Predicting 3‐month risk for adolescent suicide attempts among pediatric emergency department patients
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Background: The incidence of adolescent suicide is rising in the United States, yet we have limited information regarding short‐term prediction of suicide attempts. Our aim was to identify predictors of suicide attempts within 3‐months of an emergency department (ED) visit. Methods: Adolescents, ages 12–17, seeking health care at 13 pediatric EDs (Pediatric Emergency Care Applied Research Network) and one Indian Health Service Hospital in the United States were consecutively recruited. Among 10,664 approached patients, 6,448 (60%) were enrolled and completed a suicide risk survey. A subset of participants ( n = 2,897) was assigned to a 3‐month telephone follow‐up, and 2,104 participants completed this follow‐up (73% retention). Our primary outcome was a suicide attempt between the ED visit and 3‐month follow‐up. Results: One hundred four adolescents (4.9%) made a suicide attempt between enrollment and 3‐month follow‐up. A large number of baseline predictors of suicide attempt were identified in bivariate analyses. The final multivariable model for the full sample included the presence of suicidal ideation during the past week, lifetime severity of suicidal ideation, lifetime history of suicidal behavior, and school connectedness. For the subgroup of adolescents who did not report recent suicidal ideation at baseline, the final model included only lifetime severity of suicidal ideation and social connectedness. Among males, the final model included only lifetime severity of suicidal ideation and past week suicidal ideation. For females, the final model included past week suicidal ideation, lifetime severity of suicidal ideation, number of past‐year nonsuicidal self‐injury (NSSI) incidents, and social connectedness. Conclusions: Results indicate that the key risk factors for adolescent suicide attempts differ for subgroups of adolescents defined by sex and whether or not they report recent suicidal thoughts. Results also point to the importance of school and social connectedness as protective factors against suicide attempts.
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Social connectedness is emerging as a potential target in assessing clinical risk and in suicide prevention strategies.
“Social connectedness is emerging as a potential target in assessing clinical risk and in suicide prevention strategies.”
From Suicide in young people: screening, risk assessment, and intervention (2023) · cites this paper as [41]
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Self-citation
- Authors
- King, C. A., Grupp‐Phelan, J., Brent, D., Dean, J. M., Webb, M., Bridge, J. A., Spirito, A., Chernick, L. S., Mahabee‐Gittens, E. M., Mistry, R. D., Rea, M., Keller, A., Rogers, A., Shenoi, R., Cwik, M., Busby, D. R., Casper, T. C., & the Pediatric Emergency Care Applied Research Network
- Affiliations
- University of Michigan (US)
- University of California, San Francisco (US)
- University of Pittsburgh (US)
- University of Utah (US)
- The Ohio State University (US)
- Brown University (US)
- Columbia University Irving Medical Center (US)
- University of Cincinnati (US)
- University of Colorado Anschutz (US)
- University of California Davis Medical Center (US)
- Baylor College of Medicine (US)
- Johns Hopkins University (US)
- Corresponding author
- King, Cheryl A.
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2019-07-21
- Volume
- 60
- Issue
- 10
- Pages
- 1055-1064
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC6742557
- OpenAlex
- W2963768087
- Semantic Scholar
- a1f377504ae86335dddadfc78342699f43388bbe
- Cited by
- 101
- References
- 32
- Citations by year
- 2026: 15 · 2025: 13 · 2024: 18 · 2023: 15 · 2022: 11 · 2021: 18 · 2020: 6 · 2019: 5
- FWCI
- 11.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (U01 MH104311)
- Maternal and Child Health Bureau (U03MC00008, U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC22684, U03MC28845, H3MC26201, U03MC22685)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Health › Gun Ownership and Violence Research
- Keywords
- adolescent suicide attempts, suicide risk prediction, suicidal ideation, non-suicidal self-injury, school connectedness, social connectedness, sex differences, suicide risk factors
- MeSH terms
- Adolescent, Child, Child Health Services, Emergency Service, Hospital, Female, Follow-Up Studies, Humans, Male, Prognosis, Suicide, Attempted, Time Factors, Risk Assessment
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