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“Existing research suggests that many well-established risk factors for suicide (such as depression, hopelessness, and impulsivity) do not predict suicide attempts among adolescents who have suicidal thoughts or engage in nonsuicidal self-harm,” wrote Becky Mars, Ph.D., a research fellow in epidemiology in the Department of Population Health Sciences at the University of Bristol and an American Foundation for Suicide Prevention postdoctoral fellow, and colleagues. “Longitudinal studies investigating predictors of future suicide attempts in these high-risk groups are extremely scarce.”
Researchers examined the Avon Longitudinal Study of Parents and Children, a population-based birth cohort study in the United Kingdom, for participants’ answers on two self-report questionnaires on suicidal thoughts and self-harm completed at 16 and 21 years of age. At baseline, 456 adolescents reported suicidal thoughts, and 569 adolescents reported nonsuicidal self-harm. Researchers explored the associations between risk factors at baseline and future first-time suicide attempts through age 21. (Participants who reported attempting suicide at baseline were excluded to focus on predictors of first-time suicide attempts.)
Among participants with suicidal thoughts at age 16, the following factors strongly predicted a suicide attempt by age 21, all of which were associated with two to three times higher risk of suicide attempt:
- Nonsuicidal self-harm
- Cannabis use
- Other illicit drug use
- Higher levels of the personality type intellect/openness
Among participants with nonsuicidal self-harm at age 16, the following factors strongly predicted a suicide attempt by age 21, all of which were associated with twice the risk of a suicide attempt:
- Cannabis use
- Other illicit drug use
- Insufficient sleep
“It might appear surprising that we did not find evidence of an association for several well-established suicide risk factors, including depression symptoms, psychiatric disorder, suicidal plans, and impulsivity. However, our results are consistent with previous research that has suggested that these factors appear to be associated with suicide attempts … but are not involved in the transition,” the researchers wrote.
For related information, see the Psychiatric News article “Irritability in Childhood May Point to Teens at High Risk for Suicide” and the Psychiatric Services article “ ‘13 Reasons Why’: Viewing Patterns and Perceived Impact Among Youths at Risk of Suicide.”
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