Adolescent Suicide Risk Research Articles

Mental Health and Suicide Risk Among High School Students and Protective Factors - Youth Risk Behavior Survey, United States, 2023.

Adolescent mental health and suicide risk remain substantial public health concerns. High pre-COVID rates of poor mental health and suicide-related behaviors have continued to rise, highlighting the need to identify factors that might foster positive mental health outcomes and reduce suicide-related behaviors at population levels. Using CDC's 2023 Youth Risk Behavior Survey, CDC analyzed the prevalence of mental health and suicide risk indicators and their associations with individual-, family-, and school- or community-level protective factors. Prevalence estimates were calculated for each of the mental health and suicide risk indicators by demographic characteristic. Prevalence ratios adjusted for sex, sexual identity, grade, and race and ethnicity were calculated to examine the association between protective factors and mental health and suicide risk indicators. Overall, 39.7% of students experienced persistent feelings of sadness and hopelessness, 28.5% experienced poor mental health, 20.4% seriously considered attempting suicide, and 9.5% had attempted suicide. Mental health and suicide risk indicators differed by sex, sexual identity, grade, and race and ethnicity. All protective factors were associated with lower prevalence of one or more risk indicators. Findings from this report can serve as a foundation for the advancement of research on protective factors and for the development and implementation of programs, practices, and policies that protect and promote mental health and emotional well-being among youth.

Risk and Protective Factors of Self-Harm and Suicide in Adolescents in The Era of Society 5.0: A Systematic Review

Risk and Protective Factors of Self-Harm and Suicide in Adolescents in The Era of Society 5.0: A Systematic Review

Alcohol abuse among adolescents and suicide risk - is there a correlation?

Introduction: Adolescent alcohol abuse is a critical public health issue with far-reaching consequences for individual development and societal well-being. Adolescent alcohol consumption poses significant health risks, particularly due to its effects on brain development and its association with increased suicide risk. Purpose of the work: This study aims to investigate the relationship between alcohol abuse and suicide risk in adolescents. Materials and methods: A comprehensive analysis of research papers available on PubMed and Google Scholar was undertaken using the search terms including the following keywords: alcohol abuse/ alcohol abuse in adolescence/ alcohol consumption in adolescence/ alcohol abuse and suicide risk in adolescence/ suicide risk factors in adolescence/ suicidal tendencies among teenagers. Conclusions:Adolescent alcohol abuse has profound implications for brain development and mental health, significantly increasing the risk of suicide. Effective public health strategies, including early intervention, education, and strong support systems, are essential to mitigate these risks and promote healthier environments for young individuals. Addressing the underlying causes of alcohol abuse and providing targeted support can reduce its long-term consequences and improve adolescent well-being.

Could school programs based on social-emotional learning prevent substance abuse among adolescents?

In this editorial, we comment on the article Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs by Liu et al . While the article focused on the issue of suicide and social-emotional learning programs as a possible intervention, we here discuss evidence of other reported outcomes and if it could be an effective way to prevent substance abuse among adolescents.

Suicide risk in adolescents with deviant behavior and different hardiness levels

BACKGROUND: The paper discusses the role of hardiness in adolescents with deviant behavior as a personal resource in coping with the challenges of the modern world and its contribution to the prevention of suicide risk in the situation of the increasing prevalence of suicide in adolescence. AIM: The aim is to study the indicators of suicide risk in adolescents with deviant behavior and different hardiness levels. MATERIALS AND METHODS: The study involved 63 adolescents aged 14–17 years. The study was carried out using the Hardiness Survey by E.N. Osin and E.I. Rasskazova; A Suicide Risk Questionnaire modified by T.N. Razuvaeva. RESULTS: Low and medium hardiness levels were distributed almost equally, with the exception of 8% of adolescents with high hardiness level. The component of hardiness “Commitment” has a negative association with the indicator of suicidal risk “Affectivity” (p 0,05) at low hardiness level and with “Failure” (p 0,01) at medium hardiness level. The component of hardiness “Control” is also correlated with the indicator of suicidal risk “Maximalism” (p 0,05) at low hardiness level. There was found no associations between the component of hardiness “Challenge” and the indicators of suicide risk. In adolescents with deviant behavior the suicide risk greatly determined by external reasons at low hardiness level and by internal reasons at medium hardiness level. CONCLUSIONS: These findings allow to identify the following targets of psychological correction to reduce suicidal risk in adolescents with deviant behavior: increasing commitment in life events with their control and the formation of self-confidence at low hardiness level, formation of a ban of any form of suicidal behavior at medium hardiness level, increasing activity regardless of hardiness level.

Comparison of Acoustic Parameters of Voice and Speech According to Vowel Type and Suicidal Risk in Adolescents

Globally, suicide prevention and understanding suicidal behavior represent significant health challenges. The predictive potential of voice, speech, and language appears as a promising solution to the difficulty in assessment. ObjectiveTo analyze variations in acoustic parameters in voice and speech based on vowel types according to different levels of suicidal risk among adolescents in a text reading task. MethodologyCross-sectional analytical design using non-probabilistic sampling. Our sample comprised 98 adolescents aged 14 to 19, undergoing voice acoustic assessment, along with suicidal ideation determination through the Okasha Suicidality Scale and Beck Depression Inventory. Acoustic analysis of recordings was conducted using Praat for phonetic research, Python program, Focusrite interface, and microphone to register voice and speech acoustic parameters such as Fundamental Frequency, Jitter, and Formants. Subsequently, data from adolescents with and without suicidal risk were compared. ResultsSignificant differences were observed between suicidal and non-suicidal adolescents in several acoustic aspects, especially in females in fundamental frequency (F0), signal-to-noise ratio (HNRdB) and temporal variability measured by jitter and standard deviation. In mens, differences were found in F0 and HNRdB (p < 0.05). ConclusionThis study demonstrated statistically significant variations in various voice acoustic parameters among adolescents with and without suicidal risk. These findings underscore the potential relevance of voice and speech as markers for suicidal risk.

생태 체계론적 관점에서 본 청소년 자살위험 유발 변인

Objectives The purpose of this study was to explore the factors affecting adolescent suicide risk and to compare middle and high school students as a basis for developing targeted programs. Methods Based on the results of the safety perception survey of 527 adolescents in Ilgae-gun, Chungcheongnam-do, relevant variables were measured and used in the analysis. The suicide risk for individual system, environmental system, and social system factors were analyzed using t-test and analysis of variance. Hierarchical regression analysis was used to compare the risk factors in Model 1, Model 2, and Model 3. Results The risk factors for suicide among adolescents that included individual, environmental, and social system factors were depression, school maladjustment, experience of sexual violence, and experience of being victimized by violence. In middle school students, depression, sexual violence, victimization, and school maladjustment were the most important risk factors for suicide, followed by negative relationships with teachers. For high school students, depression, victimization of violence, school maladjustment, victimization of sexual violence, and negative peer relationships, in that order, and perpetration of school violence were negative predictors of suicide risk. Conclusions The environment and social relationships are more influential than individual deviance as risk factors for suicide in youth. Depression and sexual victimization were major risk factors for both middle and high school students, but were particularly strong in middle school. In high school, relationship conflicts at school were identified as a major risk factor for suicide, with victimization of school violence and school maladjustment being high, along with negative peer relationships. As sexual violence factors were high risk factors in both middle and high school students, it is suggested that gender sensitivity education for adolescents is necessary.

Late-night eating and inactivity: Links to depression and suicide risk in adolescents living in Turkey.

Depression, anxiety, and eating disorders are all common during adolescence. This study aims to investigate the potential relationship between eating at night, physical activity, and depression/suicide risk in adolescents. This study followed a cross-sectional descriptive design and involved collecting data from adolescents aged 13-18 years who attend four different high schools. The data collection was done through an online survey using Google Forms. Sociodemographic form, eating at night questionnaire, International Physical Activity Questionnaire (Short Form), Reynolds Adolescent Depression Scale, and Suicide Probability Scale were used for data collection. The data collected were analyzed electronically using descriptive statistics and correlation tests to examine relationships between different parameters. The study revealed significant associations between academic achievement, daily sleep duration, and daily walking distance with depression and suicide probability (p < 0.05) among the participants. Adolescents who consumed food after 10 pm exhibited higher depression and suicide probability scores than their counterparts (p < 0.05). Additionally, an analysis of physical activity levels demonstrated that highly active adolescents had lower depression and suicide probability scores. In conclusion, this study suggests that there is a significant relationship between eating at night, physical activity, and depression/suicide risk in adolescents. Specifically, academic success, daily sleep duration, daily walking distance, and eating habits were found to be associated with depression and suicide probability. Encouraging physical activity and healthy eating habits, particularly avoiding eating late at night, may be beneficial in reducing the risk of depression and suicide among adolescents.

The effect of bullying and cyberbullying on predicting suicide risk in adolescent females: The mediating role of depression

This paper analyzed the role of depression as a mediator in the association between bullying, cyberbullying, and suicide risk in adolescent females. A total of 751 Colombian adolescent females (M= 13.71, SD=1.897), who were administered the Plutchik Suicide Risk Scale, the Beck Depression Inventory, the European Bullying Intervention Project Questionnaire and Cyberbullying. Bullying victimization and aggression and cyberbullying victimization were found to contribute statistically significant effects that explaining 22 % of the variance in depression. The variables of victimization in bullying and cyberbullying and depression explained 64 % of the variance in suicidal risk, and depression mediated the association between victim and aggressor roles in bullying and cyberbullying in predicting suicidal risk, whose total direct and indirect effects are statistically significant. The findings support the role of depression as a mediating variable between bullying and cyberbullying and suicidal risk in female adolescents and highlight the importance of focusing prevention and intervention efforts on risk factors for depression and suicidal behavior in cases of bullying and cyberbullying.

Improving rates of adolescent suicide risk screening in a primary pediatric clinic, a quality improvement project

In recent years, adolescents have experienced rising rates of suicidal ideation. Though pediatricians in our clinic were screening for depression, suicide risk screens were not completed. We designed a quality improvement (QI) project with the goal to increase the rate of suicide risk screening by 20 %, and improve clinicians’ attitudes toward the electronic health record (EHR) for mental health screening by 20 %. Baseline analyses included chart review and a provider survey. Suicide risk screen tools were built with decision-support into the EHR. After provider education was completed, the EHR-based interventions were implemented. Post-intervention, suicide risk screening completion increased from 8.8 % to 95 %. Provider attitudes towards the EHR also improved. This QI project demonstrates that implementing EHR tools that are provider-informed can help to improve suicide risk screening rates, streamline workflows, and help improve clinicians’ attitudes towards the EHR.

Childhood maltreatment, peer victimization, borderline personality feature, suicidal risk in adolescents: Direct and indirect associations among developmental trajectories.

Childhood maltreatment, peer victimization, and borderline personality traits have all been shown to be linked to suicidal risk. However, there remains a need to illuminate the possible direct and indirect pathways among them from a developmental perspective that could serve as intervention targets. This study thus aimed to investigate the direct and indirect relationships among developmental trajectories of childhood maltreatment, peer victimization, borderline personality feature, and suicidal risk in adolescents. A total of 1648 Chinese adolescents (48.12% boys; Mage = 13.69; SD = 0.82) in junior middle schools completed self-report measures on three-time points across 1 year. Latent growth curve modeling was used to evaluate the direct and indirect relationships among the developmental trajectories of the aforementioned study variables. The developmental trajectories of childhood maltreatment, peer victimization, and borderline personality feature were positively and directly related to the developmental trajectory of suicidal risk; and the developmental trajectories of childhood maltreatment, peer victimization were indirectly related to the developmental trajectory of suicidal risk through the mediating effect of the developmental trajectory of borderline personality feature. The findings elucidated the direct and indirect longitudinal relationships among childhood maltreatment, peer victimization, borderline personality feature, and suicidal risk, highlighting that interventions should target childhood maltreatment, peer victimization, and borderline personality feature to decrease suicidal risk in adolescents with a developmental perspective.

Post-Pandemic Evolution of Suicide Risk in Children and Adolescents Attending a General Hospital Accident and Emergency Department.

Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people. However, the longer-term impact of the pandemic on children's and adolescents' mental health, especially with regard to self-harm, is still to be fully discovered. We carried out a retrospective study where we collected data related to suicide ideation and self-harm behaviours in all patients aged under 18 that required on-call psychiatric services at the General Hospital Accident and Emergency (A&E) department in Salamanca, Spain, during 2019 (pre-pandemic) and in both 2021 and 2022 to capture possible variation at different time points during the post-pandemic period. A total of 316 patients aged under 18 were seen by on-call psychiatric services at the A&E department during the three time periods: 78 in 2019, 98 in 2021 and 140 in 2022. The mean age was 15.12 (SD 2.25) and females represented more than twice the number of males each year. More than half of all patients assessed during 2022 disclosed suicide thoughts, whilst in 2019, it was near 25%. This increase in suicide ideation rates was more marked among females (X2 = 15.127; p = 0.001), those aged over 15 (X2 = 16.437; p < 0.001) and/or those with a previous history of mental health problems (X2 = 17.823; p < 0.001). We identified an increase in the proportion of males with suicide ideas, especially between 2021 and 2022 (X2 = 8.396; p = 0.015). Our study suggests that children's and adolescents' demand for urgent mental healthcare and their clinical presentations in A&E departments with suicide thoughts and/or self-injuries do not seem to be declining after the pandemic but increasing over time. More research is warranted to understand possible factors involved in this sustained upward trend.

Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs.

Adolescents are considered one of the most vulnerable groups affected by suicide. Rapid changes in adolescents' physical and mental states, as well as in their lives, significantly and undeniably increase the risk of suicide. Psychological, social, family, individual, and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct, indirect, or combined pathways. Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide. When deliberately cultivated, fostered, and enhanced, self-awareness, self-management, social awareness, interpersonal skills, and responsible decision-making, as the five core competencies of social-emotional learning, can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support. Among numerous suicide intervention methods, school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents. The characteristics of school-based interventions based on social-emotional competence, including their appropriateness, necessity, cost-effectiveness, comprehensiveness, and effectiveness, make these interventions an important means of addressing the crisis of adolescent suicide. To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide, additional financial support should be provided, the combination of social-emotional learning and other suicide prevention programs within schools should be fully leveraged, and cooperation between schools and families, society, and other environments should be maximized. These efforts should be considered future research directions.

Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis.

Suicide remains the second most common cause of death in young people aged 10-24 years and is a growing concern globally. The literature reports a vast number of factors that can predispose an adolescent to suicidality at an individual, relational, community, or societal level. There is limited high-level research identifying and understanding these risk and protective factors of adolescent suicidality. The present study used an umbrella review and meta-analysis to synthesize evidence from the review literature in the past 20 years on risk and protective factors of self-harm and suicidality (behavior and ideation) in adolescents. The umbrella review included 33 quantitative reviews with 1149 individual studies on suicidality and self-harm. Based on the data synthesis, it compared the public health impact of exposure on the population of the identified exposure. Bullying victimization was the most attributed environmental exposure for suicidality. The other identified significant school and individual factors were sleeping disturbance, school absenteeism, and exposure to antidepressants. Several significant vulnerable young populations were identified with significantly higher prevalence of suicidality, including lesbian, gay, bisexual, transgender, queer (or questioning) youth and those with mental health disorders, problem behaviors, previous suicidality, self-harm, and gender (female). A person-centered approach emphasizing connectedness and bully-free school environments should be a priority focus for schools, health professionals, and public health policymakers.

Antidepressants and suicide risk in children and adolescents

IntroductionIn recent years, the prescription of antidepressants for children has faced significant scrutiny due to studies suggesting an elevated risk of suicide among those treated with these medications. The primary objective of this study is to examine the causal connection between antidepressant use and suicidal behavior in children and adolescents.ObjectivesIn this article, we will examine the current research on this topic and discuss the current status of practical guidelines and recommendations for prescribing antidepressants to children and adolescents.MethodsWe conducted a literature review using the Google Scholar database, employing keywords such as antidepressants, suicide, children, and adolescents.ResultsThe literature yielded conflicting data. While it has been established that SSRIs moderately elevate the risk of suicide ideation and attempts, with venlafaxine, paroxetine, and sertraline showing a higher risk compared to other SSRIs like fluoxetine and citalopram, several studies indicate that their use is linked to a noteworthy reduction in suicide rates among children and adolescents.ConclusionsThe existence of a definitive causal relationship between antidepressants and suicidality in children and adolescents is currently uncertain, and the underlying mechanisms remain inadequately understood.Disclosure of InterestNone Declared

A Prospective Examination of the Interpersonal-Psychological Theory of Suicidal Behavior in Adolescents

ABSTRACT Objective Given the large and complex array of suicide risk factors, theoretical frameworks are critical to furthering our understanding of risk. This study prospectively examined several key constructs of the interpersonal-psychological theory of suicidal behavior (IPTS) in a large, geographically diverse sample of U.S. adolescents. Method Conducted in collaboration with the Pediatric Emergency Care Applied Research Network, adolescents, ages 12 to 17, were recruited from emergency departments. Baseline and 6-month follow-up samples were comprised of 6,448 (59% female sex) and 2,009 (64% female sex) adolescents, with self-identified race/ethnicity as follows (baseline/follow-up): White (52%/54%), Black (22%/23%), Multiracial (6%/6%), American Indian (3%/3%), other/unknown race (15%/14%), and Latinx (25%/23%). Youth and parents completed adolescent suicide risk surveys at baseline and 6-month follow-up (retention, 69%). Latent class analysis was used to identify classes of painful and provocative events (PPE), considered a precursor to acquired capability. Results In keeping with IPTS tenets, thwarted belongingness (TB), perceived burdensomeness (PB), and the interaction between TB and PB were each significant predictors of suicidal ideation at baseline and follow-up. However, only PB and PPE were significant predictors of cross-sectional suicide attempts and only TB and PPE were significant predictors of prospective suicide attempts in models that adjusted for baseline suicidal ideation. The three-way interaction among PB, TB and PPE was nonsignificant. Conclusions Results from this large-scale prospective study suggest the importance of TB, PB, and PPE to our understanding of suicidal thoughts and suicide attempts among adolescents, pointing to promising prevention and intervention targets.

Identification of factors associated with suicidal behavior in Colombian indigenous children and adolescents

Suicide among indigenous children and adolescents poses a particularly challenging public health issue for Western healthcare systems. The aim of this study was to identify psychological factors and parent/caregiver attachment-related factors associated with suicide risk in indigenous children and adolescents. A correlational cross-sectional study was conducted, involving 399 children and adolescents and their families from four indigenous communities, with a mean age of 11.93 years. 89% of children and adolescents were found to have some level of self-reported suicide risk, with parents identifying this risk in 21.1% of children and youth. The risk was found to be associated with perceived criticism by caregivers, the use of physical punishment, and the identification of feelings of worthlessness. In addition to highlighting high indicators of suicide risk in the studied population, this study concludes that indicators of distress in children and adolescents are associated with disruptions in the perception of relationships with their parents.

Identificación temprana de las señales de alerta del riesgo suicida en adolescentes

Identificación temprana de las señales de alerta del riesgo suicida en adolescentes

Advice on suicide prevention, for parents, from pediatricians and school psychologists

The American Academy of Pediatrics (AAP) recommends pediatricians and health professionals screen for suicidal ideation and risk factors of suicide, and focused on this in a clinical report published in January: Suicide and Suicide Risk in Adolescents.

Social support systems involved in suicide prevention and intervention among adolescents: A Delphi study in Shanghai

The rotes of attempted and completed suicide among adolescents are increasing globally. Social support can help decrease the risk of adolescent suicide, but this aspect has been rarely studied in China. The present study aimed to use the Delphi methodology to establish a set of guidelines for the development of social support resources, with the goal of collectively reducing suicide risks among adolescents in Shanghai. We commenced the study in April 2021, established a research team, searched the keywords using Web of Science from 2016 to 2021 and ultimately designed a pre-evaluation index. Next, following Donabedian’s Structure–Process-Outcome model, the research developed a questionnaire comprising 3 level-1, 12 level-2, and 73 level-3 indicators. Ten experts were enlisted to conduct three rounds of e-mail inquiries in order to finalize the indicator system, resulting in 2 level-1, 11 level-2, and 52 level-3 indicators, as well as expert consensus. Our findings indicate that the social support systems should include parents, schools, psychiatric hospitals, social organizations, and government departments, with the government sector being the most important ((M = 9.4). Furthermore, our study revealed that school counselors and psychologists play similar roles to psychiatrists within the interdisciplinary team (M ± S = 9.2 ± 1.1). As per the expert consensus, social support systems should strengthen government-led and interdisciplinary collaboration, prioritize suicide prevention in schools and encourage greater involvement from social organizations.