Multimodal neuroimaging of suicidal thoughts and behaviors in a U.S. Population-based sample of school-age children
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OBJECTIVE: Suicide deaths and suicidal thoughts and behaviors are considered a public health emergency, yet their underpinnings in the brain remain elusive. The authors examined the classification accuracy of individual, environmental, and clinical characteristics, as well as multimodal brain imaging correlates, of suicidal thoughts and behaviors in a U.S. population-based sample of school-age children. METHODS: Children ages 9-10 years (N=7,994) from a population-based sample from the Adolescent Brain Cognitive Development study were assessed for lifetime suicidal thoughts and behaviors. After quality control procedures, structural MRI (N=6,238), resting-state functional MRI (N=4,134), and task-based functional MRI (range, N=4,075-4,608) were examined. Differences with Welch's t test and equivalence tests, with observed effect sizes (Cohen's d) and their 90% confidence intervals <|0.15|, were examined. Classification accuracy was examined with area under precision-recall curves (AUPRCs). RESULTS: Among the 7,994 unrelated children (females, N=3,757, 47.0%), those with lifetime suicidal thoughts and behaviors based on child (N=684, 8.6%), caregiver (N=654, 8.2%), and concordant (N=198, 2.5%) reports had higher levels of social adversity and psychopathology, among themselves and their caregivers, compared with never-suicidal children (N=6,854, 85.7%). Only one imaging test survived statistical correction: caregiver-reported suicidal thoughts and behaviors were associated with a thinner left bank of the superior temporal sulcus. On the basis of the prespecified bounds of |0.15|, approximately 48% of the group mean differences for child-reported suicidal thoughts and behaviors comparisons and approximately 22% for caregiver-reported suicidal thoughts and behaviors comparisons were considered equivalent. All observed effect sizes were relatively small (d≤|0.30|), and both non-imaging and imaging correlates had low classification accuracy (AUPRC ≤0.10). CONCLUSIONS: Commonly applied neuroimaging measures did not reveal a discrete brain signature related to suicidal thoughts and behaviors in youths. Improved approaches to the neurobiology of suicide are critically needed.
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In children aged 9-10 from the ABCD cohort, suicidal thoughts and behaviors were associated with minimal macroscopic structural differences, aside from a thinner left superior temporal sulcus.
“In one large pediatric study from the Adolescent Brain Cognitive Development (ABCD) cohort (14), children aged 9–10 with suicidal thoughts and behaviors showed minimal macroscopic structural differences, aside from a thinner left superior temporal sulcus.”
From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [14]
In the ABCD cohort, children aged 9-10 with suicidal thoughts and behaviors showed only minimal macroscopic structural differences.
“In the ABCD cohort, children aged 9–10 with suicidal thoughts and behaviors showed only minimal macroscopic structural differences (14)”
From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [14]
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- Authors
- Vidal-Ribas, P., Janiri, D., Doucet, G. E., Pornpattananangkul, N., Nielson, D. M., Frangou, S., & Stringaris, A.
- Affiliations
- Social and Behavioral Science Branch, National Institute of Child Health and Human Development, Bethesda, Md. (Vidal-Ribas); Section of Clinical and Computational Psychiatry (COMP-ψ), NIMH, Bethesda, Md. (Vidal-Ribas, Pornpattananangkul, Nielson, Stringaris); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Janiri, Doucet, Frangou); Department of Neurology and Psychiatry, Sapienza University of Rome (Janiri); Boys Town National Research Hospital, Omaha (Doucet); Department of...
- National Institutes of Health (US)
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2021-04-01
- Volume
- 178
- Issue
- 4
- Pages
- 321-332
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC8016742
- OpenAlex
- W3124064148
- Cited by
- 45
- References
- 68
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 7 · 2023: 6 · 2022: 8 · 2021: 8 · 2020: 3
- FWCI
- 4.94
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (R03AG064001)
- National Institute of Mental Health (R01MH116147, ZIAMH002957, R01MH113619)
- National Institute on Drug Abuse (U01DA041106, U01DA041120, U01DA041156, U01DA041174, U01DA041048, U24DA041147, U01DA041148, U01DA041022, U01DA041028, U01DA041134, U01DA041025, U24DA041123, U01DA041093, U01DA041089, U01DA041117)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- suicidal ideation, suicidal behavior, children, adolescents, neuroimaging, superior temporal sulcus, brain structure, social adversity, psychopathology, caregiver reports, neurobiology of suicide, Adolescent Brain Cognitive Development Study
- MeSH terms
- Brain Cortical Thickness, Mental Disorders, Brain, Brain Mapping, Child, Female, Humans, Magnetic Resonance Imaging, Male, Organ Size, Suicide, Attempted, Temporal Lobe, United States, Suicidal Ideation, Functional Neuroimaging
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