(PS11-61) How Exposure to Suicide Deaths and Attempts Impacts Suicide Thoughts and Behaviors in Adolescents

Introduction: Rates of suicide thoughts and behaviors have been increasing in adolescents (CDC, 2023). One potential risk factor is exposure to someone who died by suicide or attempted suicide. Previous studies have found that adults with exposure to suicide are at a higher risk for suicide ideation (SI) and suicide attempts (SA; Cerel et. al., 2016). This increased risk could be attributed to relationships forming through shared experiences with suicide (Swanson & Colman, 2013). However, much remains unknown about subsequent suicide thoughts and behaviors in adolescents with exposure to individuals who died by or attempted suicide. The current study examined how exposure to suicide associated with occurrence of SI and SA in a sample of community adolescents.

Methods: This study included 278 high school students ages 13 to 18 (mean age = 15.43, SD = 1.13). The majority of the sample was white (74.3%), with 10.6% Asian, 6.4% multi-ethnic, and 3.4% Black. An equal amount identified as male or female (48% male, 48% female) and 4% as trans, nonbinary, or gender fluid. Lifetime SI was reported by 22.7% and lifetime SA by 4.7%. About one-quarter (24.5%) reported knowing someone who attempted suicide and 29.1% reported knowing someone who died by suicide. Participants completed a demographics questionnaire and the Self-Injurious Thoughts and Behaviors Interview-Short Form (SITBI-SF).

Results: Chi-square analyses found that adolescents with exposure to suicide death had greater likelihood for SI (χ²  (1) = 7.427, p < .01) compared to those with no exposure, but it was not significant for SA. However, adolescents with exposure to suicide attempts had greater likelihood for SA (χ²  (1) = 12.171, p < .01), but not SI. The participants with exposure to suicide death most frequently listed the relationship as being an acquaintance (44.2%), close friend (16.9%), or biological uncle (11.7%). Those who reported exposure to suicide attempts most frequently listed the relationship as being a close friend (51.3%), sibling (16.2%), or acquaintance (16.2%).

Conclusion: The findings suggest that individuals with exposure to suicide attempts are more likely to have a personal history of a suicide attempt, but not suicide ideation. On the contrary, adolescents with exposure to suicide death are more likely to report suicide thoughts, but not suicide attempts. It is possible that adolescents who experienced the aftermath of a death by suicide were deterred from acting on their thoughts of suicide. It is also possible that adolescents with exposure to suicide attempts were more influenced by individuals they knew. The group that knew someone who survived an attempt most commonly reported it to be a close friend, while deaths by suicide were most often acquaintances. Future studies may benefit from examining how closeness of relationship to people who have attempted or died by suicide relates to risk for suicide in those exposed.