Risk Factors For Adolescent Suicide Research Articles

Positive and negative social media experiences and proximal risk for suicidal ideation in adolescents.

Social media (SM) has received considerable attention as a potential risk factor for adolescent suicide. Few empirical studies, however, have examined adolescents' daily negative and positive experiences on SM and its proximal impacts on suicidal ideation (SI), particularly using intensive monitoring designs. Adolescents (N = 60; 14-17 years; 49% girls; 62% LGBTQ+) recruited using SM across the United States and participated in an 8-week intensive monitoring protocol. Ecological momentary assessment (three brief surveys per day) asked about negative and positive SM experiences and SI (passive and active). Multilevel modelling was used to evaluate the within-person relationships between daily SM experiences (e.g. individual fluctuations compared to a person's average) and SI, controlling for average levels of SM experiences, SM use screen time, and lifetime SI. Significant within-person effects of negative and positive SM experiences were associated with days when adolescents had SI. Specifically, on days when teens endorsed more frequent negative SM experiences than usual, they were more likely to report SI. However, more positive SM experiences than usual were associated with a lower likelihood of having SI. There were no significant effects of SM use ('screen time') on SI or on the reverse associations of SI on next-day SM experiences. Results indicate that SM experiences may be dynamic and modifiable risk and protective factors for SI in adolescents, whereas there is no effect of SM screen time on SI. Our results highlight that targeting negative SM experiences and augmenting the positive experiences on SM may be critical targets to improve teens' mental health and prevent suicide, rather than focusing on limiting SM screen time.

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.

Temperament, parenting, mental disorders, life stressors and help-seeking behavior of Asian adolescent suicide attempters: A case control study.

PurposeThe need to elucidate risk factors for adolescent suicide is urgent, as suicide consistently ranks among the top causes of death globally. Understanding suicide risk factors could inform more effective interventions. Previous studies have identified certain risk factors associated with suicide, but there is a paucity of research among adolescent and multi-ethnic Asian populations.Materials and methodsThis case-control study sampled 13-to-19-year-old Asian adolescents who had attempted suicide (N = 60) and controls (N = 58) matched by age, ethnicity and gender at group-level (73.7% female). Life stressors, temperament, parenting style, mental health conditions and help-seeking behavior were examined.ResultsAll domains of life stress apart from emerging adult responsibility were higher among cases than controls, especially home life, peer pressure and romantic relationships. Suicide attempters tended to avoid new situations, be less adaptable to changes, have a negative outlook and irregular sleep-wake cycle. Additionally, they perceived their parents to be significantly more aggressive, neglecting, rejecting and cold, while parents’ perceptions of their own parenting were only significantly different in the domain of parental neglect. Cases were more likely to exhibit disorders of disruptive behavior, eating, mood, anxiety, symptoms of schizophrenia and experience of disturbing events. Significant differences were also found for 10 out of 12 Axis II disorders, particularly borderline, depressive, and avoidant personality disorder traits. No significant case-control differences were found regarding overall rates of help-seeking.ConclusionFindings from this study may help in suicide prevention efforts through more tailored interventions.

Association Between Suicide and Drinking Habits in Adolescents

ObjectivesAdolescent suicide is a serious social problem. Adolescent alcohol use is one of the most important risk factors for adolescent suicide. This study aimed to identify the relationship between drinking habits and suicide among Korean adolescents.MethodsData from the 14th and 15th Korean Youth Risk Behavior Web-based Survey, conducted in 2018 and 2019, were used for analysis. Multiple logistic regression analysis was used to identify the relationship between drinking habits—including the age of drinking initiation, frequency of drinking, average drinking amount, frequency of drunkenness—and suicidal ideation, plans, and attempts.ResultsEven after adjusting for age, sex, school grade, academic achievement, socioeconomic status, depression, stress, and drinking habits, the frequencies of drinking and drunkenness increased the risk of suicide attempts. Suicide attempts were associated with the frequency of drinking in girls and middle school students, and with the frequency of drunkenness in boys and high school students.ConclusionThis study identified associations between drinking habits (the age of drinking initiation, frequency of drinking, average amount of drinking, frequency of drunkenness) and suicidal behavior in adolescents. Our findings suggest that to prevent adolescent suicide, it might be necessary to investigate drinking habits, including the frequencies of drinking and drunkenness. Moreover, considering the differences in sex and school grade, it is important to include the individual group characteristics when evaluating drinking habits.

Adolescent suicide and suicidal behavior: a review

Suicide among adolescent has emerged as a major public health issue in many low and middle-income (LAMI) countries. Suicidal behavior including ideation and attempt are the most important predictors of completed suicide and offer critical points for intervention. This article reviews recent population and national data based studies of adolescent suicide and suicide attempters for analyzing risk factors for adolescent suicide and suicidal behavior. According to WHO estimates, 800,000 suicide deaths occurred worldwide in 2016 and it is the third leading cause of death for 15-19 year olds. The suicide rate in Bangladesh was 5.9 per 100,000 population in 2016 (4.7 for males and 7.0 for females). Approximately, 90 percent of suicide cases meet criteria for a psychiatric disorder, particularly major depression, substance abuse and prior suicide attempts are strongly related to adolescent suicides. The relationship between psychiatric disorders and adolescent suicide is now well established. Factors related to family adversity, social alienation and precipitating problems also contribute to the risk of suicide. The main target of effective prevention of adolescent suicides is to reduce suicide risk factors. Recognition and effective management and control of psychiatric disorders, e.g. depression, are essential in preventing adolescent suicides. Research on the treatment of diagnosed depressive disorders and of those with suicidal behavior is reviewed.

The association between leptin receptor polymorphism and suicidal behaviour in depressed adolescents

Objective: Suicide is the second leading cause of death in adolescence. Genetic studies implicate the genetic component of suicide independent from associated psychiatric disorder. Although genetics is an important factor that might be associated with suicide, limited progress is achieved to identify the candidate genes in adolescents.Methods: The study included 97 patients and 106 controls. Five leptin receptor single nucleotide polymorphism (SNP) region examined. Depressive scores were measured with Children Depression Inventory and suicidal behaviour was measured by Suicide Probability Scale. Logistic and linear regression analysis used for determining to predictors.Results: In linear regression analysis (R2: 0.786) both previous suicide attempt (B:5.553, t:2.613 p: .035) and having a mutant allele in rs1171276 SNP region (B:4.346 t:2.220 p: .048) have been associated with suicidal behaviour. In logistic regression analysis, family history of depression (p < .0001, OR: 4.2 [1.7–9.6]) and number of stressful life events (p: .001, OR: 1.7 [1.3–2.1]) predicted depression significantly.Conclusion: Leptin receptor polymorphism could result in an increase in impulsive behaviour and suicide scores with leptin resistance. Our research is the first study to investigate the relationship between depression, suicidal behaviour and leptin receptor polymorphism in adolescent sample. Similar studies could be carried out on a community basis.KEY POINTSAn association has been found between rs1171276 single nucleotide polymorphism of leptin receptor and the suicide probability scores in depressed adolescents.Family history of depression and number of stressful life events predict depressive scores significantly.Leptin receptor single nucleotide polymorphism may be a risk factor for adolescent suicide by increasing impulsive behaviour.

Pediatric Hospitalists at the Front Line of Gun Violence Prevention: Every Patient Encounter Is an Opportunity to Promote Safe Gun Storage.

Pediatric hospitalists have a critical role to play in the prevention of firearm death and injury in children. Gun violence is the second leading cause of death for children and adolescents.1 Just over half of these deaths are homicide, with the remaining attributed to suicide and unintentional shootings. There are more child deaths from gun violence than child deaths from cancer, heart disease, and lung disease combined.1 These startling statistics should urge all pediatricians to act, including those invested in the care of hospitalized children. This uniquely American problem is driven, in part, by access to unsecured firearms. In America, 4.6 million children live in a household with at least 1 loaded, unlocked gun.2 Access to unsecured firearms puts children at risk for unintentional shootings and adolescents at risk for suicide.3 Responsible storage (keeping guns locked, unloaded, and separate from ammunition) can decrease these risks.3 The majority of children in gun-owning households are aware of where their parents store the gun, with more than one-third reporting previously handling the gun.4 We cannot rely on curious children to not find a gun that is “hidden” or to know what to do if they encounter a gun. Educational programs that are focused on teaching children about gun safety do not work. In fact, after completing gun safety training programs, preschool- and school-aged children are just as likely to approach and play with a handgun as those not given the training.5 Access to a firearm is key modifiable risk factor for adolescent suicide in the United States.6 Of the adolescents screened in 1 study, …

Adolescent Suicide as a Failure of Acute Stress-Response Systems.

Suicide is the second leading cause of death worldwide for adolescents. Despite decades of research on correlates and risk factors for adolescent suicide, we know little about why suicidal ideation and behavior frequently emerge in adolescence and how to predict, and ultimately prevent, suicidal behavior among youths. In this review, we first discuss knowledge regarding correlates, risk factors, and theories of suicide. We then review why adolescence is a period of unique vulnerability, given changing biology and social network reorganization. Next, we present a conceptual model through which to interpret emerging findings in adolescent suicide research. We suggest that a promising area for future research is to examine adolescent suicide as a failure of biological responses to acute stress in the proximal moments of a suicidal crisis. After reviewing initial evidence for this conceptualization, we review future directions for studies on adolescent suicide.

Peer Deviance, Social Networks, and Suicide Ideation Intensity in a Clinical Sample of Adolescents

Although research has identified interpersonal difficulties as risk factors for adolescent suicidality, parent and peer relationships are often assessed as discrete risk domains. The current study uses a social network approach to assess individual differences in the degree to which a clinical sample of 129 adolescents being treated for suicidal ideation rely on parents or peers for their attachment needs. Youth who affiliated with deviant peers were more likely to: (a) report greater intensity (increased frequency and duration and decreased controllability) of their suicide ideation, and (b) identify peers rather than adults as attachment figures. Adolescents’ peer relationships are associated with suicide ideation intensity in a clinical sample of suicidal and depressed adolescents.

Parenting and Chinese Adolescent Suicidal Ideation and Suicide Attempts: The Mediating Role of Hopelessness

Various family factors are risk factors for adolescent suicidality (suicidal ideation and suicide attempts). However, little is known about the role of parenting in adolescent suicidality. The present study examined the unique relations between three parenting dimensions (parental warmth, behavioral control, and psychological control) and adolescent suicidality, as well as the mediating role of adolescent hopelessness among these relations. A total of 1529 Chinese adolescents (52 % male; mean age = 14.74 years, SD = 1.48) completed anonymous questionnaires designed to assess three parenting dimensions, hopelessness, suicidal ideation and suicide attempts. After controlling for gender, age, family structure, and socioeconomic status, it was found that parental warmth negatively predicted adolescent suicidality, whereas psychological control positively predicted adolescent suicidality. In addition, parental warmth negatively predicted adolescent hopelessness, whereas psychological control positively predicated adolescent hopelessness, which in turn enhanced adolescent suicidality. Although behavioral control did not predict adolescent suicidality, it did negatively predict adolescent hopelessness, which in turn promoted adolescent suicidality. These findings revealed the differential roles of different parenting dimensions in adolescent suicidality, and the mediation effect of adolescent hopelessness between parenting and adolescent suicidality. Future practices would benefit from incorporating both parenting and hopelessness for optimal intervention effect.

청소년 자살자에 대한 심리적 부검 방법론에 대한 고찰

Recently, local governments and suicide prevention centers have been trying to implement psychological autopsy. This effort has focused on adult suicide so far ; however, there are some difficulties in its application to adolescent suicide. Therefore, in this study, psychological autopsy studies of Korea were reviewed, and a methodology for adolescents' psychological autopsy was suggested. For the effective performance of the psychological autopsy in adolescent suicide, cooperation with each area of the government and implementation of bodies is necessary. In addition, the central system, which disseminates the standardized interview to the community and manages the data nationwide, should be prepared. Also, in order to improve the accuracy of diagnosis and to obtain various types of information, a structured interview should be adopted as the psychological autopsy, as well as considering the use of social media. Investigation of specific risk factors for adolescent suicide through psychological autopsy can enable determination of the intervention point for effective suicide prevention.

A focus on recent cases of suicides among Italian children and adolescents and a review of literature.

Suicidal behaviors are among the leading causes of death worldwide. The large spread of suicide suggests that educational programs and literature to parents or guardians should include information about the potential risks and potential consequences of the onset of the idea of suicide in children. We identified 55 cases of suicide among children and young adults <18-year-old occurring in Italy between 1st January, 2011 and 31st December, 2013. The results point to the need to increase our understanding of the dramatic rise in suicidal behaviors during childhood/adolescence and of the causal pathways linking these behaviors to child-adolescent mental disorders. During routine care visits, pediatricians should be skilled to recognize risk factors for adolescent suicide in order to intervene appropriately.

DEPRESSION AND EXPOSURE TO SUICIDE PREDICT SUICIDE ATTEMPT

To examine the role of depression and exposure to peer or family suicide and their interaction as risk factors for adolescent suicide attempts. The study used the public-use data set of the National Longitudinal Study of Adolescent Health (Add Health), which is a nationally representative stratified sample of U.S. high school students. Sample size was 4,719. Analyses predicted suicide attempts from preexisting depression and exposure to suicide of a friend or family member, controlling for previous suicide attempts, exposure, and depression. The greatest risk for future suicide attempts (relative risk = 3.3), was attributable to an attempt in the preceding year, controlling for preexisting and current depression and exposure. There was a main effect of exposure with the next highest relative risk of 3.2. A similar risk ratio, 3.2, was found for the difference between no depression and current severe depression, controlling for past depression and attempts. There was no evidence of an interaction between exposure to a peer or family member suicide attempt and depression. Supplementary analyses found that exposure to a friend or family member suicide attempt or completed suicide each added significantly to risk for adolescents regardless of depression levels. Exposure to suicidal behavior in a friend or family member poses risk equivalent to the risk posed by becoming severely depressed. Attending to such risks could benefit clinical practice with adolescence and public health suicide prevention efforts.

Displacement and Adolescent Suicide: Introduction to a Special Section

Empirical findings from previous studies indicate that the risk factors for adolescent suicide are multifaceted and likely the result of the interaction between individual and contextual risk factors. In this special section, we focus on one subdomain of risk factors for adolescent suicide, namely, displacement. During adolescence, experiences of displacement due to changes in family or peer relationships may be particularly important because these relationships play a key role in meeting developmental tasks. This special section brings together new findings from four empirical studies investigating how displacement affects risk for suicide across individuals in different contexts and across various domains of displacement. The findings suggest that (a) these risk factors are multifaceted and (b) they often represent an interaction between individual and contextual risk factors. At the same time, the articles in this special section indicate that the role of displacement is complex, and it may sometimes serve a protective role when combined with other factors (e.g., mental health treatment).

Parental Displacement and Adolescent Suicidality: Exploring the Role of Failed Belonging

Prior studies have demonstrated that events causing displacement from parents—such as parental death, abandonment of the adolescent, or divorce—represent a risk factor for adolescent suicide, but research to date has not established a theoretical model explaining the association between parental displacement and adolescent suicidal behavior. The current studies examined the construct of failed belonging proposed by the interpersonal theory of suicide as one factor that may link parental displacement with adolescent suicide. Study 1 found that low levels of belonging mediated the association between parental displacement and adolescent suicide attempts in a large, urban community sample of older adolescents between the ages of 18 and 23. In Study 2, parental displacement interacted with low belonging to predict suicide attempts, such that adolescents (average age = 16.6 years; SD = 1.2) who experienced both displacement and low levels of belonging had the highest risk for suicide.

Suicidal Behaviour in Adolescence

Adolescent suicide and suicidal behaviours have become major public health issues in recent years. Suicide is widely recognized as a major cause of mortality in young people, and nonfatal suicidal behaviours in young people are associated with considerable morbidity. Suicidal behaviour in adolescence covers a wide spectrum of phenomena for which an exact definition and an understanding of the interrelations remain controversial.1 The epidemiology of youth suicide is a fascinating story. The 20th century produced a steady rise in the incidence of suicide in young males punctuated by decreases during the World Wars; however, since the 1 990s, rates of suicide in young men have steadily declined. This was partly due to an increased number of cars with catalytic converters and to declines in rates of unemployment and divorce.2 Some researchers, especially in the United States, have strongly supported the important role of selective serotonin reuptake inhibitors use in explaining the reduction of adolescent suicide,3'4 a claim refuted by Biddle et al.2 Following the introduction of the black box warning, there was a new rise in adolescent suicide, which some authors attributed to reduced prescriptions of these agents, although Wheeler et al5 have vigorously disputed this interpretation. One other major epidemiologic finding in recent years has been the finding that, in China, southern India, and Singapore, the accepted sex differences for suicide are reversed, and that young females are more at risk for suicide than males.6 In these young females, mental illness seems to be less of a factor in their suicides than has been reported in the West7 and most fatalities are due to pesticide ingestion. Undoubtedly, the restriction of the use of pesticides is a very important preventative measure in these countries.8 It has become increasingly clear that family genetic studies play an important role in understanding suicide and that, especially in youth, suicide is inherited distinctively from any concurrent psychiatric illness.9 It has also become increasingly apparent that genetic transmission is more characteristic of suicide in youth than that of suicide in older people. The biological mechanism that may be involved is probably related to serotonin metabolism and low turnover of 5-hydroxyindoleacetic acid as measured in the cerebral spinal fluid, which in turn is related to aggression and impulsivity.10 This, combined with a genetic predisposition for a heightened stress reaction via genetic mechanisms in the hypothalamo-pituitary-adrenal axis, provides a plausible basis for beginning to understanding suicide in youth. Psychological risk factors that have been the focus of recent attention include overgeneralized autobiographical memory associated with interpersonal relationships,12 deficits in problem solving,13 as well as high levels of impulsiveaggressiveness. 14 Additional potential precursors of suicidal behaviour in depressed adolescents are other early development traits, such as temperament and emotional regulation.15 Adolescent suicidal behaviour also seems to be related to just about all types of serious psychiatric disorder, including: eating disorders,16 schizophrenia,17 and, of course, all forms of depression, especially bipolar disorder. Social risk factors for adolescent suicide include parental separation, divorce, and family discord, as well as child abuse and imitation.18 Media reporting and, naturally, alcohol and drug abuse are also important facilitators of suicide among young people. Bullying and peer victimization are extremely dangerous precipitators19,20 and, together with the understudied effects of immigration, are reviewed more extensively in this issue's In Review.21,22 A new social force impinging on youth suicide is the Internet.2 As an increasingly popular source of information, concerns have been raised about the existence of websites that promote suicide23 as well as suicide websites that have been claimed to have facilitated suicide pacts among strangers. …

Epidemiology of youth suicide and suicidal behavior

Suicide is the third leading cause of death among young people in the U.S. and represents a significant public health problem worldwide. This review focuses on recent developments in our understanding of the epidemiology and risk factors for adolescent suicide and suicidal behavior. The suicide rate among children and adolescents in the U.S. has increased dramatically in recent years and has been accompanied by substantial changes in the leading methods of youth suicide, especially among young girls. Much work is currently underway to elucidate the relationships between psychopathology, substance use, child abuse, bullying, internet use, and youth suicidal behavior. Recent evidence also suggests sex-specific and moderating roles of sex in influencing risk for suicide and suicidal behavior. Empirical research into the causal mechanisms underlying youth suicide and suicidal behavior is needed to inform early identification and prevention efforts.

Predicting adolescent suicidality: Comparing multiple informants and assessment techniques

Adolescent suicidality is a serious problem among American youth. Common risk factors for adolescent suicidality include depression and conduct problems but there is little agreement on the best means to assess these factors. We compared multiple informants (mothers, fathers, the adolescent and a sibling) and multiple assessment techniques using a sample of more than 460 families. Assessment techniques included paper–pencil instruments, observer ratings, and diagnostic interviews. Suicidality was assessed concurrently and two years after the risk assessment. Adolescent-reported paper–pencil instruments and diagnostic interviews were strongly associated with concurrent and future suicidality. Parents' report of adolescent feelings and behaviors were also useful. Observed behaviors were not useful in assessing suicidality risk factors. Clinical recommendations include utilizing paper–pencil and diagnostic adolescent risk factor assessment and focusing on emotions.

Social and Interpersonal Factors Relating to Adolescent Suicidality: A Review of the Literature

This article reviews the empirical literature concerning social and interpersonal variables as risk factors for adolescent suicidality (suicidal ideation, suicidal behavior, death by suicide). It also describes major social constructs in theories of suicide and the extent to which studies support their importance to adolescent suicidality. PsychINFO and PubMed searches were conducted for empirical studies focused on family and friend support, social isolation, peer victimization, physical/sexual abuse, or emotional neglect as these relate to adolescent suicidality. Empirical findings converge in documenting the importance of multiple social and interpersonal factors to adolescent suicidality. Research support for the social constructs in several major theories of suicide is summarized and research challenges are discussed.

The role of the pediatrician in preventing suicide in adolescents with alcohol use disorders

Worldwide, suicide is among the top five causes of mortality in the 15- to 19- year age group. Pediatricians and primary care providers are in a distinctive position to help prevent suicide in adolescents. According to the Guidelines for Adolescent Preventive Services, all adolescents should have at least an annual preventive services visit, which should address both the biomedical and psychosocial aspects of health. Suicide prevention may best be accomplished by detection and management of specific risk factors, rather than by attempting to recognize those youth who are considered most likely to commit suicide. Alcohol use has been regarded as an important risk factor for adolescent suicidal behavior and the diagnosis of an alcohol use disorder indicates an elevated risk for adolescent suicide. Although the causal relationship between alcohol use and suicide remains unknown, a clear and strong relationship exists. Pediatricians and other health care providers should be skilled to recognize risk factors for adolescent suicide, including alcohol and drug misuse, depression, major loss, and recent suicides within a community. The relative frequency of suicidal behavior among adolescents suffering from alcohol use disorders and its distressing effects on individuals, families and society merits further research and development of prevention strategies in general pediatric settings.