Higher Childhood Peer Reports of Social Preference Mediates the Impact of the Good Behavior Game on Suicide Attempt

Abstract

The Good Behavior Game (GBG) is a universal classroom-based preventive intervention directed at reducing early aggressive, disruptive behavior and improving children's social adaptation into the classroom. GBG is one of the few universal preventive interventions delivered in early elementary school that has been shown to reduce the risk for future suicide attempts. This paper addresses one potential mechanism by which the GBG lowers the risk of later suicide attempt. In this study we tested whether the GBG, by facilitating social adaptation into the classroom early on, including the level of social preference by classmates, thereby lowers future risk of suicide attempts. The measure of social adaptation is based on first and second grade peer reports of social preference (“which children do you like best?”; “which children don't you like?”). As part of the hypothesized meditational model, we examined the longitudinal association between childhood peer social preference and the risk of future suicide attempt, which has not previously been examined. Data were from an epidemiologically-based randomized prevention trial, which tested the GBG among two consecutive cohorts of first grade children in 19 public schools and 41 classrooms. Results indicated that peer social preference partially mediated the relationship between the GBG and the associated reduction of risk for later suicide attempts by adulthood, specifically among children characterized by their first grade teacher as highly aggressive, disruptive. These results suggest that positive childhood peer relations may partially explain the GBG-associated reduction of risk for suicide attempts and may be an important and malleable protective factor for future suicide attempt.

Contribution of genes and environment to the longitudinal association between childhood impulsive‐aggression and suicidality in adolescence

“…Future studies should aim to identify and test the role of putative environmental factors in the association between impulsive‐aggression and suicidality, as they might be promising targets for early preventive interventions. For example, the Good Behavior Game, an intervention designed to reduce aggression, was found to reduce suicidal behaviors via environmental mechanisms such as improving social adaptation into the classroom (Newcomer et al, ). Understanding the role of such early interventions in reducing environmental risks for impulsive‐aggressive and suicidality may open important clinical avenues.…”

Nonsuicidal Self-Injury Among African American and Hispanic Adolescents and Young Adults: a Systematic Review

“…Muehlenkamp et al (2010) have applied this model to preventing NSSI in predominantly White adolescents through engagement of school personnel as well as peers. Similarly, Newcomer et al (2016) examined the potential mechanisms by which the Good Behavior Game, a classroom-based universal preventive intervention designed to impart self-regulations skills, impacted future risk for suicide attempt. In a majority African American sample, the authors found that social integration and acceptance during first grade may contribute to decreased risk for future suicide attempt.…”

Master Clinician Review: Saving Holden Caulfield: Suicide Prevention in Children and Adolescents

“…27 The effects on suicidal outcomes were strongest among aggressive males, in whom program effects were mediated by improvements in positive peer ratings for these youth. 28 Hence, the GBG appears to have long-lasting effects on youths' suicidal ideation and behavior, but only if teachers receive the requisite training and supervision.…”