Psychosocial and Risk Behavior Correlates of Youth Suicide Attempts and Suicidal Ideation

Yale Child Study Center, New Haven, CT 06520-7900, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 08/2001; 40(7):837-46. DOI: 10.1097/00004583-200107000-00019
Source: PubMed


To identify the independent psychosocial and risk behavior correlates of suicidal ideation and attempts.
The relationships between suicidal ideation or attempts and family environment, subject characteristics, and various risk behaviors were examined among 1,285 randomly selected children and adolescents, aged 9 through 17 years, of whom 42 (3.3%) had attempted suicide and 67 (5.2%) had expressed suicidal ideation only. The youths and their parents were enumerated and interviewed between December 1991 and July 1992 as part of the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study.
Compared with subjects with suicidal ideation only, attempters were significantly more likely to have experienced stressful life events, to have become sexually active, to have smoked more than one cigarette daily, and to have a history of ever having smoked marijuana. After adjusting for sociodemographic characteristics, a statistically significant association was found between suicidal ideation or attempt and stressful life events, poor family environment, parental psychiatric history, low parental monitoring, low instrumental and social competence, sexual activity, marijuana use, recent drunkenness, current smoking, and physical fighting. Even after further adjusting for the presence of a mood, anxiety, or disruptive disorder, a significant association persisted between suicidal ideation or attempts and poor family environment, low parental monitoring, low youth instrumental competence, sexual activity, recent drunkenness, current smoking, and physical fighting.
Low parental monitoring and risk behaviors (such as smoking, physical fighting, alcohol intoxication, and sexual activity) are independently associated with increased risk of suicidal ideation and attempts, even after adjusting for the presence of psychiatric disorder and sociodemographic variables.

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    • "Similarly, evidence suggests that factors intrinsic to the parent may be associated with a greater risk for suicide attempts in children and adolescents. Specifically, parental psychiatric history has been linked to an increased risk for child suicidal ideation or attempts (King, et al. 2001). These associations , however, have not been examined specifically in environments where abuse was present. "
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    ABSTRACT: The current study aimed to examine the role that a history of abuse plays in the association with suicide attempts in children and adolescents who have experienced trauma. Children and adolescents were recruited from a local community mental health center specializing in the treatment of child trauma. Abuse history, history of suicide attempts, various demographics, and psychosocial measures were gathered from children and adolescents as well as their mothers. Hierarchical logistic regression analyses revealed the overall model, as well as individual predictors of age, child depression, physical and sexual abuse to be significant in the association with a history of suicide attempts. The current study revealed significant risk factors for suicide attempts in children and adolescents who have been maltreated, including age, depressive symptoms, history of sexual abuse, and history of physical abuse. Future research should further delineate the magnitude of these risk factors in order to inform and strengthen the process of risk assessment and subsequent treatment of these individuals for mental health clinicians.
    Journal of Child & Adolescent Trauma 06/2015; 8(2). DOI:10.1007/s40653-015-0043-2
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    • "Despite the young age (9–11 years) of study participants , suicidality was high, with an overall prevalence of 26%. This rate is nearly 5 times the rate of suicidality of the general population at this age (King et al., 2001), and over twice as high as that reported among 8-year-old children in the LONGSCAN study (Thompson et al., 2005). The higher prevalence in the current study may be attributable to more severe maltreatment and/or the additional stress of entry to foster care, as only 6.1% of the participants in the LONGSCAN study were in foster care and not all of them had substantiated maltreatment (Thompson et al., 2005). "
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    ABSTRACT: This study sought to determine the prevalence of suicidal ideation, plans, and attempts among 515 preadolescent (aged 9-11 years) maltreated children who entered foster care within the prior year. Over a quarter (26.4%) of the children had a history of suicidality according to their own and/or their caregiver's report, 4.1% of whom were imminently suicidal. In bivariate analyses, children at higher risk of suicidality tended to be younger, non-Hispanic, abused, and to have experienced multiple types of maltreatment, more referrals to child welfare, more household transitions, and a longer length of time in foster care. There were no gender differences. Multiple regression analyses found physical abuse and chronicity of maltreatment to be the most robust predictors of suicidality. It is critically important that these high-risk children are screened for suicidality before adolescence and that caregivers and professionals are informed of their risk status so that they may implement mental health treatment, monitoring, and harm reduction measures.
    Child Maltreatment 02/2014; 19(1). DOI:10.1177/1077559514525503 · 2.77 Impact Factor
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    • "However, only few population-based studies have examined family factors [19]. They showed several predictive or associated factors, like: poor family environment (low satisfaction with support, communication, leisure time, low parental monitoring) [27], low family support [28], low family cohesion [29], poor family functioning, poor parent–child attachment and problems of parental adjustment [1,19]. On the contrary, higher family cohesion has been reported as a protective factor against future suicide attempt [26] as well as having positive relationships with a parent [30,31]. "
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    ABSTRACT: Context: Suicide is the second leading cause of death in adolescents and young adults in Europe. Reducing suicides is therefore a key public health target. Previous studies have shown associations between suicidal behaviors, depression and family factors. OBJECTIVE: To assess the role of family factors in depression and suicidality in a large community-based sample of adolescents and to explore specific contributions (e.g. mother vs. father; conflict vs. no conflict; separation vs. no separation) taking into account other risk factors. METHODS: A cross-sectional sample of adolescents aged 17 years was recruited in 2008. 36,757 French adolescents (18,593 girls and 18,164 boys) completed a questionnaire including socio-demographic characteristics, drug use, family variables, suicidal ideations and attempts. Current depression was assessed with the Adolescent Depression Rating Scale (ADRS). Adolescents were divided into 4 groups according to suicide risk severity (grade 1 = depressed without suicidal ideation and without suicide attempts, grade 2 = depressed with suicidal ideations and grade 3 = depressed with suicide attempts; grade 0 = control group). Multivariate regressions were applied to assess the Odds Ratio of potential risk factors comparing grade 1, 2 or 3 risk with grade 0. RESULTS: 7.5% of adolescents (10.4% among girls vs. 4.5% among boys) had ADRS scores compatible with depression; 16.2% reported suicidal ideations in the past 12 months and 8.2% reported lifetime suicide attempts. Repeating a year in school was significantly associated to severity grade of suicide risk (1 and 3), as well as all substance use, tobacco use (severity grades 2 and 3) and marijuana use (severity grade 3), for girls and boys. After adjustment, negative relationships with either or both parents, and parents living together but with a negative relationship were significantly associated with suicide risk and/or depression in both genders (all risk grades), and Odds Ratios increased according to risk severity grade. CONCLUSION: Family discord and negative relationship with parents were associated with an increased suicide risk in depressed adolescents. So it appears essential to take intrafamilial relationships into account in depressed adolescents to prevent suicidal behaviours.
    Child and Adolescent Psychiatry and Mental Health 03/2013; 7(1):8. DOI:10.1186/1753-2000-7-8
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