title: Parental suicide attempt and offspring self-harm and suicidal thoughts: Results from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort.
abstract: OBJECTIVE
  Parental suicidal behavior is associated with offspring's risk of suicidal behavior. However, much of the available evidence is from population registers or clinical samples. We investigated the associations of self-reported parental suicide attempt (SA) with offspring self-harm and suicidal thoughts in the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort.
  
  
  METHODS
  Parental SA was self-reported on 10 occasions from pregnancy until their child was 11 years of age. Offspring self-reported lifetime self-harm, with and without suicidal intent, suicidal thoughts, and suicide plans, at age 16 to 17 years. Multivariable regression models quantified the association between parental SA and offspring outcomes controlling for confounders.
  
  
  RESULTS
  Data were available for 4,396 mother-child and 2,541 father-child pairs. Adjusting for confounders including parental depression, maternal SA was associated with a 3-fold increased risk of self-harm with suicidal intent in their children (adjusted odds ratio [aOR] = 2.94, 95% confidence interval [CI] = 1.43-6.07) but not with self-harm without suicidal intent (aOR = 0.83, 95% CI = 0.35-1.99). Children whose mother attempted suicide were more likely to report suicidal thoughts and plans (aOR = 5.04, 95% CI = 2.24-11.36; aOR = 2.17, 95% CI = 1.07-4.38, respectively). Findings in relation to paternal SA were somewhat weaker and not significant.
  
  
  CONCLUSIONS
  Maternal SA increased their offspring's risk of self-harm with suicidal intent and of suicidal thoughts, but was unrelated to self-harm without intent; findings for paternal suicide attempt were weaker and not significant. Maternal SA, which may not come to the attention of health care professionals, represents a major risk for psychiatric morbidity in their offspring.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom. Electronic address: Galit.Geulayov@bristol.ac.uk.
authors.forename: Galit
authors.initials: G
authors.lastname: Geulayov
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Chris
authors.initials: C
authors.lastname: Metcalfe
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Jon
authors.initials: J
authors.lastname: Heron
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Judi
authors.initials: J
authors.lastname: Kidger
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
mesh_terms: D000293:Adolescent; D016241:Child of Impaired Parents / Q000523:psychology*; D015331:Cohort Studies; D005220:Fathers / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology*; D011446:Prospective Studies; D012306:Risk; D016728:Self-Injurious Behavior / Q000523:psychology*; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D006113:United Kingdom
keywords: ALSPAC; birth cohort; child psychopathology; longitudinal study; parental self-harm