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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.


Institute for Learning Sciences and Teacher Education

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Open Access Journal Article

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Open Access

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Data collection for this research was supported through a grant from the National Institute on Drug Abuse (DA-012140-05), whereas data analysis was supported through a grant from the National Institute on Alcohol Abuse and Alcoholism (1R01AA017188-01), National Institutes of Health, United States Department of Health and Human Services; R.F.C., PI. Data analysis was also supported through grants from the National Health and Medical Research Council (Projects 491241; 594793; and 1047902), the Australian Research Council (DP109574), and the Australian Health and Medical Fund. The work of J.A.H. is supported by funding provided through the Learning Sciences Institute Australia at Australian Catholic University.