Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia.

Cullen, P; Mőller, H; Baffsky, R; Martiniuk, A; Senserrick, T; Rogers, K; Woodward, M; Stevenson, MR; McLean, R; Sawyer, S; Patton, G; Ivers, RQ

Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia.

Cullen, P Mőller, H Baffsky, R Martiniuk, A Senserrick, T Rogers, K

Woodward, M Stevenson, MR McLean, R Sawyer, S Patton, G Ivers, RQ

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Publisher:: BMJ
Publication Type:: Journal Article
Citation:: Inj Prev, 2023, 29, (4), pp. 302-308
Issue Date:: 2023-08

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Field	Value	Language
dc.contributor.author	Cullen, P
dc.contributor.author	Mőller, H
dc.contributor.author	Baffsky, R
dc.contributor.author	Martiniuk, A
dc.contributor.author	Senserrick, T
dc.contributor.author	Rogers, K https://orcid.org/0000-0001-5497-4298
dc.contributor.author	Woodward, M
dc.contributor.author	Stevenson, MR
dc.contributor.author	McLean, R
dc.contributor.author	Sawyer, S
dc.contributor.author	Patton, G
dc.contributor.author	Ivers, RQ
dc.date.accessioned	2023-09-25T03:43:41Z
dc.date.available	2023-01-20
dc.date.available	2023-09-25T03:43:41Z
dc.date.issued	2023-08
dc.identifier.citation	Inj Prev, 2023, 29, (4), pp. 302-308
dc.identifier.issn	1353-8047
dc.identifier.issn	1475-5785
dc.identifier.uri	http://hdl.handle.net/10453/172270
dc.description.abstract	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.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	BMJ
dc.relation	http://purl.org/au-research/grants/nhmrc/1134894
dc.relation	http://purl.org/au-research/grants/nhmrc/GNT1134894
dc.relation.ispartof	Inj Prev
dc.relation.isbasedon	10.1136/ip-2022-044807
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1106 Human Movement and Sports Sciences, 1117 Public Health and Health Services, 1701 Psychology
dc.subject.classification	Public Health
dc.subject.classification	4202 Epidemiology
dc.subject.classification	4206 Public health
dc.subject.mesh	Young Adult
dc.subject.mesh	Humans
dc.subject.mesh	Adolescent
dc.subject.mesh	New South Wales
dc.subject.mesh	Automobile Driving
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Accidents, Traffic
dc.subject.mesh	Australia
dc.subject.mesh	Risk Factors
dc.subject.mesh	Humans
dc.subject.mesh	Risk Factors
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Accidents, Traffic
dc.subject.mesh	Automobile Driving
dc.subject.mesh	Adolescent
dc.subject.mesh	Australia
dc.subject.mesh	New South Wales
dc.subject.mesh	Young Adult
dc.subject.mesh	Young Adult
dc.subject.mesh	Humans
dc.subject.mesh	Adolescent
dc.subject.mesh	New South Wales
dc.subject.mesh	Automobile Driving
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Accidents, Traffic
dc.subject.mesh	Australia
dc.subject.mesh	Risk Factors
dc.title	Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia.
dc.type	Journal Article
utslib.citation.volume	29
utslib.location.activity	England
utslib.for	1106 Human Movement and Sports Sciences
utslib.for	1117 Public Health and Health Services
utslib.for	1701 Psychology
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2023-09-25T03:43:39Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	29
utslib.citation.issue	4

Abstract:

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.

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http://hdl.handle.net/10453/172270