Body Mapping as a Tool to Capture Children's Expressions of Their Suicide Ideation or Attempts

Assessing suicide risk among children is complex, in part due to their developmental differences in identifying, recalling, and verbally describing internal states, alongside cultural differences in how distress is experienced. This study aimed to identify expressions of distress around suicide ideation or attempts through body mapping, a qualitative technique that facilitates both visual and verbal expressions.

Twenty-three children, ages 8-12 years (26% Black, 22% White, and 30% other races; 57% Hispanic/Latine), were recruited from an inpatient unit and interviewed within 14 days of their admission for a suicide attempt (n = 7) or suicide ideation (n = 16). Children completed the Childhood Suicide Ideation Interview, which included semi-structured questions about their suicide ideation and/or attempt and a body mapping activity, where children illustrated and described their thoughts, feelings, body sensations, and social connections surrounding their suicidal crisis on a printed body silhouette.

Analyses conducted with Anthropac yielded 94 expressions of distress. The congruence in overall experiences across children was low (24%), yet specific somatic experiences like "shaking" (70%), "pain" (43%), and "dizziness" (39%) were prevalent. Other frequent experiences included "sad" (48%), "passive suicide ideation" (43%), and "thoughts about family" (39%).

Body mapping was a valuable tool for uncovering unique expressions of distress among ethnoracially diverse children. Somatic expressions, often overlooked in risk assessments, were prominent. Ours and similar studies have the potential to inform the design of culturally and developmentally responsive risk assessment tools and safety planning protocols.