Suicide in Elementary School-Aged Children and Early Adolescents

• Published in: Pediatrics (Evanston) 2016-10, Vol.138 (4), p.1
• Main Authors: Sheftall, Arielle H, Asti, Lindsey, Horowitz, Lisa M, Felts, Adrienne, Fontanella, Cynthia A, Campo, John V, Bridge, Jeffrey A
• Format: Article
• Language: English
• Subjects: Adolescent; African Americans; Age Factors; Analysis; Behavior; Black people; Blacks; Cause of Death; Child; Child, Preschool; Elementary school students; Female; Health aspects; Humans; Male; Mental disorders; Mental Disorders - complications; Mental Disorders - epidemiology; Pediatrics; Prevention programs; Psychological aspects; Racial differences; Risk Factors; Sex Factors; Suicidal behavior; Suicidal behaviour; Suicide - psychology; Suicide - statistics & numerical data; Suicides & suicide attempts; United States
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2016-0436

Suicide in elementary school-aged children is not well studied, despite a recent increase in the suicide rate among US black children. The objectives of this study were to describe characteristics and precipitating circumstances of suicide in elementary school-aged children relative to early adolescent decedents and identify potential within-group racial differences. We analyzed National Violent Death Reporting System (NVDRS) surveillance data capturing suicide deaths from 2003 to 2012 for 17 US states. Participants included all suicide decedents aged 5 to 14 years (N = 693). Age group comparisons (5-11 years and 12-14 years) were conducted by using the χ test or Fisher's exact test, as appropriate. Compared with early adolescents who died by suicide, children who died by suicide were more commonly male, black, died by hanging/strangulation/suffocation, and died at home. Children who died by suicide more often experienced relationship problems with family members/friends (60.3% vs 46.0%; P = .02) and less often experienced boyfriend/girlfriend problems (0% vs 16.0%; P < .001) or left a suicide note (7.7% vs 30.2%; P < .001). Among suicide decedents with known mental health problems (n = 210), childhood decedents more often experienced attention-deficit disorder with or without hyperactivity (59.3% vs 29.0%; P = .002) and less often experienced depression/dysthymia (33.3% vs 65.6%; P = .001) compared with early adolescent decedents. These findings raise questions about impulsive responding to psychosocial adversity in younger suicide decedents, and they suggest a need for both common and developmentally-specific suicide prevention strategies during the elementary school-aged and early adolescent years. Further research should investigate factors associated with the recent increase in suicide rates among black children.