Diana J Whalen1, Laura Hennefield2, Nourhan M Elsayed3, Rebecca Tillman2, Deanna M Barch4, Joan L Luby2. 1. Washington University School of Medicine in St. Louis, Missouri. Electronic address: diana.whalen@wustl.edu. 2. Washington University School of Medicine in St. Louis, Missouri. 3. Washington University in St. Louis, Missouri. 4. Washington University School of Medicine in St. Louis, Missouri; Washington University in St. Louis, Missouri.
Abstract
OBJECTIVE: Suicidal thoughts and behaviors (STBs) represent a significant and escalating public health concern in youth. Evidence that STBs can emerge in the preschool years suggests that some pathways leading to clinically significant STBs begin early in life. METHOD: This prospective longitudinal study examined the developmental trajectories of STBs in children from ages 3 to 17, oversampled for preschool-onset depression. RESULTS: Three unique trajectories of STBs across childhood and adolescence were identified: low class (n = 273) characterized by low rates of STBs, early-persistent class (n = 21) characterized by steadily increasing STBs, and late-onset class (n = 21) characterized by low rates of STBs through age 10 followed by a dramatic increase from ages 11 to 14 years. Preschool measures of depression symptoms, externalizing symptoms, impulsivity, and lower income relative to needs were associated with both high-risk STB classes. Both high-risk STB classes reported greater functional impairment, more externalizing symptoms, and more cumulative stressful life events in adolescence relative to the low class; the late-onset class also reported poorer academic functioning relative to both the early-persistent and low classes. CONCLUSION: A significant minority of this prospectively followed group of preschool children evidenced STBs by and/or after age 10. Although relatively rare before age 10, approximately half of the children who experienced STBs in adolescence first exhibited STBs in early childhood and comprised a trajectory suggesting increasing STBs. In contrast, approximately half of children first exhibited STBs in early adolescence. Early screening and identification of at-risk youth during both preschool and late childhood is important for early intervention regarding STBs.
OBJECTIVE: Suicidal thoughts and behaviors (STBs) represent a significant and escalating public health concern in youth. Evidence that STBs can emerge in the preschool years suggests that some pathways leading to clinically significant STBs begin early in life. METHOD: This prospective longitudinal study examined the developmental trajectories of STBs in children from ages 3 to 17, oversampled for preschool-onset depression. RESULTS: Three unique trajectories of STBs across childhood and adolescence were identified: low class (n = 273) characterized by low rates of STBs, early-persistent class (n = 21) characterized by steadily increasing STBs, and late-onset class (n = 21) characterized by low rates of STBs through age 10 followed by a dramatic increase from ages 11 to 14 years. Preschool measures of depression symptoms, externalizing symptoms, impulsivity, and lower income relative to needs were associated with both high-risk STB classes. Both high-risk STB classes reported greater functional impairment, more externalizing symptoms, and more cumulative stressful life events in adolescence relative to the low class; the late-onset class also reported poorer academic functioning relative to both the early-persistent and low classes. CONCLUSION: A significant minority of this prospectively followed group of preschool children evidenced STBs by and/or after age 10. Although relatively rare before age 10, approximately half of the children who experienced STBs in adolescence first exhibited STBs in early childhood and comprised a trajectory suggesting increasing STBs. In contrast, approximately half of children first exhibited STBs in early adolescence. Early screening and identification of at-risk youth during both preschool and late childhood is important for early intervention regarding STBs.
Authors: Danielle C DeVille; Diana Whalen; Florence J Breslin; Amanda S Morris; Sahib S Khalsa; Martin P Paulus; Deanna M Barch Journal: JAMA Netw Open Date: 2020-02-05
Authors: Christine B Cha; Peter J Franz; Eleonora M Guzmán; Catherine R Glenn; Evan M Kleiman; Matthew K Nock Journal: J Child Psychol Psychiatry Date: 2017-11-01 Impact factor: 8.982
Authors: Joan L Luby; Amy Heffelfinger; Amy L Koenig-McNaught; Kathy Brown; Edward Spitznagel Journal: J Am Acad Child Adolesc Psychiatry Date: 2004-06 Impact factor: 8.829
Authors: D Tidemalm; B Runeson; M Waern; T Frisell; E Carlström; P Lichtenstein; N Långström Journal: Psychol Med Date: 2011-06-01 Impact factor: 7.723