

Journal of hip preservation surgery

09/18/2026

DOI: 10.1093/jhps/hnag046

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Abstract

Mental health disorders are common in young people with musculoskeletal conditions. This study aims to report the prevalence of self-harm ideation in adolescents and young adults with hip conditions, the association with psychological distress, and the impact of treatment on self-harm ideation prevalence. Five hundred consecutive patients presenting to an adolescent and young adult hip clinic completed the Optimal Screening for Prediction of Referral and Outcome Yellow Flag and the Patient Health Questionnaire-9. The primary outcome was self-harm ideation (yes/no). Patients reporting self-harm were matched 1:1 with those who reported none/mild and severe psychological distress without self-harm ideation. Chi-square or Fisher’s exact tests assessed differences between those with and without self-harm ideation. Self-harm ideation was reported by 24/500 (4.8%). Those with severe psychological distress were significantly more likely to report self-harm ideation when compared to those with none/mild distress (OR = 7.9, adjusted P < .001) or moderate distress (OR = 4.9, adjusted P = .002). Hip surgery was performed in 19/24 patients that reported self-harm ideation. After surgery, 73% (11/15) reported resolution of self-harm ideation. Pre-operative self-harm ideation was associated with a decreased improvement in International Hip Outcome Tool-12 after surgical treatment compared to none/mild (mean 22.9 vs 48.0, P = .005), or severe psychological distress (mean 22.93 vs 41.17, P < .05) without a positive response to self-harm ideation. Self-harm ideation is present in about 1 in 20 adolescents and young adults who present for evaluation of hip pain and is associated with psychological distress. After appropriate psychological care and surgical treatment, self-harm ideation resolved in three-of-four patients.

self-harm

depression

OSPRO-YF

hip dysplasia

femoroacetabular impingement

hip arthroscopy

periacetabular osteotomy

Details

Title: Subtitle: Psychological characteristics associated with self-harm ideation in adolescents and young adults with hip conditions
Creators: Aaron Blom - University of Iowa
Lauren Vande Kamp
Taylor Murray - University of Iowa
Yumeng Gao
Ashley Kochuyt - University of Iowa Hospitals and Clinics
Courtney Seffker - University of Iowa
Jenna Jensen - University of Iowa Hospitals and Clinics
Robert Westermann - University of Iowa Hospitals and Clinics
Michael Willey - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Journal of hip preservation surgery
DOI: 10.1093/jhps/hnag046
ISSN: 2054-8397
eISSN: 2054-8397
Publisher: Oxford University Press
Language: English
Electronic publication date: 09/18/2026
Academic Unit: Orthopedics and Rehabilitation; Injury Prevention Research Center; Athletic Training Program
Record Identifier: 9985236421202771

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