Predictors of Multiple Suicide Attempts among Suicidal Black Adolescents

Psychopathology, social support, and interpersonal orientation were studied in relation to suicide attempt status in acutely suicidal, psychiatrically hospitalized Black adolescents and a matched sample of White adolescents. In the total sample, multiple attempters were differentiated by lower perceived support. Within the Black youth subsample, social comparison and positive stimulation from others differentiated multiple attempters from single attempters/ideators. Only suicidal ideation predicted multiple attempts among White youth and only higher interpersonal orientation predicted multiple suicide attempts within Black adolescents.     

The Role of Social Connectedness and Sexual Orientation in the Prevention of Youth Suicide Ideation and Attempts Among Sexually Active Adolescents

The impact of types of social connectedness—family, other adult, and school—on suicide ideation and attempts among all youth, the relative impact of each type, and effect modification by sexual orientation was assessed. Data were from the 2007–2009 Milwaukee Youth Risk Behavior Surveys. Multivariable logistic regression analyses calculated the risk of suicide ideation and attempts by sexual orientation, types of social connectedness, and their interaction. Among all youth, each type of connectedness modeled singly conferred protective effects for suicide ideation. Family and other adult connectedness protected against suicide attempts. When modeled simultaneously, family connectedness protected against ideation and attempts. Sexual orientation modified the association between other adult connectedness and suicide ideation. Findings suggest that family connectedness confers the most consistent protection among all youth and sexual orientation does not generally modify the association between connectedness and suicidal behavior.     

Psychosocial–Environmental Risk Factors for Suicide Attempts in Adolescents with Suicidal Ideation: Findings from a Sample of 73,238 Adolescents

We determined risk factors that discriminate between suicide attempt (SA) adolescents and suicidal ideation only (SI only) adolescents using data from the 2010 Korea Youth Risk Behavior Web‐based Survey (12–19 years; N = 73,238). In males, heavy alcohol use, drug use, and high perceived sadness/hopelessness showed significant effects on the presence of SA versus the presence of SI only. In females, along with these variables, low academic achievement, poor perceived health status, high perceived stress, and unhealthy coping strategy were also significantly related to the presence of SA versus SI only. Therefore, clinical interventions targeting adolescents' psychological distress are warranted to prevent suicide.     

Sexual Orientation in Adolescents Who Commit Suicide

It has been suggested that there is a strong relationship between suicidal behavior and homosexuality in adolescence. It has been further suggested that it is due to the stigmatization and feelings of isolation that are experienced by many gay adolescents. Much of the literature that has given support to these hypotheses has been conducted on uncontrolled nonrepresentative samples and its generalizability is open to question. An opportunity to examine the relationship in an unselected sample arose in a case control, psychological autopsy study of 120 of 170 consecutive suicides under age 20 and 147 community age, sex, and ethnic matched controls living in the Greater New York City area. Homosexuality was defined as having had homosexual experiences or having declared a homosexual orientation. Three teenagers and no controls met these criteria. The difference was not significant. The circumstances of death were examined and are described. In no instance did suicide directly follow an episode of stigmatization. All three suicides had evidence of significant psychiatric disorder before death. In spite of opportunities for biased reporting, it is concluded that this study finds no evidence that suicide is a common characteristic of gay youth, or that when suicide does occur among gay teenagers, that it is a direct consequence of stigmatization or lack of support.     

Nonsuicidal Self-injury,Suicide Planning,and Suicide Attempts Among High-risk Adolescents Prior to Psychiatric Hospitalization

Research on Child and Adolescent Psychopathology - The purpose of this study was to understand the trajectories of nonsuicidal self-injury (NSSI) and suicide plans (SP) in the 90 days...     

Sexual Assault,Overweight, and Suicide Attempts in U.S. Adolescents

Associations between overweight, sexual assault history, and suicide attempts were examined among 31,540 adolescents from the combined 2009 and 2011 nationally representative Youth Risk Behavior Surveys samples. These variables have not previously been studied concurrently. It was hypothesized that overweight and sexual assault, together, would interact and result in increased suicide attempts. Findings across analyses included (a) no significant associations between sexual assault and overweight in females or males (p = .65 and p = .90, respectively), (b) statistically significant associations between female (but not male) overweight status and suicide attempts (p = .001), (c) a strong association between sexual assault and suicide risk in males (p < .001) and females (p < .001), and (d) an elevated risk for suicide in overweight males with co‐occurring sexual assault, with over 33% of males with such histories attempting suicide. Preliminary findings have powerful implications for research and secondary prevention.     

Suicidal Ideation of Psychiatrically Hospitalized Adolescents has One-Year Predictive Validity for Suicide Attempts in Girls Only

Clinicians commonly incorporate adolescents’ self-reported suicidal ideation into formulations regarding adolescents’ risk for suicide. Data are limited, however, regarding the extent to which adolescent boys’ and girls’ reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys’ and girls’ self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13–17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children’s Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization.     

Physical Activity,Suicide Risk Factors,and Suicidal Ideation in a Veteran Sample

The association between current level of suicidal ideation and physical activity was tested in a broad sample of veterans seeking care from the Veterans Health Administration. It was hypothesized that the two variables would be significantly inversely related. It was further hypothesized that the relationship would be mediated by depressive symptoms, disturbed sleep, and a measure of heart rate variability based on existing research regarding physical activity and sleep. Due to the first hypothesis not being supported, the second could not be tested. Post hoc correlation analyses did find associations between physical activity and depressive symptoms, in expected directions, and are discussed. Possible explanations for the negative findings along with recommendations for future research to continue exploring links between suicide risk and physical activity are presented. We conclude by suggesting that physical activity may have promise as a risk reduction intervention and that prospective data are more likely to yield significant results than the cross‐sectional methodology employed in the current study.     

The Association Between Anhedonia,Suicide Ideation,and Suicide Attempts: A Replication in a Persian Student Sample

Research suggests that anhedonia, a common symptom of depression, may be uniquely associated with suicidal behavior. However, little research has examined this association across cultures. To address this limitation, this study attempted to replicate a recent anhedonia and suicide study (conducted in a western culture) in a Persian sample using the Specific Loss of Interest and Pleasure Scale, Persian version. Participants consisted of 404 students who were recruited from a Persian university. Surprisingly, our results indicated that anhedonia levels were more than double those found in similar American student sample. Despite this marked difference in anhedonia symptoms, we found that anhedonia was associated with suicide risk, even when it was statistically accounting for other depressive symptoms. These findings suggest that anhedonia is a robust predictor of suicide risk across these two cultures. Further, anhedonia may be a particularly important treatment target among Persian students.     

The Relationship of Drug Use to Suicide Ideation and Attempts Among African American,Hispanic, and White Non-Hispanic Male Adolescents

This study presents self-report cross-sectional and longitudinal data on associations between drug use, suicide ideation, and attempts in a multiethnic sample of seventh- and eighth-grade male adolescents attending school in the greater Miami, Florida, area. African Americans had the highest prevalence of 6-month ideation (20.5%), and Haitians had the highest attempts (11.4%). For the total sample, tranquilizers had the highest odds ratio for ideation (3.4), and PCP for attempts (6.2). Psychoactive drug-use was consistently related to attempts among Hispanics, white non-Hispanics, and African Americans. Acculturation strains interacted with cocaine and crack to predict suicide attempts among Hispanic respondents.     

Manifest Predictors of Past Suicide Attempts in a Population of Icelandic Adolescents

Past suicide attempts have been found to be a major risk factor for both repeated attempts and completed suicide. The utility of this is, however, limited by the fact that the majority of all suicide attempts never come to professional attention. This paper explores the possibility of using manifest indicators to predict which individuals in a population of adolescents have attempted suicide. Using logistic regression, manifest predictors in the categories of school, leisure, peer and parent relations, consumption, and contact with suicidal behavior could identify either a quarter of the population containing three quarters of all suicide attempters or 2% of the population where two thirds of those predicted actually had attempted suicide. It is thus concluded that manifest predictors can complement psychiatric screening methods by efficiently reducing the number to be screened.     

Reasons for Attempting Suicide among a Community Sample of Adolescents

The motives of suicide attempts among a community sample of 99 U.S. high school students were explored. Participants completed an in‐depth computer‐assisted self interview about their most recent attempts as well as additional psychosocial measures. Results indicated that nearly 75% of the adolescents engaged in suicide attempts for reasons other than killing themselves and that depressive symptoms and premeditation prior to the attempt were significantly associated with increased risk for engaging in the attempts with death as a clear motive. Linking motive for an attempt (death, interpersonal communication, emotion regulation) and treatment approach may improve prevention of subsequent attempts and completed suicides.     

Effect of Socioeconomic Status on the Linkage Between Suicidal Ideation and Suicide Attempts

Previous suicide attempts are a leading risk factor for completed suicide. To identify specific characteristics of those at high risk for attempts, we investigated associations with socioeconomic status (SES). Data from the 2013 Korean Community Health Survey (KCHS) included adults who reported suicidal ideation (N = 220,245). Attempts in the past 12 months were assessed. Associations of demographic, socioeconomic, and suicide‐related behavioral factors were analyzed using multiple logistic regression. Among those with suicidal ideation, 862 (3.9%) had attempted suicide. After stratification by age and gender, results showed that low education and unemployed young adult men and women had significantly higher rates of attempts. The lowest income level was associated with significantly higher rates of attempts in only young adult women. Among those with the lowest and highest income, the association between ideation and attempts was attenuated, whereas it was enhanced among other income groups.     

Suicide and Suicidal Attempts in the United States: Costs and Policy Implications

The national cost of suicides and suicide attempts in the United States in 2013 was $58.4 billion based on reported numbers alone. Lost productivity (termed indirect costs) represents most (97.1%) of this cost. Adjustment for under‐reporting increased the total cost to $93.5 billion or $298 per capita, 2.1–2.8 times that of previous studies. Previous research suggests that improved continuity of care would likely reduce the number of subsequent suicidal attempts following a previous nonfatal attempt. We estimate a highly favorable benefit–cost ratio of 6 to 1 for investments in additional medical, counseling, and linkage services for such patients.     

Trajectories of Suicide Ideation,Nonsuicidal Self‐Injury,and Suicide Attempts in a Nonclinical Sample of Military Personnel and Veterans

Nonsuicidal self‐injury (NSSI) is a risk factor for suicide attempts, but little is known about NSSI among military personnel and veterans, or about the temporal sequencing of NSSI relative to suicide ideation and attempts. This study evaluates trajectories of suicide ideation, NSSI, and suicide attempts in a sample of 422 military personnel and veterans. Of those with a history of NSSI, 77% also experienced suicide ideation. Suicide ideation emerged before NSSI (67%) more often than the reverse (17%). Of those with a history of suicide attempt, 41% also engaged in NSSI. NSSI emerged prior to the first suicide attempt (91%) more often than the reverse (9%). The length of time from suicide ideation to suicide attempt was longer for those who first engaged in NSSI (median = 3.5 years) compared with those who did not engage in NSSI (median = 0.0 years), Wald χ²(1) = 11.985, p = .002. Age of onset was earlier for participants reporting NSSI only compared with those reporting both NSSI and suicide attempts (16.71 vs. 22.08 years), F(1, 45) = 4.149, p = .048. NSSI may serve as a “stepping stone” from suicide ideation to attempts for 41% of those who attempt suicide.     

Suicidal Ideation and Associated Factors Among School-Going Adolescents in Harare,Zimbabwe

This study determined the prevalence and associated factors of suicidal ideation among school-going adolescents in Harare, Zimbabwe. Data on 1970 respondents were obtained from a cross sectional study of the Global School-based health survey. Respondents were selected using a two-stage probability sampling technique. The prevalence of suicidal ideation was 21.6%. Males were less likely to have suicidal ideation than females (OR=0.70; 95% CI 0.54,0.91). Worrying (OR=1.81; 95% CI 1.29,2.56), feeling of loneliness (OR=2.04; 95% CI 1.43,2.90), cigarette smoking (OR=1.87; 95% CI 1.11, 3.16), and drinking alcohol (OR=1.74; 95% CI 1.17, 2.60) were associated with suicidal ideation. Public health programs designed to control cigarette smoking and alcohol use may also impact positively on suicidal ideation.     

Religiosity and Sexual Activity Among Older Adolescents

This study investigates religiosity, sexual activity, and sexual permissiveness among older adolescents. Eighty-two college students completed a survey that measured religiosity, sexual permissiveness, self-esteem, frequency of recent sexual encounters, and motivators for sexual activity or abstinence. Guilt, prayer, organized religious activity, and religious well-being predicted fewer sexual encounters. Orthodox beliefs, participation in organized religious activities, and highly-rated importance of faith predicted less permissive sexual attitudes. We conclude that guilt and religious activity can be good motivators for decreasing sexual encounters. We recommend that health practitioners encourage participation in religious activity among adolescents.