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Cited by 602Suicide and Self-Harm StudiesHomicide, Infanticide, and Child AbuseChild and Adolescent Psychosocial and Emotional Development

Annual Research Review: Suicide among youth – epidemiology, (potential) etiology, and treatment

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Cha, Christine B., Franz, Peter J., M. Guzmán, Eleonora, Glenn, Catherine R., Kleiman, Evan M., Nock, Matthew K.·2018·Journal of Child Psychology and Psychiatry
DOI 10.1111/jcpp.12831PMC PMC5867204
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Abstract

Background: Suicide is a leading cause of death and a complex clinical outcome. Here, we summarize the current state of research pertaining to suicidal thoughts and behaviors in youth. We review their definitions/measurement and phenomenology, epidemiology, potential etiological mechanisms, and psychological treatment and prevention efforts. Results: We identify key patterns and gaps in knowledge that should guide future work. Regarding epidemiology, the prevalence of suicidal thoughts and behaviors among youth varies across countries and sociodemographic populations. Despite this, studies are rarely conducted cross‐nationally and do not uniformly account for high‐risk populations. Regarding etiology, the majority of risk factors have been identified within the realm of environmental and psychological factors (notably negative affect‐related processes), and most frequently using self‐report measures. Little research has spanned across additional units of analyses including behavior, physiology, molecules, cells, and genes. Finally, there has been growing evidence in support of select psychotherapeutic treatment and prevention strategies, and preliminary evidence for technology‐based interventions. Conclusions: There is much work to be done to better understand suicidal thoughts and behaviors among youth. We strongly encourage future research to: (1) continue improving the conceptualization and operationalization of suicidal thoughts and behaviors; (2) improve etiological understanding by focusing on individual (preferably malleable) mechanisms; (3) improve etiological understanding also by integrating findings across multiple units of analyses and developing short‐term prediction models; (4) demonstrate greater developmental sensitivity overall; and (5) account for diverse high‐risk populations via sampling and reporting of sample characteristics. These serve as initial steps to improve the scientific approach, knowledge base, and ultimately prevention of suicidal thoughts and behaviors among youth.

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Crossref · 10.1111/jcpp.12831

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  • Beyond demographic characteristics, only childhood maltreatment, peer victimization, feelings of worthlessness, and low self-esteem increase risk for suicidal ideation or behaviors over time after accounting for depression and prior suicidal ideation or behaviors.

    “Results from this review suggest that beyond demographic characteristics, only childhood maltreatment, peer victimization, feelings of worthlessness, and low self-esteem increase the risk for suicidal ideation or behaviors over time, after accounting for depression and prior suicidal ideation or behaviors as predictors (Cha et al. 2018).”

    From Adolescent Suicide as a Failure of Acute Stress-Response Systems. (2019) · cites this paper as Cha et al. 2018

    The Psychological risk factors section reports that worthlessness and low self-esteem predict later suicidal thoughts or attempts after adjustment for depressive symptoms and baseline suicidality. The Environmental risk factors section supports childhood maltreatment and peer victimization as longitudinal risk factors, but does not establish that every form was assessed after both adjustments. The review also describes similar findings for neuroticism, so it does not support the claim that *only* the four listed factors increase risk. (LLM, conf=0.88)

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  • Little is known about processes immediately preceding suicide, and few effective strategies exist to intervene in the hours or minutes before suicidal behavior, perhaps particularly among youths.

    “Consequently, little is known regarding the processes that may immediately precede suicide, and few effective strategies designed to intervene in the hours or minutes before individuals engage in suicidal behavior are available (Asarnow et al. 2017, Cha et al. 2018, Miller et al. 2017a), perhaps particularly among youths.”

    From Adolescent Suicide as a Failure of Acute Stress-Response Systems. (2019) · cites this paper as Cha et al. 2018

    The Potential etiology section says the pathways by which young people develop suicidal thoughts and act on them are not well understood, and Future directions calls for more short-term, real-time research. The Prevention section says crisis lines address immediate needs but have not been studied for reducing suicidal behaviour in youth. These passages support the broad knowledge and intervention gaps, but do not specifically establish a lack of effective interventions in the hours or minutes before suicidal behaviour across individuals generally. Page numbers are unavailable in our copy. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Many young people report persistent suicidal ideation even after treatment.

    “Many young people report persistent suicidal ideation even after treatment.109”

    From Suicide in young people: screening, risk assessment, and intervention (2023) · cites this paper as [109]

    The Epidemiology > Onset and course section says many adolescents continue to experience suicidal ideation after hospitalization. This supports persistence after a clinical episode, but the paper does not establish that those adolescents had completed treatment; “even after treatment” is broader than the passage supports. No page number is available in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Recent reviews show that little is known about the etiology of adolescent suicidal ideation and behaviors and that predictors of suicidal ideation, suicidal behavior, and death by suicide are surprisingly weak.

    “Remarkably, all of these reviews demonstrate that we know surprisingly little about the etiology of adolescent suicidal ideation and behaviors and that predictors of suicidal ideation, suicidal behavior, and death by suicide are surprisingly weak.”

    From Adolescent Suicide as a Failure of Acute Stress-Response Systems. (2019) · cites this paper as Cha et al. 2018

  • Psychosocial treatments with the strongest evidence of reducing suicidal ideation and behavior in young people typically include coping skills enhancement, focus on behavior change, and fostering connections with supports (family and/or peer).

    “Psychosocial treatments with the strongest evidence of reducing suicidal ideation and behavior in young people typically include coping skills enhancement, focus on behavior change, and fostering connections with supports (family and/or peer).”

    From Suicide in young people: screening, risk assessment, and intervention (2023) · cites this paper as [109]

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Research works printed but not linked: 2

  1. Brent DA Melhem NM Oquendo M Burke A Birmaher B Stanley B … Mann JJ 2015 Familial pathways to early-onset suicide attempt JAMA Psychiatry 72 2 160 168 http://doi.org/10.1001/archpsyc.59.9.801 25548996 PMC4419699 · DOI
  2. Joiner TE 2005 Why people die by suicide Cambridge, MA Harvard University Press

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Authors
Cha, C. B., Franz, P. J., M. Guzmán, E., Glenn, C. R., Kleiman, E. M., & Nock, M. K.
Affiliations
  • Columbia University (US)
  • Harvard University (US)
  • Department of Counseling and Clinical Psychology Teachers College Columbia University New York NY
  • University of Rochester (US)
Corresponding author
Cha, Christine B.
ORCID
Venue
Journal of Child Psychology and Psychiatry
Publisher
Wiley
Published
2017-11
Volume
59
Issue
4
Pages
460-482
ISSN
  • 0021-9630 (ISSN-L)
  • 1469-7610
DOI
10.1111/jcpp.12831
PMC
PMC5867204
OpenAlex
W2765202516
Semantic Scholar
b41ab9020f5ca958b91f6329e3a820439087a09b
Cited by
602
References
231
Citations by year
2026: 52 · 2025: 72 · 2024: 86 · 2023: 106 · 2022: 86 · 2021: 93 · 2020: 60 · 2019: 39 · 2018: 4 · 2012: 1
FWCI
4.26
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Child Psychology and Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
National Institute of Mental Health (HHSN271201500513P)
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
youth suicide, suicidal ideation, suicidal behavior, suicide epidemiology, suicide risk factors, negative affect, suicide prevention, psychotherapy, technology-based interventions, vulnerable populations, cross-national comparison
MeSH terms
Suicide Prevention, Adolescent, Adolescent Behavior, Adult, Child, Child Abuse, Child, Preschool, Crisis Intervention, Family Therapy, Female, Genetic Markers, Humans, Male, Risk Factors, Suicide, Prevalence, Young Adult, Bullying, Suicidal Ideation

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