Suicide Risk and Protection for Children

by | Mar 23, 2020 | 2020, Brain Health, Depression, Infant and Children's Health

Written by Joyce Smith, BS. This study identifies protective and risk factors associated with childhood suicidality.

Suicide is among the leading causes of death worldwide,  accounting for more than 40,000 annual deaths in America (Centers for Disease Control and Prevention [CDC], 2014) and an estimated one million annual deaths across the globe (World Health Organization [WHO], 2012). To put this in perspective, suicide accounts for more annual deaths than homicide, AIDS, car accidents, and war (CDC, 2014; WHO, 2012) 1. Suicide is now a public health crisis among children and adolescents in the US. 2 and currently is the second leading cause of death in those aged 10–14 years. 2 Approximately 8 % of 9 and 10 year-old children have suicidal thoughts or behaviors and two in every 100 children report a suicidal attempt. Previous research has shown that suicidal thoughts and behaviors in childhood predict adult psychiatric morbidity and mortality and may signal a vulnerability to poor mental health throughout adulthood. Identifying children who experience suicidal thoughts and who engage in suicidal behaviors along with interventions to minimize the risk associated with these thoughts and behaviors, may serve a valuable role in shifting children’s developmental trajectories toward healthier outcomes in adolescents and adults 3,4. However, data from large-scale epidemiologic studies regarding younger children are needed.

In this current study 5, Janiri and colleagues analyzed data of 7,994 unrelated children, aged 9 to 10 years (53% boys), who participated in the Adolescent Brain and Cognitive Development (ABCD) study. ABCD, the largest available population-based sample of 9- and 10-year-olds living in the US, provided the team with complete data on child-reported and caregiver-reported suicidal behaviors and ideas, thus enabling the team to identify and rank risk and protective factors for childhood suicidal thoughts and behaviors across multiple domains. Including were mental and physical well-being, brain imaging, behavioral and cognitive characteristics, and social and family environment. The analyzed data was assessed for an association between these risk and protective factors and suicidal behaviors and thoughts.

Of the 7,994 children, 673 (8.4%) reported having past or current suicidal ideation, 75 (0.9%) reported having past or current suicidal plans and 107 (1.3%) reported having past or current suicidal attempts. Data from caregivers showed that 650 (8.1%) of the children reported having past or current suicidal ideation, 46 (0.6%) reported having any past or current suicidal plans and 39 (0.5%) reported having past or current suicidal attempts. Child psychopathology (OR = 1.7-4.8; 95% CI, 1.5-7.4) and child-reported family conflict (OR = 1.4-1.8; 95% CI, 1.1-2.5) emerged as the highest risk for suicidality. Researchers found a greater risk among children who reported more weekend screen time (OR, 1.3; 95% CI, 1.2 – 1.7). Suicidality in children was associated with an average of one additional hour of screen time on the weekends compared to those who did not report suicidality. According to a current census, in the US an estimated 98% of children aged 8 years or younger have access to internet-connected devices and have over two hours of screen time per day 6.

A positive association was observed between caregiver-reported suicidality and caregiver educational level (OR = 1.3; 95% CI, 1.1-1.5) and male sex of children (OR = 1.5; 95% CI, 1.1-2). Caregiver-reported suicidality was inversely associated with the number of household cohabitants (OR = 0.8; 95% CI, 0.7-1). Parental supervision, knowing where children were and what they were doing and with whom, strongly protected against suicidal ideation (OR, 0.8; 95% CI, 0.7 – 0.9). Positive school involvement was protective as well (OR, 0.8; 95% CI, 0.7 – 0.9).

This study identifies both risk and protective factors and encourages the implementation of interventions that treat childhood psychopathology, increase school engagement, and provide family support to mitigate the risk of suicide in this vulnerable age group.

Source: Janiri, Delfina, Gaelle E. Doucet, Maurizio Pompili, Gabriele Sani, Beatriz Luna, David A. Brent, and Sophia Frangou. “Risk and protective factors for childhood suicidality: a US population-based study.” The Lancet Psychiatry (2020).

© 2020 Elsevier Ltd. All rights reserved.

Posted March 23, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

References:

  1. Franklin JC, Ribeiro JD, Fox KR, et al. Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychological bulletin. 2017;143(2):187.
  2. National Institute of Health. Suicide. 2019; https://www.nimh.nih.gov/health/statistics/suicide.shtml. Accessed March 19, 2019.
  3. Nock MK, Green JG, Hwang I, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA psychiatry. 2013;70(3):300-310.
  4. Mars B, Heron J, Klonsky ED, et al. Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study. The Lancet Psychiatry. 2019;6(4):327-337.
  5. Janiri D, Doucet GE, Pompili M, et al. Risk and protective factors for childhood suicidality: a US population-based study. The Lancet Psychiatry. 2020.
  6. Media CS. The common sense census: Media use by kids age zero to eight. Author San Francisco, CA; 2017.