Assessing and Preventing Youth Suicidality

PI: Aleksandra Kaurin

Projektlaufzeit: 01/2023-08/2025

Förderung: German Research Foundation (DFG)

Assessing and Preventing Youth Suicidality

Learn more about the project: https://youthsuicidenetwork.com/MEMBERS/

Suicide claims more than 700,000 lives globally every year, with 9206 deaths by suicide in Germany in 2020 (WHO, 2021). Particularly child and adolescent suicides have long-lasting negative effects on families, schools, and clinical staff (Gould et al., 2018). Among youth between 10-24 years, suicide is one of the leading causes of death (WHO, 2021). In countries with the highest human development index, Germany ranks second in youth suicides (15–24 years; Doran & Kinchin, 2020), and 25.6% of 13- to 25-year-old inpatients in Germany reported at least one suicide attempt in their lives (Kaess et al., 2011).

Unlike other leading causes of death among youth, suicide can be prevented when timely interventions are available. Alleviating youth suicidality1 requires knowledge on accurate and valid assessments thereof (Kaurin et al., 2022). To date, however, such knowledge is vastly limited (Ayer et al., 2020), most likely because prior studies have primarily assessed suicidality and associated risk factors as relatively “distal” or “static” phenomena. Suicidal thoughts and behaviors, however, are unstable and short-lived phenomena, likely influenced by contextual and “proximal” risk factors that themselves fluctuate over time (Kleimann et al., 2017). This results in a mismatch between the methods used to study suicidality, the actual timescale on which it occurs, as well as the multidetermined, plausibly idiosyncratic nature of relevant risk factors (Kaurin et al., 2022). This mismatch, we can plausibly assume, is one reason behind 50 years of research with weak effect sizes (Fox et al., 2020). Further complicating matters, collecting information about suicide risk (especially in real-time) poses important safety, ethical, and methodological concerns, and the field is dominated by the persistent concern that asking youth about suicide may be harmful (i.e., iatrogenic effects; Gould et al., 2005). Before research on youth suicidality and relevant clinical services may advance, these empirical gaps need to be sustainably narrowed.

The goal of the project is to elaborate on, apply, and demonstrate methods for improving assessment approaches of youth suicidality. We will particularly focus on developmentally sensitive intensive longitudinal data assessments (i.e., ambulatory assessments), their clinical utility, as well as potential risks (e.g., iatrogenic effects), and ethical considerations that are paramount to conducting work in this field. Network meetings will serve as initial steps to discuss central malleable factors underlying elevated suicide risk in youth with the ultimate goal to prepare a DFG proposal (clinical trials) for a multicenter randomized controlled stepped care intervention trial.

References

Ayer, L., Colpe, L., Pearson, J., Rooney, M., & Murphy, E. (2020). Advancing Research in Child Suicide: A Call to Action. Journal of the American Academy of Child and Adolescent Psychiatry, 59(9), 1028–1035. doi.org/10.1016/j.jaac.2020.02.010

Doran, C. M. & Kinchin, I. (2020). Economic and epidemiological impact of youth suicide in countries with the highest human development index. PLOS ONE, 15(5), e0232940.

Fox, K. R., Huang, X., Guzmán, E. M., Funsch, K. M., Cha, C. B., Ribeiro, J. D., & Franklin, J. C. (2020). Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research. Psychological Bulletin, 146(12), 1117–1145. doi.org/10.1037/bul0000305

Gould, M., Lake, A., Kleinman, M., Galfalvy, H., Chowdhury, S. & Madnick, A. (2018). Exposure to Suicide in High Schools: Impact on Serious Suicidal Ideation/Behavior, Depression, Maladaptive Coping Strategies, and Attitudes toward Help-Seeking. International Journal of Environmental Research and Public Health, 15(3), 455. doi.org/10.3390/ijerph15030455

Kaess, M., Parzer, P., Haffner, J., Steen, R., Roos, J., Klett, M., ... & Resch, F. (2011). Explaining gender differencesin non-fatal suicidal behaviour among adolescents: a population-based study. BMC Public Health, 11, 1-7.