24-Hour warning signs for adolescent suicide attempts

• Published in: Psychological medicine 2024-05, Vol.54 (7), p.1272-1283
• Main Authors: King, Cheryl A, Gipson Allen, Polly Y, Ahamed, Sheikh Iqbal, Webb, Michael, Casper, T Charles, Brent, David, Grupp-Phelan, Jacqueline, Rogers, T Alexander, Arango, Alejandra, Al-Dajani, Nadia, McGuire, Taylor C, Bagge, Courtney L
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior - psychology; Adolescent girls; Adolescents; Alcohol; At risk populations; Behavior; Caregivers; Disease control; Disease prevention; Dissemination; Drug use; Emergency medical care; Emotions; Ethnicity; Female; Gender identity; Hispanic Americans; Hostility; Humans; Information dissemination; Interviews; Male; Non-binary gender; Parents & parenting; Polls & surveys; Rage; Risk Factors; Rumination; Signs; Suicidal behavior; Suicidal Ideation; Suicide; Suicide, Attempted; Suicides & suicide attempts; Surveys; Surveys and Questionnaires; Teenagers
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291723003112

Little is known about youth may be at greatest risk for attempting suicide, which is critically important information for the parents, caregivers, and professionals who care for youth at risk. This study used adolescent and parent reports, and a case-crossover, within-subject design to identify 24-hour warning signs (WS) for suicide attempts. Adolescents ( = 1094, ages 13 to 18) with one or more suicide risk factors were enrolled and invited to complete bi-weekly, 8-10 item text message surveys for 18 months. Adolescents who reported a suicide attempt (survey item) were invited to participate in an interview regarding their thoughts, feelings/emotions, and behaviors/events during the 24-hours prior to their attempt (case period) and a prior 24-hour period (control period). Their parents participated in an interview regarding the adolescents' behaviors/events during these same periods. Adolescent or adolescent and parent interviews were completed for 105 adolescents (81.9% female; 66.7% White, 19.0% Black, 14.3% other). Both parent and adolescent reports of suicidal communications and withdrawal from social and other activities differentiated case and control periods. Adolescent reports also identified feelings (self-hate, emotional pain, rush of feelings, lower levels of rage toward others), cognitions (suicidal rumination, perceived burdensomeness, anger/hostility), and serious conflict with parents as WS in multi-variable models. This study identified 24-hour WS in the domains of cognitions, feelings, and behaviors/events, providing an evidence base for the dissemination of information about signs of proximal risk for adolescent suicide attempts.