Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T06:05:57.037Z Has data issue: false hasContentIssue false
  • English
  • Français

Trajectories of suicide attempts from early adolescence to emerging adulthood: prospective 11-year follow-up of a Canadian cohort

Published online by Cambridge University Press:  15 April 2020

Marie-Claude Geoffroy Open the ORCID record for Marie-Claude Geoffroy [Opens in a new window] ,
Massimiliano Orri ,
Alain Girard ,
Lea C. Perret  and
Gustavo Turecki
Marie-Claude Geoffroy*
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
Massimiliano Orri
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada Bordeaux Population Health Research Center, University of Bordeaux, INSERM U1219, France
Alain Girard
Affiliation:
Research Unit on Children's Psychosocial Maladjustment, University of Montrea
Lea C. Perret
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
Gustavo Turecki
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
*
Author for correspondence: Marie-Claude Geoffroy, E-mail: marie-claude.geoffroy@mcgill.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Suicide is a leading cause of mortality in youth, yet the course of suicide attempts is poorly documented. We explored the vulnerable transition from adolescence to emerging adulthood to identify group trajectories and risk factors.

Methods

The National Longitudinal Survey of Children and Youth is a prospective representative cohort of Canadian children. We followed participants aged 7–11 years in 1994–95 to age 23 (2008–09). We modelled self-reported past-year suicide attempts (ages 12 to 23 years) using growth mixture models. We analysed risk factors from self- and parent-report questionnaires at pre-adolescence (ages 10–11) and early adolescence (ages 12–13) using multinomial logistic regressions. Analyses were adjusted for sample non-response and attrition.

Results

In 2233 participants answering questions on teen and adult suicide attempts, we identified three trajectories: never attempted (96.0%), adolescence-limited (2.0%) and persisting into adulthood (2.0%). Adolescent girls aged 12–13 with depression/anxiety symptoms, and with mothers experiencing depression had higher risks of adolescence-limited than never-attempted [relative risk RR 9.27 (95% confidence interval: 1.73–49.82); 2.03 (1.02–3.32), for each standard deviation increase; 1.07 (1.00–1.15); respectively]. Preteen ADHD symptoms increased the risk of attempts persisting into adulthood as compared to never-attempted [RR 2.05 (1.29–3.28) for each standard deviation increase]. Suicide death of schoolmate/acquaintance increased risks of an adulthood trajectory as compared to never-attempted and adolescence-limited [RR 8.41 (3.04–23.27) and 6.63 (1.29–34.06), respectively].

Conclusion

In half the participants attempting suicide, attempts continued into adulthood. We stress the need for preventive strategies in early adolescence and differential clinical/educational interventions as identified for each trajectory.

Keywords

Adolescencedevelopmentepidemiologylongitudinal studysuicide attempt
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 11 , August 2021 , pp. 1933 - 1943
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M., Edelbrock, C., & Howell, C. T. (1987). Empirically based assessment of the behavioral/emotional problems of 2-and 3-year-old children. Journal of Abnormal Child Psychology, 15(4), 629–650. https://doi.org/10.1007/BF00917246.CrossRefGoogle ScholarPubMed
Adrian, M., Miller, A. B., McCauley, E., & Vander Stoep, A. (2016). Suicidal ideation in early to middle adolescence: Sex-specific trajectories and predictors. Journal of Child Psychology and Psychiatry, 57(5), 645–653. https://www.ncbi.nlm.nih.gov/pubmed/26610726.CrossRefGoogle ScholarPubMed
Balazs, J., & Kereszteny, A. (2017). Attention-deficit/hyperactivity disorder and suicide: A systematic review. World Journal of Psychiatry, 7(1), 44. https://doi.org/10.5498/wjp.v7.i1.44.CrossRefGoogle ScholarPubMed
Beghi, M., Rosenbaum, J. F., Cerri, C., & Cornaggia, C. M. (2013). Risk factors for fatal and nonfatal repetition of suicide attempts: A literature review. Neuropsychiatric Disease and Treatment, 9, 1725. https://doi.org/10.2147/NDT.S40213.Google ScholarPubMed
Boeninger, D. K., Masyn, K. E., Feldman, B. J., & Conger, R. D. (2010). Sex differences in developmental trends of suicide ideation, plans, and attempts among European American adolescents. Suicide and Life-Threatening Behavior, 40(5), 451–464. https://doi.org/10.1521/suli.2010.40.5.451.CrossRefGoogle ScholarPubMed
Bostwick, J. M., Pabbati, C., Geske, J. R., & McKean, A. J. (2016). Suicide attempt as a risk factor for completed suicide: Even more lethal than we knew. American Journal of Psychiatry, 173(11), 1094–1100. https://doi.org/10.1176/appi.ajp.2016.15070854.CrossRefGoogle ScholarPubMed
Brezo, J., Barker, E. D., Paris, J., Hébert, M., Vitaro, F., Tremblay, R. E., & Turecki, G. (2008). Childhood trajectories of anxiousness and disruptiveness as predictors of suicide attempts. Archives of Pediatrics and Adolescent Medicine, 162(11), 1015–1021. https://doi.org/10.1001/archpedi.162.11.1015.CrossRefGoogle ScholarPubMed
Brezo, J., Paris, J., Barker, E. D., Tremblay, R., Vitaro, F., Zoccolillo, M., … Turecki, G. (2007). Natural history of suicidal behaviors in a population-based sample of young adults. Psychological Medicine, 37(11), 1563–1574. https://doi.org/10.1017/S003329170700058X.CrossRefGoogle Scholar
Burstein, B., Agostino, H., & Greenfield, B. (2019). Suicidal attempts and ideation among children and adolescents in US emergency departments, 2007–2015. JAMA Pediatrics, 173 (6) 598–600. https://doi.org/10.1001/jamapediatrics.2019.0464.CrossRefGoogle ScholarPubMed
Canner, J. K., Giuliano, K., Selvarajah, S., Hammond, E. R., & Schneider, E. B. (2018). Emergency department visits for attempted suicide and self harm in the USA: 2006–2013. Epidemiology and Psychiatric Sciences, 27(1), 94–102. https://doi.org/10.1017/S2045796016000871.CrossRefGoogle ScholarPubMed
Chassiakos, Y. L. R., Radesky, J., Christakis, D., Moreno, M. A., & Cross, C. (2016). Children and adolescents and digital media. Pediatrics, 138(5), e20162593. https://doi.org/10.1542/peds.2016-2593.CrossRefGoogle Scholar
Chronis-Tuscano, A., Molina, B. S., Pelham, W. E., Applegate, B., Dahlke, A., Overmyer, M., & Lahey, B. (2010). Very early predictors of adolescent depression and suicide attempts in children with attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 67(10), 1044–1051. https://doi.org/10.1001/archgenpsychiatry.2010.127.CrossRefGoogle ScholarPubMed
Conejero, I., Jaussent, I., Lopez, R., Guillaume, S., Olié, E., Hebbache, C., … Courtet, P. (2019). Association of symptoms of attention deficit-hyperactivity disorder and impulsive-aggression with severity of suicidal behavior in adult attempters. Scientific Reports, 9(1), 1–8. https://doi.org/10.1038/s41598-019-41046-y.CrossRefGoogle ScholarPubMed
Dahl, R. E. (2004). Adolescent brain development: A period of vulnerabilities and opportunities. Annals of the New York Academy of Sciences, 1021, 1–22. https://doi.org/10.1196/annals.1308.001.CrossRefGoogle ScholarPubMed
Dhossche, D., Ferdinand, R., van der Ende, J., Hofstra, M. B., & Verhulst, F. (2002). Diagnostic outcome of adolescent self-reported suicidal ideation at 8-year follow-up. Journal of Affective Disorders, 72(3), 273–279. https://doi.org/10.1016/S0165-0327(01)00471-2.CrossRefGoogle ScholarPubMed
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., … Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187–232. https://doi.org/10.1037/bul0000084.CrossRefGoogle ScholarPubMed
Frost, M., & Casey, L. (2016). Who seeks help online for self-injury? Archives of Suicide Research, 20(1), 69–79. https://doi.org/10.1080/13811118.2015.1004470.CrossRefGoogle ScholarPubMed
Gili, M., Castellvi, P., Vives, M., de la Torre-Luque, A., Almenara, J., Blasco, M. J., … Lagares, C. (2018). Mental disorders as risk factors for suicidal behavior in young people: A meta-analysis and systematic review of longitudinal studies. Journal of Affective Disorders, 245, 152–162. https://doi.org/10.1016/j.jad.2018.10.115.Google ScholarPubMed
Goldston, D. B., Daniel, S. S., Erkanli, A., Heilbron, N., Doyle, O., Weller, B., … Faulkner, M. (2015). Suicide attempts in a longitudinal sample of adolescents followed through adulthood: Evidence of escalation. Journal of Consulting and Clinical Psychology, 83(2), 253–264. https://doi.org/10.1037/a0038657.CrossRefGoogle Scholar
Hawton, K., & Fagg, J. (1988). Suicide, and other causes of death, following attempted suicide. British Journal of Psychiatry, 152, 359–366. https://doi.org/10.1192/bjp.152.3.359.CrossRefGoogle ScholarPubMed
Hawton, K., Saunders, K. E., & O'Connor, R. C. (2012). Self-harm and suicide in adolescents. Lancet, 379(9834), 2373–2382. https://doi.org/10.1016/S0140-6736(12)60322-5.CrossRefGoogle ScholarPubMed
Huang, K. L., Wei, H. T., Hsu, J. W., Bai, Y. M., Su, T. P., Li, C. T., … Chen, M. H. (2018). Risk of suicide attempts in adolescents and young adults with attention-deficit hyperactivity disorder: A nationwide longitudinal study. British Journal of Psychiatry, 212(4), 234–238. https://doi.org/10.1192/bjp.2018.8.CrossRefGoogle Scholar
Impey, M., & Heun, R. (2012). Completed suicide, ideation and attempt in attention deficit hyperactivity disorder. Acta Psychiatrica Scandinavica, 125(2), 93–102. https://doi.org/10.1111/j.1600-0447.2011.01798.x.CrossRefGoogle ScholarPubMed
Jones, J. D., Boyd, R. C., Calkins, M. E., Ahmed, A., Moore, T. M., Barzilay, R., … Gur, R. E. (2019). Parent-adolescent agreement about adolescents' suicidal thoughts. Pediatrics, 143(2) e20181771. https://doi.org/10.1542/peds.2018-1771.CrossRefGoogle ScholarPubMed
Keilp, J. G., Gorlyn, M., Russell, M., Oquendo, M. A., Burke, A. K., Harkavy-Friedman, J., & Mann, J. J. (2013). Neuropsychological function and suicidal behavior: Attention control, memory and executive dysfunction in suicide attempt. Psychological Medicine, 43(3), 539–551. https://doi.org/10.1017/S0033291712001419.CrossRefGoogle ScholarPubMed
Kerr, D. C., Owen, L. D., & Capaldi, D. M. (2008). Suicidal ideation and its recurrence in boys and men from early adolescence to early adulthood: An event history analysis. Journal of Abnormal Psychology, 117(3), 625–636. https://doi.org/10.1037/a0012588.CrossRefGoogle ScholarPubMed
Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustun, T. B. (2007). Age of onset of mental disorders: A review of recent literature. Current Opinion in Psychiatry, 20(4), 359–364. https://doi.org/10.1097/YCO.0b013e32816ebc8c.CrossRefGoogle ScholarPubMed
Kõlves, K., & De Leo, D. (2015). Child, adolescent and young adult suicides: A comparison based on the Queensland suicide registry. Journal of Child and Adolescent Behavior, 3(3) 209. https://doi.org/10.4172/2375-4494.1000209.Google Scholar
Lewinsohn, P. M., Rohde, P., Seeley, J. R., & Baldwin, C. L. (2001). Gender differences in suicide attempts from adolescence to young adulthood. Journal of the American Academy of Child and Adolescent Psychiatry, 40(4), 427–434. https://doi.org/10.1097/00004583-200104000-00011.CrossRefGoogle ScholarPubMed
Maire, J., Galera, C., Bioulac, S., Bouvard, M., & Michel, G. (2020). Emotional lability and irritability have specific associations with symptomatology in children with attention deficit hyperactivity disorder. Psychiatry Research, 285, 112789. https://doi.org/10.1016/j.psychres.2020.112789.CrossRefGoogle ScholarPubMed
Malone, K. M., Quinlivan, L., Grant, T., & Kelleher, C. C. (2013). Ageing towards 21 as a risk factor for young adult suicide in the UK and Ireland. Epidemiology and Psychiatric Sciences, 22(3), 263–267. https://doi.org/10.1017/S2045796012000649.CrossRefGoogle ScholarPubMed
Mann, J. J. (2003). Neurobiology of suicidal behaviour. Nature Reviews Neuroscience, 4(10), 819–828. https://doi.org/10.1038/nrn1220.CrossRefGoogle ScholarPubMed
Maple, M., Cerel, J., Sanford, R., Pearce, T., & Jordan, J. (2017). Is exposure to suicide beyond kin associated with risk for suicidal behavior? A systematic review of the evidence. Suicide and Life-Threatening Behavior, 47(4), 461–474. https://doi.org/10.1111/sltb.12308.CrossRefGoogle Scholar
Mars, B., Heron, J., Klonsky, E. D., Moran, P., O'Connor, R. C., Tilling, K., … Gunnell, D. (2019a). Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: A population-based birth cohort study. Lancet Psychiatry, 6(4), 327–337. https://doi.org/10.1016/S2215-0366(19)30030-6.CrossRefGoogle Scholar
Mars, B., Heron, J., Klonsky, E. D., Moran, P., O'Connor, R. C., Tilling, K., … Gunnell, D. (2019b). What distinguishes adolescents with suicidal thoughts from those who have attempted suicide? A population-based birth cohort study. Journal of Child Psychology and Psychiatry, 60(1), 91–99. https://doi.org/10.1111/jcpp.12878.CrossRefGoogle Scholar
Marsh, H. W., Smith, I. D., & Barnes, J. (1983). Multitrait-multimethod analyses of the self-description questionnaire: Student-teacher agreement on multidimensional ratings of student self-concept. American Educational Research Journal, 20(3), 333–357. https://doi.org/10.3102/00028312020003333.CrossRefGoogle Scholar
McLoughlin, A. B., Gould, M. S., & Malone, K. M. (2015). Global trends in teenage suicide: 2003-2014. QJM: An International Journal of Medicine, 108(10), 765–780. https://doi.org/10.1093/qjmed/hcv026.CrossRefGoogle ScholarPubMed
Mesman, J., & Koot, H. M. (2000). Child-reported depression and anxiety in preadolescence: I. Associations with parent- and teacher-reported problems. Journal of the American Academy of Child and Adolescent Psychiatry, 39(11), 1371–1378. https://doi.org/10.1097/00004583-200011000-00011.CrossRefGoogle ScholarPubMed
Muthén, B., & Muthén, L. K. (2000). Integrating person-centered and variable-centered analyses: Growth mixture modeling with latent trajectory classes. Alcoholism: Clinical and experimental research, 24(6), 882–891. https://doi.org/10.1111/j.1530-0277.2000.tb02070.x.CrossRefGoogle ScholarPubMed
Nigg, J. T. (2013). Attention-deficit/hyperactivity disorder and adverse health outcomes. Clinical Psychology Review, 33(2), 215–228. https://doi.org/10.1016/j.cpr.2012.11.005.CrossRefGoogle ScholarPubMed
Nkansah-Amankra, S. (2013). Adolescent suicidal trajectories through young adulthood: Prospective assessment of religiosity and psychosocial factors among a population-based sample in the United States. Suicide and Life-Threatening Behavior, 43(4), 439–459. https://doi.org/10.1111/sltb.12029.CrossRefGoogle ScholarPubMed
Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., … Williams, D. (2008a). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. British Journal of Psychiatry, 192(2), 98–105. https://doi.org/10.1192/bjp.bp.107.040113.CrossRefGoogle Scholar
Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008b). Suicide and suicidal behavior. Epidemiologic Review, 30, 133–154. https://doi.org/10.1093/epirev/mxn002.CrossRefGoogle Scholar
Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: Results from the national comorbidity survey replication adolescent supplement. JAMA Psychiatry, 70(3), 300–310. https://doi.org/10.1001/2013.jamapsychiatry.55.CrossRefGoogle ScholarPubMed
Offord, D. R., Boyle, M. H., & Racine, Y. (1989). Ontario child health study: Correlates of disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 28(6), 856–860. https://doi.org/10.1097/00004583-198911000-00008.CrossRefGoogle ScholarPubMed
Patton, G. C., Coffey, C., Sawyer, S. M., Viner, R. M., Haller, D. M., Bose, K., … Mathers, C. D. (2009). Global patterns of mortality in young people: A systematic analysis of population health data. Lancet, 374(9693), 881–892. https://doi.org/10.1016/S0140-6736(09)60741-8.CrossRefGoogle ScholarPubMed
Perret, L. C., Orri, M., Boivin, M., Ouellet-Morin, I., Denault, A.-S., Côté, S. M.,… Geoffroy, M.-C. (2020). Cybervictimization in adolescents and its association with subsequent suicidal ideation/attempt beyond face-to-face victimization: A longitudinal population based study. Journal of Child Psychology and Psychiatry, Advance online publication. https://doi.org/10.1111/jcpp.13158.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306.CrossRefGoogle Scholar
Randall, J. R., Nickel, N. C., & Colman, I. (2015). Contagion from peer suicidal behavior in a representative sample of American adolescents. Journal of Affective Disorders, 186, 219–225. https://doi.org/10.1016/j.jad.2015.07.001.CrossRefGoogle Scholar
Ribeiro, J. D., Franklin, J. C., Fox, K. R., Bentley, K. H., Kleiman, E. M., Chang, B. P., & Nock, M. K. (2016). Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: A meta-analysis of longitudinal studies. Psychological Medicine, 46(2), 225–236. https://doi.org/10.1017/S0033291715001804.CrossRefGoogle ScholarPubMed
Ribeiro, J. D., Huang, X., Fox, K. R., & Franklin, J. C. (2018). Depression and hopelessness as risk factors for suicide ideation, attempts and death: Meta-analysis of longitudinal studies. British Journal of Psychiatry, 212(5), 279–286. https://doi.org/10.1192/bjp.2018.27.CrossRefGoogle ScholarPubMed
Rueter, M. A., Holm, K. E., McGeorge, C. R., & Conger, R. D. (2008). Adolescent suicidal ideation subgroups and their association with suicidal plans and attempts in young adulthood. Suicide and Life-Threatening Behavior, 38(5), 564–575. https://doi.org/10.1521/suli.2008.38.5.564.CrossRefGoogle ScholarPubMed
Rueter, M. A., & Kwon, H. K. (2005). Developmental trends in adolescent suicidal ideation. Journal of Research on Adolescence, 15(2), 205–222. https://doi.org/10.1111/j.1532-7795.2005.00092.x.CrossRefGoogle Scholar
Sedgwick, R., Epstein, S., Dutta, R., & Ougrin, D. (2019). Social media, internet use and suicide attempts in adolescents. Current Opinion in Psychiatry, 32(6), 534. https://doi.org/10.1097/YCO.0000000000000547.CrossRefGoogle ScholarPubMed
Sheftall, A. H., Asti, L., Horowitz, L. M., Felts, A., Fontanella, C. A., Campo, J. V., & Bridge, J. A. (2016). Suicide in elementary school-aged children and early adolescents. Pediatrics, 138(4) e20160436. https://doi.org/10.1542/peds.2016-0436.CrossRefGoogle ScholarPubMed
Steinhausen, H. C., Bosiger, R., & Metzke, C. W. (2006). Stability, correlates, and outcome of adolescent suicidal risk. Journal of Child Psychology and Psychiatry, 47(7), 713–722. https://doi.org/10.1111/j.1469-7610.2005.01569.x.CrossRefGoogle ScholarPubMed
Swanson, S. A., & Colman, I. (2013). Association between exposure to suicide and suicidality outcomes in youth. CMAJ, 185(10), 870–877. https://doi.org/10.1503/cmaj.121377.CrossRefGoogle ScholarPubMed
Thompson, M. P., & Swartout, K. (2018). Epidemiology of suicide attempts among youth transitioning to adulthood. Journal of Youth and Adolescence, 47(4), 807–817. https://doi.org/10.1007/s10964-017-0674-8.CrossRefGoogle ScholarPubMed
Tremblay, R. E., Desmarais-Gervais, L., Gagnon, C., & Charlebois, P. (1987). The preschool behaviour questionnaire: Stability of its factor structure between cultures, sexes, ages and socioeconomic classes. International Journal of Behavioral Development, 10(4), 467–484. https://doi.org/10.1177/016502548701000406.CrossRefGoogle Scholar
Turecki, G., & Brent, D. A. (2016). Suicide and suicidal behaviour. Lancet, 387(10024), 1227–1239. https://doi.org/10.1016/S0140-6736(15)00234-2.CrossRefGoogle ScholarPubMed
Wang, M., Swaraj, S., Chung, D., Stanton, C., Kapur, N., & Large, M. (2019). Meta-analysis of suicide rates among people discharged from non-psychiatric settings after presentation with suicidal thoughts or behaviours. Acta Psychiatr Scand, 139(5), 472–483. https://doi.org/10.1111/acps.13023.CrossRefGoogle ScholarPubMed