A recent study investigated the prevalence and associated factors of suicidal thoughts in children.
The majority of research on suicide has primarily focused on adolescents and adults, leaving very limited information specifically in children. However, suicide death rates among children have been on the rise – tripling in the United States over the last decade. Previous research suggests that the development of suicidal thoughts in children may be associated with the family environment and parent-child relationship. Identifying suicide risk factors in children may be a key piece for early intervention and prevention.
In a recent study published in JAMA Network, researchers in the United States sought to determine the overall prevalence of suicidal thoughts and the associated contributing factors in children. The cross-sectional study analyzed data from the national data Archive ABCD 2.O1 baseline data set that was used in a previous study, the Adolescent Brain Cognitive Development (ABCD) study. The researchers focused on lifetime suicidal thoughts, suicide attempts, and non-suicidal self-injuries (NSSI, i.e. intentional self-inflicted damage to the body without intentions of suicide, such as cutting or burning one’s own skin).
A total of 11 814 children aged 9 to 10 years old and one caregiver for each child were included in the analysis. The prevalence of suicidal thoughts in children was estimated to be approximately 6.4% for passive suicidal thoughts, 4.4% for non-specific active suicidal thoughts, 2.4% for active suicidal thoughts with intentions or plan, 1.3% for suicide attempts and 9.1% for non-suicidal self-injury (NSSI).
Interestingly, there was a high rate (77%) of opposing views between children’s reports of suicidal thoughts and the caregivers’ reports of suicidal thoughts in their children. Half of caregivers reported no knowledge of suicidal thoughts and suicide attempts in their children. A family history of depression had a lower rate of discrepancy between the child and caregiver’s reports, possibly because these caregivers have a heightened awareness of suicidal behaviour. The study also found that suicidal thoughts in children and NSSI were associated with family conflict in the home environment and low parental monitoring. Low parental monitoring was also associated with suicide attempts.
The findings of this study suggest that most caregivers are largely unaware of their child’s suicidal thoughts. It is therefore important, in the clinical setting, that assessment for suicidal thoughts in children should be conducted directly with the child (ideally in a one-on-one interaction) and not only with their caregiver. Although there may be multiple factors that contribute to the development of suicidal thoughts, the results of this study suggest that the identification of family conflict and low parental monitoring can make them targets for intervention and improvement. This can include family programs that encourage parental monitoring or parent-child communication.
Written by Maggie Leung, PharmD.
Deville, D. C., Whalen, D., Breslin, F. J., Morris, A. S., Khalsa, S. S., Paulus, M. P., & Barch, D. M. (2020). Prevalence and Family-Related Factors Associated With Suicidal Ideation, Suicide Attempts, and Self-injury in Children Aged 9 to 10 Years. JAMA Network Open, 3(2). doi: 10.1001/jamanetworkopen.2019.20956
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