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

Psychol Med. 2013 May;43(5):983-93. doi: 10.1017/S0033291712001912. Epub 2012 Aug 30.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Affect
  • African Continental Ancestry Group / statistics & numerical data
  • Aggression / psychology
  • Child Abuse, Sexual / psychology
  • Child Abuse, Sexual / statistics & numerical data
  • Comorbidity
  • European Continental Ancestry Group / statistics & numerical data
  • Family Health
  • Female
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data
  • Humans
  • Impulsive Behavior / epidemiology
  • Interview, Psychological
  • Male
  • Mental Disorders / epidemiology*
  • Multivariate Analysis
  • Proportional Hazards Models
  • Risk Factors
  • Self-Injurious Behavior / epidemiology*
  • Self-Injurious Behavior / psychology
  • Suicide / psychology
  • Suicide / statistics & numerical data*
  • Time Factors