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Despite adolescents' suicidal thoughts and behaviors being major health problems, sparse literature exists on the roles of adolescents' disclosing their feelings to caregivers in their suicidal thoughts and behaviors. This study examined whether adolescents' comfort in disclosing their feelings and problems to caregivers predicts subsequent suicidal thoughts and behaviors and whether difficulties in emotion regulation mediate this association. High school students (N = 5,346 from 20 schools, 49% female-identified adolescents, and 35% 9th graders, 33% 10th graders, and 32% 11th graders) participated in the study for two years with four waves, each six months apart: fall semester in Year 1 (Wave 1), spring semester in Year 1 (Wave 2), fall semester in Year 2 (Wave 3), and spring semester in Year 2 (Wave 4). The degree to which adolescents felt comfortable disclosing their feelings and problems to caregivers at Wave 1 predicted lower suicidal thoughts and behaviors at Wave 4 directly and indirectly via higher emotional clarity at Wave 2 and feeling more able to handle negative emotions at Wave 3. Moreover, when female-identified adolescents reported feeling unable to handle negative emotions at Wave 3, they reported engaging in more suicidal thoughts and behaviors at Wave 4 than male-identified adolescents. Therefore, enhancing adolescents' comfort in disclosing their feelings and problems to caregivers and adolescent emotion regulation and taking a nuanced approach to support female-identified adolescents regarding their ability to handle negative emotions could prevent adolescents' suicidal thoughts and behaviors. [ABSTRACT FROM AUTHOR]

Betrayal trauma is associated with dissociative symptoms, which can increase the risk of suicidal thoughts and behaviors. Previous research demonstrates associations between a mother's history of betrayal trauma and intergenerational patterns of maltreatment and dissociation among their children. However, maternal betrayal trauma history remains unexplored in the etiology of youth suicidality. This study was conducted to investigate pathways between maternal betrayal trauma and youth suicidality, while considering the influences of youth maltreatment exposure and symptoms of dissociation. We implemented conditional growth curve modeling in a structural equation modeling framework to analyze secondary data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN; N = 1,354; 51.48% female, 53.29% Black). Predictors included mothers' betrayal trauma history, youth maltreatment exposure, and youth dissociative symptoms at ages 8, 12, and 16. The slope and intercept of dissociative symptoms at the age-8, age-12, and age-16 visit were modeled as latent factors. A robust weighted least squares estimator accounted for categorical outcomes. Indirect effects were assessed via the delta method. We found a significant indirect effect from maternal betrayal trauma to adolescent suicidal ideation through children's maltreatment exposure and the growth in children's dissociative symptoms from ages 8 through 16. Maternal betrayal trauma may play a unique role in perpetuating intergenerational patterns of trauma that contribute to subsequent trajectories of youth suicidality among their offspring. Practice implications for screening, prevention, and early intervention strategies are described, along with directions for further study. [ABSTRACT FROM AUTHOR]

Purposes: To better assess and reduce suicidal risk in first-episode psychosis (FEP), we aimed to investigate the evolution of suicidal thoughts and behaviors (STBs) and associated factors in FEP.Method: This systematic review (PROSPERO-CRD42020168050) meets PRISMA guidelines. PubMed, Medline, PsycINFO, Embase, EBM Reviews and references lists of relevant articles were searched (February 2020) to identify longitudinal studies, published in English or in French, that assessed the prevalence of STBs at entry to services and over follow-up, and examined factors associated with STBs among all persons with affective and non-affective FEP from a defined catchment area. Screening, data extraction and quality assessment using the adapted Newcastle Ottawa Scale were done independently by two reviewers. Results on prevalence and associated factors are presented by type of STB.Results: Of 3,177 references, 17 studies of 11 non-overlapping samples (n = 14,907) with varying lengths of follow-up (1-41.7 years) were included. The prevalence of STBs decreased over follow-up. Up to 21.6% made at least one suicide attempt, 27% had suicidal ideation, and 1-4.3% died by suicide during follow-up. Of 53 factors assessed across studies, only male sex, depressive symptoms, and STBs occurring early during follow-up were associated with subsequent STBs. Early intervention for psychosis decreased STBs in the first three years. Other factors were assessed in a single study, yielded conflicting results, or were not associated with STBs.Conclusions: The high prevalence of STBs following onset of psychosis highlights the need for early detection and intervention and ongoing assessment of suicidal risk throughout follow-up, with attention to identified risk factors. The heterogeneity of the studies precluded a meta-analysis and several factors were each assessed by a single study. Additional well-designed longitudinal studies of STBs and associated factors are warranted. [ABSTRACT FROM AUTHOR]

Understanding the cognitive and emotional mechanisms that link autistic traits and risk for suicide is a vital next step for research and clinical practice. This study included a broad sample of adult women (n = 74) who report finding social situations confusing and/or exhausting, and who score high on measures of autistic traits. Regardless of autism diagnostic status, these women reported high rates of suicidal thoughts and behaviors. Depression symptoms were more associated with suicidality than were autistic trait measures of social communication. Measures of neurotypical "imagination" and of repetitive behavior likewise were associated with suicidality risk. Simultaneously feeling sad and feeling stuck or unable to imagine alternate strategies, may uniquely increase suicide risk in autism. [ABSTRACT FROM AUTHOR]

Purpose Of Review: To review and discuss recent advances in evidence-based interventions (EBIs) for youth suicide risk.Recent Findings: There is a growing body of research on the effectiveness of interventions targeting suicidal ideation and behavior among adolescents. Dialectical Behavioral Therapy-Adolescent has shown effectiveness across two independent randomized controlled trials (RCTs). Several other interventions have shown effectiveness in only one trial and are in need of replication. New interventions are also being developed that incorporate developments in technology and adaptive intervention designs. It is recommended that future research focus on strategies for engaging underserved youth with interventions, consider the broader needs of youth living in poverty, and further tailor interventions to subgroups with distinct risk profiles. Limited EBIs exist for preadolescents, despite evidence for an increasing rate of suicidal behavior for these youth. Several interventions for youth suicide risk are highly promising, but further investigation is necessary. EBIs that are effective for preadolescents are needed, and greater efforts to tailor interventions for distinct subgroups of youth at risk are recommended. [ABSTRACT FROM AUTHOR]

On average, compared to non-referred youth, child psychiatric outpatients show elevated rates of suicidal thoughts and behaviors (STBs), which are predictors of completed suicide. Determining the psychopathology features that associate with highest risk for STBs among youth outpatients may yield opportunities for targeted prevention/intervention. Yet, outpatient studies are limited and have not systematically examined comorbidity and dimensional psychopathology. In 758 youth, aged 6-18, consecutively referred for neuropsychiatric evaluation, we examined the extent to which diagnostic groups, comorbid subgroups and dimensional symptoms associated with STBs. After controlling for comorbidity, mood, anxiety and conduct disorders associated with elevated STB risk. Regarding dimensions, symptoms of depression, aggression and psychosis all contributed to higher STB risk. Although ADHD (as a diagnosis or dimension) did not associate with elevated STB risk independently, ADHD that was comorbid with other conditions did. Suicide prevention/intervention efforts should be investigated in youth outpatients with the highest risk for STBs. [ABSTRACT FROM AUTHOR]

Suicidal thoughts and behaviors are a significant health concern for adolescents. Extant research suggests that sexual and gender minority adolescents are a vulnerable population at elevated risk for suicidal thoughts and behaviors, yet to date few studies have examined the unique associations between adolescent gender nonconformity and suicide risk. This study examined data from the Youth Risk Behavior Surveillance Survey (n = 7730) to estimate the association between gender nonconformity and high school-aged adolescents' likelihood of endorsing four distinct suicide outcomes: suicidal ideation, suicide plans, any suicide attempts, and single vs. multiple suicide attempts. Multivariate logistic regression analyses were utilized to control for other known risk factors for suicidal thoughts and behaviors, including age, sex, sexual minority status, depression symptoms, and suicidal ideation. Results revealed that gender nonconformity was significantly associated with higher odds of reporting suicidal ideation, suicide plans, and multiple suicide attempts in the past year above and beyond other known risk factors. Gender nonconformity is an understudied vulnerability factor that should be taken into consideration by researchers and clinicians seeking to understand adolescents' risk for suicidal thoughts and behaviors. [ABSTRACT FROM AUTHOR]

Suicide is among the leading causes of death among individuals ages 10–24, making suicidal thoughts and behaviors (STBs) a serious public health crisis among youth. Suicide risk screening and assessment are vital to addressing this public health crisis. In fact, many youths that screen positive for suicidal ideation do not have known mental health concerns and would have been missed if not asked directly. Medical settings are an optimal setting to detect suicidality early and provide appropriate follow-up monitoring and care as needed. To support effective and efficient screening and assessment of suicidal thoughts and behaviors, providers must choose measures with both strong psychometric properties and clinical utility. While measurement of STBs can vary across health settings, suicide risk screening and assessment typically involves gathering information about current suicidal ideation, suicidal behaviors, and suicidal plans via self-report questionnaires, clinical interviews, and/or computerized adaptive screens. In alignment with measurement-based care efforts, the current manuscript will provide a scoping review of measures of youth suicidal ideation, behavior, plans, and their risk factors. Specifically, the psychometric properties, clinical utility, and other key considerations for screening and assessment of adolescent suicide risk are discussed. [ABSTRACT FROM AUTHOR]