Transitions in suicide risk in a nationally representative sample of adolescents.

PURPOSE: Suicide is the third leading cause of death among older adolescents, and represents a significant public health problem. Preventing suicidal behavior depends on an understanding of the developmental transitions in suicide risk and whether the likelihood of a suicide attempt can be predicted prospectively.
METHODS: Data from the National Longitudinal Study of Adolescent Health were used for the study. The sample is nationally representative, and includes 10,424 youth assessed over three time points spanning 7 years. MPLUS was used to analyze the data.
RESULTS: Latent class analysis showed that youth could be classified into three latent classes representing degree of suicide risk. Indicators of risk included depressive symptoms, hopelessness, suicidal ideation, having a family history of suicidal behavior, and having a friend history of suicidal behavior. Latent transition analyses showed that youth in the low-risk group remained at low risk both 1 and 7 years later. Although some youth who were classified as high-risk transitioned to a lower risk group 7 years later, a significant proportion remained at high risk. Analyses also revealed that the probability of making a suicide attempt was higher for youth in the high-risk latent class 1 and 7 years earlier.
CONCLUSIONS: Findings indicate that suicide prevention efforts should be targeted primarily at youth at high risk for suicide; most youth classified as "low risk" remained at low risk as they transitioned to young adulthood.