Prospective predictors of adolescent suicidality: 6-month post-hospitalization follow-up

Abstract

Background The aim of this study was to examine prospective predictors of suicide events, defined as suicide attempts or emergency interventions to reduce suicide risk, in 119 adolescents admitted to an in-patient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Method Structured diagnostic interviews and self-report instruments were administered to adolescent participants and their parent(s) to assess demographic variables, history of suicidal behavior, psychiatric disorders, family environment and personality/temperament. Results Baseline variables that significantly predicted time to a suicide event during follow-up were Black race, high suicidal ideation in the past month, post-traumatic stress disorder (PTSD), childhood sexual abuse (CSA), borderline personality disorder (BPD), low scores on positive affectivity, and high scores on aggression. In a multivariate Cox regression analysis, only Black race, CSA, positive affect intensity and high aggression scores remained significant. Conclusions Our findings suggest the following for adolescent populations: (1) in a very high-risk population, risk factors for future attempts may be more difficult to ascertain and some established risk factors (e.g. past suicide attempt) may not distinguish as well; and (2) cross-cutting constructs (e.g. affective and behavioral dysregulation) that underlie multiple psychiatric disorders may be stronger predictors of recurrent suicide events than psychiatric diagnoses. Our finding with respect to positive affect intensity is novel and may have practical implications for the assessment and treatment of adolescent suicide attempters.

Association of Adolescent Dimensional Borderline Personality Pathology with Past and Current Nonsuicidal Self-Injury and Lifetime Suicidal Behavior: A Clinical Multicenter Study

“…These findings are also in line with previous research [51,52]. Given the fact that one of the strongest predictors of completed suicide or further SAs has been found to be a previous SA [53,54] and that the D-BPP prospectively predicts adolescent SAs [55], the group identified may be at particular risk of future suicidal behavior and even suicide.…”

Risk for Suicide Among Treatment Seeking Adolescents: The Role of Positive and Negative Affect Intensity

“…However, our understanding of the role of affect intensity in relation to adolescent risk for suicide is limited. This is a notable gap in the literature, given the importance of affect, particularly strongly experienced affect, in terms of suicide risk among adults (e.g., Lynch et al 2004) and adolescents (e.g., Yen et al 2013). Importantly, findings from studies conducted with youth are mixed.…”

“…Specifically, the present study examined the relation between adolescent risk for suicide and affect intensity using the AIR-Y. In light of past findings suggesting a unique role of PA in risk for suicide (Hirsch et al 2007;Yen et al 2013), it was hypothesized that in the current cross-sectional study PA would be uniquely associated with suicide risk among treatment-seeking adolescents. Second, given cross-sectional data linking NI (without reference to NR) to risk for suicide ), we predicted NI, but not NR, would be uniquely associated with risk for suicide.…”

Life Events: Worries and Suicide Attempts Implications in Adolescents

“…In particular, more research is warranted to determine whether the effect of worries on suicide attempts is independent of psychopathology, especially depression severity and/or hopelessness, two strong proximal factors for suicide attempts and relapse [34,47,48]. This study showed that the onset of stressful life events affected the level of worries among adolescents.…”