Suicide In Young Adults Research Articles

Unravelling Suicide and Related Behaviours in Indigenous Youth and Young Adults in the Canadian Context.

Suicide, rooted in antiquity, is now identified as a global dilemma, particularly impacting Indigenous peoples. The backdrop for this non-systematic focused review is the worldwide challenges faced by vulnerable Indigenous peoples with untenable poverty, degraded life-quality conditions, and suicidality, while the focus, as a specific case, is on the complexity of suicidality in Canadian Indigenous high-risk age groups. The aim here is to present overt and covert intersecting factors underlying suicide in Indigenous youths and young adults in the vast Canadian context. Although living in a privileged geopolitical region, their physically remote and economically compromised communities meshed with a haunting history combined with authorities' ingrained attitudes of exclusion and neglect, spawned meager health and education resources, services, and consequent dire results. The article's guiding theoretical frameworks are Transcultural Psychiatry with its emphasis on context that explains health, illness, and recovery in groups and individuals, and the Interpersonal Psychological Theory of Suicide to identify individuals' suicidality triggers. The article highlights indigenous social determinants of health, identifies elements underlying the tragic suicidality trend in these groups, and addresses literacy and education as poverty driven issues and suicidality-contributing factors promoting attitudes of hopelessness. The discussion includes joint suicide combatting efforts by Indigenous communities and Canadian authorities, these authors' psychosocial-cognitive literacy acquisition plan to address all age-groups simultaneously, and a take-home message introducing employers' desirable worker competencies for effective future employment, thereby uplifting life-quality and prospects to help thwart the spectre of suicide. The Conclusion introduces current trends in suicidality science, confirming the authors' intervention plan is a good fit in the psychosocial intervention trend. Future directions include advice to examine the effectiveness of the plan in the Indigenous context, and tweak it accordingly. For ease of reader comprehension, the article flow is included at the start of the Introduction section.

Examining the Impact of Minimum Handgun Purchase Age and Background Check Legislation on Young Adult Suicide in the United States, 1991-2020.

Objectives. To examine the independent and joint effects of state legislation on minimum age for purchasing handguns and background checks on the suicide of young adults aged 18 to 20 years. Methods. We used negative binomial regressions with fixed effects for year and generalized estimating equations for state to estimate the effects of state legislation on annual counts of firearm, nonfirearm, and total young adult suicides in all 50 US states from 1991 to 2020. Results. Minimum age laws decreased the incidence rate of firearm suicide among young adults, an effect that was amplified in states with permit to purchase laws; there was no effect on the nonfirearm or total suicide rate. Permit to purchase laws significantly decreased the young adult firearm suicide incidence rate by 39% (incidence rate ratio [IRR] = 0.61; 95% confidence interval [CI] = 0.51, 0.74) and the overall suicide incidence rate by 14% (IRR = 0.86; 95% CI = 0.75, 0.99), with no effect on the nonfirearm suicide rate. Conclusions. Permit to purchase laws are a more promising avenue for reducing young adult suicides than are age-based restrictions. (Am J Public Health. 2024;114(8):805-813. https://doi.org/10.2105/AJPH.2024.307689).

Sex differences in self-harm and suicide in young autistic adults.

Both suicide and self-harm are disproportionately common in autistic people. Sex differences in risk of self-harm and suicide are observed in the general population, but findings are mixed for autistic people. Self-cutting may be a particularly risky self-harm behaviour for suicide in autistic people. We aimed to explore sex differences and differences in method of self-harm in the association between self-harm and suicide in autistic and non-autistic adolescents and young adults. We used a total population register of 2.8 million Swedish residents. Participants were followed from age 12 until December 2021 for medical treatment because of self-harm, and death from suicide. We used Cox proportional hazard regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of death from suicide following self-harm, and Relative Excessive Risk due to Interaction (RERI) to explore the interaction between self-harm and autism in females and males. We identified 85,143 autistic individuals (31,288 female; 53,855 male) and 2,628,382 non-autistic individuals (1,286,481 female; 1,341,901 male) aged 12-37 years. Incidence of suicide following self-harm was higher in autistic males (incidence per 100,000 risk-years = 169.0 [95% CI 135.1, 211.3]) than females (125.4 [99.4, 158.3]). The relative risk was higher for autistic females (HR 26.1 [95% CI 20.2, 33.7]) than autistic males (12.5 [9.9, 15.8]). An additive effect of both autism and self-harm was observed in both females (RERI = 9.8) and males (2.0). Autistic individuals who self-harmed through cutting were at greatest risk of death from suicide (HR 25.1 [17.9, 35.2]), compared to other methods. Autistic males and females are at increased risk of death from suicide following severe self-harm, particularly self-cutting.

Active suicidal ideation associated with dysfunction in default mode network using resting-state EEG and functional MRI - Findings from the T-RAD Study

Suicide in youth and young adults is a serious public health problem. However, the biological mechanisms of suicidal ideation (SI) remain poorly understood. The primary goal of these analyses was to identify the connectome profile of suicidal ideation using resting state electroencephalography (EEG). We evaluated the neurocircuitry of SI in a sample of youths and young adults (aged 10–26 years, n = 111) with current or past diagnoses of either a depressive disorder or bipolar disorder who were enrolled in the Texas Resilience Against Depression Study (T-RAD). Neurocircuitry was analyzed using orthogonalized power envelope connectivity computed from resting state EEG. Suicidal ideation was assessed with the 3-item Suicidal Thoughts factor of the Concise Health Risk Tracking self-report scale. The statistical pipeline involved dimension reduction using principal component analysis, and the association of neuroimaging data with SI using regularized canonical correlation analysis. From the original 111 participants and the correlation matrix of 4950 EEG connectivity pairs in each band (alpha, beta, theta), dimension reduction generated 1305 EEG connectivity pairs in the theta band, 2337 EEG pairs in the alpha band, and 914 EEG connectivity pairs in the beta band. Overall, SI was consistently involved with dysfunction of the default mode network (DMN). This report provides preliminary evidence of DMN dysfunction associated with active suicidal ideation in adolescents. Using EEG using power envelopes to compute connectivity moves us closer to using neurocircuit dysfunction in the clinical setting to identify suicidal ideation.

The relationship between spirituality and suicide in young adults: the mediating role of early maladaptive schemas in Turkey

Suicide rates among young adults are high. There are many reasons for this. In this study, the effect of early maladaptive schemas on the relationship between spirituality and suicide among young adults was examined. The sample of 413 (326 females and 87 males) ranged in age from 18 to 30 (M = 20.8, SD = 2.02). Spiritual orientation, suicide probability (suicidal ideation) scale, and Young Schema Scale Short Form-3 (social isolation and defectiveness) were used in the study. Data were analysed with the SPSS 22.0 PROCESS program. As a result, social isolation and defectiveness have been found to mediate between spirituality and suicidal ideation.

Childhood maltreatment and suicide risk: The mediating role of self-compassion, mentalization, depression

BackgroundChildhood maltreatment (CM) is a well-established risk factor for depression and increased suicide risk. This study aimed to investigate the distinctive mechanisms of individual types of CM on young adult suicide risk, by exploring the potential mediating role of mentalization, self-compassion, and depression. MethodsA total of 4873 adults completed a survey screening for experiences of CM, self-compassion, mentalization, depression, and suicide risk. ResultsThe path analysis revealed significant direct effects of mentalization, self-compassion, and depression on suicide risk. Moreover, mentalization, self-compassion, and depression mediated the relationship between emotional abuse/neglect and suicide risk, whereas physical neglect contributed to suicide risk only through mentalization and depression. Furthermore, sexual abuse had a significant direct effect on suicide risk, whereas physical abuse did not show any direct or indirect effects. LimitationsThe cross-sectional design of the study limits its ability to establish causality, and the risk of recall bias in reporting physical or sexual abuse cannot be ignored. ConclusionsThis study represents the first identification of disturbances in self-compassion, mentalization, and depression that mediate the relationship between various types of CM and suicide risk in young adults. Our findings suggest substantive differences in the impact of emotional CM compared to other forms of CM. Enhancing self-compassion and mentalization abilities could be valuable intervention strategies for individuals with a history of emotional CM. Addressing factors that hinder the recall of relevant subjective experiences of physical and sexual abuse is also critical.

Developing the Blueprint for Youth Suicide Prevention.

Suicide and suicidal behavior among youth and young adults are a major public health crisis, exacerbated by the COVID-19 pandemic and demonstrated by increases in suicidal ideation and attempts among youth. Supports are needed to identify youth at risk and intervene in safe and effective ways. To address this need, the American Academy of Pediatrics and the American Foundation for Suicide Prevention, in collaboration with experts from the National Institute of Mental Health, developed the Blueprint for Youth Suicide Prevention ( Blueprint ) to translate research into strategies that are feasible, pragmatic, and actionable across all contexts in which youth live, learn, work, and play. In this piece, we describe the process of developing and disseminating the Blueprint. Through a summit and focus meetings, cross-sectoral partners convened to discuss the context of suicide risk among youth; explore the landscape of science, practice, and policy; build partnerships; and identify strategies for clinics, communities, and schools-all with a focus on health disparities and equity. These meetings resulted in 5 major takeaways: (1) suicide is often preventable; (2) health equity is critical to suicide prevention; (3) individual and systems changes are needed; (4) resilience should be a key focus; and (5) cross-sectoral partnerships are critical. These meetings and takeaways then informed the content of the Blueprint , which discusses the epidemiology of youth and young adult suicide and suicide risk, including health disparities; the importance of a public health framework; risk factors, protective factors, and warning signs; strategies for clinical settings, strategies for community and school settings; and policy priorities. Following the process description, lessons learned are also discussed, followed by a call to action for the public health community and all who serve and support youth. Finally, key steps to establishing and sustaining partnerships and implications for policy and practice are discussed.

Reasons for Suicide in Black Young Adults: A Latent Class Analysis.

Suicides have increased among Black youth in the US, though it remains unclear if these trends persist into young adulthood. Further, even less is known about the reasons why individuals begin to consider suicide as a viable option. The current study aims to redress these gaps by identifying specific reasons for suicide among a sample of 264 Black young adults who reported experiencing suicidal thoughts within the past 2weeks. Participants were recruited from an online panel. Reasons for suicide were measured using eight individual items/indicators. Latent class analysis was used to detect underlying patterns in Black young adults' reasons for considering suicide. The most commonly reported reason for considering suicide among the entire sample was feeling hopeless about the future. Black women were more likely to report considering suicide because they could not live up to other's expectations and because they felt lonely and sad. Findings for the 3-class model were retained. The first class is described as the "Somewhat hopeless and other reasons" class (n = 85; 32%). The second class is "Accomplished but extremely lonely and sad" (n = 24; 9%). The third class is described as "Pronounced feelings of failure, hopelessness, being overwhelmed, and lack of accomplishment" and includes 59% of the sample (n = 155). Culturally grounded clinical treatments and interventions are needed to meet the specific mental health needs of Black young adults. A particular focus on identifying factors that drive feelings of hopelessness and failure is warranted.

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.

Development of an IEC resource (brochure) on suicide prevention for college students: A qualitative study in the Indian context.

Information Education Communication (IEC) materials play a vital role in behavior change by raising awareness about health issues. In India, suicide is the leading cause of death in the age group of 15-39 years, exemplifying the pressing need for raising awareness about suicide prevention. This study aimed to develop a brochure on suicide prevention for young adults with the help of scientific methodology. A cross-sectional qualitative research design was used in the study, and purposive sampling was used to collect the data. The study analyzed the awareness level and existing knowledge gap about suicide prevention among college students with the help of focus group discussions (FGDs) conducted independently among mental health experts, college teachers, and college students. Based on the findings from the FGDs, a comprehensive brochure was developed. The qualitative data collected by FGDs were analyzed using direct content analysis. The findings of the FGDs helped identify the knowledge gaps with regard to young adult suicide prevention, and a brochure was prepared to address the same. The development of young adult suicide prevention IEC resources pertinent to Indian settings is crucial. To bridge the knowledge gap on suicide prevention among college students and raise awareness, a brochure was developed based on scientific findings of the FGDs.

Health Diagnoses and Service Utilization in the Year Before Youth and Young Adult Suicide.

Suicide rates among young people are rising. Health care visits provide opportunities for identification and intervention, yet studies have been limited by small or circumscribed samples. This study sought to expand the knowledge base by examining health care encounters and diagnoses among young people who later died by suicide. This case-control study examined diagnoses of mental and general medical disorders and health care utilization in the 30 and 365 days before suicide death in nine large U.S. health care systems. Data (years 2000-2015) from 445 suicide decedents ages 10-24 years were matched with data from 4,450 control group patients. Suicide decedents were more likely to have at least one mental disorder diagnosis (51% vs. 16%; adjusted OR [AOR]=5.74, 95% CI=4.60-7.18) and had higher rates of nearly all mental health conditions. Substance use disorders were common (12%) and more likely (AOR=8.50, 95% CI=5.53-13.06) among suicide decedents. More than one in three (42%) suicide decedents had a health care visit in the month before death, and nearly all (88%) had a visit in the previous year. Despite the greater likelihood of suicide associated with mental disorder diagnoses, such disorders were present among only 51% of suicide decedents. High rates of health care utilization among suicide decedents indicate a need for improving identification of mental health conditions and suicide risk across the health care system. Increased substance use screening may help identify youths at high risk because substance use disorders were significantly more prevalent and likely among suicide decedents.

The Relationship Between Self-Harm and Suicide in Adolescents and Young Adults

Nonsuicidal self-injury is a common development among adolescents that varies in severity, frequency, and associated psychiatric vulnerability. A key challenge is to understand how clinicians can identify those at greater risk, specifically for transition to suicide attempts. Shared functions (eg, to escape negative emotions) and risk factors in selected domains (eg, exposure to self-harm in others, impulsivity, cannabis and other drug use, diminished social connections, and history of bullying) between self-injury and suicide can explain this association and guide interventions. General guidelines for nonsuicidal self-injury and comorbid suicidal behavior in youth include mapping its predisposing factors and psychological functions, assessing severity and acute risk, and elucidating context (eg, interpersonal stressors). No medication has proven effective in reducing self-harm. Outpatient psychological treatment is the first option to address relevant emotional, behavioral, and interpersonal vulnerabilities, and evidence-based treatments can be effective (eg, dialectical behavior therapy, mentalization-based treatment, and cognitive-behavioral therapy). [ Psychiatr Ann. 2022;52(8):311–317.]

Suicide and Self-Harm in Adolescents and Young Adults

Suicide and Self-Harm in Adolescents and Young Adults

A Qualitative Exploration of the Experiences and Perceptions of Interpersonal Relationships Prior to Attempting Suicide in Young Adults.

Suicide is a leading public health concern. Research studies have identified significant associations between loneliness and suicidal ideation/behaviour both cross-sectionally and prospectively. Despite this, research specifically focusing on identifying the nature of loneliness experienced prior to suicide, and the role it has in association with other preceding factors, has not been fully explored. The current study recruited ten participants with a history of suicide attempts (five female, four male and one non-binary; mean age: 22.5, range: 20–25 years) to take part in one-to-one, semi-structured interviews via remote video conferencing to explore experiences of social support and loneliness prior to suicide attempt. Using Interpretative Phenomenological Analysis, several aspects of loneliness emerged as important themes that were present prior to participants’ suicide attempts. Additional themes identified were patterns of social support, personality traits, emotional secrecy and social transition. Evidence suggests that a positive relationship with parents, knowing someone with similar experiences or having membership in more than one friendship group may reduce feelings of loneliness and/or intentions to die. This research makes an important contribution to understanding the role of loneliness in relation to suicide attempts by highlighting the importance of social supports being emotionally available to those experiencing distress.

P406. Chronic Adolescent Social Instability Stress Leads to Impaired Recognition Memory and Increased Hippocampal FKBP5 and CRHR2 Expression in Adulthood

Recently published studies indicate that the Covid-19 pandemic has dramatically increased rates of anxiety, depression, and suicide in adolescents and young adults. Human and animal studies strongly indicate that early life stress leads to lasting changes to cognition and psychiatric outcomes, but less is known about how chronic adolescent stress may alter brain function across the lifespan.

An experimental investigation of the influence of loneliness on changes in belongingness and desire to escape.

ObjectiveLoneliness is a well‐established risk factor for suicide in young adults, but the mechanisms involved are still unclear. Drawing on the Interpersonal Theory of Suicide, the Evolutionary Model of Loneliness, and Prospect Theory, we examined if high and low levels of loneliness are associated with different patterns of response to losses or gains of belongingness.MethodsA sample of 188 students completed the UCLA‐Loneliness scale (version 3) and measures of suicide risk. Participants in the top and bottom tertiles of loneliness scores completed a computerized task designed to induce changes (gains, losses) or consistency in risk factors for suicide (belongingness, burdensomeness) over time, and examined the effect on desire to quit the task.ResultsThe results showed that the high loneliness group exhibited a larger magnitude of effect on desire to quit from gaining belongingness than for losing belongingness. In contrast, the low loneliness group showed a larger change in desire to quit from losing belongingness than gaining belongingness.ConclusionThe findings provide preliminary experimental support for distinct profiles of suicide risk based on prevailing levels of loneliness. The findings are discussed in relation to a need for increased precision in theoretical models of suicide and loneliness.

USA Suicides Compared to Other Western Countries in the 21st Century: Is there a Relationship with Gun Ownership?

Objectives Causes of suicide are complex indicating a nation’s psycho-socio-economic well-being hence this population-based study explores whether USA suicides worsened compared to nineteen Other Western Countries (OWC) being possibly related to gun ownership in the 21st Century. Methods Total suicide data are drawn from the latest WHO Age-Standardised-Death-Rates per million (pm) controlled for age, sex, and population, along with suicides in the five age- bands 15–34 years to 75 + years. National gun ownership data from the international Small Arms Survey. Chi-square tests any significant difference between American and OWC suicides during the century. Spearman Rank Order correlations are used to determine comparability of suicides and gun ownership per thousand person rates over the period 2000–15. Results USA had the highest gun ownership, treble the rate of the next highest country. American Total suicides rose 27%, significantly more than eight other countries (p < 0.05). The USA had significantly worse suicide outcomes for Older (75+) people than three OWC; eleven for Mature Adults 55–74; eight for Adults 34–54 and for ten countries for Young Adults 15–34. Young Adult suicides numbered 12,438, 6,702 gun-related in 2015, exceeding recent USA military losses. Only Young Adult suicides positively correlated with gun ownership (<0.025). Conclusions The key finding is whilst most countries reduced suicides American rates rose substantially this century, raising questions about US society. Importantly the easy access to firearms in the USA makes Young Adult suicide more likely when facing psycho-social stress. This study exposes the vulnerability of distressed young American adults in a permissive gun culture, with its sequel, life-long grieving parents. Highlights During 21st Century USA suicides rose substantially more than other Western nations. Only USA suicides rose >20% amongst Total suicides and in those aged 15-to-74years. USA Young Adult suicides 150,099 in 21st century, 12,438 in 2015, 6,702 were gun-related.

Effect of the FDA Black Box Suicidality Warnings for Antidepressants on Suicide Rates in the USA.

Background: Some authors claimed that the US Food and Drug Administration (FDA) black box warning on treatment-emergent suicidality with antidepressants in adolescents (issued 2004) and young adults (issued 2006) led to an increase of suicides, based on the analyses of ecological data with debatable assumptions about putative changes in suicide rates. Aims: To explore if putative changes in suicide rates in adolescents and young adults at the time of the FDA warnings is a detectable signal in the data or compatible with random fluctuations. Method: We applied different changepoint analyses for adolescent and young adult suicide rates from 1981 to 2019 in the USA. Results: Changepoint analysis did not support a detrimental effect of the FDA black box warnings. The downward trend of suicides reversed several years after the warning in adolescents (2007-2009) and many years before in young adults (1999-2001). Limitations: Our analyses cannot rule out detrimental effects of the FDA warnings. However, even if there was such an effect, it was likely small and indistinguishable from random fluctuations in the available suicide data. Conclusion: There is no detectable change of trend in adolescent or young adult suicide rates in line with a detrimental effect of the FDA black box warnings on treatment-emergent suicidality.

Three confounded high-risk groups for suicide in adolescents and young adults.

Suicide rates among adolescents and young adults have been increasing in the last decade. The current knowledge of the warning signs, risk factors, and the use of screening tools has many gaps. There are many views from within, critics, survivors, and advocacy groups to focus more on the contextual understanding of symptomatology. In clinical practice, many of these high-risk groups fail to raise the red flags due to the complex and ambiguous nature of presentations. Therefore, these groups need greater attention, and given their counter-initiative nature, they challenge the current approaches to address suicidality in adolescents and young adults.

Transgender adolescent and young adult suicide: A bioecological perspective.

Suicide is a public health crisis disproportionately affecting transgender adolescents and young adults. There are gaps in research evaluating this phenomenon using a multilevel, life-course approach. The following paper will provide an overview of the current models of suicide, critique their applicability to understanding suicide among transgender youth, and discuss how using a bioecological systems approach will help to advance our understanding of suicide among transgender youth. Transgender adolescents and young adults often face unique combinations of interpersonal and intrapersonal challenges that require managing a stark misalignment of social characters, expectations, and roles. These factors are imposed by the complex interactions and influences of the bioecological systems in which transgender adolescents and young adults are situated. Future research is needed to elucidate the characteristics of bioecological adversity faced by this vulnerable population. Identification of these relationships are likely to highlight effective targets for multilevel interventions aimed at preventing suicide.