Abstract
This study examined differences in the content and process of suicide ideation between adolescents presenting with recent suicide ideation or a suicide attempt in clinical settings. Across two combined study samples, adolescents (N = 229; 79% female; 73% Hispanic/Latine), ages 12–19, presenting with a recent suicide attempt, recent suicide ideation with a past suicide attempt history, or recent suicide ideation with no past suicide attempt history were interviewed in detail about the process and content of their suicide ideation. The group with suicide ideation and a past suicide attempt more often reported that their recent ideation lasted greater than 4 h compared to those with suicide ideation but no past suicide attempt history. The suicide attempt group more often considered ingestion as their first method of attempt, compared to the other two suicide ideation groups, and less often considered “other” methods (e.g., jumping from a height or onto train/traffic, hanging). Wish to die was lower in the ideation-only group, compared to both other groups. Separate analyses from Study 2 suggested that the majority of adolescents’ suicide ideation contained imagery; however, a higher proportion of adolescents with suicide ideation and a past suicide attempt reported imagery in their ideation than those with ideation but no past attempt. Understanding what adolescents think about when they consider suicide and how they think about it may be informative about risk of a suicide attempt.
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Data Availability
Data can be made available upon request from the corresponding author.
Notes
Past SA history was determined based on adolescents’ responses on the past suicide attempt history section of the ASII and also based on endorsement of a lifetime SA on the Patient Health Questionnaire-A (PHQ-A; Johnson et al., 2002).
Adolescents recruited from outpatient care tended to more often be in the SI/No-Past-SA group. However, they did not demonstrate statistically significant omnibus differences from those recruited from the ED or inpatient on any of the SI-related variables examined in the present analyses.
There were no differences among participants who were interviewed within 5 days of their SI or SA, greater than 5 days but within 2 weeks of their SI or SA, and those interviewed greater than two weeks from their SI or SA, on main study variables, with the exception of SI about the process of dying. Adolescents who were recruited more than 2 weeks prior more often reported SI about the process of dying (67%) than expected by chance, but this was not significantly different from those whose SI/SA occurred within the previous 5 days (34%), though it was different than those whose SI/SA occurred within the previous 2 weeks (22%).
This updated version of the interview included some rewording of the questions reflecting content of SI. Only SI content questions that were consistent across studies and that were rated with good reliability are included in the present analyses. In Study 2, the variable reflecting the effect of the adolescents’ death on others combined responses to the questions, “Did you think about how other people would feel (or react) after finding out you had died?” and “Did you think about how your death would affect other people’s lives in the long term?”.
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Acknowledgements
This research is made possible, in part, by the provision of data by New York State Psychiatric Institute and its research affiliates (via David Shaffer, retired). Thanks to Debbie Ann Chambers, Eva De Jaegere, Dalia Gefen, Lillian Polanco-Roman, Emelyn Auad, Ari Bengiyat, Nathalie Berrios, Gerson Borrero, Kara Buda, Eymi Castillo, Lia Davis, Trey Dellucci, Daniela Diaz Rincon, Hannah Ellerbeck, Jannatun Ferdowsi, Abigail Findley, Evan Gilmer, Judelysse Gomez, Kimberly Gonzalez-Quiles, Maiya Hotchkiss, Justyna Jurska, Angela Kaon, Flynn Kelly, Zara Khan, Emily Kline, Katherine McKibbon, Jose Menjivar, Tenasia Moore, Victoria Quinones, Clare Redden, Erica Rodriguez, Alejandra Roma, Beverlin Rosario-Williams, Sashana Rowe-Harriott, Lisbeth Rubi, Allan Shikh, Anna Simonyan, Julia Slotnick, Alyssa Stone, Aliona Tsypes, Ashley Vargas, and Mariah Xu for their assistance with data collection and/or coding. Thanks also to Samuel Ball, Nicole Couse, Stephanie Dillane, Jackaira Espinal, Lisa Franze, Andrew Gerber, Alice Greenfield, Elizabeth Ortiz-Schwartz, and Simone Williams, for their assistance with participant recruitment.
Funding
This research was funded, in part, by PSC-CUNY Grant ENHC-46–102, and NIH Grants MH091873 and UL1 TR002384.
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Informed consent was obtained from all research participants ages 18 or over, and parental permission and informed adolescent assent were obtained from all participants under age 18. Study 1 procedures were approved by the Institutional Review Board (IRB) of the New York State Psychiatric Institute, and analysis of the data was approved by the City University of New York IRB. Study 2 procedures were approved by the IRBs of the City University of New York, NYC Health + Hospitals/Lincoln, and the Visiting Nurse Service of New York.
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Miranda, R., Ortin-Peralta, A., Macrynikola, N. et al. Content and Process of Adolescent Suicide Ideation: Implications for Risk Assessment. Res Child Adolesc Psychopathol 51, 1657–1668 (2023). https://doi.org/10.1007/s10802-023-01092-7
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DOI: https://doi.org/10.1007/s10802-023-01092-7