Epidemiological studies indicate a high prevalence of self-injurious behavior in adolescents in the general population. So far, there are only very few studies on the course of self-injurious behavior in adolescents and young adults.

The aim of the present population-based study was the analysis of prospective predictors of onset, maintenance and cessation self-injurious behavior in adolescents.

A representative sample of the normal population of adolescents from Germany (initial sample: n = 1444; mean age = 14.7, SD = 0.80, 52% female adolescents) was studied over a two years period on 4 consecutive points of measurement in the context of the European school-based intervention study SEYLE.

There was a high remission rate (70.4%) of self-injurious behaviors at 24-month follow-up investigation. However, there was a substantial rate (29.6%) of adolescents who continued the self-injurious behavior, as well as a group of “new starters”. Self-injurious behavior during the baseline examination proved to be the strongest predictor of self-injurious behavior 2 years later. The extent of depressive symptoms and quality of peer relationships were significantly associated with maintaining self-injurious behavior two years later. Furthermore continued self-injurious behavior over the first 12-month was highly associated with suicide plans/suicide attempts at 24-month follow-up investigation.

While both, onset and maintenance of SIB are prospectively associated with an increased risk for suicidal behaviour in late adolescence, SIB cessation significantly reduces the risk for later suicidal behaviour.

The authors have not supplied their declaration of competing interest.