Researchers in the USA have performed a multi-site, prospective analysis of >2,000 adolescents aged 12-17 years to try to determine the short-term predictors of suicide attempts within 3-months of an emergency department visit. The study population was enriched to include a high proportion of adolescents at risk for suicide attempts.
At baseline, >50% of the study’s follow-up sample reported a lifetime history of suicidal ideation (SI) and ~40% reported a lifetime history of suicidal behaviour: 4.9% of the follow-up cohort made a suicide attempt between enrolment and 3-month follow-up. Multivariate analyses identified numerous predictors of short-term suicide attempts in this sample, as well as in four critically important subgroups defined by sex and the presence, or absence, of recent suicidal thoughts. Notably, school or social connectedness emerged as a key protective factor for the total follow-up sample and several subgroups of adolescents, including adolescents who did not report suicidal thoughts at baseline, and adolescent females. This key predictor was not significant for adolescent males.
Consistent with these findings, a growing body of research1 suggests that higher levels of school connectedness are associated with a lower prevalence of suicidal behaviours in general school samples, high risk adolescents, and sexual minority adolescents.2 The researchers propose, therefore, that social and school connectedness might be an important target for suicide attempt risk assessment and preventive intervention.
King, C. et al. (2019), Predicting 3-month risk for adolescent suicide attempts among paediatric emergency department patients. J. Child Psychol. Psychiatr. doi:10.1111/jcpp.13087
1Gunn, J. F., Goldstein, S. E. and Gager, C. T. (2018). A longitudinal examination of social connectedness and suicidal thoughts and behaviours among adolescents. Child Adolesc. Ment. Health, 23(4), 341-350. doi:10.1111/camh.12281
2Marraccini, M. E. and Brier, Z. M. (2017). School connectedness and suicidal thoughts and behaviours: systematic meta-analysis. Sch. Psychol. Q., 32(1), 5-21. doi: 10.1037/spq0000192.
This paper forms part of the JCPP Special issue 2019 – Suicide and self-harm: Pathways for Minimizing Suicide & Premature Deaths and Maximizing Hope and Wellbeing.
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