Problem behaviors may increase risk of suicide in children

Children who show early signs of problem behavior are more likely to have thought of killing or harming themselves, suggests new research in the latest issue of the Journal of Adolescent Health.

Past research indicates that about 20 percent of adolescents have suicidal ideation, which includes having thoughts of suicide or some level of suicide planning. The Centers for Disease Control and Prevention ranks suicide as the fourth leading cause of death in children between ages 10 and 13 from 1999 to 2007.

The new study examined 387 youth between the ages of 10 and 13. The youth, who were recruited from public schools in Philadelphia, completed the Youth Self-Report questionnaire, which includes two questions on thinking about or attempting to kill or hurt themselves.

Twenty-three boys (5.9 percent) answered positively to at least one of the questions and these youth — when compared with those who answered "no" to the questions—were also more likely to experience symptoms of depression, sleep problems, and impulsive and aggressive behavior. In addition, they reported risk-taking behavior including gambling, sex and drug use.

Researchers found that many of the youth's problems were "underrecognized" by their caregivers. Parents of the kids who had contemplated suicide reported similar levels of medical or behavioral issues in their children as did parents of kids who had not reported suicide ideation.

"We know the prevalence of suicidal ideation increases as we progress through adolescence," said study author Matthew Wintersteen, Ph.D., of the department of psychiatry and human behavior at Thomas Jefferson University in Philadelphia. "There are data that even youth as young as 6 years of age have died by suicide, so it is arguably the case that it is never too early to screen when children are exhibiting warning signs."

Lanny Berman, Ph.D., executive director of the American Association of Suicidology (AAS), agreed. "Problem behaviors are often acute risk factors for suicidal behavior, so these, indeed, should be clarion calls to a parent for a more extensive evaluation of the child's risk for suicide," said Berman. AAS launched the National Center for the Prevention of Youth Suicide in 2010 and lists "ideation" as one of its ten warning signs of suicide, along with substance abuse and anxiety.