A Longitudinal Study of Suicidal Ideation in Young Adolescents

doi:10.1097/00004583-199107000-00011

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 30, Issue 4, July 1991, Pages 597-603

https://doi.org/10.1097/00004583-199107000-00011 Get rights and content

Abstract

As part of a longitudinal study of depression and suicidal ideation in adolescents, a three-item suicide screen was administered to 1,073 students for 3 consecutive years starting at the beginning of the 7th or 8th grades. Each year over 70% of respondents reported no suicidal thoughts, and less than 5.5% attained high suicide ideation scores. Blacks and females had higher scores, respectively, than did whites and males. The individual students' suicide scores were less stable than the overall distributions with 1− and 2-year correlations reaching 0.35 and 0.28, respectively. Only one student received a high score all 3 years. The best predictors of a given year's suicide score was the previous years' depression scores. Gender, undesirable life events, family adaptability, and family cohesion were significant but less consistent predictors.

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Twenty-six years of psychosocial interventions to reduce suicide risk in adolescents: Systematic review and meta-analysis
2022, Journal of Affective Disorders
Citation Excerpt :
With regard to non-suicidal self-injury (NSSI), prevalence estimates for adolescents range widely from 7.5% to 46.5% (Cipriano et al., 2017). In recent decades, there has been increasing interest in developing interventions for suicide prevention specifically for adolescents (Fox et al., 2020). As SI, self-harming behaviors (SHB), and NSSI all have predictive value for future suicide attempts in adolescents and young adults (Hawton et al., 1993), most suicide prevention interventions in adolescents primarily target the reduction of one or more of these outcomes.
During adolescence, suicide risk increases; effective treatments are needed to reduce risk.
Databases were searched (1995–2020) for randomized controlled trials (RCTs) concerning psychosocial treatments for suicide prevention in adolescents (10–18 yrs). Data were extracted from the timepoint closest to 6 months. Cohen's ds were estimated for reducing suicidal ideation (SI), self-harming behaviors (SHB) excluding strictly non-suicidal self-injury, and suicide attempts (SA) and analyzed using generalized least square regression. Meta-analytic innovations included within-person correlations to reflect trait suicidality; annualization to control for exposure; estimated lifetime risk based on ages; and modeling inclusion/exclusion criteria. Alternate approaches included relative risk and comparison of intervention and control treatments to baseline.
Of 30 RCTs, 6 assessing SHB (4 measuring SA), and 7 assessing SI demonstrated treatment effectiveness. Overall, interventions decreased SI (n = 25) with low effect size (d = 0.08, p = 0.01), non-significant after controlling for publication bias (d = 0.05, p = 0.1); interventions were non-significant for SHB (n = 25, d = 0.001, p = 0.97) or SA (n = 18, d = 0.03, p = 0.52). To prevent one SHB, the number needed to treat (NNT) was 45[26,156]; for SA, NNT=42[24,149]. Non-superiority may relate to effectiveness of control treatments. Thus, experimental and control treatments also were compared to baseline: both reduced SI (p < 0.0001), and effectiveness improved for SHB (NNT=12) and SA (NNT=11).
Study heterogeneity and inconsistent statistical reporting limited meta-analysis.
Psychosocial interventions for suicide risk in adolescents showed little effectiveness compared with control treatments; suicide outcomes improved in both groups compared to baseline. Different approaches may be needed, including precision medicine methodologies and standardized statistical reporting criteria.
The co-occurrence of autistic traits and borderline personality disorder traits is associated to increased suicidal ideation in nonclinical young adults
2018, Comprehensive Psychiatry
Citation Excerpt :
The French version of this scale was already described [13] and used in earlier reports [14,15]. Suicidal ideation was assessed using the 3-item scale proposed by Garrison et al. [16] ("I felt life was not worth living"; “I felt like hurting myself”; “I felt like killing myself”). Responses to these items were made on the same scale as the CES-D items.
The co-occurrence of Autism Spectrum Disorder (ASD) and Borderline Personality Disorder (BPD) is not rare and has been linked to increased suicidality. Despite this significant comorbidity between ASD and BPD, no study had examined the co-occurrence of autistic traits and borderline personality disorder traits in the general population. The aim of the present study was to examine the co-occurrence of autistic and borderline traits in a non-clinical sample of young adults and its influence on the levels of suicidal ideation and depressive symptomatology.
Participants were 474 college students who completed self-report questionnaires. Data were analysed using correlation and cluster analyses.
Borderline personality traits and autistic traits were weakly correlated. However, cluster analysis yielded four groups: a low traits group, a borderline traits group, an autistic traits group, and a group characterized by high levels of both traits. Cluster analysis revealed that autistic and borderline traits can co-occur in a significant proportion of young adults. The high autistic and borderline traits group constituted 17% of the total sample and had higher level of suicidal ideation than the borderline traits group, despite similar levels of depressive symptoms.
This result suggests that the higher suicidality observed in patients with comorbid ASD and BPD may extent to non-clinical individuals with high levels of co-occurrent autistic and borderline traits.
Typology of schizotypy in non-clinical young adults: Psychopathological and personality disorder traits correlates
2016, Psychiatry Research
Few typological studies address schizotypy in young adults. Schizotypal traits were assessed on 466 college students using the Schizotypal Personality Questionnaire-Brief (SPQ-B). Other measures evaluated personality traits previously associated with schizotypy (borderline, obsessionnal, and autistic traits), psychopathological symptoms (suicidal ideations, depressive and obsessive-compulsive symptoms) and psychosocial functioning. A factor analysis was first performed on SPQ-B results, leading to four factors: negative schizotypy, positive schizotypy, social anxiety, and reference ideas. Based on these factors, a cluster analysis was conducted, which yielded four clearly distinct groups characterized by "Low" (non schizotypy), "High schizotypy" (mixed positive and negative), "Positive schizotypy", and "Social impairment". Regarding personality disorder traits and psychopathological symptoms, the "High schizotypy" cluster scored higher than the "Positive" and the "Social impairment" groups, which scored higher than the "Low" cluster. The "Positive" group had higher levels of interpersonal relationships than in the "High" and the "Social impairment" clusters, suggesting that positive schizotypy was associated to benefits such as perceived social relationships. Nevertheless the "Positive" cluster was also linked to high levels of personality disorder traits and psychopathological symptoms, and to low academic achievement, at levels similar those observed in the "Social impairment" cluster, confirming an unhealthy side to positive schizotypy.
An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain From Spinal Cord Injury and Disease
2016, Journal of Pain
Using 8-hour human laboratory experiments, we evaluated the analgesic efficacy of vaporized cannabis in patients with neuropathic pain related to injury or disease of the spinal cord, most of whom were experiencing pain despite traditional treatment. After obtaining baseline data, 42 participants underwent a standardized procedure for inhaling 4 puffs of vaporized cannabis containing either placebo, 2.9%, or 6.7% delta 9-THC on 3 separate occasions. A second dosing occurred 3 hours later; participants chose to inhale 4 to 8 puffs. This flexible dosing was used to attempt to reduce the placebo effect. Using an 11-point numerical pain intensity rating scale as the primary outcome, a mixed effects linear regression model showed a significant analgesic response for vaporized cannabis. When subjective and psychoactive side effects (eg, good drug effect, feeling high, etc) were added as covariates to the model, the reduction in pain intensity remained significant above and beyond any effect of these measures (all P < .0004). Psychoactive and subjective effects were dose-dependent. Measurement of neuropsychological performance proved challenging because of various disabilities in the population studied. Because the 2 active doses did not significantly differ from each other in terms of analgesic potency, the lower dose appears to offer the best risk-benefit ratio in patients with neuropathic pain associated with injury or disease of the spinal cord.
A crossover, randomized, placebo-controlled human laboratory experiment involving administration of vaporized cannabis was performed in patients with neuropathic pain related to spinal cord injury and disease. This study supports consideration of future research that would include longer duration studies over weeks to months to evaluate the efficacy of medicinal cannabis in patients with central neuropathic pain.
The effect of suicide attempts on suicide ideation by family members in fast developed country, Korea
2016, Comprehensive Psychiatry
Suicide is a leading cause of death globally and is one of the most exigent health problems, especially in Korea. Individuals think about suicide first before they attempt and possibly complete suicide. If attempted or completed suicide affects suicidal ideation by family members or close individuals, suicide could spread like an infectious disease. We hypothesized that a suicide attempt by a family member could affect suicidal ideation. We analyzed the association between suicidal ideation and previous suicide attempts by family members.
This study used data from the fourth and fifth Korea National Health and Nutrition Examination Survey (2007–2012). The independent variable of interest is the existence of a cohabitating family member who previously attempted suicide. The dependent variable is self-reported suicide ideation during past year. The data analysis was conducted using the chi-square test and survey logistic regression.
Suicidal ideation was reported by 14.3% of the total study population (9.5% of males, 19.0% of females), by 23.6% (22.8% of males, 31.3% of females) of individuals with a family member who attempted suicide, and by 14.1% (9.3% of males, 19.9% of females) of individuals without a family member who attempted suicide.
Individuals with a family member who attempted suicide had increased odds of suicidal ideation compared with those without a family member who attempted suicide (odds ratio = 2.09, 95% CI 1.48–2.49, p < 0.001).
To prevent suicide spreading like an infectious disease, government and policy makers should give thought and consideration to individuals with a family member who attempts suicide.
Cognitive and family correlates of current suicidal ideation in children with bipolar disorder
2015, Journal of Affective Disorders
Citation Excerpt :
Within the family domain, parenting stress and family rigidity differentiated the suicide risk groups in the univariate analyses; rigidity remained a significant predictor of any ideation, as well as the subset of youth with planful forms of ideation, in the multivariate models. Our results converge with research demonstrating links between family stress, adaptability and youth suicide risk (Garrison et al., 1991; Goldstein, 2009), and also the lack of associations between family cohesion and suicidality in PBD specifically (Goldstein, 2009). A rigid family style, including difficulty adapting to change as well as overreliance on rules and consequences, may have deleterious consequences for a child with PBD; rather than modifying family practices to accommodate the child׳s needs, these families may engage in behaviors that exacerbate a child׳s symptoms and hence risk for suicide.
Suicidality among youth with bipolar disorder is an extreme, but largely unaddressed, public health problem. The current study examined the psychosocial characteristics differentiating youth with varying severities of suicidal ideation that may dictate targets for suicide prevention interventions.
Participants included 72 youth aged 7–13 (M=9.19, SD=1.61) with DSM-IV-TR bipolar I, II, or NOS and a parent/caregiver. Current suicidal ideation and correlates were assessed at intake, including: demographics and clinical factors (diagnosis, symptom severity, psychiatric comorbidity); child factors (cognitive risk and quality of life); and family factors (parenting stress, family cohesion, and family rigidity).
Current ideation was prevalent in this young sample: 41% endorsed any ideation, and 31% endorsed active forms. Depression symptoms, quality of life, hopelessness, self-esteem, and family rigidity differentiated youth with increasing ideation severity. Separate logistic regressions examined all significant child- and family-level factors, controlling for demographic and clinical variables. Greater family rigidity and lower self-esteem remained significant predictors of current planful ideation. Diagnosis, index episode, comorbidity, and mania severity did not differentiate non-ideators from those with current ideation.
Limitations include the small sample to examine low base-rate severe ideation, cross-sectional analyses and generalizability of findings beyond the outpatient clinical sample.
Findings underscore the importance of assessing and addressing suicidality in preadolescent youth with bipolar disorder, before youth progress to more severe suicidal behaviors. Results also highlight child self-esteem and family rigidity as key treatment targets to reduce suicide risk in pediatric bipolar disorder.

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: This research was supported by Grant MH-40363 from the National Institute of Mental Health.

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ORIGINAL ARTICLEA Longitudinal Study of Suicidal Ideation in Young Adolescents

Abstract

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

J. Psychosom. Res.

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Psychiatry

J. Am. Acad. Child Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

The significance of life events as etiologic factors in the diseases of children

J. Psychosom. Res.

Psychiatric disorders in pediatric primary care

Arch. Gen. Psychiatry

Correlates of suicidal ideation and attempts in a community sample of junior high and high school students

Journal of Clinical Child Psychology

Statistical Methods for Rates and Proportions

The study of suicidal behavior in the schools

Suicide Life Threat. Behav.

Depressive symptoms in early adolescence

Epidemiology of depressive symptoms in young adolescents

J. Am. Acad. Child Adolesc. Psychiatry

A longitudinal study of depressive symptomatology in young adolescents

J. Am. Acad. Child. Adolesc. Psychiatry

Prevalence of specific suicidal behaviors in a high school sample

Am. J. Psychiatry

ORIGINAL ARTICLE
A Longitudinal Study of Suicidal Ideation in Young Adolescents