title: Suicide in Elementary School-Aged Children and Early Adolescents.
abstract: Suicide in elementary school-aged children is not well studied, despite a recent increase in the suicide rate among US black children. The objectives of this study were to describe characteristics and precipitating circumstances of suicide in elementary school-aged children relative to early adolescent decedents and identify potential within-group racial differences.
  
  
  
  We analyzed National Violent Death Reporting System (NVDRS) surveillance data capturing suicide deaths from 2003 to 2012 for 17 US states. Participants included all suicide decedents aged 5 to 14 years (N = 693). Age group comparisons (5-11 years and 12-14 years) were conducted by using the χ2test or Fisher's exact test, as appropriate.
  
  
  
  Compared with early adolescents who died by suicide, children who died by suicide were more commonly male, black, died by hanging/strangulation/suffocation, and died at home. Children who died by suicide more often experienced relationship problems with family members/friends (60.3% vs 46.0%; P = .02) and less often experienced boyfriend/girlfriend problems (0% vs 16.0%; P < .001) or left a suicide note (7.7% vs 30.2%; P < .001). Among suicide decedents with known mental health problems (n = 210), childhood decedents more often experienced attention-deficit disorder with or without hyperactivity (59.3% vs 29.0%; P = .002) and less often experienced depression/dysthymia (33.3% vs 65.6%; P = .001) compared with early adolescent decedents.
  
  
  
  These findings raise questions about impulsive responding to psychosocial adversity in younger suicide decedents, and they suggest a need for both common and developmentally-specific suicide prevention strategies during the elementary school-aged and early adolescent years. Further research should investigate factors associated with the recent increase in suicide rates among black children.
authors.affiliation: Research Institute at Nationwide Children's Hospital, and.
authors.forename: Arielle H
authors.initials: AH
authors.lastname: Sheftall
authors.affiliation: Department of International Health, The School of Public Health, Johns Hopkins University, Baltimore, Maryland; and.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Asti
authors.affiliation: Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Horowitz
authors.affiliation: Research Institute at Nationwide Children's Hospital, and.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Felts
authors.affiliation: Departments of Psychiatry and.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Fontanella
authors.affiliation: Departments of Psychiatry and.
authors.forename: John V
authors.initials: JV
authors.lastname: Campo
authors.affiliation: Research Institute at Nationwide Children's Hospital, and jeff.bridge@nationwidechildrens.org.|Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bridge
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States