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Suicidal Ideation of Psychiatrically Hospitalized Adolescents has One-Year Predictive Validity for Suicide Attempts in Girls Only

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Abstract

Clinicians commonly incorporate adolescents’ self-reported suicidal ideation into formulations regarding adolescents’ risk for suicide. Data are limited, however, regarding the extent to which adolescent boys’ and girls’ reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys’ and girls’ self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13–17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children’s Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization.

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Acknowledgements

The authors gratefully acknowledge the adolescents who participated in this study; and the support of the physicians, nurses, social workers, and administrative staff of the University of Michigan Child and Adolescent Psychiatric Inpatient Program. We also thank the study coordinators, independent evaluators, and research assistants. We especially thank Anne Kramer, Barbara Hanna, Ken Guire, Kristin Chadha, Alissa Huth-Bocks, Elisa Berger, Jeff Ammons, and Kiel Opperman, who contributed as University of Michigan staff members, and Lois Weisse, Cheryl McManus, and Tracy Laichalk, who contributed as Havenwyck Hospital staff members. This work was supported by a NIMH grant (R01 MH63881) and K24 career development award to Dr. Cheryl King.

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Authors and Affiliations

  1. Departments of Psychiatry and Psychology, University of Michigan Depression Center, University of Michigan, Ann Arbor, MN, USA

    Cheryl A. King & Ewa K. Czyz

  2. Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MN, USA

    Qingmei Jiang

  3. School of Psychological Science, Oregon State University, Corvallis, OR, USA

    David C. R. Kerr

  4. Oregon Social Learning Center, Eugene, OR, USA

    David C. R. Kerr

  5. Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA

    Cheryl A. King

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  1. Cheryl A. King
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  2. Qingmei Jiang
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  4. David C. R. Kerr
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Correspondence to Cheryl A. King.

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Qingmei Jiang was at the Michigan Institute for Clinical and Health Research when this study was conducted.

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King, C.A., Jiang, Q., Czyz, E.K. et al. Suicidal Ideation of Psychiatrically Hospitalized Adolescents has One-Year Predictive Validity for Suicide Attempts in Girls Only. J Abnorm Child Psychol 42, 467–477 (2014). https://doi.org/10.1007/s10802-013-9794-0

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