Timing of menarche and self-harm in adolescence and adulthood: a population-based cohort study

AbstractBackgroundPrevious studies of pubertal timing and self-harm are limited by subjective measures of pubertal timing or by the conflation of self-harm with suicide attempts and ideation. The current study investigates the association between an objective measure of pubertal timing – age at menarche – and self-harm with and without suicidal intent in adolescence and adulthood in females.MethodBirth cohort study based on 4042 females from the Avon Longitudinal Study of Parents and Children (ALSPAC). Age at menarche was assessed prospectively between ages 8 and 17 years. Lifetime history of self-harm was self-reported at ages 16 and 21 years. Associations between age at menarche and self-harm, both with and without suicidal intent, were examined using multivariable logistic regression.ResultsLater age at menarche was associated with a lower risk of lifetime self-harm at age 16 years (OR per-year increase in age at menarche 0.87; 95% CI 0.80–0.95). Compared with normative timing, early menarche (<11.5 years) was associated with an increased risk of self-harm (OR 1.31, 95% CI 1.04–1.64) and later menarche (>13.8 years) with a reduced risk (OR 0.74, 95% CI 0.58–0.93). The pattern of association was similar at age 21 years (OR per-year increase in age at menarche 0.92, 95% CI 0.85–1.00). There was no strong evidence for a difference in associations with suicidal v. non-suicidal self-harm.ConclusionsRisk of self-harm is higher in females with early menarche onset. Future research is needed to establish whether this association is causal and to identify potential mechanisms.

Download Full-text

Pubertal timing and self-harm: a prospective cohort analysis of males and females

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796020000839 ◽

2020 ◽

Vol 29 ◽

Author(s):

Elystan Roberts ◽

Carol Joinson ◽

David Gunnell ◽

Abigail Fraser ◽

Becky Mars

Keyword(s):

Pubertal Timing ◽

Cohort Analysis ◽

Height Velocity ◽

Birth Cohort Study ◽

Future Research ◽

Peak Height Velocity ◽

Early Puberty ◽

Suicidal Intent ◽

Increased Risk ◽

Self Harm

Abstract Aims Early puberty is associated with an increased risk of self-harm in adolescent females but results for males are inconsistent. This may be due to the use of subjective measures of pubertal timing, which may be biased. There is also limited evidence for the persistence of pubertal timing effects beyond adolescence, particularly in males. The primary aim of the current study was therefore to examine the association between pubertal timing and self-harm in both sexes during adolescence and young adulthood, using an objective measure of pubertal timing (age at peak height velocity; aPHV). A secondary aim was to examine whether this association differs for self-harm with v. without suicidal intent. Methods The sample (n = 5369, 47% male) was drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort study. Mixed-effects growth curve models were used to calculate aPHV. Lifetime history of self-harm was self-reported at age 16 and 21 years, and associated suicidal intent was examined at age 16 years. Associations were estimated using multivariable logistic regression adjusted for a range of confounders. Missing data were imputed using Multiple Imputation by Chained Equations. Results Later aPHV was associated with a reduced risk of self-harm at 16 years in both sexes (females: adjusted per-year increase in aPHV OR 0.85; 95% CI 0.75–0.96; males: OR 0.72; 95% CI 0.59–0.88). Associations were similar for self-harm with and without suicidal intent. There was some evidence of an association by age 21 years in females (adjusted per-year increase in aPHV OR 0.91; 95% CI 0.80–1.04), although the findings did not reach conventional levels of significance. There was no evidence of an association by age 21 years in males (adjusted per-year increase in aPHV OR 0.99; 95% CI 0.74–1.31). Conclusions Earlier developing adolescents represent a group at increased risk of self-harm. This increased risk attenuates as adolescents transition into adulthood, particularly in males. Future research is needed to identify the modifiable mechanisms underlying the association between pubertal timing and self-harm risk in order to develop interventions to reduce self-harm in adolescence.

Download Full-text

Childhood adversity, pubertal timing and self-harm: a longitudinal cohort study

Psychological Medicine ◽

10.1017/s0033291721000611 ◽

2021 ◽

pp. 1-9

Author(s):

Abigail Emma Russell ◽

Carol Joinson ◽

Elystan Roberts ◽

Jon Heron ◽

Tamsin Ford ◽

...

Keyword(s):

Structural Equation ◽

Pubertal Timing ◽

Childhood Adversity ◽

Height Velocity ◽

Age At Menarche ◽

Peak Height Velocity ◽

Early Puberty ◽

Increased Risk ◽

Early Pubertal Timing ◽

Self Harm

Abstract Background The occurrence of early childhood adversity is strongly linked to later self-harm, but there is poor understanding of how this distal risk factor might influence later behaviours. One possible mechanism is through an earlier onset of puberty in children exposed to adversity, since early puberty is associated with an increased risk of adolescent self-harm. We investigated whether early pubertal timing mediates the association between childhood adversity and later self-harm. Methods Participants were 6698 young people from a UK population-based birth cohort (ALSPAC). We measured exposure to nine types of adversity from 0 to 9 years old, and self-harm when participants were aged 16 and 21 years. Pubertal timing measures were age at peak height velocity (aPHV – males and females) and age at menarche (AAM). We used generalised structural equation modelling for analyses. Results For every additional type of adversity; participants had an average 12–14% increased risk of self-harm by 16. Relative risk (RR) estimates were stronger for direct effects when outcomes were self-harm with suicidal intent. There was no evidence that earlier pubertal timing mediated the association between adversity and self-harm [indirect effect RR 1.00, 95% confidence interval (CI) 1.00–1.00 for aPHV and RR 1.00, 95% CI 1.00–1.01 for AAM]. Conclusions A cumulative measure of exposure to multiple types of adversity does not confer an increased risk of self-harm via early pubertal timing, however both childhood adversity and early puberty are risk factors for later self-harm. Research identifying mechanisms underlying the link between childhood adversity and later self-harm is needed to inform interventions.

Download Full-text

Attachment Organization in Suicide Prevention Research

Crisis ◽

10.1027/0227-5910/a000231 ◽

2014 ◽

Vol 35 (1) ◽

pp. 60-66 ◽

Cited By ~ 10

Author(s):

Amanda Venta ◽

Carla Sharp

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Interpersonal Relationships ◽

Suicide Ideation ◽

Suicide Attempts ◽

Critical Role ◽

Self Report ◽

Future Research ◽

Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

Download Full-text

Faculty Opinions recommendation of Childhood predictors of completed and severe suicide attempts: findings from the Finnish 1981 Birth Cohort Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1160813.622225 ◽

2009 ◽

Author(s):

Shailesh Jain

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Suicide Attempts ◽

Birth Cohort Study ◽

Childhood Predictors

Download Full-text

Cardiovascular disease in people born to unmarried mothers in two historical periods: The Helsinki Birth Cohort Study 1934–1944

Scandinavian Journal of Public Health ◽

10.1177/14034948211019792 ◽

2021 ◽

pp. 140349482110197

Author(s):

H. Maiju Mikkonen ◽

Minna K. Salonen ◽

Antti Häkkinen ◽

Clive Osmond ◽

Johan G. Eriksson ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cohort Study ◽

World War Ii ◽

Birth Cohort ◽

Birth Cohort Study ◽

World War ◽

Unmarried Mothers ◽

Increased Risk ◽

Married Mothers ◽

Historical Periods

Aims:Socio-economic conditions in early life are important contributors to cardiovascular disease – the leading cause of mortality globally – in later life. We studied coronary heart disease (CHD) and stroke in adulthood among people born out of wedlock in two historical periods: before and during World War II in Finland. Methods: We compared offspring born out of wedlock before (1934–1939) and during (1940–1944) World War II with the offspring of married mothers in the Helsinki Birth Cohort Study. The war affected the position of unmarried mothers in society. We followed the study subjects from 1971 to 2014 and identified deaths and hospital admissions from CHD and stroke. Data were analysed using a Cox regression, adjusting for other childhood and adulthood socio-economic circumstances. Results: The rate of out-of-wedlock births was 240/4052 (5.9%) before World War II and 397/9197 (4.3%) during World War II. Among those born before World War II, out-of-wedlock birth was associated with an increased risk of stroke (hazard ratio (HR)=1.44; 95% confidence interval (CI) 1.00–2.07) and CHD (HR=1.37; 95% CI 1.02–1.86). Among those born out of wedlock during World War II, the risks of stroke (HR=0.89; 95% CI 0.58–1.36) and CHD (HR=0.70; 95% CI 0.48=1.03) were similar to those observed for the offspring of married mothers. The p-values for interaction of unmarried×World War II were ( p=0.015) for stroke and ( p=0.003) for CHD. Conclusions: In a society in which marriage is normative, being born out of wedlock is an important predictor of lifelong health disadvantage. However, this may change rapidly when societal circumstances change, such as during a war.

Download Full-text

Impact of Cleft lip and Palate on Mother-to-Infant Bonding: a Cross-Sectional Study in the Japan Environment and Children's Study

10.21203/rs.2.13306/v1 ◽

2019 ◽

Author(s):

Shinobu Tsuchiya ◽

Masahiro Tsuchiya ◽

Haruki Momma ◽

Takeyoshi Koseki ◽

Kaoru Igarashi ◽

...

Keyword(s):

Cohort Study ◽

Maternal Depression ◽

Birth Cohort ◽

Maternal Age ◽

Cleft Lip ◽

Advanced Age ◽

Psychological Status ◽

Birth Cohort Study ◽

Increased Risk ◽

The Impact

Abstract Background Cleft lip and/or palate (CL/P) is among the most prevalent congenital birth defects. They negatively affect maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of CL/P births with bonding disorders still remains unclear. To address this question, we examined the impact of CL/P birth on mother-to-infant bonding, using the nationwide birth cohort study, Japan Environment and Children's Study. Methods This study was conducted as a nationwide birth cohort study of the Japan environment and children’s study (JECS), an ongoing nationwide birth cohort study in Japan. 104,065 of foetuses in fifteen regional centres in JECS were enrolled. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers with CL/P infants were included in our analyses. Results First, no increased risk of bonding disorders was observed among all the mothers with CL/P births (odds ratio [95% CI]; 0.97 [0.63-1.48], p = 0.880), and advanced maternal age or multiple parity would adversely affect the associations between bonding disorders and CL/P births, respectively. Thus, after stratification with a combination of maternal age and parity, a significant association of CL/P birth with bonding disorders was found only among advanced-age multiparae (OR [95% CI] = 2.51 [1.17-5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression. Conclusion CL/P birth may increase the risk of bonding disorders among advanced-age multiparae possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.

Download Full-text

Trends in self-poisoning and psychotropic drug use in people aged 5–19 years: a population-based retrospective cohort study in Australia

BMJ Open ◽

10.1136/bmjopen-2018-026001 ◽

2019 ◽

Vol 9 (2) ◽

pp. e026001 ◽

Cited By ~ 7

Author(s):

Rose Cairns ◽

Emily A Karanges ◽

Anselm Wong ◽

Jared A Brown ◽

Jeff Robinson ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Selective Serotonin Reuptake Inhibitors ◽

Age Groups ◽

Cohort Effect ◽

Population Based ◽

Psychotropic Medicine ◽

Increased Risk ◽

Self Harm

ObjectivesTo characterise trends in self-poisoning and psychotropic medicine use in young Australians.DesignPopulation-based retrospective cohort study.SettingCalls taken by the New South Wales and Victorian Poisons Information Centres (2006–2016, accounting for 70% of Australian poisoning calls); medicine dispensings in the 10% sample of Australian Pharmaceutical Benefits Scheme data (July 2012 to June 2016).ParticipantsPeople aged 5–19 years.Main outcome measuresYearly trends in intentional poisoning exposure calls, substances taken in intentional poisonings, a prevalence of psychotropic use (dispensing of antidepressants, antipsychotics, benzodiazepines and medicines for attention deficit hyperactivity disorder (ADHD)).ResultsThere were 33 501 intentional poisonings in people aged 5–19 years, with an increase of 8.39% per year (95% CI 6.08% to 10.74%, p<0.0001), with a 98% increase overall, 2006–2016. This effect was driven by increased poisonings in those born after 1997, suggesting a birth cohort effect. Females outnumbered males 3:1. Substances most commonly taken in self-poisonings were paracetamol, ibuprofen, fluoxetine, ethanol, quetiapine, paracetamol/opioid combinations, sertraline and escitalopram. Psychotropic dispensing also increased, with selective serotonin reuptake inhibitors (SSRIs) increasing 40% and 35% July 2012 to June 2016 in those aged 5–14 and 15–19, respectively. Fluoxetine was the most dispensed SSRI. Antipsychotics increased by 13% and 10%, while ADHD medication dispensing increased by 16% and 10%, in those aged 5–14 and 15–19, respectively. Conversely, dispensing of benzodiazepines to these age groups decreased by 4% and 5%, respectively.ConclusionsOur results signal a generation that is increasingly engaging in self-harm and is increasingly prescribed psychotropic medications. These findings indicate growing mental distress in this cohort. Since people who self-harm are at increased risk of suicide later in life, these results may foretell future increases in suicide rates in Australia.

Download Full-text