Prevalence and predictors of persistent suicide ideation, plans, and attempts during college

Abstract

Background Suicide is the second-leading cause of death among college students in the US and is preventable. Approximately 1,100 college students die by suicide each year. This study examined the prevalence and predictors of one-time and persistent suicide ideation, plans, and attempts reported during college. Methods Data were gathered prospectively over four years. Face-to-face interviews were conducted with 1,253 first-year college students at one large mid-Atlantic university. Risk factors were measured in Year 1. Results An estimated 12%wt of individuals experienced suicide ideation at some point during college, and of those individuals, 25% had more than one episode of ideation (persistent ideation; 2.6%wt of the overall sample). Ten individuals had a plan or attempt during college (0.9%wt of the sample). Risk factors for persistent suicide ideation included low social support, childhood or adolescent exposure to domestic violence, maternal depression, and high self-reported depressive symptoms. Persistent ideators differed from one-time ideators only by higher levels of depression (p=.027). Persistent ideators were no more likely than one-time ideators to have made a suicide plan or attempt during college (8% vs. 9%, respectively). Limitations Although the sample size is large, only a small percentage of participants had persistent ideation, suicide plans or attempts during college. Conclusion These results have implications for programs aimed at identifying college students at risk for suicide. The accurate identification of college students at-risk for suicide is an important step toward suicide prevention.

Recurrent suicidal ideation in young adults

“…Our population-based estimate of frequency (2% of the overall sample; 32% of those with a history of SI) is similar to the 3% and 25% of American college students respectively who reported more than one SI episode over four years. 8 Similarly, Zivin et al 12 reported that 35% of college students with suicidal thoughts reported suicidal thoughts two years later. Borges et al 7 reported that 35% of American adults aged 25-65 years reported recurrent SI over ten years.…”

“…[1][2][3] Often defined as an indicator of severe emotional distress, suicidal ideation (SI) is one of the most robust predictors of self-harm, suicide attempts and completed suicide. 2,[4][5][6] SI that recurs over time could indicate ongoing severe depression [7][8][9] and may be linked to an increased risk of making suicide plans and suicide attempts. 5,10 However few longitudinal studies investigate recurrent SI in population-based samples 10,11 and in particular among young adults in whom the prevalence may be elevated.…”

“…5,10 However few longitudinal studies investigate recurrent SI in population-based samples 10,11 and in particular among young adults in whom the prevalence may be elevated. [7][8][9]12 Specifically, the developmental transition between adolescence and young adulthood represents a critical life period typically characterized by leaving the family home, joining the workforce, attending college or university, engaging in long-term relationships, and starting a new family. 13 In those with a psychosocial, psychological, and/or genetic predisposition to mental health problems, 8 these new social and environmental situations or stressors may lead to recurrent SI.…”

“…[7][8][9]12 Specifically, the developmental transition between adolescence and young adulthood represents a critical life period typically characterized by leaving the family home, joining the workforce, attending college or university, engaging in long-term relationships, and starting a new family. 13 In those with a psychosocial, psychological, and/or genetic predisposition to mental health problems, 8 these new social and environmental situations or stressors may lead to recurrent SI. Indeed, the frequency of SI is high during adolescence and young adulthood.…”

“…Indeed, the frequency of SI is high during adolescence and young adulthood. 2,3,8,14,15 A 2008 systematic review suggested that the 12-month prevalence estimates of SI are 15.0-29.0% (interquartile range [IQR], 16.9-24.1) in adolescents aged 12-17 years compared to 2.1-10.0% (IQR, 2.4-6.7) in adults ≥18 years. 2 The lifetime prevalence estimates of SI in adults ≥18 years is 5.6-14.3% 2 compared to 18% in young adults age 19-24 years.…”