Early Pubertal Timing, Suicidality, and Self-Injurious Behaviors in Preadolescents: Evidence for Concurrent and Emergent Risk Prediction

Katherine R Luking; Laura Hennefield; Ana Ortin Peralta; Amanda J Wright; Diana J Whalen

doi:10.1016/j.jaac.2024.10.016

Early Pubertal Timing, Suicidality, and Self-Injurious Behaviors in Preadolescents: Evidence for Concurrent and Emergent Risk Prediction

J Am Acad Child Adolesc Psychiatry. 2025 Jan 3:S0890-8567(25)00001-2. doi: 10.1016/j.jaac.2024.10.016. Online ahead of print.

Authors

Katherine R Luking¹, Laura Hennefield², Ana Ortin Peralta³, Amanda J Wright⁴, Diana J Whalen⁵

Affiliations

¹ Saint Louis University, St. Louis, Missouri.
² Washington University in St. Louis School of Medicine, St. Louis, Missouri. Electronic address: lhennefield@wustl.edu.
³ Yeshiva University, Bronx, New York; Albert Einstein School of Medicine, Bronx, New York.
⁴ University of Zürich, Zürich, Switzerland.
⁵ Washington University in St. Louis School of Medicine, St. Louis, Missouri.

PMID: 39798665
DOI: 10.1016/j.jaac.2024.10.016

Abstract

Objective: To determine whether advanced puberty at age 9/10, relative to same-aged peers, predicts current and/or new-onset self-injurious thoughts and behaviors (SITBs). New predictors of SITBs in preadolescence are urgently needed to address this escalating public health crisis of youth self-harm and suicidality.

Method: Data from the baseline, 1-year, and 2-year waves of the Adolescent Brain and Cognitive Development Study were used. Bayesian mixed-effects models were estimated for test and replication split halves and tested whether relatively advanced youth-reported pubertal development at 9/10 years predicted SITBs (suicidal ideation, suicide attempts, and non-suicidal self-injury) as reported by preadolescents (each wave) and their caregiver (baseline, 2-year follow-up) in a computerized version of the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS). Preadolescents with baseline self-reported puberty, KSADS (N=8,708; 44.6% female; 60.8% white non-Hispanic), and demographic information were included.

Results: Baseline preadolescent-reported puberty predicted the presence of any SITB before or at baseline (OR=1.50, 95% CI=1.23-1.85) and the new-onset SITBs between baseline and 2-year follow-up in preadolescents SITB-naive at baseline (OR=2.26, 95% CI=1.66-3.21).

Conclusion: Preadolescents reporting relatively advanced puberty were more likely to have experienced SITBs and, if SITB naïve, were more likely to experience onset of SITBs across the following two years. Findings were not explained by child psychopathology or other familial and psychosocial factors known to predict SITBs. Screening preadolescents for advanced puberty at age 9/10 and applying targeted suicide-screening for those youth showing advanced puberty should be considered in primary care and mental health settings.

Keywords: adolescence; preadolescence; puberty; self-injurious behavior; suicide.