Psychotic experiences and psychological distress predict contemporaneous and future non-suicidal self-injury and suicide attempts in a sample of Australian school-based adolescents

Martin, Graham; Thomas, Hannah J.; Andrews, Tori; Hasking, Penelope; Scott, James G.

doi:10.1017/s0033291714001615

Cited by 82 publications

(69 citation statements)

References 39 publications

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“…For adolescents with baseline suicidal ideation, psychological distress (at baseline) was associated with incident suicide attempts at 1‐year follow‐up. This finding has face validity and is consistent with previous studies showing psychological distress as a significant and independent predictor of suicidal ideation and attempt outcomes . There was little support for the IPTS theory in the mediation models.…”

Section: Discussionsupporting

confidence: 86%

Investigating the role of hallucinatory experiences in the transition from suicidal thoughts to attempts

Hielscher

DeVylder

Connell

et al. 2019

Acta Psychiatr Scand

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Objective Psychotic experiences, including auditory hallucinatory experiences (HEs), are strongly associated with both suicidal thoughts and behaviour. This study examined their role in the ideation‐to‐attempt transition in adolescents, including their direct and indirect effect via potential mediators. Method Participants were from an Australian prospective longitudinal cohort of 1669 adolescents (12–17 years); of which a subsample endorsing baseline suicidal ideation (n = 216) was the focus of most analyses. Suicidal thoughts and behaviours were measured using the Self‐Harm Behaviour Questionnaire. The Diagnostic Interview Schedule for Children was used to assess auditory HEs. Potential mediators of interest were psychological distress and Interpersonal Theory of Suicide (IPTS) constructs. Results Among adolescents reporting suicidal ideation at baseline (n = 216), 6.5% had attempted suicide during follow‐up. The size of auditory HEs’ univariate effect suggests a possible strong relationship with increased risk of incident suicide attempts (OR = 2.40; 95%CI = 0.76–7.56); however, there was inadequate statistical power to produce a precise estimate. When HEs were accompanied by distress there was a nine‐fold increased risk of acting on suicidal thoughts. Distress was independently associated with risk of attempt transition (OR = 4.09), whereas IPTS constructs were poor explanatory variables in most models. Conclusion Adolescents with psychological distress and auditory HEs are at high risk of incident suicide attempts. Further investigations on the role of negative/distressing content of hallucinations in the ideation‐to‐attempt transition are warranted.

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Section: Discussionsupporting

confidence: 86%

Investigating the role of hallucinatory experiences in the transition from suicidal thoughts to attempts

Hielscher

DeVylder

Connell

et al. 2019

Acta Psychiatr Scand

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“…These partially inconsistent findings should be considered in light of the low rate of psychosis in the sample overall; replication in samples wherein psychosis is more prevalent is needed. Further, although psychotic experiences are linked to future NSSI behavior among adolescents (Martin et al, 2015), data on how psychosis contributes to suicidality in self-injurers is lacking. This may be because studies on adolescent suicidality often exclude patients with psychosis.…”

Section: Discussionmentioning

confidence: 99%

Adolescent self-injurers: Comparing non-ideators, suicide ideators, and suicide attempters

Stewart

Esposito

Glenn

et al. 2017

Journal of Psychiatric Research

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Adolescent non-suicidal self-injury (NSSI) and suicidality are serious health concerns; however, factors that contribute to the transition from NSSI to suicide ideation and suicide attempts are unclear. To address this gap, we investigated whether demographic characteristics, child maltreatment, and psychiatric factors are associated with the level suicidality among adolescents with a history of self-injury. Participants were three groups of adolescent inpatient self-injurers (n = 397, 317 female), aged 13–18 years (M = 15.44, SD = 1.36): (a) non-ideators (n = 96; no current suicide ideation and no lifetime suicide attempts), (b) suicide ideators (n = 149; current ideation and no lifetime attempts), and (c) suicide attempters (n = 152; current ideation and at least one lifetime attempt). Participants completed interviews assessing psychiatric diagnoses, suicidality, and NSSI characteristics, as well as questionnaires on childhood trauma, psychiatric symptoms, and risky behavior engagement. Depression severity was associated with greater odds being a suicide ideator (p < 0.001, OR = 1.04) and an attempter (p < 0.001, OR = 1.05) compared to a non-ideator. Suicide attempters used more NSSI methods and reported greater risky behavior engagement than non-ideators (p = 0.03, OR = 1.29 and p = 0.03, OR = 1.06, respectively) and ideators (p = 0.015, OR = 1.25 and p = 0.04, OR = 1.05, respectively); attempters used more severe NSSI methods (e.g., burning). Our results identify a wide range of risk markers for increasing lethality in a sample at high risk for suicide mortality; future research is needed to refine risk assessments for adolescent self-injurers and determine the clinical utility of using risk markers for screening and intervention.

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“…Moreover, a three year follow-up is longer than follow-up periods in most previous studies (Kelleher et al, 2013;Martin et al, 2015;Sullivan et al, 2015), thus increasing the likelihood of suicidal ideation or suicide attempts to occur, and enhancing statistical power. The present study is also the first longitudinal study that included dimensional symptom scales in the statistical analyses and used general population samples stratified by the presence or absence of mental disorders in an attempt to disentangle longitudinal associations between PE and suicidal ideation and suicide attempts from connected psychopathology, while minimizing residual confounding.…”

Section: Strengths and Limitationsmentioning

confidence: 98%

“…Therefore, it remains unclear whether there is a specific association between PE and suicidal behaviour or whether the association reflects the increased risk of suicidal behaviour in more severe states of mental distress associated with multidimensional psychopathology (Guloksuz et al, 2015;van Nierop et al, 2015b). In a previous study, PE were only associated with suicide attempts in individuals with associated psychological distress, while in the absence of psychological distress there was no association (Martin et al, 2015). Similarly, PE were particularly predictive of suicidal behaviour in the context of a mental disorder (DeVylder et al, 2015b;Kelleher et al, 2013).…”

Section: Introductionmentioning

confidence: 97%

Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology

Honings

Drukker

Nierop

et al. 2016

Psychiatry Research

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Psychotic experiences and incident suicidal ideation and behaviour 2 ABSTRACT This study examines the longitudinal associations between psychotic experiences (PE) and incident suicidal ideation and behaviour in the general population, and to what degree the association may be confounded by nonpsychotic psychopathology. Data from three prospective, general population cohorts were combined into one dataset (n=15837) and analysed using logistic regression, controlling for continuous measures of depression, anxiety and mania symptoms. Analyses were conducted in the entire sample, and in subsamples stratified by presence or absence of mental disorders. The presence of PE at baseline increased the risk of incident suicidal ideation and behaviour. However, adjustment for dimensional measures of psychopathology reduced effect sizes, although PE remained significantly associated with suicide attempts. Further examination of the associations revealed that PE were only associated with suicide attempts in individuals with at least one mental disorder.Similarly, in individuals without mental disorders, the risk of suicidal ideation increased as PE co-occurred with more symptom domains. The results of this study confirm that individuals with PE are at increased risk of suicidal ideation and behaviour. However, these associations are not specific, but reflect the increased risk of suicidal ideation in individuals with subthreshold multidimensional psychopathology and suicide attempts in individuals with co-occurring mental disorders.

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Psychotic experiences and psychological distress predict contemporaneous and future non-suicidal self-injury and suicide attempts in a sample of Australian school-based adolescents

Cited by 82 publications

References 39 publications

Investigating the role of hallucinatory experiences in the transition from suicidal thoughts to attempts

Investigating the role of hallucinatory experiences in the transition from suicidal thoughts to attempts

Adolescent self-injurers: Comparing non-ideators, suicide ideators, and suicide attempters

Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology

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