Cited by 219Suicide and Self-Harm StudiesPersonality Disorders and PsychopathologyHomicide, Infanticide, and Child Abuse

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Psychiatric diagnoses as contemporaneous risk factors for suicide attempts among adolescents and young adults: Developmental changes

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Goldston, David B., Daniel, Stephanie Sergent, Erkanli, Alaattin, Reboussin, Beth A., Mayfield, Andrew, Frazier, Patricia H., Treadway, Sarah L.·2009·Journal of Consulting and Clinical Psychology

DOI 10.1037/a0014732PMC PMC2819300

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Abstract

The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to 13 years (n = 1,825 assessments). Semistructured psychiatric diagnostic instruments were administered at repeated assessments to assess psychiatric disorders and suicide attempts. After controlling for demographic variables and prehospitalization suicide attempts, most contemporaneous psychiatric disorders (major depressive disorder [MDD], dysthymic disorder, generalized anxiety disorder [GAD], panic disorder, attention-deficit/hyperactivity disorder [AD/HD], conduct disorder, and substance use disorder [SUD]) were related to increased risk of attempts. The relationship between suicide attempts and MDD, GAD, AD/HD, and SUD strengthened as participants got older. MDD, dysthymic disorder, GAD, and panic disorder were more commonly associated with repeat than 1st-time suicide attempts. In sum, most major psychiatric disorders are associated with increased risk for suicide attempts, but the strength of the relationships between these disorders and attempts changes over the course of development.

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BackgroundMethodResultInfluentialSelf-citation
Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents
Etter, D. J., Stafford, A. M., Ouyang, F., Gilbert, A. L., Williams, R. L., Hall, J. A., Tu, W., Downs, S. M., & Aalsma, M. C. (2017) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2017.08.026 · Cited by 43
“More specifically, substance abuse disorder diagnoses [38], alcohol use [27, 34, 39], marijuana use [39], and illicit drug use [27] have all been associated with an increased risk for suicidality in adolescent populations.”
Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspective
Cai, H. X., Chow, I. H. I., Lei, S., Lok, K.-I., Su, Z., Cheung, T. C. C., Peshkovskaya, A. G., Tang, Y., Jackson, T., Ungvari, G. S., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.093 · Cited by 42
Correlates of Suicide Ideation and Attempts in Children and Adolescents With Eating Disorders
Mayes, S. D., Fernández‐Mendoza, J., Baweja, R. K., Calhoun, S. L., Mahr, F., Aggarwal, R., & Arnold, M. (2014) · Eating Disorders · doi:10.1080/10640266.2014.915694 · Cited by 39
“, 2004), that conduct problems in psychiatric and general population samples are linked with suicide ideation and attempts (Agosti et al., 2011; Bulik et al., 2008; Cho et al., 2008; Corcos et al., 2002; Favaro & Santonastaso, 1997; Franko et al., 2004; Goldston et al., 2009; James et al., 2004; Mayes, Gorman et al.,…”
Background
Correlates of Suicidality: Investigation of a Representative Sample of Manitoba First Nations Adolescents
Mota, N. P., Elias, B., Tefft, B. M., Medved, M. I., Munro, G., & Sareen, J. (2012) · American Journal of Public Health · doi:10.2105/ajph.2011.300385 · Cited by 37
What is the Role of Internalizing and Externalizing Symptoms in Adolescent Suicide Behaviors?
Piqueras, J. A., Soto‐Sanz, V., Marín, J. R., & García‐Oliva, C. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16142511 · Cited by 39
“The simultaneous presence of several internalizing problems, particularly anxiety and depression, is associated with an increased risk for suicide attempts [32,33].”
Background
Suicidal thoughts and attempts in First Nations communities: links to parental Indian residential school attendance across development
Bombay, A., McQuaid, R. J., Schwartz, F. D., Thomas, A., Anisman, H., & Matheson, K. (2018) · Journal of Developmental Origins of Health and Disease · doi:10.1017/s2040174418000405 · Cited by 35
The Association Between Traumatic Brain Injury and Suicide: Are Kids at Risk?
Richard, Y., SWAINE, B. R., Sylvestre, M., LESAGE, A. D., Zhang, X., & Feldman, D. E. (2015) · American Journal of Epidemiology · doi:10.1093/aje/kwv014 · Cited by 36
Pathways to Suicide-Related Behavior in Offspring of Mothers With Depression: The Role of Offspring Psychopathology
Hammerton, G., Zammit, S., Mahedy, L., Pearson, R. M., Sellers, R., Thapar, A., & Collishaw, S. (2015) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2015.02.006 · Cited by 34
“It is also important for clinicians to consider that offspring of mothers with depression may be at increased risk for making a suicide attempt if they have symptoms of ADHD.”
BackgroundInfluential
Measuring sustainment of prevention programs and initiatives: a study protocol
Palinkas, L. A., Spear, S. E., Mendon, S. J., Villamar, J. A., Valente, T. W., Chou, C.-P., Landsverk, J. A., Kellam, S. G., & Brown, C. H. (2015) · Implementation Science · doi:10.1186/s13012-016-0467-6 · Cited by 34
“, depression), risks which are directly linked to suicide [7, 8, 38, 39].”
Background
How do cognitive distortions and substance-related problems affect the relationship between child maltreatment and adolescent suicidal ideation?
Miller, A. B., & Esposito-Smythers, C. L. (2013) · Psychology of Violence · doi:10.1037/a0031355 · Cited by 31
“These crosssectional associations were hypothesized to remain significant after accounting for potential confounding variables, including mood disorder, gender, race, and other traumas, all of which have been associated with adolescent SI (Goldston et al., 2009; Valois, Zullig, Huebner, & Drane, 2004)”
Background
Umbrella Review of the Global Prevalence of Conduct Disorder in Children and Adolescents
Ayano, G., Abraha, M., Tsegay, L., & Gizachew, Y. (2023) · Psychiatric Quarterly · doi:10.1007/s11126-023-10060-9 · Cited by 37
Trends and instigators among young adolescent suicide in the United States
Labuhn, M., LaBore, K., Ahmed, T., & Ahmed, R. (2021) · Public Health · doi:10.1016/j.puhe.2021.08.004 · Cited by 31
Attachment Organization in Suicide Prevention Research
Venta, A. C., & Sharp, C. (2013) · Crisis · doi:10.1027/0227-5910/a000231 · Cited by 29
Risk of Suicide Attempt among Adolescents with Conduct Disorder: A Longitudinal Follow-up Study
Wei, H.-T., Lan, W.-H., Hsu, J.-W., Bai, Y., Huang, K., Su, T., Li, C., Lin, W.-C., Chen, T., & Chen, M. (2016) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.06.057 · Cited by 28
Somatic Symptoms of Anxiety and Suicide Ideation Among Treatment‐Seeking Youth With Anxiety Disorders
Crawford, E. A., Burke, T. A., Siegel, D., Jager‐Hyman, S., Alloy, L. B., & Kendall, P. C. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12479 · Cited by 28
Self-Harm Behaviors, Suicide Attempts, and Suicidal Ideation in a Clinical Sample of Children and Adolescents with Psychiatric Disorders
Predescu, E., & Șipoș, R. (2023) · Children · doi:10.3390/children10040725 · Cited by 38
Youth Suicide Prevention in Primary Care: A Model Program and Its Impact on Psychiatric Emergency Referrals
Wintersteen, M. B., & Diamond, G. S. (2013) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000028 · Cited by 28
“…use, anxiety, depression, trauma, abuse) have been associated with increased risk for suicide among youth (Aseltine, Schilling, James, Glanovsky, & Ja-cobs, 2009; Brodsky et al., 2008; Goldston et al., 2009; Haas et al., 2010; Prinstein et al., 2008; Zhao, Montoro, Igartua, & Thombs, 2010).”
Two Studies of Connectedness to Parents and Suicidal Thoughts and Behavior in Children and Adolescents
Conner, K. R., Wyman, P. A., Goldston, D. B., Bossarte, R. M., Lu, N., Kaukeinen, K. A., Tu, X. M., Houston, R. J., Lamis, D. A., Chan, G., et al. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.952009 · Cited by 27
“We included MDE and AUD because they confer risk for suicidal behavior in youth (Esposito-Smythers & Spirito, 2004; Goldston et al., 2009) and are rigorously assessed with SSAGA.”
Self-citation
Prospective Study of Major Loss Life Events and Risk for Suicidal Thoughts and Behaviors Among Adolescents and Young Adults
Daniel, S. S., Goldston, D. B., Erkanli, A., Heilbron, N., & Franklin, J. C. (2017) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12305 · Cited by 25
“As described by Goldston et al. (2009), participants who died or dropped out of the study did not differ from the other participants in the age at which they were hospitalized, gender, or the number of suicide attempts prior to the index hospitalization, but a greater proportion of individuals lost…”
Self-citation
Adolescent but Not Parent Report of Irritability Is Related to Suicidal Ideation in Psychiatrically Hospitalized Adolescents
Frazier, E. A., Liu, R. T., Massing‐Schaffer, M., Hunt, J., Wolff, J. C., & Spirito, A. (2015) · Archives of Suicide Research · doi:10.1080/13811118.2015.1004497 · Cited by 26
“There is a well-established link between suicidal ideation and concurrent psychiatric disorders including depression, anxiety, conduct, and substance use disorders (Goldston et al., 2009), as well as related concerns such as poor problem solving and high family conflict (Thompson et al., 2012).”
Background
Is externalizing psychopathology a robust risk factor for suicidal thoughts and behaviors? A meta‐analysis of longitudinal studies
Witte, T. K., Gauthier, J. M., Huang, X., Ribeiro, J. D., & Franklin, J. C. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22625 · Cited by 26
Impact of an online depression prevention intervention on suicide risk factors for adolescents and young adults
Dickter, B., Bunge, E. L., Brown, L. M., Leykin, Y., Soares, E. E., Voorhees, B. W. V., Marko-Holguin, M., & Gladstone, T. R. G. (2019) · mHealth · doi:10.21037/mhealth.2019.04.01 · Cited by 29
“, mood or schizophrenia spectrum disorders) and substance use as additional factors related to adolescent suicidal ideation (4,5,60-62), which were not measured in this study.”
Background
A Longitudinal Examination of Child Maltreatment Dimensions, Emotion Regulation, and Comorbid Psychopathology
Duprey, E. B., Handley, E. D., Russotti, J. M., Manly, J. T., & Cicchetti, D. (2022) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-022-00913-5 · Cited by 25
Role of Impulsivity and Other Personality Dimensions in Attempted Suicide with Self-Poisoning among Children and Adolescents
Ghanem, M. H., Gamaluddin, H., Mansour, M., Abdelsamie, A., Shaker, N. M., & Rafei, H. H. R. E. (2013) · Archives of Suicide Research · doi:10.1080/13811118.2013.805645 · Cited by 25
Classification of Co‐occurring Depression and Substance Abuse Symptoms Predicts Suicide Attempts in Adolescents
Effinger, J., & Stewart, D. G. (2012) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2012.00092.x · Cited by 24
Suicide Ideation and Attempts are Associated with Co-occurring Oppositional Defiant Disorder and Sadness in Children and Adolescents with ADHD
Mayes, S. D., Calhoun, S. L., Baweja, R. K., Feldman, L., Syed, E. U., Gorman, A. A., Montaner, J., Annapareddy, J., Gupta, N., Bello, A., et al. (2014) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-014-9451-0 · Cited by 24
Substance Use Disorders and Poverty as Prospective Predictors of Adult First-Time Suicide Ideation or Attempt in the United States
Thompson, R. G., Alonzo, D. M., Hu, M., & Hasin, D. S. (2016) · Community Mental Health Journal · doi:10.1007/s10597-016-0045-z · Cited by 24
“Gender, age, race/ethnicity, education level, marital status, having any psychiatric disorder (Goldsmith et al. 2002; Goldston et al. 2009; Grant et al. 2003; Moscicki et al. 2010; U.S. Department of Health and Human Services (HHS) Office of the Surgeon General and National Action Alliance for…”
Brief report: Suicidal ideation in adolescent girls: Impact of race
Robinson, W. L., Droege, J. R., Hipwell, A. E., Stepp, S. D., & Keenan, K. E. (2016) · Journal of Adolescence · doi:10.1016/j.adolescence.2016.08.013 · Cited by 24
“Numerous studies identify depression as a key predictor of suicidality (e.g., Foley, Goldston, Costello, & Angold, 2006; Horwitz, Hill, & King, 2011) and depressed adolescents have been reported as five times more likely to make a suicide attempt (Goldston et al., 2009).”
Factors Associated With Length of Stay in Emergency Departments for Pediatric Patients With Psychiatric Problems
Smith, J. L., Nadai, A. S. D., Petrila, J. P., & Storch, E. A. (2019) · Pediatric Emergency Care · doi:10.1097/pec.0000000000001651 · Cited by 23
Factores de riesgo de ideación suicida en una muestra de adolescentes y jóvenes colombianos autoidentificados como homosexuales
Pineda-Roa, C. A. (2017) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2017.06.001 · Cited by 29
Acutely Suicidal Adolescents Who Engage in Bullying Behavior: 1-Year Trajectories
King, C. A., Horwitz, A. G., Berona, J., & Jiang, Q. (2013) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2012.09.016 · Cited by 25
“Goldston and colleagues [12] found that up to 13 years after hospitalization, co-occurring major depressive disorder and conduct disorder was the only unique pattern of comorbidity that elevated risk for suicide attempts.”
Panic Disorder and Agoraphobia in OCD patients: Clinical profile and possible treatment implications
Torres, A. R., Ferrão, Y. A., Shavitt, R. G., Diniz, J. B., Costa, D. L. C., do Rosário, M. C., Miguel, E. C., & Fontenelle, L. F. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.11.017 · Cited by 23
Suicidal thoughts and behaviors in preadolescents: Findings and replication in two population‐based samples
Walsh, R. F. L., Sheehan, A. E., & Liu, R. T. (2020) · Depression and Anxiety · doi:10.1002/da.23087 · Cited by 20
“…of risk for suicide differ between adolescents and adults, and adolescents are developmentally different from preadolescents, it cannot be assumed that characteristics or processes applicable to older age groups are equally relevant to preadolescents (Goldston et al., 2009; Sheftall et al., 2016).”
Background
Effect of Esketamine on Depressive Symptoms in Adolescents With Major Depressive Disorder at Imminent Suicide Risk: A Randomized Psychoactive-Controlled Study
Kosik‐Gonzalez, C., Fu, D., Chen, L. N., Lane, R., Bloch, M. H., DelBello, M. P., Moreno, C., Drevets, W. C., & Canuso, C. M. (2025) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2025.02.015 · Cited by 20
The Roles of Emotion Regulation Self-Efficacy and Emotional Avoidance in Self-Injurious Thoughts and Behaviors
Spitzen, T. L., Tull, M. T., & Gratz, K. L. (2020) · Archives of Suicide Research · doi:10.1080/13811118.2020.1818654 · Cited by 21
The Study of Motivation in the Suicidal Process: The Motivational Interview for Suicidality
Moselli, M., Frattini, C., Williams, R., & Ronningstam, E. F. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.598866 · Cited by 18
Differences Between Youth with a Single Suicide Attempt and Repeaters Regarding Their and Their Parents History of Psychiatric Illness
Jakobsen, I. S., Christiansen, E., Larsen, K. J., & Waaktaar, T. (2011) · Archives of Suicide Research · doi:10.1080/13811118.2011.589731 · Cited by 18
“Studies by Kuramoto and colleagues ( 2009 ) and D'Eramo and colleagues (2004) found that youths who attempted suicide repeatedly were diagnosed with externalizing disorders more often than youths who had made only one attempt.”
Background
Depression and Quality of Life Mediating the Association Between Attention Deficit/Hyperactivity Disorder and Suicidality in Military Recruits.
Tai, Y., & Gau, S. (2017) · Military Medicine · doi:10.7205/milmed-d-16-00394 · Cited by 14
Suicidality Protective Factors for African American Adolescents: A Systematic Review of the Research Literature
Droege, J. R. (2017) · SOJ Nursing & Health Care · doi:10.15226/2471-6529/3/2/00130 · Cited by 18
“, depression) are also associated with suicidality [10,16,19,20,28,29,51].”
Reducing suicide risk in parentally bereaved youth through promoting effective parenting: testing a developmental cascade model
Zhang, N., Sandler, I. N., Tein, J., & Wolchik, S. A. (2021) · Development and Psychopathology · doi:10.1017/s0954579421001474 · Cited by 19
“Also, there are numerous studies linking depression to suicidal behaviors (Evans et al., 2004; Franklin et al., 2017; Gili et al., 2019; Goldston et al., 2009) including research in bereaved samples (Prigerson et al., 1999).”
Background
Suicidality in homeless children and adolescents: A systematic review
Flach, Y., & Razza, T. S. (2021) · Aggression and Violent Behavior · doi:10.1016/j.avb.2021.101575 · Cited by 16
A Pilot Study Examining ADHD and Behavioural Disturbance in Female Mentally Disordered Offenders
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“A positive correlation has been identified between impulsivity and suicidal behaviour [15], and a higher risk of suicide has been reported in individuals with adult ADHD [16,17].”
Background
Suicidality and self‐injury with selective serotonin reuptake inhibitors in youth: Occurrence, predictors and timing
Sørensen, J. Ø., Rasmussen, A., Roesbjerg, T., Verhulst, F. C., & Pagsberg, A. K. (2021) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13360 · Cited by 19
Psychotropic Medications and Substances of Abuse Interactions in Youth
Kaminer, Y., Goldberg, P. H., & Connor, D. F. (2010) · Substance Abuse · doi:10.1080/08897070903442665 · Cited by 15
Risk Factors for Suicide Reattempt among Adolescents and Young Adults: The Role of Psychiatric Disorders
Mehanović, E., Rosso, G., Cuomo, G. L., Diecidue, R., Maina, G., Costa, G., & Vigna‐Taglianti, F. (2023) · Psychiatric Quarterly · doi:10.1007/s11126-023-10064-5 · Cited by 20
“%) had a diagnosis of psychiatric disorders, consistently with what reported elsewhere [20, 23, 24, 27, 29].”
Influential
Risk of conduct and oppositional defiant disorder symptoms in offspring of parents with mental health problems: Findings from the Raine Study
Ayano, G., Lin, A. P., Betts, K. S., Tait, R. J., Dachew, B. A., & Alati, R. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.03.054 · Cited by 15

Authors: Goldston, D. B., Daniel, S. S., Erkanli, A., Reboussin, B. A., Mayfield, A., Frazier, P. H., & Treadway, S. L.
Affiliations: Duke University (US)
University of North Carolina at Greensboro (US)
Wake Forest University Health Sciences (US)
ORCID: Goldston, David B.
Daniel, Stephanie Sergent
Reboussin, Beth A.
Mayfield, Andrew
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 2009
Volume: 77
Issue: 2
Pages: 281-290
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/a0014732
PMC: PMC2819300
OpenAlex: W2078220592
Cited by: 219
References: 43
Citations by year: 2026: 8 · 2025: 15 · 2024: 17 · 2023: 11 · 2022: 14 · 2021: 16 · 2020: 8 · 2019: 13 · 2018: 12 · 2017: 12 · 2016: 12 · 2015: 10 · 2014: 17 · 2013: 21 · 2012: 15
FWCI: 11.30
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of Consulting and Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (R01-MH048762; K24-MH066252)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords: suicide attempts, mental illness, adolescents, young adults, developmental changes, major depressive disorder, dysthymia, generalized anxiety disorder, panic disorder, attention deficit hyperactivity disorder, conduct disorder, substance use disorders, repeated suicide attempts, risk factors
MeSH terms: Adolescent, Mental Disorders, Child, Child Development, Female, Follow-Up Studies, Humans, Male, Risk Factors, Suicide, Attempted, Young Adult

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Psychiatric diagnoses as contemporaneous risk factors for suicide attempts among adolescents and young adults: Developmental changes

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