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Cited by 150Suicide and Self-Harm StudiesHomicide, Infanticide, and Child AbuseGrief, Bereavement, and Mental Health

Association between exposure to suicide and suicidality outcomes in youth

Open access
Swanson, Sonja A., Colman, Ian·2013·Canadian Medical Association Journal
DOI 10.1503/cmaj.121377PMC PMC3707992
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Abstract

BACKGROUND: Ecological studies support the hypothesis that suicide may be "contagious" (i.e., exposure to suicide may increase the risk of suicide and related outcomes). However, this association has not been adequately assessed in prospective studies. We sought to determine the association between exposure to suicide and suicidality outcomes in Canadian youth. METHODS: We used baseline information from the Canadian National Longitudinal Survey of Children and Youth between 1998/99 and 2006/07 with follow-up assessments 2 years later. We included all respondents aged 12-17 years in cycles 3-7 with reported measures of exposure to suicide. RESULTS: We included 8766 youth aged 12-13 years, 7802 aged 14-15 years and 5496 aged 16-17 years. Exposure to a schoolmate's suicide was associated with ideation at baseline among respondents aged 12-13 years (odds ratio [OR] 5.06, 95% confidence interval [CI] 3.04-8.40), 14-15 years (OR 2.93, 95% CI 2.02-4.24) and 16-17 years (OR 2.23, 95% CI 1.43-3.48). Such exposure was associated with attempts among respondents aged 12-13 years (OR 4.57, 95% CI 2.39-8.71), 14-15 years (OR 3.99, 95% CI 2.46-6.45) and 16-17 years (OR 3.22, 95% CI 1.62-6.41). Personally knowing someone who died by suicide was associated with suicidality outcomes for all age groups. We also assessed 2-year outcomes among respondents aged 12-15 years: a schoolmate's suicide predicted suicide attempts among participants aged 12-13 years (OR 3.07, 95% CI 1.05-8.96) and 14-15 years (OR 2.72, 95% CI 1.47-5.04). Among those who reported a schoolmate's suicide, personally knowing the decedent did not alter the risk of suicidality. INTERPRETATION: We found that exposure to suicide predicts suicide ideation and attempts. Our results support school-wide interventions over current targeted interventions, particularly over strategies that target interventions toward children closest to the decedent.

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  • Some studies indicate increased risk of suicide attempts and completion with media coverage of suicides in a community and when adolescents learn of schoolmates' suicides.

    “The concept of suicide as a contagion among children has garnered significant interest, and some studies indicate increased risk of attempts and completion with media coverage of suicides in a community, and when adolescents learn of suicides of schoolmates [29–31].”

    From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [31]

    The Results report increased odds of suicide attempts among adolescents exposed to a schoolmate’s suicide. The Abstract also reports ecological evidence that suicide rates rise after a highly publicized suicide. But the Strengths and limitations section says this study did not measure media exposure, and it did not assess completed suicides among the adolescents; the source therefore does not support both outcomes for both forms of exposure. (LLM, conf=0.86)

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  • Studies did not find increased risks of attempted suicide or suicide among friends versus acquaintances exposed to a suicide, despite increased onset of psychopathology shortly after bereavement.

    “studies did not find increased risks of attempted suicide or suicide among friends versus acquaintances exposed to a suicide (Brent et al., 1992(Brent et al., , 1996b(Brent et al., , 1994,;,;Feigelman & Gorman, 2008;Swanson & Colman, 2013;Watkins & Gutierrez, 2003), despite increased onset of psychopathology shortly after bereavement (Brent et al., 1993a(Brent et al., , 1993b(Brent et al., , 1994”

    From Pre- and postloss features of adolescent suicide bereavement: A systematic review (2016) · cites this paper as Swanson & Colman, 2013

    The Results and Interpretation report that, among youth exposed to a schoolmate’s suicide, personally knowing the decedent did not increase suicidality risk relative to knowing the person less closely; the measured outcomes included suicide attempts. The paper does not report a comparison for deaths by suicide. The psychopathology clause is attached to different citations, so it is not assessed here. (LLM, conf=0.87)

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Research works printed but not linked: 2

  1. Cutrona CE. Social support in the transition to parenthood. J Abnorm Psychol 1984;93:378-90.
  2. Cutrona CE, Russell D. The provisions of social relations and adaptation to stress. In: Jones WH, Perlman D, editors. Advances in personal relations. Greenwich (CT): JAI Press; 1987. p. 37-67.

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Authors
Swanson, S. A., & Colman, I.
Affiliations
Harvard University (US)
ORCID
Venue
Canadian Medical Association Journal
Publisher
CMA Impact Inc.
Published
2013-05-21
Volume
185
Issue
10
Pages
870-877
ISSN
  • 0820-3946 (ISSN-L)
  • 1488-2329
DOI
10.1503/cmaj.121377
PMC
PMC3707992
OpenAlex
W2151301579
Cited by
150
References
35
Citations by year
2026: 12 · 2025: 12 · 2024: 5 · 2023: 10 · 2022: 5 · 2021: 15 · 2020: 11 · 2019: 10 · 2018: 12 · 2017: 13 · 2016: 15 · 2015: 17 · 2014: 7 · 2013: 6
FWCI
16.67
Type
journal article
Language
en
Open access
Locations
  • Canadian Medical Association Journal (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • uO Research (University of Ottawa) (submittedVersion, public-domain)
  • University of Ottawa - Library
Funders
  • Canada Research Chairs
  • Hospital for Sick Children
  • Canadian Institutes of Health Research (116328)
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 › Grief, Bereavement, and Mental Health
Keywords
suicide exposure, suicide contagion, suicidality, youth, suicidal ideation, suicide attempts, adolescents, prospective cohort, suicide risk factors, mental health promotion, school-based intervention, suicide prevention education, suicide prevention services, suicide prevention funding
MeSH terms
Adolescent, Canada, Child, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Surveys and Questionnaires, Risk Factors, Suicide, Cohort Studies

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