Silver Jamilah, Olino Thomas M, Carlson Gabrielle A, Dougherty Lea R, Klein Daniel N
Stony Brook University, Stony Brook, New York, USA.
Temple University, Philadelphia, Pennsylvania, USA.
Suicide Life Threat Behav. 2023 Feb;53(1):89-99. doi: 10.1111/sltb.12924. Epub 2022 Oct 14.
The rates of suicide in youth have increased dramatically, leading to increased interest in routinely screening youth for suicidality. However, data on suicidal ideation (SI) in younger children are sparse, especially with brief self-report measures that can easily be used for screening non-referred samples.
We evaluated a community sample of 497 6-year-old children and their parents and followed them into adolescence. SI was assessed via child self-report at ages 6 and 9 using an item from the Children's Depression Inventory, and via parent-report at age 6 using an item from the Early Childhood Inventory. Child psychopathology and functioning were assessed via semi-structured interviews every 3 years from age 6 through 15.
Child endorsement of SI at age 6 did not predict later psychopathology or functioning. Child endorsement of SI at age 9 was associated with attention deficit hyperactivity disorder (ADHD) and disruptive behavior disorders (DBD) diagnoses across the adolescent follow-up assessments. Parent endorsement of child SI predicted an increased likelihood of later SI and non-suicidal self-injury, a higher rate of DBD and externalizing symptoms, and poorer global functioning in adolescence.
Our results support recommendations against administering SI screening measures to children under the age of 10.
青少年自杀率急剧上升，这使得人们对常规筛查青少年自杀倾向的兴趣增加。然而，关于年幼儿童自杀意念（SI）的数据稀少，尤其是使用可轻松用于筛查非转诊样本的简短自我报告测量方法时。
我们评估了497名6岁儿童及其父母的社区样本，并跟踪他们进入青春期。在6岁和9岁时通过儿童自我报告，使用儿童抑郁量表中的一个项目评估自杀意念；在6岁时通过父母报告，使用幼儿量表中的一个项目评估自杀意念。从6岁到15岁，每3年通过半结构化访谈评估儿童心理病理学和功能状况。
6岁时儿童认可有自杀意念并不能预测后期的心理病理学或功能状况。在整个青少年随访评估中，9岁时儿童认可有自杀意念与注意力缺陷多动障碍（ADHD）和破坏性行为障碍（DBD）的诊断相关。父母认可孩子有自杀意念预示着后期自杀意念和非自杀性自伤的可能性增加、破坏性行为障碍和外化症状的发生率更高，以及青少年期整体功能较差。
我们的结果支持反对对10岁以下儿童进行自杀意念筛查测量的建议。
