Exploring the Psychological Functioning of Clinically Referred Youth with Family History of Suicidal Behaviors

• In Event: 1-040 - Family History of Suicidal Behaviors and Youth Outcomes

Integrative Statement

Introduction: There has been extensive research demonstrating the familial risk of psychopathology on youth. However, there has been less attention to the familial risk of suicidal behaviors (attempts and completions) which crosses the boundaries of psychiatric disorders. A study based in the United States estimated that approximately 10,000-20,000 children and adolescents lose a parent to suicide each year. Additionally, research suggests that youth exposed to parental suicidal behavior are at increased risk of psychiatric disorders and suicidal behavior. Examining familial risk more broadly, family suicide attempts have been associated with negative outcomes in substance use, behavioral problems, emotional distress and life expectancy. Due to the increasing rates of youth suicide in the United States, further exploration of risk factors such as family history of suicide attempts is warranted.
Aim: The current investigation examines a range of child psychological functioning outcomes among clinically presenting youth with and without a family history of suicide behaviors. We hypothesized that youth exposed to family history of suicide attempt or completion would exhibit worse functioning than youth without an exposure to family history of suicide attempt or completion.
Method: Participants are youth and their parents referred for a psychiatric evaluation at a mood specialty clinic through a hospital-based behavioral health outpatient clinic. The information gathered in the evaluation is included in a data registry. The sample included 194 children and adolescents with a mean age of 14.5 (SD = 2.48). The sample consisted of 64% females and 43% ethnic/racial minorities. Family history of suicide attempt or completion was gathered from parental report through a structured interview focused on psychopathology in first degree relatives. Domains of youth psychological functioning included parent and/or child reports of internalizing and externalizing symptoms, social skills, hopelessness, quality of life, depression symptoms, and anxiety symptoms.
Results: In the clinical sample, 17% of youth had a family history of suicide attempt or completion in a first degree relative. There were no significant differences between the two groups in terms of age, gender, race, income, or mood disorder diagnoses. Hierarchical regression analyses showed that there were no significant mean differences between the two groups on any of the functioning outcomes examined. However, tests of interactions revealed a significant interaction between age and family history of suicide in association with externalizing symptoms on the Child Behavioral Checklist. Exploration of this interaction revealed that there was a significant negative association between age and externalizing symptoms for those youth without a family history of suicide (b = -2.75, p < .05). For youth with a family history of suicide, however, there was a non-significant association between age and externalizing symptoms.
Conclusion: Family history of suicide behaviors may not be a proximal risk for poor functioning among clinically referred youth. Additionally, maintenance across age of externalizing symptoms among youth with family history may be suggestive of a particular vulnerability in functioning.

Authors

• Rhonda Boyd, Children's Hospital of Philadelphia
  Presenting Author

• Jason Jones, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia
  Non-Presenting Author

• Laura Butler, Children's Hospital of Philadelphia
  Non-Presenting Author

• Kristin Borreggine, Children's Hospital of Philadelphia
  Non-Presenting Author

• Tami D Benton, Children's Hospital of Philadelphia
  Non-Presenting Author