24-Hour warning signs for adolescent suicide attempts

Area of Science:

• Psychiatry
• Adolescent Health
• Suicidology

Background:

• Understanding the immediate precursors to adolescent suicide attempts is vital for timely intervention.
• Limited research exists on the specific 24-hour warning signs (WS) preceding suicide attempts in youth.

Purpose of the Study:

• To identify 24-hour warning signs for suicide attempts in adolescents.
• To provide actionable information for parents, caregivers, and professionals.

Main Methods:

• A case-crossover, within-subject design was employed.
• Adolescents (N=1094, ages 13-18) completed bi-weekly surveys for 18 months.
• Interviews with adolescents and parents were conducted for 105 adolescents who reported an attempt, comparing the 24 hours before the attempt to a control period.

Main Results:

• Parent and adolescent reports indicated suicidal communications and social withdrawal as significant warning signs.
• Adolescent self-reports identified specific feelings (e.g., self-hate, emotional pain), cognitions (e.g., suicidal rumination, perceived burdensomeness), and conflict with parents as warning signs.
• Multivariable models confirmed these factors as predictors of suicide attempts.

Conclusions:

• The study identified key 24-hour warning signs in cognitive, emotional, and behavioral domains for adolescent suicide attempts.
• This provides an evidence base for disseminating information on proximal risk indicators.
• Findings can inform prevention strategies and support for at-risk youth.