Adolescent Suicide Attempters Research Articles

The association between hate crime laws that enumerate sexual orientation and adolescent suicide attempts.

The association between hate crime laws that enumerate sexual orientation and adolescent suicide attempts.

Protective Associations between Supportive Environment and Suicidality among Minority and Majority Adolescents

Objective To examine the association between supportive environments and adolescent suicidal behavior, especially among marginalized minority groups. Methods Participants included 12,196 middle and 16,981 high school students who completed the 2019 Vermont Youth Risk Behavior Survey. Multiple logistic regression models were used to assess the association between three protective factors that were part of a supportive environment (feeling like they matter to people in their community, usually eating dinner at home, having a trusted adult) and suicidality (plan or attempt), controlling for key demographics (sex, sexual orientation, gender identity, and race/ethnicity). Moderating effects of demographics were also explored. Results All supportive environment variables were protective of making a suicide plan and making a suicide attempt (ORs < 0.75, p-values < 0.005). Students of minority identities were significantly more likely to make a suicide plan (middle school ORs: 1.34–3.51, p-values < 0.0005; high school ORs: 1.19–3.38, p-values < 0.02) and attempt suicide (middle school ORs: 1.42–3.72, p-values < 0.006; high school ORs: 1.38–3.25, p-values < 0.0005) compared to students with majority demographic characteristics. Generally, the associations between having a supportive environment and suicidality did not vary within sexual orientation, gender identify, or race/ethnicity subgroups, suggesting that these supportive environment factors were more universally protective. However, a few associations were stronger among students in the majority demographic groups. Conclusions These data suggest that having a supportive environment is protective of suicidality for adolescents from both majority and minority demographic groups. HIGHLIGHTS A supportive environment is protective of adolescent suicide plan and attempt. Minority sexual, gender, and racial identities are risk factors for suicidality. Minority and majority students are protected by supportive environments.

Additive Effects of Polygenic Risk and Family History on Adolescent Suicide Attempts in a Diverse Sample

Additive Effects of Polygenic Risk and Family History on Adolescent Suicide Attempts in a Diverse Sample

Impact of negative life events on adolescent suicide attempts: A moderated mediation analysis

Suicide is a major public health problem among adolescents, and negative life events (NLE) have been considered a significant risk factor for suicide attempts. However, the mediating and moderating processes underlying the relationship between NLE and suicide attempts have remained obscure. We examined both the mediating role of depression and the moderating role of peer support underlying this relationship. The results showed that depression fully mediated the positive relationship between NLE and adolescent suicide attempts. A moderated mediation analysis further revealed that the indirect path from NLE to suicide attempts was moderated by peer support. These findings suggest that the development of depression plays a key role in explaining why adolescents who have experienced NLE are at a greater risk of suicide attempts than those who have not. A healthy peer support system could serve as a buffer to reduce the adverse outcomes resulting from NLE. Overall, the results may contribute to developing an integrative framework of theory and effective interventions.

Suicide in adolescents: A case study

Suicidal behavior is the most violent behavior that a person commits against himself. Suicidal behavior is a complex form of behavior in which biological, psychological, cultural, environmental and social factors are effective together, which deeply affect the individual, his environment, society and subsequent generations. The etiology of suicidal behavior in adolescents includes problems such as psychiatric illness, domestic violence and restlessness, mental disorders, social events, previous suicide attempts, loss of family relatives, parental divorce, physical and/or sexual abuse, and substance use. Suicide attempt in children and adolescents; emerges as a growing public health problem. In this study, it was aimed to investigate the risk factors of suicidal behavior in adolescents and to examine the case sample. According to the results of the research, the presence of existing depressive symptoms before the Z.D. suicide attempt, previous suicide attempts, being in adolescence, having acute stresses, etc. Presence of risk factors such as suicide, loss of a lover, having a family history of suicide and being alone in the suicide attempt suggest that Z.D. is the trigger. In the presence of risk factors that increase the risk of suicide, it is important to recognize the triggers in advance and to plan an intervention.

A systems science approach to identifying data gaps in national data sources on adolescent suicidal ideation and suicide attempt in the United States

BackgroundSuicide is currently the second leading cause of death among adolescents ages 10–14, and third leading cause of death among adolescents ages 15–19 in the United States (U.S). Although we have numerous U.S. based surveillance systems and survey data sources, the coverage offered by these data with regard to the complexity of youth suicide had yet to be examined. The recent release of a comprehensive systems map for adolescent suicide provides an opportunity to contrast the content of surveillance systems and surveys with the mechanisms listed in the map.ObjectiveTo inform existing data collection efforts and advance future research on the risk and protective factors relevant to adolescent suicide.MethodsWe examined data from U.S. based surveillance systems and nationally-representative surveys that included (1) observations for an adolescent population and (2) questions or indicators in the data that identified suicidal ideation or suicide attempt. Using thematic analysis, we evaluated the codebooks and data dictionaries for each source to match questions or indicators to suicide-related risk and protective factors identified through a recently published suicide systems map. We used descriptive analysis to summarize where data were available or missing and categorized data gaps by social-ecological level.ResultsApproximately 1-of-5 of the suicide-related risk and protective factors identified in the systems map had no supporting data, in any of the considered data sources. All sources cover less than half the factors, except the Adolescent Brain Cognitive Development Study (ABCD), which covers nearly 70% of factors.ConclusionsExamining gaps in suicide research can help focus future data collection efforts in suicide prevention. Our analysis precisely identified where data is missing and also revealed that missing data affects some aspects of suicide research (e.g., distal factors at the community and societal level) more than others (e.g., proximal factors about individual characteristics). In sum, our analysis highlights limitations in current suicide-related data availability and provides new opportunities to identify and expand current data collection efforts.

The role of parents’ and friends’ support in preventing suicide attempts among French sexual minority adolescents

ObjectivesFrench sexual minority adolescents are at higher risk for suicide attempts than their heterosexual peers. However, little is known about the role of parents’ and friends’ support among French lesbian, gay and bisexual (LGB) youth. This study aimed to research the role of their support in preventing suicide attempts among LGB adolescents in France. Materials and MethodsData were drawn from a French cross-sectional study entitled “Portraits d'adolescents”. Parental support was defined by satisfactory relations between participants and their parents. Friends’ support was defined by satisfactory relations between participants and their friends. Chi-square and multiple logistic regression analyses were used to estimate and identify associated factors of suicide attempts in LGB as opposed to heterosexual youth. ResultsData from a sample of 14,265 French adolescents aged 13 to 20 were analyzed. Among them, 637 (4.47%) identified as LGB. Attempted suicide was independently associated with sexual orientation (30.7% vs 10.6%; OR = 2.59 [2.11–3.18]; p < 0.0001). Both parents’ and friends’ support appeared to be protective factors in suicide attempts among heterosexuals (adjusted ORs = 0.40 [0.35–0.46] and 0.61 [0.51–0.75], respectively), whereas in the LGB group, only parental support was significant (adjusted OR = 0.42 [0.27–0.65]), independently of other variables. DiscussionPrevention efforts might be carried out by identifying within-group differences among French adolescents with different sexual orientations. The supportive role of family members should be strengthened. Positive resources and salutary support systems may effectively prevent suicide attempts. ConclusionsFrench LGB adolescents have a higher risk for suicide attempts than their heterosexual peers. Parental support was reconfirmed as a major protective factor against suicide attempts in sexual minority adolescents.

Psychopathological Differences Between Self-Injurious Behaviors and Suicide Attempts in Adolescents.

Suicidal attempts and self-injurious behavior are major public health concerns, and they are strong predictors of death in youths worldwide. Given the risk of death, there is an urgent need to understand the differences and identify effective interventions. This study aimed to investigate the relationship between the predictors associated with non-suicidal self-injury and suicide attempts among adolescents. The study recruited a total of 61 adolescents aged 12-18 years, with suicide attempts (n=32) and non-suicidal self-injury (n=29). Turgay Disruptive Behavioral Disorders Screening and Rating Scale-Parent form, Rosenberg Self-esteem Scale, and Beck Anxiety and Beck Depression Inventory assessment scales were applied. All participants were interviewed with the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition. The adolescents with the suicide attempts were found to have lower self-esteem, higher depression, inattention and hyperactivity-impulsivity scores than the group with non-suicidal self-injury. Higher inattention scores and rural residency were positively and significantly associated with suicide attempts, adjusting for other discrimination types (odds ratio=1.250, 95% CI=1.024-1.526; odds ratio=4.656, 95% CI=1.157-18.735). This study shows that some clinical psychiatric factors may be helpful in distinguishing adolescents with suicide attempts from adolescents with non-suicidal self-injury. Future research is needed to determine the predictive role of these variables in distinguishing suicidal attempts from self-injurious behavior.

The associated factors of suicide attempt in French sexual minority adolescents

The associated factors of suicide attempt in French sexual minority adolescents

Young Adult Outcomes Associated With Adolescent Suicidality: A Meta-analysis.

Suicide is one of the leading causes of death among adolescents worldwide. Adolescents who present with suicidality may be at an increased risk for future mental illness and suicidality in young adulthood. The objective of this study was to systematically assess the relationship between adolescent suicidal ideation and suicide attempts (suicidality) and young adult psychopathological outcomes. Medline, Embase, and PsychInfo (OVID Interface) were searched for articles published before August 2021. Included articles were prospective cohort studies that compared young adult (19-30 years) psychopathological outcomes between suicidal and nonsuicidal adolescents. We extracted data related to suicidality in adolescence, mental health outcomes in young adulthood, and covariates. Outcomes were analyzed via random-effect meta-analyses and reported using odds ratios. Of 9401 references screened, we included 12 articles comprising over 25 000 adolescents. Four outcomes were meta-analyzed: depression, anxiety, suicidal ideation, and suicide attempt. Adjusted meta-analyses showed that adolescent suicidal ideation was associated with young adult suicide attempt (odds ratio [OR] = 2.75, 95% confidence interval [CI]:1.70-4.44), depressive disorders (OR = 1.58, 95% CI: 1.20-2.08), and anxiety disorders (OR = 1.41, 95% CI: 1.01-1.96), whereas adolescent suicide attempts were associated with young adult suicide attempt (OR = 5.71, 95% CI: 2.40-13.61), and young adult anxiety disorders (OR = 1.54, 95% CI: 1.01-2.34). Results for young adult substance use disorders were mixed. Significant heterogeneity between studies was observed because of differences in timing, method of assessments, and covariate adjustment. Adolescents experiencing suicidal ideation or with a history of suicide attempt may have increased odds of further suicidality or mental disorders in young adulthood.

Co-Developmental Trajectories of Parental Psychological Distress and Child Internalizing and Externalizing Problems in Childhood and Adolescence: Associations with Self-Harm and Suicide Attempts

Growing evidence has suggested that parental mental illness and child internalizing and externalizing problems tend to co-occur and engender risk for adverse child outcomes; however, there is considerable heterogeneity in their joint developmental trajectories. This study aimed to evaluate the joint developmental trajectories of maternal and paternal psychological distress and child internalizing and externalizing problems from early childhood to middle adolescence. Given that suicide and self-harm are major public health issues in adolescence and often occur in the context of other mental health issues, we also examined the association between these joint trajectories and these outcomes in adolescence. Parallel-process latent class growth analysis was applied to 14 years of follow-up data from a large-scale, nationally representative sample of youths participating in the UK’s Millennium Cohort Study (MCS; n = 12,520, 50.9% male). Results showed the best-fitting solution had four trajectory classes: (1) low symptoms, 59.0%; (2) moderate symptoms in children, 22.5%; (3) notable symptoms in fathers, 10.7%; and (4) co-occurring maternal and child symptoms, 7.8%. The trajectory groups differed in their self-harm and suicide attempts in adolescence, underscoring the possible importance of the roles of both parental distress and child problem behaviors processes in these outcomes. Future studies will be valuable to rigorously test the directionality and the respective roles of parents and children in this association. Our findings suggest the need for two-generation mental health intervention programs that are tailored based on co-developmental trajectory group membership.

Psychosocial Aspects of Deliberate Physical Suicide Attempts by Children and Adolescents.

Suicide is the second most common cause of death among young people in Lithuania. This study aimed to evaluate circumstance, and conditions possibly related to suicide attempt in adolescents. Study was performed at the tertiary Children's Hospital. Medical documentation of the suicide attempts from January 2011 to April 2018 was analyzed. There were 102 cases included in the study: 83.8% female and 16.2% male patients (average age of 15.02 ± 1.9); 40.6% of patients lived in divorced families, 17.7% in orphanages, 4.2% in foster care; 36.4% suffered from parental alcoholism, and 17.2% experienced suicide in close surroundings; 54.1% experienced bullying or violence (26.0%), and 85.4% showed signs of other types of self-harm, girls more often (P < .001). In 52.8% of cases, the attempt was spontaneous, and 34% relapsed. In summary female gender, living in orphanages, and signs of other self-harm were significantly related to suicide attempt.

Self-injury Functions, Romantic Relationship Stress, and Suicide Attempts in Adolescents

Self-injury Functions, Romantic Relationship Stress, and Suicide Attempts in Adolescents

Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China.

Evidence suggested that thyroid-stimulating hormone (TSH) and lipid levels were associated with major depressive disorder (MDD). However, its role in suicide attempts in adolescents with MDD was unclear. This investigation was to probe into the relationship between TSH, lipid levels, and attempted suicide in adolescents with MDD. A total of 179 adolescents with MDD were included from January 2021 to January 2022. Socio-demographic data and clinical data were obtained through self-made questionnaires. TSH and lipid levels were analyzed by a recognized laboratory. The Epidemiological Studies Depression Scale (CES-D) was used to assess the severity of depression. Questions about whether there was a behavior of suicide attempts were completed through conversation interviews. Results showed that the CES-D total score, TSH, and low-density lipoprotein cholesterol (LDL-C) of suicide attempters were significantly higher than those of non-suicide attempters. Ordinary family relationships were more likely to attempt suicide than good family relationships. The CES-D total score, ordinary family relationships, TSH and LDL-C were still significant in binary logistic regression, with an adjusted odds ratio (OR) of 1.04, 3.42, 5.14, and 1.76, respectively. The area under the receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) ranged from 0.60 to 0.74. Suicide attempts are common among adolescents with MDD and were associated with CES-D total score, ordinary family relationships, TSH, and LDL-C. Given the association between suicide attempts and TSH and LDL-C, the dynamic changes in TSH and LDL-C levels should be detected regularly.

Drawing attention? Going through judgments regarding child and adolescent suicide attempts in emergency rooms from a professional perspective.

To understand the perceptions of the multidisciplinary team of an emergency department regarding the care of children and adolescents who have attempted suicide. An exploratory-descriptive, qualitative study, in light of the Symbolic Interactionism theoretical framework. Thirteen professionals from the multidisciplinary team from two emergency rooms (children and adults) of a secondary hospital in São Paulo participated. Data were collected between August and September 2018 using semi-structured interviews, analyzed using thematic content analysis complemented by the IRAMUTEQ® software. Two central categories emerged: Multidisciplinary team perceptions regarding attempted suicide care; and Multidisciplinary team perceptions regarding the possibilities for improving attempted suicide care. From these, professional perceptions of care, risk factors, emotional reactions, limitations of emergency rooms and strategies for improving practice were observed. Professionals perceived suicide attempt care from a biomedical and reductionist perspective, with an approach marked by stigma, judgment and lack of preparation.

Drawing attention? Going through judgments regarding child and adolescent suicide attempts in emergency rooms from a professional perspective

RESUMO Objetivo: Compreender as percepções da equipe multiprofissional de um departamento de urgência e emergência diante do cuidado à criança e ao adolescente por tentativa de suicídio. Método: Estudo exploratório-descritivo, qualitativo, à luz do referencial teórico do Interacionismo Simbólico. Participaram 13 profissionais da equipe multiprofissional de dois prontos-socorros (infantil e adulto) de um hospital secundário de São Paulo. Os dados foram coletados entre agosto e setembro de 2018 utilizando entrevista semiestruturada, analisados pela análise temática de conteúdo com complementação do software IRAMUTEQ®. Resultados: Emergiram duas categorias centrais: Percepções da equipe multiprofissional diante do cuidado à tentativa de suicídio; e Percepções da equipe multiprofissional diante das possibilidades para o aperfeiçoamento do cuidado à tentativa de suicídio. A partir dessas, observaram-se as percepções dos profissionais diante do cuidado, fatores de risco, reações emocionais, limitações dos prontos-socorros e estratégias para aperfeiçoamento da prática. Conclusão: Os profissionais perceberam o cuidado às tentativas de suicídio sob uma ótica biomédica e reducionista, com abordagem marcada por estigma, julgamento e falta de preparo.

The relationship between sleep disturbance and self-harming behaviours in high-risk clinical adolescents

Emerging research has identified sleep disturbance as an important risk factor for predicting self-harming behaviours. However, the temporality of this relationship, particularly in clinical adolescent samples remains poorly understood. This study examines the relationship between sleep disturbance and self-harming behaviours (namely nonsuicidal self-injury and suicide attempts) in clinical adolescents engaging in risk-taking and self-harming behaviours using secondary analyses from a clinical cohort study. Cross-lagged structural equation modelling was used to determine whether baseline sleep disturbance and self-harming behaviours were predictors of each other over a one-year follow-up period in a sample of adolescents (n = 238, 89.5% female) attending and receiving treatment from an outpatient clinic specializing in risk-taking and self-harming behaviours. When controlling for age, sex and depressive symptoms, greater sleep disturbance (p = 0.001) at baseline independently predicted higher numbers of suicide attempts at follow-up. No bidirectional relationship was found when sleep disturbance was modelled with the frequency of nonsuicidal self-injury. This study adds to the growing evidence that sleep disturbance may predict suicidal behaviours. Clinicians should thus regularly assess for sleep disturbances when evaluating suicidal behaviours in high-risk adolescents. Further research and clinical trials should investigate whether sleep-based interventions may be efficacious in reducing the prevalence of suicidal behaviours.

Characterization of some risk factors for suicide attempts in adolescents. La Palma, 2022

Introduction: suicide attempts have increased considerably in adolescents and young people in recent decades, as reflected by studies in various countries. Objective: to characterize the risk factors that were present in adolescents who made a suicide attempt, in the period from January 2020 to November 2022, belonging to the Pedro Borrás Astorga Polyclinic in the municipality of La Palma. Methods: a descriptive, cross-sectional study was carried out in adolescents who attempted suicide, belonging to the Pedro Borrás La Palma Polyclinic, in the period from January 2020 to November 2022.in order to obtain the data, a visit was made to the Hygiene and Epidemiology and Statistics departments of said polyclinic, in addition, the family medical offices to which these adolescents belong were visited and their individual and family health histories were reviewed, with prior informed consent. Results: a predominance of the female sex was found, and the age group was 15 to 19 years. Most of these adolescents are studying and have a pre-university level of schooling, with a predominance of belonging to dysfunctional families. The main risk factors found were the breakup of love relationships, family conflicts and hereditary family antecedents, with the ingestion of psychotropic drugs being the most frequent method used.Conclusions: the characterization of some of the risk factors present in the adolescents with suicide attempts studied is of vital importance in order to be able to intervene in the reduction of suicidal risk and thus prevent the suicide attempt from being consummated.

Bruns N, Willemsen L, Stang A, et al. Pediatric ICU admissions after adolescent suicide attempts during the pandemic. Pediatrics 2022; 150: e2021055973 (Andere Studienart)

Im Verlauf der COVID-19-Pandemie war das Risiko einer schweren Erkrankung durch eine SARS-CoV-2-Infektion bei Kindern und Jugendlichen geringer als bei Erwachsenen. Kontaktbeschränkungen, Einsamkeit und Ungewissheit über die Zukunft haben aber das psychische Wohlbefinden der jungen Menschen stark belastet. Bisher publizierte Untersuchungen über die Zunahme von Selbstverletzungen, Selbstmordge-danken und Selbstmorden unter Jugendlichen haben unterschiedliche Resultate ergeben. Ziel dieser retrospektiven Multizenterstudie aus Deutschland war es, Einweisungen in pädiatrische Intensivstationen während des ersten Lockdowns und ein Jahr später während eines zweiten verlängerten Lockdowns jeweils mit den Jahren vor der Pandemie zu vergleichen. Es handelt sich um eine Teilanalyse einer grösseren retrospektiven multi-zentrischen Beobachtungsstudie. In der ersten Pandemiewelle hatten 37 Intensivstationen teilgenommen, was 23 % der 159 deutschen pädiatrischen Intensivstationen entspricht; in der zweiten Welle nahmen noch 27 Intensivstationen teil. Kinder und Jugendliche unter 18 Jahren, die wegen Unfällen oder Verletzungen auf diesen Intensivstationen hospitalisiert worden waren, wurden anhand von ICD-10-Codes identifiziert. Die Gesamtzahl der Einweisungen und Suizidversuche ging während des ersten Lockdowns im Jahr 2020 zurück (standardisierte Morbiditätsrate 0,74 bzw. 0,69) und stieg dann im Jahr 2021 stark an (standardisierte Morbiditätsrate 2,14 bzw. 2,84). Als Einschränkungen der Studie nennen die Autorinnen und Autoren eine Überrepräsentation von Universitätskliniken, die als Verlegungszentren für schwere Fälle dienen, und das retrospektive Design, da die Kriterien für die Aufnahme in die Intensivstation sich zwischen den Kliniken unterschieden.

Prediction Models for Suicide Attempts among Adolescents Using Machine Learning Techniques.

Suicide attempts (SAs) in adolescents are difficult to predict although it is a leading cause of death among adolescents. This study aimed to develop and evaluate SA prediction models based on six different machine learning (ML) algorithms for Korean adolescents using data from online surveys. Data were extracted from the 2011-2018 Korea Youth Risk Behavior Survey (KYRBS), an ongoing annual national survey. The participants comprised 468,482 nationally representative adolescents from 400 middle and 400 high schools, aged 12 to 18. The models were trained using several classic ML methods and then tested on internal and external independent datasets; performance metrics were calculated. Data analysis was performed from March 2020 to June 2020. Among the 468,482 adolescents included in the analysis, 15,012 cases (3.2%) were identified as having made an SA. Three features (suicidal ideation, suicide planning, and grade) were identified as the most important predictors. The performance of the six ML models on the internal testing dataset was good, with both the area under the receiver operating characteristic curve (AUROC) and area under the precision-recall curve (AUPRC) ranging from 0.92 to 0.94. Although the AUROC of all models on the external testing dataset (2018 KYRBS) ranged from 0.93 to 0.95, the AUPRC of the models was approximately 0.5. The developed and validated SA prediction models can be applied to detect high risks of SA. This approach could facilitate early intervention in the suicide crisis and may ultimately contribute to suicide prevention for adolescents.