title: Pubertal stage and deliberate self-harm in adolescents.
abstract: OBJECTIVE
  To ascertain the association between pubertal stage and deliberate self-harm.
  
  
  METHODS
  Cross-sectional survey of 12- to 15-year-olds in 300 secondary schools in the U.S. state of Washington in February-April 2002 and the Australian state of Victoria in June-August 2002. A total of 3,332 students in grades 7 and 9 provided complete data on episodes of deliberate self-harm in the previous 12 months and pubertal stage. Pubertal stage was assessed with the Pubertal Development Scale.
  
  
  RESULTS
  The prevalence of deliberate self-harm was 3.7% with a more than twofold higher rate in females. Late puberty was associated with a more than fourfold higher rate of self-harm (odds ratio 4.6, 95% confidence interval 1.5-14) after adjustment for age and school grade level. In contrast age had a protective association (odds ratio 0.7, confidence interval 0.4-1.0). The sharpest rises in prevalence across puberty were for self-laceration and self-poisoning in females. Higher rates of depressive symptoms, frequent alcohol use, and initiation of sexual activity largely accounted for the association between self-harm and pubertal stage in multivariate models.
  
  
  CONCLUSIONS
  Puberty is associated with changes in the form and frequency of self-harm. For adolescents with a gap between puberty and brain development, risk factors such as early sexual activity and substance abuse may be particularly potent.
authors.affiliation: Drs. Patton, Hemphill, Bond, and Toumbourou are with the Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne; Drs. Beyers, McMorris, and Catalano are with the Seattle Social Development Research Group, School of Social Work, University of Washington, Seattle. Electronic address: george.patton@rch.org.au.
authors.forename: George C
authors.initials: GC
authors.lastname: Patton
authors.affiliation: Drs. Patton, Hemphill, Bond, and Toumbourou are with the Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne; Drs. Beyers, McMorris, and Catalano are with the Seattle Social Development Research Group, School of Social Work, University of Washington, Seattle.
authors.forename: Sheryl A
authors.initials: SA
authors.lastname: Hemphill
authors.affiliation: Drs. Patton, Hemphill, Bond, and Toumbourou are with the Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne; Drs. Beyers, McMorris, and Catalano are with the Seattle Social Development Research Group, School of Social Work, University of Washington, Seattle.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Beyers
authors.affiliation: Drs. Patton, Hemphill, Bond, and Toumbourou are with the Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne; Drs. Beyers, McMorris, and Catalano are with the Seattle Social Development Research Group, School of Social Work, University of Washington, Seattle.
authors.forename: Lyndal
authors.initials: L
authors.lastname: Bond
authors.affiliation: Drs. Patton, Hemphill, Bond, and Toumbourou are with the Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne; Drs. Beyers, McMorris, and Catalano are with the Seattle Social Development Research Group, School of Social Work, University of Washington, Seattle.
authors.forename: John W
authors.initials: JW
authors.lastname: Toumbourou
authors.affiliation: Drs. Patton, Hemphill, Bond, and Toumbourou are with the Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne; Drs. Beyers, McMorris, and Catalano are with the Seattle Social Development Research Group, School of Social Work, University of Washington, Seattle.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: McMORRIS
authors.affiliation: Drs. Patton, Hemphill, Bond, and Toumbourou are with the Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne; Drs. Beyers, McMorris, and Catalano are with the Seattle Social Development Research Group, School of Social Work, University of Washington, Seattle.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Catalano
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications; D016017:Odds Ratio; D015995:Prevalence; D011627:Puberty; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000453:epidemiology; D014739:Victoria / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology