Publication Date



Purpose: 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

Document Type

Journal Article

Access Rights

ERA Access

Access may be restricted.