TY - JOUR T1 - Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia JF - Injury Prevention JO - Inj Prev DO - 10.1136/ip-2022-044807 SP - ip-2022-044807 AU - Patricia Cullen AU - Holger Mőller AU - Rachel Baffsky AU - Alexandra Martiniuk AU - Teresa Senserrick AU - Kris Rogers AU - Mark Woodward AU - Mark R Stevenson AU - Rebecca McLean AU - Susan Sawyer AU - George Patton AU - Rebecca Q Ivers Y1 - 2023/02/22 UR - http://injuryprevention.bmj.com/content/early/2023/02/22/ip-2022-044807.abstract N2 - Introduction Self-harm and suicide are leading causes of morbidity and death for young people, worldwide. Previous research has identified self-harm is a risk factor for vehicle crashes, however, there is a lack of long-term crash data post licensing that investigates this relationship. We aimed to determine whether adolescent self-harm persists as crash risk factor in adulthood.Methods We followed 20 806 newly licensed adolescent and young adult drivers in the DRIVE prospective cohort for 13 years to examine whether self-harm was a risk factor for vehicle crashes. The association between self-harm and crash was analysed using cumulative incidence curves investigating time to first crash and quantified using negative binominal regression models adjusted for driver demographics and conventional crash risk factors.Results Adolescents who reported self-harm at baseline were at increased risk of crashes 13 years later than those reporting no self-harm (relative risk (RR) 1.29: 95% CI 1.14 to 1.47). This risk remained after controlling for driver experience, demographic characteristics and known risk factors for crashes, including alcohol use and risk taking behaviour (RR 1.23: 95% CI 1.08 to 1.39). Sensation seeking had an additive effect on the association between self-harm and single-vehicle crashes (relative excess risk due to interaction 0.87: 95% CI 0.07 to 1.67), but not for other types of crashes.Discussion Our findings add to the growing body of evidence that self-harm during adolescence predicts a range of poorer health outcomes, including motor vehicle crash risks that warrant further investigation and consideration in road safety interventions. Complex interventions addressing self-harm in adolescence, as well as road safety and substance use, are critical for preventing health harming behaviours across the life course.Data are available on reasonable request. The data supporting the findings of this study are not publicly available. However, data are available from the authors on reasonable request and with permission of data custodians supplying the original data and with approval from the NSW Population Health Services and Research Ethics Committee. ER -