Pubertal stage and deliberate self-harm in adolescents

George C. Patton, Sheryl A. Hemphill, Jennifer M. Beyers, Lyndal Bond, John W. Toumbourou, Barbara J. McMorris, Richard F. Catalano

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114 Scopus citations


OBJECTIVE: To ascertain the association between pubertal stage and deliberate self-harm. METHOD: 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. Copyright 2007

Original languageEnglish (US)
Pages (from-to)508-514
Number of pages7
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number4
StatePublished - Apr 2007


  • Adolescence
  • Deliberate self-harm
  • Depression
  • Parasuicide
  • Puberty
  • Suicidal behavior


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