Adolescent suicide is a large public health problem. When suicide is attempted and interrupted, it can put a significant financial and logistical strain on health resources. Therefore, it is important to understand what factors predict suicidal ideation in adolescents.
Shirley Yen of the Department of Psychiatry and Human Behavior at Brown University in Rhode Island wanted to assess the risk of suicide in a group of adolescents receiving inpatient psychiatric care. Yen evaluated 119 teens for 6 months after their release from a psychiatric hospital and found that there were several factors that predicted who would attempt suicide again and when.
Overall, 19% of the participants attempted suicide again and 37% had a suicide event, which included any intervention to prevent suicide as well as attempts. The risk factors that emerged included previous self-harm, borderline personality (BPD), previous suicide attempts, depression, and posttraumatic stress. Surprisingly, Yen found that race was also significant in that the black participants had high rates of repeat suicide attempts than the white participants.
But the biggest risk factor was childhood sexual abuse (CSA). Although Yen did not find that psychological issues such as anxiety, substance misuse, or ADHD predicted suicide attempts, she did find a direct link between posttraumatic stress (PTSD) resulting from CSA and suicide attempts. Almost half of the participants that reported having PTSD also had a history of CSA.
Research has demonstrated repeatedly that survivors of CSA are extremely vulnerable to a number of negative physical and psychological outcomes. Yen also looked at personality traits and found low positive mood and high aggression were common in the suicide attempters. Again, CSA can increase feelings of aggression and low positive affect can be a symptom of depression or PTSD.
Yen added, “The adverse short- and long-term consequences of CSA underscore the need for the assessment of childhood abuse and also public health awareness of its ramifications, such as increased suicide risk.” Overall, these findings show that adolescents, and especially those with a history of CSA, are at extremely high risk of taking their own lives in the period immediately following inpatient treatment and therefore, should be monitored closely by parents, caregivers, and clinicians.
Yen, S., et al. (2013). Prospective Predictors of Adolescent Suicidality: 6-Month Post-Hospitalization Follow-Up. Psychological Medicine 43.5 (2013): 983-93. ProQuest. Web.
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