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Research on Child and Adolescent Psychopathology

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01-07-2015

Multi-Level Risk Factors for Suicidal Ideation Among at-Risk Adolescent Females: The Role of Hypothalamic-Pituitary-Adrenal Axis Responses to Stress

Auteurs: Matteo Giletta, Casey D. Calhoun, Paul D. Hastings, Karen D. Rudolph, Matthew K. Nock, Mitchell J. Prinstein

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 5/2015

Abstract

Adopting a multi-level approach, this study examined risk factors for adolescent suicidal ideation, with specific attention to (a) hypothalamic-pituitary-adrenal (HPA) axis stress responses and (b) the interplay between HPA-axis and other risk factors from multiple domains (i.e., psychological, interpersonal and biological). Participants were 138 adolescent females (M _age = 14.13 years, SD = 1.40) at risk for suicidal behaviors. At baseline, lifetime suicidal ideation and a number of risk factors were assessed (i.e., depressive symptoms, impulsiveness, pubertal status and peer stress). Participants were exposed to a psychosocial stress task and HPA-axis responses were assessed by measuring cortisol levels pre- and post-stressor. At 3 months post-baseline, suicidal ideation again was assessed. Using group-based trajectory modeling, three groups of cortisol stress-response patterns were identified (i.e., hyporesponsive, normative, and hyperresponsive). As compared to females in the normative and hyporesponsive group, females in the hyperresponsive group were more likely to report a lifetime history of suicidal ideation at baseline, above and beyond the effects of the other predictors. Moreover, as compared to females in the normative group, females in the hyperresponsive group were at increased risk for reporting suicidal ideation 3 months later, after controlling for prior ideation. No interactions between cortisol group and the other risk factors were significant, with the exception of a non-significant trend between impulsiveness and cortisol group on lifetime suicidal ideation. Findings highlight the importance of HPA-axis responses to acute stressors as a risk factor for suicidal ideation among adolescents.

vorige artikel Introduction to the Special Section: Biopsychosocial Processes in the Etiology and Development of Internalizing Problems

volgende artikel Self-Reported and Observed Punitive Parenting Prospectively Predicts Increased Error-Related Brain Activity in Six-Year-Old Children

Clinical scores were identified by calculating appropriate female and age normed T-scores. T-scores equal or higher than 70 indicated clinically relevant scores (Reynolds and Kamphaus 1992).

Group-based trajectory models also were conducted controlling for psychotropic medication usage, in addition to birth control and corticosteroids. Although these models supported a four-class solution over a three-class solution, logistic regression models examining the effect of cortisol trajectory membership on suicidal ideation provided identical results, with increased risk for suicidal ideation among adolescents in the hyperresponsive group as compared to adolescents in the other cortisol groups

To ensure that the exclusion of pre-task cortisol data collected using the passive drool saliva procedure (see Measures) did not bias results, additional group-based trajectory models were conducted including in the analyses pre-task cortisol data collected using the passive drool saliva procedure. High similar results emerged as when excluding these pre-task cortisol values. Specifically, a three-class trajectory model was supported, including a normative, a hyporesponsive and a hyperresponsive group. These cortisol groups showed identical patterns to those depicted in Fig. 1. Moreover, 137 of the 138 participants were found to belong to the same cortisol trajectory group when estimating models with and without these cortisol values. Despite the similarity across results, models estimated with pre-task cortisol assessed via passive drool procedure as missing are presented as primary analyses, due to significant differences in cortisol concentration that can emerge by using different methods of saliva collection (i.e., salivette vs. passive drool; Poll et al. 2007).

In this study, the relatively broad age range, including participants between 12 and 16 years, was not ideal for examining the effect of pubertal timing (i.e., pubertal status adjusted by chronological age). However, it should be acknowledged that pubertal timing also may be a relevant predictor of adolescent suicidal ideation (see Wichstrøm 2000). To explore this hypothesis, additional models were estimated in which the effect of pubertal status on suicidal ideation (lifetime and at follow-up) was replaced by pubertal timing. Like pubertal status, pubertal timing predicted lifetime suicidal ideation (OR = 1.71, p = 0.046, 95 % CI [1.01, 2.90]), suggesting that early maturing females were more likely to report a lifetime history of suicidal ideation as compared to their peers. However, as pubertal status, no effect of pubertal timing was found on suicidal ideation at follow-up (OR = 0.63, p = 0.220, 95 % CI [0.30, 1.32]).

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Titel: Multi-Level Risk Factors for Suicidal Ideation Among at-Risk Adolescent Females: The Role of Hypothalamic-Pituitary-Adrenal Axis Responses to Stress
Auteurs: Matteo Giletta
Casey D. Calhoun
Paul D. Hastings
Karen D. Rudolph
Matthew K. Nock
Mitchell J. Prinstein
Publicatiedatum: 01-07-2015
Uitgeverij: Springer US
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 5/2015
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-014-9897-2

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