Characteristics of suicidal ideation that predict the transition to future suicide attempts in adolescents

J Child Psychol Psychiatry. 2014 Nov;55(11):1288-96. doi: 10.1111/jcpp.12245. Epub 2014 May 15.

Abstract

Background: The present study sought to examine characteristics of suicidal ideation (SI) that predict a future suicide attempt (SA), beyond psychiatric diagnosis and previous SA history.

Methods: Participants were 506 adolescents (307 female) who completed the Columbia Suicide Screen (CSS) and selected modules from the Diagnostic Interview Schedule for Children (C-DISC 2.3) as part of a two-stage high school screening and who were followed up 4-6 years later to assess for a SA since baseline. At baseline, participants who endorsed SI on the CSS responded to four questions regarding currency, frequency, seriousness, and duration of their SI. A subsample of 122 adolescents who endorsed SI at baseline also completed a detailed interview about their most recent SI.

Results: Thinking about suicide often (OR = 3.5, 95% CI = 1.7-7.2), seriously (OR = 3.1, 95% CI = 1.4-6.7), and for a long time (OR = 2.3, 95% CI = 1.1-5.2) were associated with a future SA, adjusting for sex, the presence of a mood, anxiety, and substance use diagnosis, and baseline SA history. However, only SI frequency was significantly associated with higher odds of a future SA (OR = 3.6, 95% CI = 1.4-9.1) when also adjusting for currency, seriousness, and duration. Among ideators interviewed further about their most recent SI, ideating 1 hr or more (vs. less than 1 hr) was associated with a future SA (OR = 3.6, 95% CI = 1.0-12.7), adjusting for sex, depressive symptoms, previous SA history, and other baseline SI characteristics, and it was also associated with making a future SA earlier.

Conclusions: Assessments of SI in adolescents should take special care to inquire about frequency of their SI, along with length of their most recent SI.

Keywords: Suicidal ideation; adolescence; suicide attempt.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Adult
  • Child
  • Female
  • Humans
  • Male
  • Prognosis
  • Suicidal Ideation*
  • Suicide, Attempted / psychology*
  • Young Adult