Preadolescent Suicidal Thoughts and Behaviors: An Intensive Longitudinal Study of Risk Factors

Objective Dramatic increases in rates of suicidal thoughts and behaviors (STBs) among youth highlights the need to pinpoint early risk factors. This study used intensive longitudinal sampling to assess concurrent associations between risk factors and STB status, how proximal changes in risk factors were related to STB status, and how risk factors prospectively predicted changes in STB status in a preadolescent sample enriched for early childhood psychopathology. Method 192 participants were included from the Study Y, a longitudinal study of children with and without preschool depression. Participants aged 7-to 12-years completed a diagnostic interview, followed by 12 months of intensive longitudinal sampling, assessing experiences of suicidal ideation and eleven psychosocial variables with known links to STBs in adolescents and adults. Preadolescents with STB history (high risk) received surveys weekly and those without STB history (lower risk) received surveys monthly. Results Being female, having elevated depressive symptoms, greater use of expressive suppression and rumination, emotional clarity, and perceived burdensomeness were uniquely concurrently associated with the likelihood of STB endorsement. Within the high-risk group, (1) increases in depression, suppression, rumination, and perceived burdensomeness, and decreases in positive affect from weekt to weekt+1 were associated with a higher likelihood of a positive STB status at weekt+1, and (2) increased suppression, perceived burdensomeness, and caregiver criticism and conflict compared to participants’ mean levels prospectively predicted increases in the likelihood of a positive STB report. Conclusion Psychosocial factors influencing STBs in adolescents and adults also affect preadolescents in day-to-day life. Expressive suppression and perceived burdensomeness emerged as novel risk indicators and potential targets for treatment. In addition, increases in depression, rumination, and caregiver criticism and conflict as well as decreases in positive affect might prompt heightened STB screening and assessments for preadolescents with a history of STBs.