February 07, 2020
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Family-related factors influence suicidality, self-injury in children

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Danielle C. DeVille

High family conflict and low parental monitoring are associated with an increased risk for suicidality and self-injury in children, according to results of a cross-sectional analysis published in JAMA Network Open.

“Although it is now common practice for pediatricians and primary care providers to screen for suicidality, it frequently starts around puberty or is directed at the parent,” Danielle C. DeVille, MA, of the department of psychology at The University of Tulsa in Oklahoma, told Healio Psychiatry. “Our study suggests that this type of mental health screening should begin earlier and be directed at the youth themselves, or even as a one-on-one interaction to improve early identification of at-risk youth.”

According to the researchers, little is known about suicidal behaviors and ideation in children, despite suicide being a leading cause of death for children in the United States. To address this research gap, they assessed the overall prevalence of suicide attempts, suicidal ideation and nonsuicidal self-injury, as well as family-related factors associated with self-injury and suicidality, among 11,814 participants aged 9 to 10 years of the Adolescent Brain Cognitive Development (ABCD) study. Using an epidemiologically informed school-based recruitment strategy, this previous study represented the demographic composition of its 21 sites and the U.S. as a whole.

DeVille and colleagues applied poststratification sociodemographic weighting to the data and reported approximate prevalence rates of 6.4% (95% CI, 5.7-7.3) for lifetime history of passive suicidal ideation, 4.4% (95% CI, 3.9-5) for nonspecific active suicidal ideation, 2.4% (95% CI, 2.1-2.7) for active ideation with method, intent or plan and 1.3% (95% CI, 1-1.6) for suicide attempts. They also reported a rate of 9.1% (95% CI, 8.1-10.3) for nonsuicidal self-injury. Further, they covaried the results by family history, sex, relevant psychosocial variables and internalizing and externalizing problems and found that high family conflict was significantly associated with suicidal ideation (OR = 1.12; 95% CI, 1.07-1.16) and nonsuicidal self-injury (OR = 1.09; 95% CI, 1.05-1.14). Further, low parental monitoring was significantly associated with suicidal ideation (OR = 0.97; 95% CI, 0.95-0.98), attempts (OR = 0.91; 95% CI, 0.86-0.97) and nonsuicidal self-injury (OR = 0.95; 95% CI, 0.93-0.98). After internal replication, these findings remained. However, most of children’s reports of self-injury and suicidality were either not reported by their caregivers or unknown.

We believe that this research is incredibly important for the scientific and clinical communities, as well as for families," DeVille said. "Awareness and identification of early signals of mental health problems, specifically suicidality, can help reduce our current increasing suicide rate.” – by Joe Gramigna

Disclosures: DeVille reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.