Abstract
Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric inpatient hospitalization and again at 3, 6, 9, 15, and 18 months postdischarge through a series of structured interviews and parent- and adolescent-reported instruments. Symptoms of depression, posttraumatic stress disorder, externalizing psychopathology, hopelessness, and engagement in several forms of self-injurious/suicidal behaviors (i.e., suicide threats/gestures, plans, nonsuicidal self-injury [NSSI]) were assessed. Latent growth curve analyses revealed a period of suicidal ideation remission between baseline and 6 months following discharge, as well as a subtle period of suicidal ideation reemergence between 9 and 18 months postdischarge. Changes in suicidal ideation predicted suicide attempts. After accounting for the effects of suicidal ideation, baseline suicide threats/gestures also predicted future suicide attempts. Higher adolescent-reported depressive symptoms, lower parent-reported externalizing symptoms, and higher frequencies of NSSI predicted weaker suicidal ideation remission slopes. Findings underscore the need for more longitudinal research on the course of adolescent suicidality.
Highlights
Little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor
Previously cited data provide information about the lifetime and 12-month prevalence of suicidal behaviors, little is known about the temporal course of adolescent suicidal ideation or suicidal behavior
Few prior studies have been able to identify factors that are associated with suicide attempts after controlling for the effects of suicidal ideation
Summary
Little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. Rates of suicidal ideation and attempts are elevated among youth, and prior data suggest risk of such outcomes are especially high among those recently discharged from psychiatric hospitalization, data are not currently available on the short-term course of suicidal ideation and attempts immediately following release from adolescent psychiatric hospitalization. Such information could significantly enhance our understanding of the nature of suicidal behaviors and would offer essential information for clinical assessment and treatment planning. The identification of factors that can prospectively predict suicide attempts above and beyond prediction of suicidal ideation is important for clinical theory, and for the clinical assessment and prevention of suicidality among youth
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