Social Anxiety and Suicidality in Youth: A Systematic Review and Meta-analysis

Abstract

Suicide is a leading cause of death among young people every year. Identifying risk factors provides opportunities to intervene, and social anxiety may represent one such factor. This systematic review and meta-analysis aimed to review the evidence of associations between social anxiety and suicidality in youth (10–25 years). Embase, PsycInfo, and Medline were searched to identify relevant articles. Meta-analysis was conducted to examine the mean effect sizes of concurrent and prospective associations between social anxiety and three indices of suicidality in adolescents aged 10–25 years. Meta-analyses of 16 studies showed that social anxiety was associated cross-sectionally with suicide attempt (r = 0.10, 95% CI: 0.04, 0.15), suicidal ideation (r = 0.22, 95% CI: 0.02, 0.41), and suicide risk (r = 0.24, 95% CI: 0.05, 0.41), and prospectively at trend level with suicidal ideation (r = 0.62, 95% CI: -0.03, 0.90). An examination of the prospective associations with suicide attempt and risk was not possible due to a lack of studies. Several studies suggested that results could not be solely attributed to depressive symptoms. A high level of heterogeneity was observed in each meta-analysis. Moderation analysis was possible for gender and publication year only; neither was significant. Findings provide further evidence of a link between social anxiety and suicidal thoughts and behaviors in youth but are limited by the small number of studies of mixed quality. This review supports future research into social anxiety symptoms as potential risk factors and treatment targets for suicidal youth.

Prevalence, risk factors, and severity of suicidal ideation among Chinese adolescents: A Cross-Sectional Study

“…Anxiety symptoms were also identi ed as a signi cant risk factor for both suicidal ideation and severity of suicidal ideation. This association is consistent with the existing literature on the comorbidity between anxiety and suicidal ideation in adolescents [13,40,41]. A study involving 7054 adolescents, with an average age of 15.8 years, found a signi cant association between generalized anxiety symptoms and suicidal ideation [42].…”

“…Another cross-sectional study, conducted among senior high school students, revealed a moderate correlation between anxiety symptoms and suicidal ideation [43]. Moreover, a systematic review and meta-analysis demonstrated a signi cant association between higher levels of social anxiety and more frequent occurrences of suicidal ideation [40]. Multiple multilevel analyzed studies have consistently highlighted a signi cant correlation between learning anxiety and suicidal ideation [44].…”

The role of social support in suicidal behavior: A literature review

“…Individuals with suicidal behavior tend to hurt themselves before deciding to kill themselves. Research reveals suicidal behavior is closely related to low self-esteem, shame, hopelessness, feeling alone, stress and the presence of psychiatric disorders [3,13]. Suicidal behavior is also often associated with a state of individual trauma to something.…”

“…In addition to negative stress coping, another risk factor for suicidal behavior is psychiatric disorders. Psychiatric disorders such as major depression, bipolar disorder, personality disorders, and anxiety have been shown to be significantly associated with suicidal behavior [3].…”

The Effect of Appearance Anxiety on Social Anxiety among College Students: Sequential Mediating Effects of Self-Efficacy and Self-Esteem

“…Individuals with social anxiety disorder report low quality of life and severe impairments in social, occupational, and educational functioning [ 6 , 7 ]. In addition, a recent meta-analysis of the relationship between social anxiety and suicide in youth showed that higher levels of social anxiety were associated with more frequent suicidal ideation and higher current suicidal risk [ 8 ]. Given the harmfulness of social anxiety, it is necessary to investigate its mechanism and formulate timely intervention measures for college students with social anxiety.…”