Prevalence, correlates and treatment of lifetime suicidal behavior among adolescents: Results from the National Comorbidity Survey Replication – Adolescent Supplement (NCS-A)

By Matthew K. Nock, J. Green, I. Hwang, Katie A. McLaughlin, N. Sampson, Alan M. Zaslavsky, Ronald C. Kessler. JAMA psychiatry, 2013

1,580 citations recorded by the source corpus.

Context Although suicide is the third leading cause of death among US adolescents, little is known about the prevalence, correlates, or treatment of its immediate precursors, adolescent suicidal behaviors (i.e., suicide ideation, plans, and attempts). Objectives To estimate lifetime prevalence of suicidal behaviors among US adolescents and associations of retrospectively-reported temporally primary DSM-IV disorders with the subsequent onset of suicidal behaviors. Design Dual-frame national sample of adolescents from the National Comorbidity Survey-Replication Adolescent Supplement (NCS-A). Setting Face-to-face household interviews with adolescents and questionnaires with parents. Participants 6,483 adolescents (ages 13–18 years) and parents. Main outcome measures Lifetime suicide ideation, plans, and attempts. Results The estimated lifetime prevalence of suicide ideation, plans, and attempts among NCS-A respondents is 12.1%, 4.0% and 4.1%. The vast majority of adolescents with these behaviors meet lifetime criteria for at least one DSM-IV mental disorder assessed in the survey. Most temporally primary (based on retrospective age-of-onset reports) fear/anger, distress, disruptive behavior, and substance disorders significantly predict elevated odds of subsequent suicidal behaviors in bivariate models. The most consistently significant associations of these disorders are with suicide ideation, although a number of disorders also predict plans and both planned and unplanned attempts among ideators. Most suicidal adolescents (>80%) receive some form of mental health treatment. In most cases (>55%) treatment starts prior to onset of suicidal behaviors but fails to prevent these behaviors from occurring. Conclusions Suicidal behaviors are commonly occurring among US adolescents, with rates that approach those of adults. The vast majority of youth with suicidal behaviors have pre-existing mental disorders. The disorders most powerfully predicting ideation, though, are different from those most powerfully predicting conditional transitions from ideation to plans and attempts. These differences suggest that distinct prediction and prevention strategies are needed for ideation, plans among ideators, planned attempts, and unplanned attempts.

Subfields: Computer Networks and Communications

View Paper: https://www.semanticscholar.org/paper/5ad749defe53fad155d1ed135b49d2f1b5339f0b

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Citations in the corpus

School-Based Suicide Prevention: A Framework for Evidence-Based Practice (2018, background): “Indeed, the average length of time between first serious thought of suicide and first suicide attempt is approximately 1 year (Nock et al., 2013).”
Differentiating suicide attempters from suicide ideators: a critical frontier for suicidology research. (2014, result): “…this general pattern reported by Kessler et al. was subsequently found in other large-scale studies as well, including an international epidemiological study examining suicidality across 21 countries (Nock, Borges, & Ono, 2012), and an epidemiological study of adolescents (Nock et al., 2013).”
Beyond Screen Time: Identity Development in the Digital Age (2020, background): “Perhaps most seriously, both anxiety and depression are linked to suicide (Nock et al., 2013); depressed individuals have a 30- fold higher likelihood of successfully committing suicide than their non-depressed counterparts (Klein, Torpey, Bufferd, & Dyson, 2008).”