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. 2012 Jun;42(3):341-51.
doi: 10.1111/j.1943-278X.2012.0095.x. Epub 2012 Apr 30.

What's the Harm in Asking About Suicidal Ideation?

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What's the Harm in Asking About Suicidal Ideation?

Charles W Mathias et al. Suicide Life Threat Behav. .
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Abstract

Both researchers and oversight committees share concerns about patient safety in the study-related assessment of suicidality. However, concern about assessing suicidal thoughts can be a barrier to the development of empirical evidence that informs research on how to safely conduct these assessments. A question has been raised if asking about suicidal thoughts can result in iatrogenic increases of such thoughts, especially among at-risk samples. The current study repeatedly tested suicidal ideation at 6-month intervals for up to 2-years. Suicidal ideation was measured with the Suicidal Ideation Questionnaire Junior, and administered to adolescents who had previously received inpatient psychiatric care. Change in suicidal ideation was tested using several analytic techniques, each of which pointed to a significant decline in suicidal ideation in the context of repeated assessment. This and previous study outcomes suggest that asking an at-risk population about suicidal ideation is not associated with subsequent increases in suicidal ideation.

Figures

Figure 1
Figure 1
The number of adolescents with decreases (A) or increases (B) in suicidal ideation, classified by magnitude of change from first to last assessment. Small effect 20–50%, medium 50–80%, and large > 80% SD group suicidal ideation change from first to last assessment.
Figure 2
Figure 2
Pattern of change in suicidal ideation score plotted as a function of suicidal ideation at the study outset across 2-years of repeated assessments for the full sample (2a N = 170) and for those cases completing all 5 study visits (2b N = 54). Very High = 2 SD above the average initial suicidal ideation value, High = 1 SD, Average = the average initial suicidal ideation value, and Low = 0.5 SD below the average initial suicidal ideation.

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