Suicidal Ideation In Youth Research Articles

Self-compassion, self-referential caudate circuitry, and adolescent suicide ideation

Suicide is the second leading cause of death in youth, and depression is a strong proximal predictor of adolescent suicide. It is important to identify psychological factors that may protect against suicide ideation in depressed adolescents. Self-compassion may be such a factor. Converging evidence indicates the inverse association between self-compassion and suicide ideation, but the neural mechanisms underlying their link remain unknown. Because self-referential caudate activity is associated with both self-compassion and suicide ideation, its functional connectivity might explain their relationship. In this study, we examined the relationship between self-compassion and caudate functional connectivity during self-appraisals, a typical self-referential paradigm, and their associations with suicide ideation in both depressed and healthy youth. In the scanner, 79 depressed youth and 36 healthy controls evaluated, from various perspectives, whether phrases they heard were self-descriptive. Self-compassion and suicide ideation were rated with self-report and interview-based measures. We found that self-compassion was associated with stronger left caudate functional connectivity with bilateral posterior superior temporal sulcus/temporoparietal junction, the left middle temporal gyrus (MTG), and the left middle occipital gyrus during positive versus negative self-appraisals. Stronger left caudate connectivity with the left MTG explained the association between higher self-compassion and lower suicide ideation, even controlling for non-suicide ideation depression severity, anxiety severity, and non-suicidal self-injurious behavior. The findings suggest that the left caudate to MTG connectivity during positive versus negative self-referential processing could be a biomarker to be targeted by neural stimulation interventions for reducing suicide ideation in depressed youth, combined with self-compassion interventions.

Social anxiety symptoms and their relationship with suicidal ideation and depressive symptoms in adolescents: A prospective study

AbstractBackgroundSocial anxiety disorder typically emerges in adolescence and its symptoms often co‐occur with depression and suicidal ideation. It is important to understand whether social anxiety symptoms precede depression and suicidal ideation in youth. This study aimed to investigate the temporal associations between baseline social anxiety and later suicidal ideation and depressive symptoms in a community youth sample.MethodsThe Wellcome Trust NSPN (Neuroscience in Psychiatry Network) study recruited 2397 youth aged 14–24 in the United Kingdom to participate in a prospective observational study. Participants were assessed for symptoms of social anxiety, generalised anxiety, depression and suicidal ideation at baseline, 1‐year follow‐up, and 2‐year follow‐up. We conducted multiple linear regression analyses and mediation analyses to examine whether baseline social anxiety was associated with 2‐year suicidal ideation and depressive symptoms (excluding suicide‐related items), and whether these associations were mediated by 1‐year depressive symptoms. The study was preregistered on the Open Science Framework.ResultsResults from multiple linear regression analyses indicated that baseline social anxiety symptoms were associated with 2‐year suicidal ideation (β = 0.07, p < 0.05, 95% CI [0.02, 0.12]) and 2‐year depressive symptoms (β = 0.08, p < 0.05, 95% CI [0.02, 0.13]), after controlling for baseline predicted variable. Furthermore, 1‐year depressive symptoms significantly mediated the relationship between baseline social anxiety symptoms and 2‐year suicidal ideation (β = 0.04, 95% CI [0.02, 0.05]), and the relationship between baseline social anxiety symptoms and 2‐year depressive symptoms (β = 0.06, 95% CI [0.03, 0.08]) after adjusting for age, sex, and other covariates.ConclusionsWe found evidence that baseline social anxiety symptoms were associated with 2‐year suicidal ideation and 2‐year depressive symptoms via 1‐year depressive symptoms in non‐clinical adolescents. These results may have important implications for targeted psychological interventions.

0982 Quadratic Association Between Ecologically Assessed Sleep Duration and Next-day Suicidal Ideation in Youth

0982 Quadratic Association Between Ecologically Assessed Sleep Duration and Next-day Suicidal Ideation in Youth

Primary emotional systems, childhood trauma, and suicidal ideation in youths with bipolar disorders

BackgroundBipolar disorders (BD) in youths are strongly associated with suicidal ideation. Childhood trauma is a prominent environmental stressor associated with both BD diagnosis and suicide. Primary emotional systems are altered in adult BD and may contribute to suicide risk in youths. ObjectiveThe aim of this study was to investigate primary emotional systems distribution patterns and childhood trauma in youths' BD with and without suicidal ideation (BD-IS, BD-NIS). Participants and settingWe assessed 289 participants, 103 youths with DSM-5 BD and 186 healthy controls (HCs). MethodsPrimary emotional systems were obtained with Panksepp's Affective Neuroscience Personality Scale (ANPS), and history of childhood trauma using the Childhood Trauma Questionnaire (CTQ). Suicidal ideation was assessed through the Columbia Suicide Scale for the Rating of Suicide Severity (C-SSRS). The associations with suicidal ideation were tested using two different multivariate models. ResultsOver 48 % of participants reported lifetime suicidal ideation and differed on clinical variables from BD-NIS. According to the first model (Wilk's Lambda = 0.72, p < 0.0001), BD-IS scored higher on Panksepp's ANGER and lower on PLAY and CARE than BD-NIS. Both BD-SI and BD-NSI scored higher on ANGER and SEEK and lower on PLAY and CARE than HCs. BD-IS reported more emotional abuse than BD-NIS. They also reported more emotional, sexual, and physical abuse, and emotional neglect than HCs. Only ANGER (OR = 1.13, 95 % CI = 1.01–1.26, Wald = 5.72) and CTQ-Emotional abuse (OR = 1.26, 95 % C.I. = 1.04–1.52, Wald = 5.72) independently predicted suicidal ideation. ConclusionsFindings support the importance of assessing primary emotional systems and childhood trauma, in particular emotional abuse, in youths with BD at risk for suicide.

Measurement Models of Child Maltreatment and Associations With Suicidal Ideation Endorsement by Youth in Foster Care: A Multiverse Analytic Approach.

Youth suicidal ideation is a prevalent experience, particularly among youth exposed to maltreatment, with a variety of indicators such as youth statements of ideation. To better understand suicidal ideation, and the associations with youth mental health outcomes, a fruitful path may be through the study of the dimensions (e.g., severity, frequency) of maltreatment exposure. While there exists extensive work on methods to best operationalize casefile records of maltreatment, such work has not been undertaken for youth self-reports, which are an important indicator of youth functioning following exposure. To address the lack of clarity of how to best operationalize youth self-reports of maltreatment, a multiverse analytic approach was taken to operationalize severity and frequency in a sample of 471 8- to 17-year-old children in foster care. We examined differences across measurement models and the models' associations with caregiver reports of youth suicidal ideation statements. Results indicate that the operationalizations used to define maltreatment resulted in differing measurement models that further differed in their associations with reports of youth suicidal ideation. This study highlights the importance of how researchers operationalize their data and the role dimensions of maltreatment have in further elucidating differential outcomes for youth exposed to maltreatment.

3.43 Irritability as Measured by CAST-IRR and Its Relationship With Suicidal Ideation in Youths

3.43 Irritability as Measured by CAST-IRR and Its Relationship With Suicidal Ideation in Youths

2.18 Suicidal Ideation in Youth With and Without ADHD: Cognitive Mediators

2.18 Suicidal Ideation in Youth With and Without ADHD: Cognitive Mediators

Linguistic correlates of suicidal ideation in youth at clinical high-risk for psychosis.

Suicidal ideation (SI) is prevalent among individuals at clinical high-risk for psychosis (CHR). Natural language processing (NLP) provides an efficient method to identify linguistic markers of suicidality. Prior work has demonstrated that an increased use of "I", as well as words with semantic similarity to "anger", "sadness", "stress" and "lonely", are correlated with SI in other cohorts. The current project analyzes data collected in an SI supplement to an NIH R01 study of thought disorder and social cognition in CHR. This study is the first to use NLP analyses of spoken language to identify linguistic correlates of recent suicidal ideation among CHR individuals. The sample included 43 CHR individuals, 10 with recent suicidal ideation and 33 without, as measured by the Columbia-Suicide Severity Rating Scale, as well as 14 healthy volunteers without SI. NLP methods include part-of-speech (POS) tagging, a GoEmotions-trained BERT Model, and Zero-Shot Learning. As hypothesized, individuals at CHR for psychosis who endorsed recent SI utilized more words with semantic similarity to "anger" compared to those who did not. Words with semantic similarity to "stress", "loneliness", and "sadness" were not significantly different between the two CHR groups. Contrary to our hypotheses, CHR individuals with recent SI did not use the word "I" more than those without recent SI. As anger is not characteristic of CHR, findings have implications for the consideration of subthreshold anger-related sentiment in suicidal risk assessment. As NLP is scalable, findings suggest that language markers may improve suicide screening and prediction in this population.

Addressing Socioeconomic Determinants of Youth Suicidal Ideation: Lessons from a Youth Development Approach in India.

Socioeconomic situations in young people's families and communities make them more vulnerable to suicidal ideations. The Youth Helpline has made a significant difference in youth's lives and livelihoods by addressing their social and economic needs with positive mental health support. The quantitative and qualitative data validate the micro- and macro-level impact of the Youth Helpline in Puducherry. However, the multi-stakeholder model faces challenges in ensuring accountability, particularly from government partners. This paper highlights how direct intervention on the socio-economic determinants of youth suicidal ideation has positively affected youth mental health and reduced suicidal ideation in Puducherry. Social identity-based inequalities and access and affordability to mental health services are the major contributors to youth mental health problems. This paper critically discusses the Youth Helpline's multi-stakeholder process and youth-led approach to addressing socio-economic determinants, as well as the Helpline's impact on youth mental health.

Prevalence and correlates of externalizing behaviors among youth seeking treatment following trauma exposure.

Trauma-exposed youth often experience impairing externalizing problems (EXTs), yet the relationship between EXTs, trauma exposure, and posttraumatic stress symptoms (PTSS) are not well understood. To examine the extent of their co-occurrence, we report the rates and correlates of youth EXTs relative to clinically elevated PTSS in a sample of youth referred to a trauma and grief specialty clinic. Self- and caregiver-report measures were obtained from 260 youth ages 7-19 years (M = 11.92, SD = 3.21; 53.5% female) during a pretreatment assessment. The sample was divided into 4 groups according to the youths' PTSS and EXT score elevations, and these groups were then compared according to rates of youth depressive symptoms, youth suicidal ideation, and caregiver strain. The 4 groups were comorbid PTSS and EXTs (18%); EXTs-only group (36%); PTSS-only group (13%), and subclinical symptom group (34%). The comorbid PTSS and EXTs group had the highest scores on all other child and caregiver symptom measures. Compared to the subclinical group, youth in the PTSS-only group had increased depressive symptoms and suicidal ideation, whereas youth in the EXTs-only group had elevated levels of caregiver strain. Co-occurring PTSS and EXTs is a common presentation among trauma-exposed youth referred to treatment. These youth are also likely to suffer from other problems of clinical concern, including suicidal ideation, and their problems are associated with caregiver distress. More research is needed to examine unique risk and resiliency factors related to the development of youth EXTs in response to trauma exposure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The association between callous–unemotional traits and suicide ideation among youth: A conditional process analysis

BackgroundThe relationship between callous–unemotional (CU) traits (the affective facet of psychopathy and the psychopathy that occurs during childhood and adolescence) and suicide ideation (SI) remains unclear. The mechanisms underlying this association still have a gap in the literature. The aims of this study were to determine whether and how callous–unemotional traits were associated with suicide ideation, and to evaluate the mediating effect of negative affect (includes irritability, depression, and anxiety) and the moderating effect of future orientation on the association. MethodsData were extracted from a longitudinal study involving middle and high school students, with 1,913 students (55.3% girls) aged 11 to 19 years (14.9 ± 1.6 years) completing a self–reported online survey. The conditional process analysis was examined using Mplus 8.3. ResultsWe found that callous–unemotional traits positively predicted youths' current suicide ideation, with the observed positive relationship partly mediated by negative affect. However, callous–unemotional traits did not predict the worst–point suicide ideation, which indicated the connection fully mediated by negative affect. Furthermore, future orientation moderated these indirect effects. LimitationsUse of self–report measures and cross–sectional design. ConclusionsThese findings provided evidence for current debates and conflicting conclusions, and set the foundation for future research, as well as implied the important intervention goals for reducing suicide ideation in youth.

Detailed assessment of suicidal ideation in youth with bipolar disorder versus major depressive disorder.

There is a critical need to better understand the factors underlying the increased suicide risk for youth with bipolar disorder (BD) in order to develop targeted prevention efforts. This study aimed to examine differences in characteristics of suicide ideation (SI) in youth with BD compared to youth with major depressive disorder (MDD) that may be associated with increased suicide risk. One hundred and fifty-one participants (92 MDD and 59 BD), ages 13-21, completed a diagnostic interview and clinical assessments. Lifetime symptoms of SI and SA were assessed using the Columbia Suicide Severity Rating Scale. Ordinal logistic regression models were used to investigate whether the diagnostic group predicted the severity and intensity of the most severe or most common SI with the age of onset, age, and gender as covariates. Compared to MDD youth, BD youth were more likely to report experiencing more severe SI, p= 0.039, experiencing the most severe SI more frequently, p= 0.002, having less control of the most severe SI, p= 0.012, and that deterrents were less likely to stop them from acting on the most severe SI, p= 0.006. This study highlights differences in the severity and intensity of SI in youth with BD and suggests that youth with BD have greater difficulty inhibiting thoughts of SI which may lead to less resistance to suicide action. Findings underscore the need for a more detailed assessment of SI in youth with BD to better understand SI as a proximal risk factor for future SA and a potential target for intervention.

Elevated cognitive rumination and adverse life events are associated with lower cortical surface area and suicidal ideation in adolescents with major depressive disorder

IntroductionSuicide is the second most common cause of death among young people. Structural brain alterations, rumination, and recent stressful experiences contribute to suicidal thoughts and behaviors (STBs). MethodsHere, we employed structural equation modeling (SEM) to examine the unique and combined relationships of these risk factors with STBs in a sample of young people with major depressive disorder (MDD) from the Magnetic Resonance-Improving Mood with Psychoanalytic and Cognitive Therapies (MR-IMPACT) study (N = 67, mean age = 15.90; standard deviation ± 1.32). ResultsWhereas increased rumination and lower surface area of brain regions, that have been previously reported to be involved in both STBs and rumination, were associated with each other (Beta = −0.268, standard error (SE) = 0.114, Z = −2.346, p = 0.019), only increased rumination was related to greater severity of suicidal ideation (Beta = 0.281, SE = 0.132, Z = 2.134, p = 0.033). In addition, we observed that recent stress was associated with lower surface area in the suicidal ideation model without covariate only (Beta = −0.312, SE = 0.149, Z = −2.089, p = 0.037). For the attempt models, no associations were found between any of the risk factors and suicide attempts. LimitationsWe emphasize that these findings from this secondary analysis are hypothesis-forming and preliminary in nature given the small sample size for SEM analyses. ConclusionOur findings suggest that neither lower surface area nor recent stress are directly associated with youth suicidal ideation or attempt. However, lower surface area is related to recent stress and increased rumination, which predicted greater severity of suicidal ideation in young people with MDD.

The relationship between daily positive future thinking and past-week suicidal ideation in youth: An experience sampling study.

Reduced positive future thinking has been associated with suicidal ideation and behavior in adults, and appears to be exacerbated by negative affect. Yet, this has received little attention in youth. Prior research has also focused on longer-term future thinking, e.g., months and years, and relied on lab-based assessments. Using the experience sampling method (ESM), we investigated whether short-term future thinking in daily life was associated with suicidal ideation in youth and explored the role of affect in the future thinking–suicidal ideation relationship. A community sample of N = 722 adolescent twins and their non-twin siblings completed ESM as part of the TwinssCan study (n = 55 with, and n = 667 without, past-week suicidal ideation). Participants completed self-report questionnaires, including on past-week suicidal ideation as part of the SCL-90. Subsequently, daily future thinking was assessed each morning for six days with ESM. To investigate the relationship between daily positive future thinking and past-week suicidal ideation, we estimated a mixed-effects linear regression model with a random intercept for participant, including age and sex as covariates. The relationship between daily positive future thinking, past-week suicidal ideation, and average positive and negative affect from the previous day was investigated by estimating two separate mixed-effects linear regression models (one for negative affect, one for positive affect), with a random intercept for participant, and random slopes for average positive and negative affect. Our results showed that participants reporting higher past-week suicidal ideation also reported significantly less daily positive future thinking during the ESM period, and this association remained significant when controlling for previous-day average positive and negative affect. Higher average positive affect from the previous day was significantly associated with higher positive future thinking. Although average negative affect from the previous day was associated with lower positive future thinking, this association was not statistically significant. Our findings indicate that short-term future thinking relates to suicidal ideation among a non-clinical sample of adolescents. Future research should investigate the directionality of the future thinking–suicidal ideation relationship, in order to investigate whether impaired future thinking may be an early warning signal for escalating suicidal ideation in youth.

Reducing Suicidal Ideation in Preadolescents With a History of Foster Care by Promoting School Readiness in Early Childhood.

Preadolescents with a history of foster care placement report suicidal ideation (SI) at higher rates than their peers, which increases their risk for suicide attempts in adolescence. Despite these increased risks, few interventions have been shown to reduce SI in these youth. This study examined the main and mediated long-term effects of a program to increase school readiness in children in foster care at age 5years on SI when the children were ages 9-11years, 4-6years after the intervention ended. Children who received the intervention were less likely to report SI, although the difference did not reach statistical significance. The intervention reduced SI indirectly through its positive effect on children's self-esteem at age 9years. Implications for programming to reduce SI and subsequent suicide attempts in youth with a history of foster care are discussed.

Societal factors and psychological distress indicators associated with the recent rise in youth suicide in Taiwan: A time trend analysis.

We investigated recent trends in youth suicide and their associations with societal and psychological factors in Taiwan. Suicide data (1971-2019) for 10-24 year olds were extracted from Taiwan's national cause-of-death data files. We investigated changes in trends in youth suicide rates, societal factors (gross domestic product per capita, Gini index, overall and youth unemployment rates, divorce rates in people aged 40-59 years [i.e. the age of most 15-24 year olds' parents] and Internet use rates) and psychological distress indicators (youth self-harm rates and the prevalence of worry-related insomnia, and suicide ideation, plan and attempt) using joinpoint regression and graphic examinations. The associations of these factors with youth suicide rates were examined using Prais-Winsten regression. Suicide rates in Taiwan's 10-24 year olds changed from a downward trend (2005-2014) to an upward trend in 2014 and increased 11.5% (95% confidence interval = [5.2%, 18.1%]) annually between 2014 and 2019. There was also an upturn in divorce rates among females aged 40-59 years in 2014 and self-harm rates among 15- to 24-year-old youth in 2013. The prevalence of self-reported insomnia and suicide ideation, plan and attempt in youth started to increase from 2013 to 2016. In the regression analysis, Internet use, female divorce rates and youth self-harm rates were positively associated with youth suicide rates. Suicide rates and the prevalence of suicidal behaviors began to increase in Taiwanese youth in the 2010s. These increases may be associated with concurrent rises in parental divorce rates, Internet use and poor sleep. Further research is needed to examine the mechanisms underlying recent increases in youth suicide risk.

Brief Report: Exploratory Evaluation of Clinical Features Associated with Suicidal Ideation in Youth with Autism Spectrum Disorder.

There has been a heightened awareness of an increased risk of suicidality among individuals with autism spectrum disorder (ASD) due to high rates of suicidal ideation (SI) in this population (11-66%). The current study investigated the rate of parent-endorsed SI and associated clinical features in 48 youths with ASD (Age; M: 12.97years, SD: 2.33). SI was endorsed in 18.75% of participants. Youth with SI exhibited significantly higher levels of affective problems, externalizing problems, feelings of humiliation and rejection, and symptoms related to perfectionism. Results indicate that co-occurring mental health problems are associated with suicidal ideation and provide relevant targets for psychotherapeutic intervention. This preliminary study in a modest sample suggests the value of further research in larger samples to replicate and generalize these findings.

Social Media: A Brave New World

Social media platforms have become vital conduits in the lives of young people today. The proliferation of social media platforms has created an unprecedented amount of access to various aspects of public and personal life. It has also brought the issue of suicide into the spotlight, with many recognizing the potential connection between social media use, self-harm, and suicidal ideation in youth. The two issues are connected in the sense that young people use social media to express themselves, to create relationships with friends, and to entertain themselves. Because of this, social media is a powerful tool for positive growth as well as potential harm. It is important for the clinician working with youth to understand the role social media plays in youth suicide and how one can help prevent further harm by risk reduction.

Protective factors for suicidal ideation among Black adolescents indirectly exposed to community violence.

Community violence exposure has been identified as a risk factor for Black youth suicide ideation. However, little is known about factors that protect community violence exposed youth against suicide ideation. The current study examined associations between knowledge of family member and peers' community violence exposure and Black youth's subsequent suicidal ideation, and investigated self-worth and social support as protective factors. Participants were a community sample of Black youth (N=447, 47.4% female; Mage=11.77, SD=0.35) who reported about community violence exposure, self-worth, social support, and suicide ideation in grades 6 and 7. Regression analyses revealed that grade 6knowledge of family member and peers' community violence exposure was associated with increases in suicide ideation assessed in grade 7. Self-worth attenuated the association between knowledge of others' community violence exposure and suicide ideation for male adolescents. For female adolescents, social support attenuated the association between knowledge of others' community violence and suicide ideation. Findings highlight the consequential impact of knowledge about community violence for Black youth's suicidal ideation. Enhancing protective factors for Black youth is an important target for intervening with exposure to violence and reducing suicide ideation.

Parental education and youth suicidal behaviours: a systematic review and meta-analysis.

Lower parental education has been linked to adverse youth mental health outcomes. However, the relationship between parental education and youth suicidal behaviours remains unclear. We explored the association between parental education and youth suicidal ideation and attempts, and examined whether sociocultural contexts moderate such associations. We conducted a systematic review and meta-analysis with a systematic literature search in PubMed, PsycINFO, Medline and Embase from 1900 to December 2020 for studies with participants aged 0-18, and provided quantitative data on the association between parental education and youth suicidal ideation and attempts (death included). Only articles published in English in peer-reviewed journals were considered. Two authors independently assessed eligibility of the articles. One author extracted data [e.g. number of cases and non-cases in each parental education level, effect sizes in forms of odds ratios (ORs) or beta coefficients]. We then calculated pooled ORs using a random-effects model and used moderator analysis to investigate heterogeneity. We included a total of 59 articles (63 study samples, totalling 2 738 374 subjects) in the meta-analysis. Lower parental education was associated with youth suicidal attempts [OR = 1.12, 95% Confidence Interval (CI) = 1.04-1.21] but not with suicidal ideation (OR = 1.05, 95% CI = 0.98-1.12). Geographical region and country income level moderated the associations. Lower parental education was associated with an increased risk of youth suicidal attempts in Northern America (OR = 1.26, 95% CI = 1.10-1.45), but with a decreased risk in Eastern and South-Eastern Asia (OR = 0.72, 95% CI = 0.54-0.96). An association of lower parental education and increased risk of youth suicidal ideation was present in high- income countries (HICs) (OR = 1.14, 95% CI = 1.05-1.25), and absent in low- and middle-income countries (LMICs) (OR = 0.91, 95% CI = 0.77-1.08). The association between youth suicidal behaviours and parental education seems to differ across geographical and economical contexts, suggesting that cultural, psychosocial or biological factors may play a role in explaining this association. Although there was high heterogeneity in the studies reviewed, this evidence suggests that the role of familial sociodemographic characteristics in youth suicidality may not be universal. This highlights the need to consider cultural, as well as familial factors in the clinical assessment and management of youth's suicidal behaviours in our increasingly multicultural societies, as well as in developing prevention and intervention strategies for youth suicide.