Developmental Trajectories of Suicidal Thoughts and Behaviors From Adolescence Through Adulthood

Abstract

Objective Little is known about the patterns among individuals in the long-term course of suicidal thoughts and behaviors (STBs). The objective of this study was to identify developmental trajectories of STBs from adolescence through young adulthood, as well as risk and protective covariates, and nonsuicidal outcomes associated with these trajectories. Method 180 adolescents (ages 12–18 at recruitment) were repeatedly assessed over an average of 13.6 years (2,273 assessments) since their psychiatric hospitalization. Trajectories were based on ratings of STBs at each assessment. Covariates included psychiatric risk factors (proportion of time in episodes of psychiatric disorders, hopelessness, trait anxiety, impulsivity, and aggression in adulthood, sexual and physical abuse, parental history of suicidal behavior), protective factors (survival and coping beliefs, social support in adulthood, parenthood), and nonsuicidal outcomes (social adjustment and functional impairment in adulthood, school drop-out, incarcerations). Results Using a Bayesian group-based trajectory model, four trajectories of STBs were identified: (1) an Increasing Risk class (11%), (2) a Highest Overall Risk class (12%), (3) a Decreasing Risk class (33%), and (4) a Low Risk class (44%). The four classes were associated with distinct patterns of correlates in risk and protective factors and nonsuicidal outcomes. Conclusion Adolescents and young adults have heterogeneous developmental trajectories of STBs. These trajectories and their covariates may inform strategies for predicting STBs and targeting interventions for individuals at risk for suicidal behavior.

What distinguishes adolescents with suicidal thoughts from those who have attempted suicide? A population‐based birth cohort study

“…The potential mechanisms underlying this relationship require further study but could include genetic influences, imitation, social transmission and assortative relating. In contrast to these findings, a recent study of hospitalised adolescents found no association between family history of suicidal behaviour and suicidal ideation/behaviours (Goldston et al., ). Our sample was population‐based, and we were not able to explore associations with hospitalisation/service use.…”

“…There is increasing evidence from both clinical and population‐based samples that one of these risk factors, exposure to self‐harm in others, reliably distinguishes between young people with suicidal ideation and attempts (Asarnow et al., ; Dhingra, Boduszek, & O'Connor, ; O'Connor & Nock, ). Other factors that have been found to be associated with suicide attempts amongst ideators in this age group include mental health problems, aggression, impulsivity, substance abuse, female gender, stressful life events, abuse, relationship problems, pregnancy events and factors relating to service use/treatment (Asarnow et al., ; Borges, Benjet, Medina‐Mora, Orozco, & Nock, ; Goldston et al., ; Nock et al., ; O'Connor, Rasmussen, & Hawton, ; Taliaferro & Muehlenkamp, ). However, effect sizes are often small, and findings have frequently been inconsistent across studies or have not been replicated.…”

Digital phenotyping of suicidal thoughts

“…Although several studies find different phenotypes based on risk factors for suicidal thoughts and several others have examined profiles of suicidal thinking based on the trajectory of suicidal thinking measured weeks or months apart (Czyz & King, 2015;Goldston et al, 2016;Wolff et al, 2018), no prior studies have examined whether there are different phenotypes of suicidal thoughts based on the actual experience of thoughts itself. Recent theoretical work by Bernanke, Stanley, and Oquendo (2017) suggests that there may be at least two subtypes of the experience of suicidal thinking.…”

Suicidal Behavior in Adolescents: A Latent Class Analysis

“…Indeed, suicide is the second leading cause of death in young populations [8]. Suicidal behavior among children and adolescents is, however, different to that reported in adult populations [9]. Prevalence rates seem to vary not only by age but also by gender.…”