Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation

Objective: To identify the independent psychosocial and risk behavior corre lates of suicidal ideation and attempts. Method: The relationships between suicidal ideation or attempts and family environment, subject characteristi cs, and various risk behaviors were examined among 1,285 randomly selected children and adolescents, aged 9 through 17 years, of whom 42 (3.3%) had at tempted suicide and 67 (5.2%) had expressed suicidal ideation only. The you ths and their parents were enumerated and interviewed between December 1991 and July 1992 as part of the NIMH Methods for the Epidemiology of Child an d Adolescent Mental Disorders (MECA) Study. Results: Compared with subjects with suicidal ideation only, attempters were significantly more likely to have experienced stressful life events, to have become sexually active, to have smoked more than one cigarette daily, and to have a history of ever ha ving smoked marijuana. After adjusting for sociodemographic characteristics , a statistically significant association was found between suicidal ideati on or attempt and stressful life events, poor family environment, parental psychiatric history, low parental monitoring, low instrumental and social c ompetence, sexual activity, marijuana use, recent drunkenness, current smok ing, and physical fighting. Even after further adjusting for the presence o f a mood, anxiety, or disruptive disorder, a significant association persis ted between suicidal ideation or attempts and poor family environment, low parental monitoring, low youth instrumental competence, sexual activity, re cent drunkenness, current smoking, and physical fighting. Conclusion: Low p arental monitoring and risk behaviors (such as smoking, physical fighting, alcohol intoxication, and sexual activity) are independently associated wit h increased risk of suicidal ideation and attempts, even after adjusting fo r the presence of psychiatric disorder and sociodemographic variables.