Correlates and Consequences of Suicidal Cognitions and Behaviors in Children Ages 3 to 7 Years.
OBJECTIVE
Despite research documenting the existence of depression and other psychiatric disorders in early childhood, little is known about the nature and consequences of suicidal cognitions and behaviors (SI) in young children ages 3 to 7 years. The identification of trajectories of SI across childhood is a critical step toward preventing childhood suicide.


METHODS
Participants were 306 children enrolled in a prospective longitudinal investigation of young children and their families. Children and their families completed a baseline assessment between ages 3 and 7 years, and at least 1 follow-up assessment (ages 7-12 years). Child psychopathology, suicidal thoughts, plans, and behaviors were assessed via parent and trained interviewer report before age 9, and also with self-report after age 9. Data on maternal history of psychopathology, as well as maternal and family history of suicide attempts, were also obtained through parent report.


RESULTS
Controlling for a range of clinical and demographic variables, early-childhood SI (as defined as suicidal thoughts, behavior, or any expression of plans/attempts occurring before age 7) and suicidal themes in play were concurrently associated with childhood attention-deficit/hyperactivity (ADHD) and oppositional defiant/conduct disorders (ODD/CD). Early-childhood SI also predicted school-age depression and ODD/CD; however, these findings were no longer significant after controlling for the same diagnoses at the childhood baseline. Longitudinal analysis indicated that early-childhood SI was a robust predictor of school-age SI, even after accounting for psychiatric disorders at both time points.


CONCLUSIONS
Extending current research, these findings demonstrate that early-childhood SI confers significant risk for continuation into school-age SI and is concurrently associated with ADHD and ODD/CD. Although the meaning of early-childhood SI remains unclear, results suggest that it is a clinically important phenomenon that should be carefully assessed and taken seriously as a marker of risk for ongoing suicidal ideation/behavior. These findings suggest that early screening for SI in childhood is indicated in clinical settings, particularly in children less than 7 years of age with depression and externalizing disorders.
Washington University School of Medicine, St. Louis. Electronic address: whalend@psychiatry.wustl.edu.
Diana J
DJ
Whalen
University of Massachusetts Amherst, Amerst, MA.
Katherine
K
Dixon-Gordon
Washington University School of Medicine, St. Louis.
Andrew C
AC
Belden
Washington University School of Medicine, St. Louis; Washington University.
Deanna
D
Barch
Washington University School of Medicine, St. Louis.
Joan L
JL
Luby
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis; D000067290:Behavior Rating Scale; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D003071:Cognition; D019955:Conduct Disorder / Q000175:diagnosis; D003863:Depression / Q000453:epidemiology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D057566:Self Report; D013406:Suicide, Attempted / Q000517:prevention & control / Q000706:statistics & numerical data*; D014861:Washington
early childhood; longitudinal; psychopathology; suicidality