High alcohol use a strong and significant risk factor for repetitive self-harm in female and male youth: a prospective cohort study

Abstract

Background: Deliberate self-harm (DSH) is reported by between 5 and 17% of youth aged 14–25 years. Current management measures focus on repetition prevention in high-risk groups. Objectives: To examine risk factors and predictors of DSH and DSH repetition in a community sample, by gender. Methods: A prospective cohort of 20 822 young adults (aged 17–24 years) was recruited when obtaining their driving license. A random sample of 5000 was approached for follow-up 12–18 months; 2991 (60%) responded and formed the cohort for this analysis. Patterns of self-harm, using a modified Beck Suicide Inventory, were investigated with logistic regression. Results: DSH was reported by 4.1% (123/2991) at baseline. Over the following 12 months, 3.0% (90/2991) reported new instances of DSH which included 20% (25) respondents who had engaged in DSH at baseline. Psychological distress was a risk factor for engaging in DSH in the past 12 months, OR 3.55 (95% CI 2.06–6.14). Although several clinical risk factors differed between genders, high alcohol use, OR 23.6 (95% CI 3.64–153) and psychological distress, OR 4.97 (95% CI 1.08–22.9) were significant risk factors for repeat DSH in both males and females. Conclusion: In this community cohort, 1 in 25 youth had self-harmed in the year prior; of these, 4 in 5 did not repeat DSH over the following year. High alcohol use stands out as a strong risk factor for DSH repetition. Assessing alcohol use may help clinicians identify those who are at greatest risk for repetitive self-harm.

• Deliberate self-harm
• youth
• repetition
• alcohol
• gender

Funding

The DRIVE Study was funded by the National Health and Medical Research Council of Australia, Roads and Traffic Authority of New South Wales, NRMA Motoring and Services, NRMA Road Safety Trust, New South Wales Health and the Motor Accidents Authority of New South Wales. Alexandra Martiniuk, Rebecca Ivers, and Teresa Senserrick received salary funding from the National Health and Medical Research Council of Australia during the writing of this paper. Alexandra Martiniuk also received funding from a University of Sydney Fellowship. No funding agency had any role in the design, analysis or interpretation of the data. All authors had full access to all the data and take full responsibility for the integrity of this study and its analyses.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.