Prospective predictors of adolescent suicidality: 6-month post-hospitalization follow-up
Open accessAbstract
Background: The aim of this study was to examine prospective predictors of suicide events, defined as suicide attempts or emergency interventions to reduce suicide risk, in 119 adolescents admitted to an in-patient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Method: Structured diagnostic interviews and self-report instruments were administered to adolescent participants and their parent(s) to assess demographic variables, history of suicidal behavior, psychiatric disorders, family environment and personality/temperament. Results: Baseline variables that significantly predicted time to a suicide event during follow-up were Black race, high suicidal ideation in the past month, post-traumatic stress disorder (PTSD), childhood sexual abuse (CSA), borderline personality disorder (BPD), low scores on positive affectivity, and high scores on aggression. In a multivariate Cox regression analysis, only Black race, CSA, positive affect intensity and high aggression scores remained significant. Conclusions: Our findings suggest the following for adolescent populations: (1) in a very high-risk population, risk factors for future attempts may be more difficult to ascertain and some established risk factors (e.g. past suicide attempt) may not distinguish as well; and (2) cross-cutting constructs (e.g. affective and behavioral dysregulation) that underlie multiple psychiatric disorders may be stronger predictors of recurrent suicide events than psychiatric diagnoses. Our finding with respect to positive affect intensity is novel and may have practical implications for the assessment and treatment of adolescent suicide attempters.
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Low positive affect is a risk factor for suicidal behavior independent of negative affect and may be another mechanism leading to suicidal behavior.
“However, low positive affectivity may be a mechanism that contributes to adolescent suicidal ideation and behaviors independent of other risk factors.”
From Skills to Enhance Positivity in adolescents at risk for suicide: Protocol for a randomized controlled trial (2023) · cites this paper as [10]
The Results and Discussion report that low positive affect predicted subsequent suicide events in hospitalized adolescents, including in multivariate analyses, and was a stronger predictor than negative affect intensity. The Method defines the outcome as attempts or emergency interventions to prevent an attempt; the paper does not establish low positive affect as a predictor of suicidal ideation specifically or test it as a causal mechanism. (LLM, conf=0.84)
Experimental — accuracy not yet measuredRisk factors found in non-clinical or community samples may generalize poorly to clinical or high-risk individuals seen by mental health providers.
“Furthermore, risk factors identified in non-clinical or community samples may be of limited generalizability to the clinical or high-risk individuals more often encountered by mental health care providers (for examples, see King, Berona, Czyz, Horwitz, & Gipson, 2015; Yen et al., 2013; for a related discussion, see Millman, Gold, Mittal, & Schiffman, 2019).”
From Sleep and suicide: A systematic review and meta-analysis of longitudinal studies (2020) · cites this paper as Yen et al., 2013
Experimental — accuracy not yet measuredLow positive affect prospectively predicts time to suicidal events in adolescents over six months of follow-up, even after controlling for depression severity and anhedonia.
“Low positive affect has been found to prospectively predict time to suicidal events (i.e., either a suicide attempt or an emergency intervention for an acute suicidal crisis) in adolescents over six months of follow-up, even after controlling for a number of other predictors, including depression severity and anhedonia [10].”
From Skills to Enhance Positivity in adolescents at risk for suicide: Protocol for a randomized controlled trial (2023) · cites this paper as [10]
Our own prospective follow-up studies found 19-20% suicide re-attempt rates by 6 months post-discharge.
“Our own prospective follow-up studies found 19–20% suicide re-attempt rates by 6 months post-discharge [10, 11].”
From Skills to Enhance Positivity in adolescents at risk for suicide: Protocol for a randomized controlled trial (2023) · cites this paper as [10]
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“…found to prospectively predict time to suicidal events (i.e., either a suicide attempt or an emergency intervention for an acute suicidal crisis) in adolescents over six months of follow-up, even after controlling for a number of other predictors, including depression severity and anhedonia [10].”
InfluentialSelf-citation
- Authors
- Yen, S., Weinstock, L. M., Andover, M. S., Sheets, E. S., Selby, E. A., & Spirito, A.
- Affiliations
- Brown University (US)
- Fordham University (US)
- Colby College (US)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Yen, S.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-08-30
- Volume
- 43
- Issue
- 5
- Pages
- 983-993
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC3663078
- OpenAlex
- W2160944777
- Semantic Scholar
- 610dd65ce1543b3c2ccf12bbd7faff3c542a0368
- Cited by
- 154
- References
- 56
- Citations by year
- 2026: 12 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 9 · 2021: 22 · 2020: 17 · 2019: 16 · 2018: 12 · 2017: 10 · 2016: 13 · 2015: 8 · 2014: 11 · 2013: 5 · 2012: 2
- FWCI
- 9.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Cambridge
- National Institute of Mental Health (K23MH069904)
- 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 › Personality Disorders and Psychopathology
- Keywords
- adolescent suicidality, suicide attempts, suicide risk factors, inpatient psychiatric hospitalization, post-traumatic stress disorder, child sexual abuse, borderline personality disorder, positive affectivity, aggression, racial disparities, Black adolescents, psychiatric comorbidity, family environment, temperament
- MeSH terms
- Adolescent, Adolescent Behavior, Affect, Aggression, Mental Disorders, Child Abuse, Sexual, Family Health, Female, Follow-Up Studies, Hospitalization, Humans, Impulsive Behavior, Interview, Psychological, Male, Risk Factors, Suicide, Time Factors, Comorbidity, Multivariate Analysis, Proportional Hazards Models, Self-Injurious Behavior, Black People, White People
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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