(PS8-23) Association Between Age at Menarche and Presentation of Self-injurious Thoughts and Behaviors in a Sample of Adolescents Hospitalized on an Inpatient Psychiatric Unit

Abstract Text: Earlier age at menarche (AAM) is associated with increased risk for the development of psychopathology (Graber et al., 1997). Among all psychiatric symptoms, self-injurious thoughts and behaviors (SITBs) are some of the most severe and dangerous, and prior work has found that earlier AAM and exposure to early-life adversity are associated with greater risk for engagement in SITBs (Owens et al., 2020). Menarche is also associated with the onset of suicidal ideation. One study found that girls with earlier AAM experienced suicidal ideation at an earlier age (Ortin & Miranda, 2020). Stumper et al. (2024) found that youth on an inpatient psychiatric unit with earlier AAM presented with more severe depressive symptoms, more severe suicidal ideation, and deficits in their emotion regulation abilities. The present study expands on this prior work to identify the extent to which AAM is related to the onset and lifetime occurrence of suicidal ideation, suicide plans, and suicide attempts. We hypothesize that adolescents with earlier AAM will have had an earlier age of SITB onset and higher likelihood of lifetime occurrence of SITBs. Data for this study were collected as part of a larger, intensive longitudinal study that aimed to predict SITBs after adolescents leave inpatient hospitalization. The subsample used for the current analysis includes 200 adolescent inpatients ages 12–18 (M = 14.84, SD = 1.65). All participants in our sample presented to the hospital with suicidal ideation, were assigned female sex at birth, and reported reaching menarche. Participants completed a self-report version of the Self-Injurious Thoughts and Behaviors Interview and reported their AAM as part of the Tanner Staging Questionnaire. Analyses show that earlier AAM is significantly associated with earlier age of onset of suicidal ideation (b = 0.71, CI = 0.45–0.96, p < .001), earlier age at first making a suicide plan (b = 0.63, CI = 0.39–0.86, p < .001), and earlier age at first suicide attempt (b = 0.64, CI = 0.40–0.88, p < .001). AAM does not significantly predict lifetime occurrence of a suicide plan (OR = 0.80, CI = 0.60–1.05, p = .116). However, earlier AAM is significantly associated with an increased likelihood of lifetime occurrence of a suicide attempt (OR = 0.77, CI = 0.60–0.97, p = .032). In additional planned analyses, we will include relevant covariates (e.g., anxiety and depression symptoms, demographic characteristics, and exposure to early-life adversity). We also plan to explore other outcomes related to SITB severity, such as readmission to the hospital during the study. These results contribute to our understanding of how AAM is associated with the onset and occurrence of SITBs, which may inform care of adolescents on an inpatient psychiatric unit.