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Posted
July, 2006
Stability
and Outcomes of Suicidal Thoughts and Behavior among
Swiss Youths at Ages 13, 16, and 20 Years
Cross-sectional
studies have identified concurrent correlates of suicidality
among youths. However, longitudinal studies of representative
samples are needed to determine the developmental course and
outcomes of suicidal thoughts and behavior. To track the course,
correlates, and outcomes of suicidality from early adolescence
through young adulthood, a team of researchers at the University
of Zurich analyzed data obtained in the Zurich Adolescent
Psychology and Psychopathology Study (ZAPPS). Risk for suicide
was assessed at three ages in terms of endorsement of at least
one of two items concerning suicidal thoughts and behavior
on the YSR and the Young Adult Self-Report (YASR), which was
the predecessor of the Adult Self-Report (ASR). Youths who
endorsed one or both items pertaining to suicide at any of
the three assessments were compared with demographically matched
control youths who did not endorse either item. At Time 1
(mean age 13 years), 7.6% of the 593 participants endorsed
the item pertaining to suicidal thoughts. At Time 2 (mean
age 16 years), there was a significant increase to 10.8%.
And at Time 3 (mean age 20 years), there was a significant
decrease to 7.9%. A similar trend was found for endorsement
of the item pertaining to suicidal behavior, from 2.2%, rising
to 3.2%, and declining to 1.7%, although these changes were
not statistically significant. Significantly more girls than
boys reported suicidal behavior at Times 1 and 2. Classification
of youths as being at risk for suicide (i.e., they endorsed
at least one YSR/YASR suicide item) vs. not at risk showed
significant stability from each assessment to the next assessment(s).
At each assessment, youths who were classified as being at
risk scored significantly higher than control youths on all
YSR/YASR problem scales except the YASR Intrusive scale. Based
on the youths' responses to separate questionnaires, the following
significant psychosocial correlates of suicide risk were found
at all three assessments: More total life events; more negative
impact of life events; lower self-esteem; higher self-awareness;
and more rejection by parents. DSM-IV diagnoses made from
the Composite International Diagnostic Interview (CIDI) administered
in young adulthood were significantly predicted by the following
YSR/YASR scores, after controlling for scores that were similar
to the outcome diagnosis: Substance abuse disorders were predicted
by Time 1 suicide risk and Externalizing and also by Time
3 Externalizing; depressive disorders were predicted by Time
1 suicide risk and Time 3 Internalizing; phobias were predicted
by Time 1 suicide risk and Time 3 Internalizing; and "any
diagnosis" was predicted by Time 1 suicide risk and Time
3 Total Problems. Endorsement of one or both YSR suicide items
at age 13 was thus a significant predictor of all four categories
of DSM-IV diagnoses 7 years later, at age 20.
Reference: Steinhausen, H-C., Bösiger,
R., & Winkler Metzke, C. (2006). Stability, Correlates,
and Outcome of Adolescent Suicidal Risk. Journal of Child
Psychology and Psychiatry, 47, 713-722.
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