The natural history of self-harm from adolescence to young adulthood : a population-based cohort study

Moran, Paul, Coffey, Carolyn, Romaniuk, Helena, Olsson, Craig, Borshmann, Rohan, Carlin, John B. and Patton, George C. 2012, The natural history of self-harm from adolescence to young adulthood : a population-based cohort study, The Lancet, vol. 379, no. 9812, pp. 236-243, doi: 10.1016/S0140-6736(11)61141-0.

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Title The natural history of self-harm from adolescence to young adulthood : a population-based cohort study
Author(s) Moran, Paul
Coffey, Carolyn
Romaniuk, Helena
Olsson, CraigORCID iD for Olsson, Craig
Borshmann, Rohan
Carlin, John B.
Patton, George C.
Journal name The Lancet
Volume number 379
Issue number 9812
Start page 236
End page 243
Total pages 8
Publisher The Lancet Publishing Group
Place of publication London, England
Publication date 2012-01-21
ISSN 0140-6736
Keyword(s) adolescent
risk factors
self-injurious behavior
young adult
Summary Background Knowledge about the natural history of self-harm is scarce, especially during the transition from adolescence to young adulthood, a period characterised by a sharp rise in self-inflicted deaths. From a repeated measures cohort of a representative sample, we describe the course of self-harm from middle adolescence to young adulthood.

Methods A stratified, random sample of 1943 adolescents was recruited from 44 schools across the state of Victoria, Australia, between August, 1992, and January, 2008. We obtained data pertaining to self-harm from questionnaires and telephone interviews at seven waves of follow-up, commencing at mean age 15·9 years (SD 0·49) and ending at mean age 29·0 years (SD 0·59). Summary adolescent measures (waves three to six) were obtained for cannabis use, cigarette smoking, high-risk alcohol use, depression and anxiety, antisocial behaviour and parental separation or divorce.

Findings 1802 participants responded in the adolescent phase, with 149 (8%) reporting self-harm, More girls (95/947 [10%]) than boys (54/855 [6%]) reported self-harm (risk ratio 1·6, 95% CI 1·2–2·2). We recorded a substantial reduction in the frequency of self-harm during late adolescence. 122 of 1652 (7%) participants who reported self-harm during adolescence reported no further self-harm in young adulthood, with a stronger continuity in girls (13/888) than boys (1/764). During adolescence, incident self-harm was independently associated with symptoms of depression and anxiety (HR 3·7, 95% CI 2·4–5·9), antisocial behaviour (1·9, 1·1–3·4), high-risk alcohol use (2·1, 1·2–3·7), cannabis use (2·4, 1·4–4·4), and cigarette smoking (1·8, 1·0–3·1). Adolescent symptoms of depression and anxiety were clearly associated with incident self-harm in young adulthood (5·9, 2·2–16).

Interpretation Most self-harming behaviour in adolescents resolves spontaneously. The early detection and treatment of common mental disorders during adolescence might constitute an important and hitherto unrecognised component of suicide prevention in young adults.

Funding National Health and Medical Research Council, Australia, and operational infrastructure support programme, Government of Victoria, Australia.
Language eng
DOI 10.1016/S0140-6736(11)61141-0
Field of Research 170106 Health, Clinical and Counselling Psychology
Socio Economic Objective 920410 Mental Health
HERDC Research category C1.1 Refereed article in a scholarly journal
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Document type: Journal Article
Collections: Faculty of Health
School of Psychology
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