Archives of Suicide Research

Jenssen, Henriette; Jakobsen, Sarah Grube; Larsen, Christina Petrea; Christiansen, Erik

doi: 10.1080/13811118.2025.2490153pmid: 40347241

Abstract Objective Suicide is among the leading causes of death among adolescents. Many risk factors for suicide are well known, and self-harm ideation and behavior are among the strongest. Still, there is limited research on factors that distinguish those with self-harm ideation and those who self-harm. Our aim is to investigate nonpsychiatric risk factors that distinguish between adolescents with self-harm ideation, those who self-harm, and those who engage in repeated self-harm. Method This survey analysis was based on findings from a cross-sectional study (N = 7,943 adolescents). Multinomial logistic regression was employed to compare the effects of various exposures (including social relations, happiness, vulnerability, being bullied, self-worth, physical and sexual abuse) on self-harm ideation, self-harm, and repeated self-harm, using a reference group of adolescents without self-harming behavior. Results Adolescents exhibiting self-harming behavior showed significantly higher levels of exposure, with the highest exposure observed in the repeated self-harm group. Vulnerability and lack of self-worth emerged as the most significant risk factors. Additionally, we found a clear dose-response effect across all groups. Conclusions This study highlights the significant increase in the risk of self-harm with the accumulation of risk factors in adolescents’ lives, emphasizing the importance of providing support and assistance to those exposed to multiple risk factors. Addressing these factors may help reduce the risk of suicidal behavior, as self-harm remains one of the strongest risk factors for suicide attempt and suicide. Furthermore, the findings point out the critical role of single risk factors, particularly vulnerability and lack of self-worth.

Anton-Lotruglio, Elaine M.; O’Brien, Kimberly H. McManama

doi: 10.1080/13811118.2025.2509653pmid: 40454444

Abstract Objective Suicide rates continue to rise, particularly among young adults, with college student-athletes representing a specific subgroup of concern. The aim of this systematic review was to clarify the individual and environmental risk factors for suicide specific to U.S. college student-athletes. Method Databases searched included the State University of New York (SUNY) libraries, Google Scholar, Web of Science, PsychINFO, Semantic Scholar, and PubMed. No date restrictions were applied, resulting in 112 articles and reports included in this review. Studies examining U.S. student-athletes participating in intercollegiate athletics within the context of suicide, including ideation, actions, or attempts, met the inclusion criteria for this thematic review. The PRISMA framework guided the literature selection and content review. Results Risk factors included the convergence of academic and athletic pressure, toxic team culture, barriers to accessing services, complexities of the athlete identity, and experiences of injury. Conclusion Given these unique risk factors, approaches to suicide prevention, intervention, and postvention for U.S. college student-athletes should include mandated suicide training for college athletic department personnel, routine mental health screening for athletes, improved access to mental health services, and the implementation of collaborative multidisciplinary care.

Wilner, Julianne G.; Cho, Emma; De Nadai, Alessandro S.; Au, Josephine S.; Russo, Jillian M.; Kaplan, Courtney; Naclerio, Maria; Lee, Eileen; Salisbury, Angela; Dickstein, Daniel P.

doi: 10.1080/13811118.2025.2476987pmid:

Gonçalves de Rezende, Marcos; Arantes Figueiredo de Paula Eduardo, Juliana; Levi, Vitória; Leite da Roza, Daiane; de Carvalho Cavalli, Ricardo; Bettiol, Heloisa; Rossi Menezes, Paulo; Del-Ben, Cristina Marta

doi: 10.1080/13811118.2025.2488524pmid:

Jin, Yufei; Kieslich, Karel; Hall, Anna; Pitman, Alexandra

doi: 10.1080/13811118.2025.2489159pmid: 40192036

Abstract Objective Previous research has identified loneliness as a risk factor for suicidal ideation and attempt but has lacked studies using representative samples of adolescents. We aimed to address this evidence gap by using a nationally representative sample of US adolescents to investigate whether loneliness is longitudinally associated with suicide-related outcomes. Method We analyzed data on 17,751 participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health) aged 11–21 years at baseline. We used multivariable logistic regression to test the longitudinal association between baseline loneliness (1995; aged 11–21 years) and past-year suicidal ideation and suicide attempt measured six years later (2001–2002; aged 18–28 years) and 13 years later (2008–2009; aged 24–34 years) adjusted for socio-demographic and clinical characteristics. Results Adolescents with higher levels of loneliness aged 11–21 years were 1.97 times more likely to report suicidal ideation six years later (ORadj1=1.97, 95% CI [1.45, 2.67], p < 0.001), but this association was no longer significant after adjustment (ORadj2=1.10, 95% CI [0.75, 1.61], p = 0.62). They were also significantly more likely to report suicidal ideation at 13-year follow-up (ORadj1=2.22, 95% CI [1.71, 2.89], p < 0.001), even after adjustment (ORadj2=1.36, 95% CI [1.00, 1.86], p = 0.049). However, there was no association between loneliness and suicide attempt at either follow-up point. Conclusions Loneliness aged 11–21 years predicts suicidal ideation (but not suicide attempt) 13 years later, suggesting a need for interventions delivered at the start of adolescence to prevent the onset of distressing suicidal ideation later in adolescence and young adulthood.

Sierra, Valentín Quiroz

doi: 10.1080/13811118.2025.2490154pmid: 40249106

Abstract Introduction Suicide is the leading cause of non-accidental death for Native American young people ages 15-24. Alarmingly, suicide rates have continued to rise over the past decade despite ongoing prevention efforts. This shortcoming has urged some scholars to (re)examine dominant theoretical models to better direct suicide prevention efforts in tribal communities. Method Using Indigenous Wholistic Theory, this study used an algorithmic approach to identify a broader set of factors associated with suicidal ideation among Native American high school students in California (n = 2,609). Data were drawn from the 2019–2020 California Healthy Kids Survey, a statewide school-based dataset. Lasso penalized regression was employed to select the most predictive variables for suicidal ideation from a set of 17 candidate factors. Results Ten predictors were retained in the final model: depressive symptoms; school-based victimization; sexual and gender minority status; lifetime use of alcohol, vapes, and cannabis; breakfast consumption; access to alcohol and other drugs; and parent education level. Conclusion A combination of factors spanning individual, emotional-social, mental-political, and physical-economic domains predicted individualized risk for experiencing suicidal ideation. These findings underscore the need to move beyond psycho-centric models and toward more comprehensive understandings of suicide-related behavior among Native American youth.

Gu, Jialei; Liu, Luming; Wu, Xinchun; Wang, Wenchao

doi: 10.1080/13811118.2025.2492688pmid: 40254987

Abstract With its susceptibility in victimized populations and the potential for suicidality, non-suicidal self-injury (NSSI) is among the most severe health concerns in college students, indicating an urgency to explore its antecedents and interventions. The present study aims to examine the relationship between bullying victimization and NSSI and the mediating roles of internal shame, external shame, depressive symptoms, and PTSD symptoms based on the general strain theory, the vulnerability-stress theory, and the transactional stress theory. By adopting a three-time-point design with 6-month intervals, hypotheses were tested using data from 634 Chinese college students (374 female; Mage = 18.97). Through a structural equation modeling approach, the study found that bullying victimization was positively correlated with NSSI via internal shame and depressive symptoms. However, this study found no evidence for the mediating association of either external shame or PTSD symptoms in the examined relationship. Through a lens of emotion-driven mechanism, this study contributes to understanding the roles of internal shame and depressive symptoms in NSSI intervention strategies among victims of bullying. The results also illuminate the differentiation of the mechanisms of internal and external shame and the discrepancy between depressive symptoms and PTSD symptoms as two types of post-traumatic symptomatology.

McGillivray, Lauren; Wong, Quincy J. J.; Gan, Daniel Z. Q.; Rheinberger, Demee; Baffsky, Rachel; Torok, Michelle

doi: 10.1080/13811118.2025.2495970pmid: 40279156

Abstract Objective Self-harm among children and adolescents is a global public health issue, with concerning trends of increased rates of hospital presenting self-harm in younger age groups (5–12 years). Few studies have investigated risk factors of emerging self-harm in preadolescent populations (<12 years). This study aimed to identify key factors associated with recent (past 12-months) self-harm in preadolescents (5–12 years) compared to adolescents (13–18 years). Method This cross-sectional case-control study recruited 305 parents/guardians who had a child (aged 5–18 years) that had (i) recently engaged in self-harm (case group) or (ii) never engaged in self-harm (control group). Participants completed an online parent-report questionnaire that assessed demographic characteristics and self-harm, childhood adversity, child-parent relationships, peer relationships, and problematic digital media use. Data were analyzed using univariate and multivariate logistic regression analyses. Results Poorer emotion regulation (OR = 1/0.76 = 1.32), lower parental age (OR = 1/0.83 = 1.20), lower household income (OR = 4.38), problematic peer relationships (OR = 1.38), and lifetime suicidal ideation (OR = 20.34) were associated with increased odds of self-harm among all youth ages. Higher parent education was associated with greater odds of self-harm among preadolescents (OR = 0.02). Lifetime mental health diagnosis (OR = 7.84) and lower levels of childhood adversity (OR = 0.60) were associated with greater odds of recent self-harm among adolescents. Conclusions Coordinated multi-agency efforts are essential for holistically addressing common, modifiable individual, social, and socioeconomic risk factors of youth self-harm that may help to prevent onset in young people.

Sung, Meekang; Subramanian, S. V.; Kim, Rockli

doi: 10.1080/13811118.2025.2507591pmid: 40480963

Abstract Objective Research gaps persist in understanding the underlying sociodemographic patterning of hospital-presenting self-injury (HPSI) in South Korea. Our research aims to understand the relationship between HPSI and gender over time in relation to its sociodemographic attributes. Method The study utilized the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS) from 2004 to 2021. The change in the age-standardized rate per 100,000 Koreans over age groups and their gender distribution was examined. Logistic regression models were employed to understand the association between gender and HPSI. Results The study encompassed 497,882 injury patients, with 13,139 HPSI patients. The age-standardized rate per 100,000 was similar across years, and significantly higher in older age groups over 70. Also, the HPSI rate was higher in women (43.01, 95% CI: 40–46.08) than in men (36.65, 95% CI: 34.03–39.28). This gender pattern was consistent across years but showed an opposite trend over age 50, where men experience more HPSI. Gender gaps showed a decreasing trend over time, except for the 2019–2021 period in which HPSI rates rose disproportionately among adolescent girls and elderly men. Regression models confirmed these patterns, where the odds ratio of women on HPSI was 1.76 (95% CI: 1.46–2.16) in the fully adjusted model, it was 4.33 (95% CI: 3.64–5.14) in age group ≤20 and 0.39 (95% CI: 0.34–0.44) in age group >80. Conclusions The gender pattern of HPSI varies significantly by age group. Further research is imperative to delve into the root causes of these differences.

Yin, Yi; Tong, Yongsheng; Zhao, Liting; Li, Xiaohong

doi: 10.1080/13811118.2025.2507601pmid: 40391746

Abstract Objective Crisis lines face challenges in identifying individuals at high suicide risk. We aimed to compare two routine methods for predicting suicide acts at different time points. Methods In this prospective cohort study, we recruited and monitored 8859 callers from the Beijing Psychological Support Hotline. We evaluated their suicide risk through two strategies during their index calls: (a) one screening about suicidal ideation, plan, or behavior in the last two weeks and (b) the Comprehensive Suicidal Risk Assessment Scale, which included more risk factors, such as depression, hopelessness, and psychological distress. We monitored their suicidal behaviors for one year through telephone interviews. Results The number of callers who attempted suicide or died by suicide within 24 hours (1.2%), 30 days (3.8%), 180 days (6.9%), or 365 days (9.1%) was: 102, 341, 615, and 802, respectively. The sensitivities, specificities, and positive predictive values for screening for recent suicidal history were higher than those of the comprehensive scale for predicting suicidal acts within each time point. However, with the increasing duration of the follow-up, the screening had a poorer predictive ability than the comprehensive scale (predicting suicide acts within 270 days: Youden’s index, 34.5% vs. 36.2%.; the Area under the Receiver Operator Characteristic Curve, 67.2% vs. 68.1%), especially among those without a history of suicide attempts. Conclusions Screening for recent suicidal history is valid for predicting suicidal acts within six months; however, screening is insufficient for predicting long-term suicidal acts compared to assessing more suicide risk factors.