Childhood circumstances, adolescent adjustment, and suicide attempts in a New Zealand birth cohort.

OBJECTIVE: To estimate the prevalence of attempted suicide during adolescence in a birth cohort of New Zealand children studied to the age of 16 years and to examine the relationships among adolescent problems of adjustment, psychopathology, childhood circumstances, and risks of adolescent suicide attempts.
METHOD: Attempted suicide, adolescent problems of adjustment, psychopathology, and childhood circumstances were assessed as part of a longitudinal study of a birth cohort of 954 New Zealand children studied at annual intervals to the age of 16 years.
RESULTS: By 16 years, 3.0% of the sample (4.2% of girls and 1.9% of boys) reported having made a suicide attempt. There were strong associations between attempted suicide and rates of adolescent problem behaviors or psychopathology; teenagers having problems of adjustment or psychiatric disorders were up to 22 times more likely to attempt suicide. Risks of attempted suicide were also higher among children from disadvantaged or dysfunctional family backgrounds. A loglinear model fitted to the measures of attempted suicide, adolescent psychopathology, problems of adjustment, and childhood circumstances suggested the presence of a causal chain process in which childhood problems were significantly (p < .005) related to increased risks of later psychopathology and problems of personal adjustment which were, in turn, related to significantly (p < .05) increased rates of attempted suicide.
CONCLUSIONS: A common pathway that leads to increased vulnerability to suicidal behavior involves early disadvantageous childhood and family circumstances, which lead to increased risks of adolescent psychopathology and problems of adjustment, which lead to increased risks and vulnerability to adolescent suicidal behaviors.