Association of sociodemographic, proximal, and distal clinical factors with current suicidal ideation: Findings from a nonclinical sample of young adults

Abstract Background Accumulating evidence indicates that a variety of distal and proximal factors might impact a risk of suicide. However, the association between both groups of factors remains unknown. Therefore, in the present study, we aimed to investigate the interplay between distal and proximal correlates of the current suicidal ideation. Methods A total of 3,000 individuals (aged 18–35 years, 41.7% males), who had reported a negative history of psychiatric treatment, were enrolled through an online computer-assisted web interview. Self-reports were administered to measure: (a) distal factors: a history of childhood trauma (CT), reading disabilities (RDs), symptoms of attention-deficit/hyperactivity disorder (ADHD), lifetime history of non-suicidal self-injury (NSSI), lifetime problematic substance use as well as family history of schizophrenia and mood disorders; (b) proximal factors: depressive symptoms, psychotic-like experiences (PLEs), and insomnia; and (c) sociodemographic characteristics. Results Suicidal ideation was directly associated with unemployment, being single, higher level of RD, lifetime history of NSSI as well as higher severity of PLEs, depression, and insomnia. The association of distal factors with suicidal ideation was fully (a history of CT and symptoms of ADHD) or partially (a history of NSSI and RD) mediated by proximal factors (PLEs, depression, and insomnia). Conclusions Main findings from this study posit the role of distal factors related to neurodevelopmental disorders, CT and NSSI in shaping suicide risk. Their effects might be partially or fully mediated by depression, PLEs, and insomnia.

[1]  N. Karcher,et al.  Strengthening associations between psychotic like experiences and suicidal ideation and behavior across middle childhood and early adolescence , 2022, Psychological Medicine.

[2]  M. Cannon,et al.  A revised and extended systematic review and meta-analysis of the relationship between childhood adversity and adult psychiatric disorder. , 2022, Journal of psychiatric research.

[3]  S. Fazel,et al.  Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies , 2022, Evidence-Based Mental Health.

[4]  G. Carrà,et al.  Testing the Impact of Depressive and Anxiety Features on the Association between Attention-Deficit/Hyperactivity Disorder Symptoms and Academic Performance among University Students: A Mediation Analysis , 2022, Brain sciences.

[5]  J. Schiffman,et al.  A Deeper Dive Into the Relation Between Psychotic-like Experiences and Suicidal Ideation and Behaviors in Children Across the United States. , 2022, Schizophrenia bulletin.

[6]  G. Carrà,et al.  Clinical correlates of comorbid attention deficit hyperactivity disorder in adults suffering from bipolar disorder: A meta-analysis , 2022, The Australian and New Zealand journal of psychiatry.

[7]  Richard T. Liu,et al.  Prevalence and Correlates of Suicide and Nonsuicidal Self-injury in Children: A Systematic Review and Meta-analysis. , 2022, JAMA psychiatry.

[8]  C. Jia,et al.  Associating factors of suicide and repetition following self-harm: A systematic review and meta-analysis of longitudinal studies , 2022, EClinicalMedicine.

[9]  Rashelle J. Musci,et al.  Suicide attempt endophenotypes: Latent profiles of child and adolescent aggression and impulsivity differentially predict suicide attempt in females , 2022, Preventive medicine reports.

[10]  Lijun Kang,et al.  Suicidal ideation in college students having major depressive disorder: Role of childhood trauma, personality and dysfunctional attitudes. , 2022, Journal of affective disorders.

[11]  A. Tuulio-Henriksson,et al.  Psychotic-like experiences of young adults in the general population predict mental disorders , 2022, Psychiatry Research.

[12]  Wanjie Tang,et al.  The effects of peer bullying and poverty on suicidality in Chinese left behind adolescents: The mediating role of psychotic‐like experiences , 2022, Early intervention in psychiatry.

[13]  C. Walsh,et al.  The Mediating Roles of Mental Health and Substance Use on Suicidal Behavior Among Undergraduate Students With ADHD , 2022, Journal of attention disorders.

[14]  I. Galynker,et al.  The Narrative-Crisis Model of suicide and its prediction of near-term suicide risk. , 2021, Suicide & life-threatening behavior.

[15]  S. Shortreed,et al.  Utility of item 9 of the patient health questionnaire in the prospective identification of adolescents at risk of suicide attempt. , 2021, Suicide & life-threatening behavior.

[16]  K. Michel Suicide Models and Treatment Models Are Separate Entities. What Does It Mean for Clinical Suicide Prevention? , 2021, International journal of environmental research and public health.

[17]  Sung-Wan Kim,et al.  Non‐suicidal self‐injury is associated with psychotic like experiences, depression, and bullying in Korean adolescents , 2021, Early intervention in psychiatry.

[18]  G. Biggio,et al.  Insomnia, sleep loss, and circadian sleep disturbances in mood disorders: a pathway toward neurodegeneration and neuroprogression? A theoretical review , 2021, CNS Spectrums.

[19]  Verinder Sharma,et al.  Association among early life stress, mood features, hopelessness and suicidal risk in bipolar disorder: The potential contribution of insomnia symptoms. , 2020, Journal of psychiatric research.

[20]  Wan Wang,et al.  The effects of alexithymia, experiential avoidance, and childhood sexual abuse on non-suicidal self-injury and suicidal ideation among Chinese college students with a history of childhood sexual abuse. , 2020, Journal of affective disorders.

[21]  D. Barch,et al.  Psychotic Like Experiences are Associated with Suicide Ideation and Behavior in 9 to 10 Year Old Children in the United States , 2020, Research on Child and Adolescent Psychopathology.

[22]  J. Mann,et al.  A Brain-Centric Model of Suicidal Behavior. , 2020, The American journal of psychiatry.

[23]  S. Bastianini,et al.  Stress & sleep: A relationship lasting a lifetime , 2020, Neuroscience & Biobehavioral Reviews.

[24]  D. MacKinnon,et al.  Does Nonsuicidal Self-Injury Predict Later Suicidal Attempts? A Review of Studies , 2020, Archives of suicide research : official journal of the International Academy for Suicide Research.

[25]  I. Galynker,et al.  How do distal and proximal risk factors combine to predict suicidal ideation and behaviors? A prospective study of the narrative crisis model of suicide. , 2020, Journal of affective disorders.

[26]  C. Jia,et al.  The short-term rate of non-fatal and fatal repetition of deliberate self-harm: A systematic review and meta-analysis of longitudinal studies. , 2020, Journal of affective disorders.

[27]  S. Ciasca,et al.  Behavior Problems and Depressive Symptoms in Developmental Dyslexia: Risk Assessment in Brazilian Students , 2020, Clinical neuropsychiatry.

[28]  C. Tzourio,et al.  Pathways From ADHD Symptoms to Suicidal Ideation During College Years: A Longitudinal Study on the i-Share Cohort , 2020, Journal of attention disorders.

[29]  Joshua M. Langberg,et al.  Prevalence and predictors of suicidal ideation, plan, and attempts, in first-year college students with ADHD , 2019, Journal of American college health : J of ACH.

[30]  M. Benassi,et al.  Internalizing Symptoms in Developmental Dyslexia: A Comparison Between Primary and Secondary School , 2020, Frontiers in Psychology.

[31]  D. Freeman,et al.  The revised Green et al., Paranoid Thoughts Scale (R-GPTS): psychometric properties, severity ranges, and clinical cut-offs , 2019, Psychological Medicine.

[32]  David A. Brent,et al.  Suicide and suicide risk , 2019, Nature Reviews Disease Primers.

[33]  R. Delorme,et al.  Association between suicidal spectrum behaviors and Attention-Deficit/Hyperactivity Disorder: A systematic review and meta-analysis , 2019, Neuroscience & Biobehavioral Reviews.

[34]  M. Cannon,et al.  Association of Psychotic Experiences With Subsequent Risk of Suicidal Ideation, Suicide Attempts, and Suicide Deaths: A Systematic Review and Meta-analysis of Longitudinal Population Studies , 2019, JAMA psychiatry.

[35]  J. Muehlenkamp,et al.  Protective factors do not moderate risk for past-year suicide attempts conferred by recent NSSI. , 2019, Journal of affective disorders.

[36]  B. Nelson,et al.  The interplay between childhood trauma, cognitive biases, psychotic-like experiences and depression and their additive impact on predicting lifetime suicidal behavior in young adults , 2019, Psychological Medicine.

[37]  I. Galynker,et al.  Suicide Crisis Syndrome Mediates the Relationship Between Long‐term Risk Factors and Lifetime Suicidal Phenomena , 2018, Suicide & life-threatening behavior.

[38]  P. Cuijpers,et al.  The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviors. , 2018, Journal of affective disorders.

[39]  V. Carli,et al.  Psychosocial Factors Correlated with Undisclosed Suicide Attempts to Significant Others: Findings from the Adolescence SEYLE Study. , 2018, Suicide & life-threatening behavior.

[40]  E. Fuller-Thomson,et al.  Suicide Attempts Among Individuals With Specific Learning Disorders: An Underrecognized Issue , 2018, Journal of learning disabilities.

[41]  R. Kessler,et al.  Association Between Psychotic Experiences and Subsequent Suicidal Thoughts and Behaviors: A Cross-National Analysis From the World Health Organization World Mental Health Surveys , 2017, JAMA psychiatry.

[42]  S. H. Lincoln,et al.  Suicidal behaviors and their relationship with psychotic-like symptoms in children and adolescents at clinical high risk for psychosis. , 2017, Comprehensive psychiatry.

[43]  M. Kaess,et al.  Prospective risk for suicidal thoughts and behaviour in adolescents with onset, maintenance or cessation of direct self-injurious behaviour , 2017, European Child & Adolescent Psychiatry.

[44]  I. Galynker,et al.  Prediction of suicidal behavior in high risk psychiatric patients using an assessment of acute suicidal state: The suicide crisis inventory , 2017, Depression and anxiety.

[45]  Lisa S. Rotenstein,et al.  Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students , 2017 .

[46]  Tim Kendall,et al.  Predicting suicide following self-harm: systematic review of risk factors and risk scales. , 2016, The British journal of psychiatry : the journal of mental science.

[47]  M. Rudd,et al.  The Importance of Temporal Dynamics in the Transition From Suicidal Thought to Behavior , 2016 .

[48]  T. Paunio,et al.  Differences and similarities of risk factors for suicidal ideation and attempts among patients with depressive or bipolar disorders. , 2016, Journal of affective disorders.

[49]  Robert Bossarte,et al.  Does Suicidal Ideation as Measured by the PHQ-9 Predict Suicide Among VA Patients? , 2016, Psychiatric services.

[50]  Daniel C. Murrie,et al.  Reformulating Suicide Risk Formulation: From Prediction to Prevention , 2015, Academic Psychiatry.

[51]  T. Willoughby,et al.  The link between nonsuicidal self-injury and acquired capability for suicide: A longitudinal study. , 2015, Journal of abnormal psychology.

[52]  K. Eklund,et al.  Psychosocial Functioning of Children with and without Dyslexia: A Follow-up Study from Ages Four to Nine. , 2015, Dyslexia.

[53]  J. Schiffman,et al.  Psychotic experiences as indicators of suicidal ideation in a non-clinical college sample , 2015, Psychiatry Research.

[54]  M. Large,et al.  Meta‐analysis of the association between suicidal ideation and later suicide among patients with either a schizophrenia spectrum psychosis or a mood disorder , 2015, Acta psychiatrica Scandinavica.

[55]  H. Jeon,et al.  Childhood Exposure to Psychological Trauma and the Risk of Suicide Attempts: The Modulating Effect of Psychiatric Disorders , 2014, Psychiatry investigation.

[56]  M. Richards,et al.  Risk for suicidal problems in poor-help-seeking adolescents with psychotic-like experiences: Findings from a cross-sectional survey of 16,131 adolescents , 2014, Schizophrenia Research.

[57]  Matthew K Nock,et al.  Improving the short-term prediction of suicidal behavior. , 2014, American journal of preventive medicine.

[58]  Zhengxue Qiao,et al.  Associations between impulsivity, aggression, and suicide in Chinese college students , 2014, BMC Public Health.

[59]  I. Melle,et al.  Childhood trauma is associated with severe clinical characteristics of bipolar disorders. , 2013, The Journal of clinical psychiatry.

[60]  C. Glenn,et al.  Quantifying the impact of recent negative life events on suicide attempts. , 2013, Journal of abnormal psychology.

[61]  R. Braithwaite Attention-deficit hyperactivity disorder across the lifespan , 2013, British Journal of Psychiatry.

[62]  M. Pinquart,et al.  Meta-analysis of sleep disturbance and suicidal thoughts and behaviors. , 2012, The Journal of clinical psychiatry.

[63]  M. Oquendo,et al.  Neuropsychological function and suicidal behavior: attention control, memory and executive dysfunction in suicide attempt , 2012, Psychological Medicine.

[64]  W. Veling,et al.  The validity of the 16-item version of the Prodromal Questionnaire (PQ-16) to screen for ultra high risk of developing psychosis in the general help-seeking population. , 2012, Schizophrenia bulletin.

[65]  C. Hulme,et al.  Validity of a Protocol for Adult Self-Report of Dyslexia and Related Difficulties , 2012, Dyslexia.

[66]  Katherine M Keyes,et al.  Childhood maltreatment and the structure of common psychiatric disorders , 2012, British Journal of Psychiatry.

[67]  R. O’Connor The integrated motivational-volitional model of suicidal behavior. , 2011, Crisis.

[68]  Ronak Patel,et al.  The depressed patient and suicidal patient in the emergency department: evidence-based management and treatment strategies. , 2011, Emergency medicine practice.

[69]  A. Danese,et al.  Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. , 2011, The American journal of psychiatry.

[70]  A. Kokoszka,et al.  [Polish version of the Revised Hallucination Scale (RHS) by Morrison et al. Its factor analysis and the prevalence of hallucinatory-like experiences among healthy participants]. , 2011, Psychiatria polska.

[71]  C. Morin,et al.  The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. , 2011, Sleep.

[72]  Nicole M. German,et al.  Patient health questionnaire depression scale as a suicide screening instrument in depressed primary care patients: a cross-sectional study. , 2011, The primary care companion for CNS disorders.

[73]  R. Kessler,et al.  Parental Psychopathology and the Risk of Suicidal Behavior in their Offspring: Results from the World Mental Health Surveys , 2010, Molecular Psychiatry.

[74]  David R. Williams,et al.  Childhood adversities as risk factors for onset and persistence of suicidal behaviour , 2010, British Journal of Psychiatry.

[75]  M. Cannon,et al.  Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis , 2010, Psychological Medicine.

[76]  M. Itokawa,et al.  Psychotic‐like experiences are associated with suicidal feelings and deliberate self‐harm behaviors in adolescents aged 12–15 years , 2010, Acta psychiatrica Scandinavica.

[77]  Kelly C. Cukrowicz,et al.  The interpersonal theory of suicide. , 2010, Psychological review.

[78]  Emilio Ferrer,et al.  Uncoupling of Reading and IQ Over Time , 2010, Psychological science.

[79]  T. Brugha,et al.  Suicide attempts, gender, and sexual abuse: data from the 2000 British Psychiatric Morbidity Survey. , 2009, The American journal of psychiatry.

[80]  N. Sampson,et al.  Mental Disorders, Comorbidity and Suicidal Behavior: Results from the National Comorbidity Survey Replication , 2009, Molecular Psychiatry.

[81]  Catherine Deri Armstrong,et al.  The Mental Health of Canadians With Self-Reported Learning Disabilities , 2009, Journal of learning disabilities.

[82]  Kristopher J Preacher,et al.  Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models , 2008, Behavior research methods.

[83]  C. King,et al.  Social and Interpersonal Factors Relating to Adolescent Suicidality: A Review of the Literature , 2008, Archives of suicide research : official journal of the International Academy for Suicide Research.

[84]  J. Sareen,et al.  Chronic Pain Conditions and Suicidal Ideation and Suicide Attempts: an Epidemiologic Perspective , 2007 .

[85]  E. D. Klonsky Non-suicidal self-injury: an introduction. , 2007, Journal of clinical psychology.

[86]  M. Rietschel,et al.  Psychiatric comorbidity and functional impairment in a clinically referred sample of adults with attention-deficit/hyperactivity disorder (ADHD) , 2007, European Archives of Psychiatry and Clinical Neuroscience.

[87]  Ronald C Kessler,et al.  Validity of the World Health Organization Adult ADHD Self‐Report Scale (ASRS) Screener in a representative sample of health plan members , 2007, International journal of methods in psychiatric research.

[88]  Beth A Reboussin,et al.  Suicidality, School Dropout, and Reading Problems Among Adolescents , 2006, Journal of learning disabilities.

[89]  R. de Graaf,et al.  Childhood adversities and risk for suicidal ideation and attempts: a longitudinal population-based study , 2006, Psychological Medicine.

[90]  M. Oquendo,et al.  Prospective studies of suicidal behavior in major depressive and bipolar disorders: what is the evidence for predictive risk factors? , 2006, Acta psychiatrica Scandinavica.

[91]  R. Kessler,et al.  A risk index for 12-month suicide attempts in the National Comorbidity Survey Replication (NCS-R) , 2006, Psychological Medicine.

[92]  Kevin B. Wright,et al.  Researching Internet-Based Populations: Advantages and Disadvantages of Online Survey Research, Online Questionnaire Authoring Software Packages, and Web Survey Services , 2006, J. Comput. Mediat. Commun..

[93]  A. Bifulco,et al.  The childhood experience of care and abuse questionnaire (CECA.Q): validation in a community series. , 2005, The British journal of clinical psychology.

[94]  L. Roeger,et al.  Sexual abuse and suicidality: gender differences in a large community sample of adolescents. , 2004, Child abuse & neglect.

[95]  H. MacMillan,et al.  The relationship between childhood physical abuse and suicidality among depressed women: results from a community sample. , 2003, The American journal of psychiatry.

[96]  Jan Fawcett,et al.  Clinical correlates of inpatient suicide. , 2003, The Journal of clinical psychiatry.

[97]  Anthony P Morrison,et al.  Cognitive and emotional predictors of predisposition to hallucinations in non-patients. , 2002, The British journal of clinical psychology.

[98]  J. Pearson,et al.  Contact with mental health and primary care providers before suicide: a review of the evidence. , 2002, The American journal of psychiatry.

[99]  O. Hart,et al.  The psychometric characteristics of the traumatic experiences checklist (TEC): first findings among psychiatric outpatients , 2002 .

[100]  K. L. Gratz,et al.  Measurement of Deliberate Self-Harm: Preliminary Data on the Deliberate Self-Harm Inventory , 2001 .

[101]  B. Pennington,et al.  Psychiatric comorbidity in children and adolescents with reading disability. , 2000, Journal of child psychology and psychiatry, and allied disciplines.

[102]  R. Blum,et al.  Adolescents with learning disabilities: risk and protective factors associated with emotional well-being: findings from the National Longitudinal Study of Adolescent Health. , 2000, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[103]  A. Wells,et al.  Cognitive factors in predisposition to auditory and visual hallucinations. , 2000, The British journal of clinical psychology.

[104]  D. Fergusson,et al.  Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood , 2000, Psychological Medicine.

[105]  C Waternaux,et al.  Toward a clinical model of suicidal behavior in psychiatric patients. , 1999, The American journal of psychiatry.

[106]  S. Gau,et al.  Attention-deficit hyperactivity disorder and suicidality: The mediating effects of psychiatric comorbidities and family function. , 2019, Journal of affective disorders.

[107]  M. Sahoo,et al.  Psychological Co-morbidity in Children with Specific Learning Disorders , 2015, Journal of family medicine and primary care.

[108]  J. Balázs,et al.  Attention-deficit hyperactivity disorder and suicidality in a treatment naïve sample of children and adolescents. , 2014, Journal of affective disorders.

[109]  R. Spitzer,et al.  The PHQ-9: validity of a brief depression severity measure. , 2001, Journal of general internal medicine.