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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    • "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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    • "Substance use in adolescence is also related to later adult problems (Chassin et al., 1999; Trim, Meehan, King, & Chassin, 2007), including binge drinking or the use of hard drugs, which can undermine young adult emotional, physical, and economic well-being (Chassin et al., 1999). Other risky behaviors related to adolescent suicidal behaviors include illegal activities, fighting and life-threatening activities, legal problems, and incarceration (King et al., 2001). Such activities can influence adult well-being and lead to subsequent social marginalization that increases vulnerability to suicide in adulthood (Fergusson et al., 2000; Langhinrichsen-Rohling, Arata, Bowers, O'Brien, & Morgan, 2004). "
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    ABSTRACT: Young adult suicide is an important social problem, yet little is known about how risk for young adult suicide develops from earlier life stages. In this study the authors report on 759 young adults who were potential high school dropouts as youth. At both adolescence and young adulthood, measures of suicide risk status and related suicide risk factors are collected. With a two-by-two classification on the basis of suicide risk status at both adolescence and young adulthood, the authors distinguish four mutually exclusive groups reflecting suicide risk at two life stages. Using ANOVA and logistic regression, both adolescent and young adult suicide risk factors are identified, with evidence of similarity between risk factors at adolescence and at young adulthood, for both individual-level and social-context factors. There is also support for both continuity and discontinuity of adolescent suicide risk. Implications for social policy are discussed.
    Youth &amp Society 12/2012; 44(4):524-547. DOI:10.1177/0044118X11407526 · 1.82 Impact Factor
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    • "For example, among 2,598 pre/early adolescents in the United States, it was found that parent supervision played a significant role in reducing suicidal expression, but mainly among girls [38]. Other research has suggested that low parental monitoring, was independently associated with increased suicide expression [39]. Another longitudinal study provided even more inconclusive information - that parental vigilance was associated with increased rates of suicidality [40]. "
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    ABSTRACT: We investigated correlates for suicidal expression among adolescents in the Seychelles. Data on 1,432 students (52% females) were derived from the Global School-based Health Survey. Participants were divided into three groups: those with no suicidal behavior (N = 1,199); those with suicide ideation/SI (N = 89); and those reporting SI with a plan to carry out a suicide attempt/SISP (N = 139), each within a 12-month recall period. Using multinomial logistic regression, we examined the strength of associations with social, behavioral and economic indicators while adjusting for covariates. Sixteen percent of school-attending adolescents reported a suicidal expression (10% with a plan/6.2% without). Those reporting SI were younger (relative risk ratio RRR = 0.81; CI = 0.68–0.96), indicated signs of depression (RRR = 1.69; CI = 1.05–2.72) and loneliness (RRR=3.36; CI =1.93–5.84). Tobacco use (RRR = 2.34; CI = 1.32–4.12) and not having close friends (RRR = 3.32; CI = 1.54–7.15) were significantly associated with SI. Those with SISP were more likely to be female (RRR = 0.47; 0.30–0.74), anxious (RRR = 3.04; CI = 1.89–4.88) and lonely (RRR = 1.74; CI = 1.07–2.84). Having no close friends (RRR = 2.98; 1.56–5.69) and using tobacco (RRR = 2.41; 1.48–3.91) were also strongly associated. Having parents who were understanding was protective (RRR = 0.50; CI = 0.31–0.82). Our results suggest that school health promotion programs may benefit from targeting multiple factors associated with suicidal expression. More research, particularly multilevel designs are needed to identify peer and family influences which may modify associations with suicidality.
    International Journal of Environmental Research and Public Health 12/2012; 9(11):4122-34. DOI:10.3390/ijerph9114122 · 2.06 Impact Factor
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