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

Published online by Cambridge University Press:  30 August 2012

S. Yen ,
L. M. Weinstock ,
M. S. Andover ,
E. S. Sheets ,
E. A. Selby  and
A. Spirito
S. Yen*
Affiliation:
Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
L. M. Weinstock
Affiliation:
Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
M. S. Andover
Affiliation:
Department of Psychology, Fordham University, Bronx, NY, USA
E. S. Sheets
Affiliation:
Department of Psychology, Colby College, Waterville, ME, USA
E. A. Selby
Affiliation:
Department of Psychology, Rutgers University, New Brunswick, NJ, USA
A. Spirito
Affiliation:
Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
*
*Address for correspondence: S. Yen, Ph.D., 700 Butler Drive, Providence, RI 02906, USA. (Email: [email protected])
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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.

Keywords

Adolescentaggressionimpulsivitypositive affectivitysuicide
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 5 , May 2013 , pp. 983 - 993
Copyright
Copyright © Cambridge University Press 2012

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