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Cited by 138Suicide and Self-Harm StudiesHomicide, Infanticide, and Child AbuseChild and Adolescent Psychosocial and Emotional Development

Familial Pathways to Early-Onset Suicide Attempt: A 5.6-Year Prospective Study

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Brent, David A., Melhem, Nadine M., Oquendo, Maria, Burke, Ainsley, Birmaher, Boris, Stanley, Barbara, Biernesser, Candice, Keilp, John +6 more·2015·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2014.2141PMC PMC4419699
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Abstract

IMPORTANCE: Suicide attempts are strong predictors of suicide, a leading cause of adolescent mortality. Suicide attempts are highly familial, although the mechanisms of familial transmission are not understood. Better delineation of these mechanisms could help frame potential targets for prevention. OBJECTIVE: To examine the mechanisms and pathways by which suicidal behavior is transmitted from parent to child. DESIGN, SETTING, AND PARTICIPANTS: In this prospective study conducted from July 15, 1997, through June 21, 2012, a total of 701 offspring aged 10 to 50 years (mean age, 17.7 years) of 334 clinically referred probands with mood disorders, 191 (57.2%) of whom had also made a suicide attempt, were followed up for a mean of 5.6 years. MAIN OUTCOMES AND MEASURES: The primary outcome was a suicide attempt. Variables were examined at baseline, intermediate time points, and the time point proximal to the attempt. Participants were assessed by structured psychiatric assessments and self-report and by interview measures of domains hypothesized to be related to familial transmission (eg, mood disorder and impulsive aggression). RESULTS: Among the 701 offspring, 44 (6.3%) had made a suicide attempt before participating in the study, and 29 (4.1%) made an attempt during study follow-up. Multivariate logistic regression revealed that proband suicide attempt was a predictor of offspring suicide attempt (odds ratio [OR], 4.79; 95% CI, 1.75-13.07), even controlling for other salient offspring variables: baseline history of mood disorder (OR, 4.20; 95% CI, 1.37-12.86), baseline history of suicide attempt (OR, 5.69; 95% CI, 1.94-16.74), and mood disorder at the time point before the attempt (OR, 11.32; 95% CI, 2.29-56.00). Path analyses were consistent with these findings, revealing a direct effect of proband attempt on offspring suicide attempt, a strong effect of offspring mood disorder at each time point, and impulsive aggression as a precursor of mood disorder. CONCLUSIONS AND RELEVANCE: Parental history of a suicide attempt conveys a nearly 5-fold increased odds of suicide attempt in offspring at risk for mood disorder, even after adjusting for the familial transmission of mood disorder. Interventions that target mood disorder and impulsive aggression in high-risk offspring may attenuate the familial transmission of suicidal behavior.

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  • The transmission of impulsive-aggressive traits has at least partially explained familial aggregation of suicidal behaviour.

    “In studies examining the familial transmission of suicidal behaviour the transmission of impulsive-aggressive traits has at least partially explained familial aggregation of suicidal behaviour 31,34,38 .”

    From Suicide and suicide risk (2019) · cites this paper as [38]

    The Discussion reports that offspring impulsive aggression increased suicide-attempt risk through subsequent mood disorder. But the Results (‘Suicide Attempts in Offspring’; page not specified) found that the proposed pathway from parental attempt through Cluster B disorder, offspring impulsive aggression and mood disorder to offspring attempt was not statistically significant (P = .08). The paper therefore supports a role for impulsive aggression in offspring risk, not the claim that transmission of those traits explained familial aggregation in this study. (LLM, conf=0.88)

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  • Children of parents with a history of mood disorders and suicide attempts have a 5-fold increased odds of suicide attempt.

    “A study examining the familial transmission of suicidal behavior showed children of parents with a history of mood disorders and suicide attempts had a 5-fold increased odds of suicide attempt.22”

    From Evidence-based youth suicide prevention and intervention in pediatric primary care settings. (2024) · cites this paper as [22]

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Research works printed but not linked: 1

  1. [40]Olsen D Portner J Bell R Family Adaptability and Cohension Evaluation Scales (FACES-II) Minneapolis University of Minnesota Press 1982

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Authors
Brent, D. A., Melhem, N. M., Oquendo, M., Burke, A., Birmaher, B., Stanley, B., Biernesser, C., Keilp, J., Kolko, D., Ellis, S., Porta, G., Zelazny, J., Iyengar, S., & Mann, J. J.
Affiliations
  • University of Pittsburgh (US)
  • Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York
  • New York State Psychiatric Institute (US)
  • University of Pittsburgh Medical Center (US)
Corresponding author
Brent, David A.
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2015-02-01
Volume
72
Issue
2
Pages
160
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2014.2141
PMC
PMC4419699
OpenAlex
W2098417629
Cited by
138
References
61
Citations by year
2026: 7 · 2025: 6 · 2024: 14 · 2023: 7 · 2022: 14 · 2021: 17 · 2020: 11 · 2019: 11 · 2018: 14 · 2017: 14 · 2016: 13 · 2015: 10
FWCI
14.48
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (K01MH077930, R10MH056390, MH-056612, MH056390, R10MH056612, MH077930, R01MH056612, R01MH056390)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
suicide attempts, parent-offspring transmission, mood disorders, impulsive aggression, adolescent suicide, suicide prevention, offspring risk
MeSH terms
Adolescent, Adult, Child, Disease Susceptibility, Female, Humans, Male, Middle Aged, Prospective Studies, Suicide, Attempted, United States, Child of Impaired Parents, Age of Onset, Mood Disorders, Young Adult

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