Incidence and Course of Adolescent Deliberate Self-Harm in Victoria, Australia, and Washington State.
OBJECTIVE
There have been few longitudinal studies of deliberate self-harm (DSH) in adolescents. This cross-national longitudinal study outlines risk and protective factors for DSH incidence and persistence.


METHODS
Seventh and ninth grade students (average ages 13 and 15 years) were recruited as state-representative cohorts, surveyed, and then followed up 12 months later (N = 3,876), using the same methods in Washington State and Victoria, Australia. The retention rate was 99% in both states at follow-up. A range of risk and protective factors for DSH were examined using multivariate analyses.


RESULTS
The prevalence of DSH in the past year was 1.53% in Grade 7 and .91% in Grade 9 for males and 4.12% and 1.34% for Grade 7 and Grade 9 females, respectively, with similar rates across states. In multivariate analyses, incident DSH was lower in Washington State (odds ratio [OR] = .67; 95% confidence interval [CI] = .45-1.00) relative to Victoria 12 months later. Risk factors for incident DSH included being female (OR = 1.93; CI = 1.35-2.76), high depressive symptoms (OR = 3.52; CI = 2.37-5.21), antisocial behavior (OR = 2.42; CI = 1.46-4.00), and lifetime (OR = 1.85; CI = 1.11-3.08) and past month (OR = 2.70; CI = 1.57-4.64) alcohol use relative to never using alcohol.


CONCLUSIONS
Much self-harm in adolescents resolves over the course of 12 months. Young people who self-harm have high rates of other health risk behaviors associated with family and peer risks that may all be targets for preventive intervention.
Learning Sciences Institute Australia, Australian Catholic University, Fitzroy, Victoria, Australia; School of Psychology, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia. Electronic address: jessica.heerde@acu.edu.au.
Jessica A
JA
Heerde
Research Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia; Centre for Adolescent Health, Murdoch Childrens Research Institute, Flemington, Victoria, Australia.
John W
JW
Toumbourou
Learning Sciences Institute Australia, Australian Catholic University, Fitzroy, Victoria, Australia; Centre for Adolescent Health, Murdoch Childrens Research Institute, Flemington, Victoria, Australia; School of Psychology, Australian Catholic University, Fitzroy, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; School of Psychology, Deakin University, Burwood, Victoria, Australia.
Sheryl A
SA
Hemphill
University of Washington School of Social Work, Seattle, Washington.
Todd I
TI
Herrenkohl
Centre for Adolescent Health, Murdoch Childrens Research Institute, Flemington, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.
George C
GC
Patton
Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington.
Richard F
RF
Catalano
D000293:Adolescent; D000294:Adolescent Behavior; D003863:Depression / Q000453:epidemiology; D005195:Family Relations / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology
Adolescence; Cross-national; Deliberate self-harm; Longitudinal; Protective factors; Risk factors