title: Effect of exposure to suicidal behavior on suicide attempt in a high-risk sample of offspring of depressed parents.
abstract: OBJECTIVE
  Exposure to suicidal behavior in peers and relatives is thought to increase risk for suicidal behavior in vulnerable individuals, possibly as a result of imitation or modeling. This study examines exposure to suicidal behavior and likelihood of suicide attempt in a high-risk cohort of offspring of a depressed parent.
  
  
  METHODS
  A total of 449 offspring of 255 probands with a mood disorder were enrolled in a family study. Probands and offspring were assessed for psychopathology and suicide attempt history, and offspring for suicide exposure. Generalized estimating equations (GEE) and generalized least squares models were used to compare suicide attempt history in exposed and nonexposed offspring as well as characteristics of exposure in exposed offspring suicide attempters and exposed nonattempters. GEE was used to compare exposure occurring before first attempt in attempter offspring and exposure occurring before the same age in matched nonattempter offspring.
  
  
  RESULTS
  Offspring reporting exposure to suicidal behavior were four times more likely to report a lifetime suicide attempt compared with unexposed offspring, controlling for age. Suicide attempt status was not associated with age at first exposure, total number or degree (attempt or threat) of exposures, or relationship. Analysis of exposure occurring before age at first suicide attempt found no association between exposure and suicide attempt.
  
  
  CONCLUSIONS
  Offspring exposed to suicidal behavior are more likely to report a lifetime suicide attempt than nonexposed offspring. However, when examining the temporal sequence of exposure and attempt, the association is no longer significant, suggesting that imitation is not sufficient explanation.
authors.affiliation: Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. Akb2127@columbia.edu
authors.forename: Ainsley K
authors.initials: AK
authors.lastname: Burke
authors.forename: Hanga
authors.initials: H
authors.lastname: Galfalvy
authors.forename: Benjamin
authors.initials: B
authors.lastname: Everett
authors.forename: Dianne
authors.initials: D
authors.lastname: Currier
authors.forename: Jamie
authors.initials: J
authors.lastname: Zelazny
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
authors.forename: Nadine M
authors.initials: NM
authors.lastname: Melhem
authors.forename: David
authors.initials: D
authors.lastname: Kolko
authors.forename: Jill M
authors.initials: JM
authors.lastname: Harkavy-Friedman
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Barbara
authors.initials: B
authors.lastname: Stanley
authors.forename: John J
authors.initials: JJ
authors.lastname: Mann
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D001714:Bipolar Disorder / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology* / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D019263:Dysthymic Disorder / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D012307:Risk Factors; D012931:Social Environment; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data