Clinical and psychosocial predictors of suicide attempts and nonsuicidal self-injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT)
Abstract
OBJECTIVE: The authors assessed whether clinical and psychosocial factors in depressed adolescents at baseline predict suicide attempts and nonsuicidal self-injury over 28 weeks of follow-up. METHOD: Participants were 164 adolescents with major depressive disorder taking part in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT). Clinical symptoms, family function, quality of current personal friendships, and suicidal and nonsuicidal self-harm were assessed at baseline. Suicidal and nonsuicidal self-harm thoughts and behaviors were assessed during 28 weeks of follow-up. RESULTS: High suicidality, nonsuicidal self-injury, and poor family function at entry were significant independent predictors of suicide attempts over the 28 weeks of follow-up. Nonsuicidal self-injury over the follow-up period was independently predicted by nonsuicidal self-injury, hopelessness, anxiety disorder, and being younger and female at entry. CONCLUSIONS: Both suicidal and nonsuicidal self-harm persisted in depressed adolescents receiving treatment in the ADAPT study. A history of nonsuicidal self-injury prior to treatment is a clinical marker for subsequent suicide attempts and should be as carefully assessed in depressed youths as current suicidal intent and behavior.
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Non-suicidal self-harm is strongly associated with suicide attempt history and predicts future attempts in longitudinal studies.
“However, investigation of predictors of attempts among people who engage in non-suicidal self-harm is also important, because this factor is strongly associated with suicide attempt history and predicts future attempts in longitudinal studies.15, 16, 17, 18, 19”
From Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study (2019) · cites this paper as [16]
Suicidal thoughts and non-suicidal self-harm are strongly associated with suicide attempts.
“Suicidal thoughts and non-suicidal self-harm are strongly associated with suicide attempts.”
From Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study (2019) · cites this paper as [16]
The data corroborates the association between depression, anxiety and self-injury.
“the data corroborates the association between depression, anxiety and self-injury [73, 93–101]”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [99]
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- Authors
- Wilkinson, P., Kelvin, R., Roberts, C., Dubicka, B., & Goodyer, I.
- Affiliations
- University of Cambridge (GB)
- Venue
- American Journal of Psychiatry
- Published
- 2011-05
- Volume
- 168
- Issue
- 5
- Pages
- 495-501
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2118162214
- Cited by
- 645
- References
- 29
- Citations by year
- 2026: 17 · 2025: 45 · 2024: 41 · 2023: 49 · 2022: 31 · 2021: 52 · 2020: 44 · 2019: 46 · 2018: 48 · 2017: 36 · 2016: 37 · 2015: 57 · 2014: 55 · 2013: 41 · 2012: 34
- FWCI
- 48.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- 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
- suicide attempts, non-suicidal self-injury, adolescent depression, major depressive disorder, family functions, hopelessness, anxiety disorders, suicidal ideation, ADAPT trial, antidepressants, psychotherapy
- MeSH terms
- Adolescent, Child, Combined Modality Therapy, Major Depressive Disorder, Female, Humans, Male, Psychiatric Status Rating Scales, Suicide, Attempted, Cognitive Behavioral Therapy, Chi-Square Distribution, Logistic Models, Self-Injurious Behavior, Selective Serotonin Reuptake Inhibitors, Antidepressive Agents, Second-Generation, Statistics, Nonparametric, Suicidal Ideation
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