Asking Preadolescents About Suicide Is Not Associated With Increased Suicidal Thoughts

Area of Science:

• Child and Adolescent Psychiatry
• Mental Health Screening
• Suicidology

Background:

• Rising rates of suicidal thoughts and behaviors (STBs) in preadolescents necessitate effective screening.
• The safety of repeated suicide-risk screening in preadolescents (8-12 years) is not well-established.
• This study investigated potential iatrogenic effects of screening in this age group.

Purpose of the Study:

• To determine if repeated suicide-risk screening iatrogenically increases suicidal thoughts and behaviors (STBs) in preadolescents.
• To compare the safety of screening in lower-risk versus higher-risk preadolescent groups.
• To inform clinical practice regarding suicide-risk screening in young children.

Main Methods:

• The Ask-Suicide Screening Questions (ASQ) was administered to 194 preteens (ages 8-12) over 12 months.
• Lower-risk preadolescents (n=68) were screened monthly; higher-risk preadolescents (n=124) were screened weekly.
• Remote administration via text/email was used, with analyses examining screen completion, positive screens, and changes over time.

Main Results:

• No evidence indicated that repeated screening increased suicidal thoughts in either the lower-risk or higher-risk groups.
• Positive screens were rare in the lower-risk group (1.6%) with no increase over time.
• In the higher-risk group, 7% of screens were positive, without exacerbation of suicidal thoughts due to frequent screening.

Conclusions:

• Suicide-risk screening appears safe for preadolescents aged 8-12 years.
• Clinicians can confidently screen preadolescents, as benefits likely outweigh risks.
• This research supports the use of suicide-risk screening in pediatric populations.