1. Compared to early adolescents, younger children who died by suicide were more commonly black, males, died by hanging/strangling/suffocation, died at home, and experienced relationship problems with their family members and friends.
2. Elementary school-aged children who died by suicide were less likely to leave a suicide note, be depressed, or experience girlfriend/boyfriend problems compared with early adolescents.
Evidence Rating Level: 2 (Good)
Study Rundown: Currently, suicide is one of the leading causes of death in United States school-aged children. Despite its prevalence, little data exists regarding what factors contribute to this statistic. In the current study, researchers compared data from the National Violent Death Reporting System (NVDRS) to examine precipitating factors of suicide and individual characteristics in elementary school-aged children to early adolescent suicide decedents. Compared to early adolescents, results of this study found that younger children who died by suicide were more commonly black males, died by hanging/strangling/suffocation, died at home, and experienced relationship problems with their family members and friends. Contrastingly, these children were less likely to leave a suicide note, be depressed, or experience girlfriend/boyfriend problems when compared to early adolescents. Younger children and early adolescent decedents both disclosed the intent of suicide to others with the same frequency. Generalizability of study findings is limited as NVDRS data was only available for 17 states and information regarding precipitating circumstances associated with suicide was unknown for a portion of cases. Despite these limitations, study findings indicate a need for further characterization of suicide in young children to aid in tailoring preventative strategies to those at highest risk.
In-Depth [retrospective cohort]: Data was obtained between 2003 and 2012 from the NVDRS, a state-based surveillance system that collects data on violent deaths. A total of 693 cases of children aged 5 to 14 years were included for analysis, with children aged 5-11 years compared to those 12-14 years. Precipitating circumstances collected from the NVDRS included mental health history, treatment status, substance abuse, physical health history, relationship problems, school problems, legal problems, and other stressful life events. Of the cases examined, 36.8% of younger children were black compared to 11.6% in early adolescent decedents (p < 0.001), 80.5% of childhood decedents died by hanging/strangulation/suffocation compared to 64.1% in early adolescent decedents (p = 0.008), and 97.7 % of children’s suicides occurred at the child’s residence compared with 87% in early adolescents (p = 0.006). In terms of precipitating factors, significantly more young adolescent decedents had boyfriend/girlfriend problems compared to younger children (16% vs. 0%, respectively, p < 0.001). However, significantly more young childhood decedents had relationship problems when compared to early adolescent decedents (60.3% vs. 46%, respectively, p = 0.02) and significantly fewer childhood decedents left a suicide note compared to early adolescents (7.7% vs. 30.2%, respectively, p < 0.001). From a mental health perspective, 33.3% of childhood decedents experienced depression/dysthymia compared to 65.5% of early adolescent decedents (p = 0.001); 59.3% of childhood decedents were diagnosed with ADD/ADHD compared to 29% of early adolescents decedent (p = 0.002). In both childhood and adolescent decedents, 29% disclosed their suicide intent to another person prior to their death.
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