A developmental psychopathology model of early childhood STBs.

• In Event: Responding to the alarming rise of suicide in youth under the age of 12

Abstract

Despite misconceptions that young children do not experience self-injurious thoughts and behaviors (STBs), emerging data suggests that STBs do commonly occur in childhood (Luby, Whalen et al., 2019; Martin et al., 2016; Whalen et al., 2015). In addition, although rare, rates of suicide deaths in young children under 12 are increasing (Ayer et al., 2020). Moreover, the development of STBs among youth is associated with recurrent, persistent, and escalating STBs over time (Glenn et al., 2017; Miranda et al., 2021). Thus, childhood represents a critical opportunity to intervene and prevent STBs by altering developmental trajectories toward persistent and escalating STBs. However, the majority of what we know about STBs comes from cross-sectional, retrospective studies of adults or adolescents, after STBs have already developed for many individuals.
One way to address major gaps in knowledge of STBs and improve interventions is to integrate a developmental psychopathology approach that focuses on how and when risk for STBs first emerges and develops across childhood. Children begin to develop a concept of death at around age 5 (Mishara, 1999), thus the transition from early to middle childhood may be a vulnerable period for early emergence of STBs. Such knowledge regarding the development progression of STBs from early childhood and beyond could transform our ability to apply effective early interventions that offset negative trajectories. This presentation will present a developmental psychopathology model of childhood STBs along with a research agenda that can guide critical work in this area.
Specifically, we will describe the following 4 key principles of developmental psychopathology (Cicchetti & Rogosch, 2002) and their application to research on STBs. Principle 1 asserts that psychopathology exists along a continuum from developmentally typical to atypical. Thus, we emphasize the importance of identifying the range of typical to atypical STB-related behavior across development, including in early to middle childhood, to help identify early forms of maladaptive STB-related behavior. Principle 2 recognizes that the expression of and risk for psychopathology may change across developmental phases. Applied to STBs, this principle suggests that it is essential to understand how vulnerability for later development of self-injurious thoughts and behavior is expressed early in childhood. Principle 3 asserts that it is critical to understand how behavior moves along the continuum from typical to atypical across the lifespan. When applied to STBs, this principle suggests the importance of understanding how death or self-injurious-related thoughts may persist and worsen over time. Finally, principal 4 asserts that waiting until problematic behavior and psychopathology has already developed is more difficult to treat. Thus, from a developmental psychopathology perspective, the identification of risk for and expressions of STBs early in development, potentially even before suicidal ideation even develops, is the most efficient and effective way to prevent morbidity and mortality. Conducting research from a developmental psychopathology perspective helps to trace the origins of STBs back to when risk first emerges, often early in life, and identifies how risk unfolds over time. This work will pave the way for more targeted and tailored preventive interventions.

Authors

• Caroline Oppenheimer

• Catherine R. Glenn, Old Dominion University

• Adam Bryant Miller, RTI International
  Presenting Author