Ortin-Peralta Ana, Schiffman Amara, Malik Jill, Polanco-Roman Lillian, Hennefield Laura, Luking Katherine
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States.
Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, United States.
Front Psychiatry. 2024 Sep 23;15:1417991. doi: 10.3389/fpsyt.2024.1417991. eCollection 2024.
Parental suicide attempts and suicide death increase suicide risk in their offspring. High levels of impulsivity have been observed in families at high risk for suicide. Impulsivity, a highly heritable trait that is especially elevated in childhood, is frequently measured with the UPPS-P Impulsive Behavior Scale, which includes negative urgency, positive urgency, sensation seeking, premeditation, and perseverance. Our study examined the association between the UPPS-P facets and suicide ideation (without suicide attempts) and suicide attempts at baseline and first-time endorsement within the next two years in childhood. We also examined how the UPPS-P facets mediated the association between parental suicide attempts and suicide death and offspring first-time suicide ideation and attempts at follow-up.
The sample was 9,194 children (48.4% female; 9-10 years old) from the Adolescent Brain Cognitive Development (ABCD) study, assessed yearly three times. At Time 1 (T1), caregivers reported on suicide attempts and suicide deaths (combined) of the biological parents. Caregivers and children reported on suicide ideation and attempts in the KSADS-PL DSM-5 at each time point, T1 and follow-up (T2 and/or T3). The Short UPPS-P Scale (child-report) assessed the impulsivity facets at T1, which were computed as latent variables.
At T1, 6.7% of children had a parent who had attempted or died by suicide. Most UPPS-P facets were associated with suicide ideation and attempts at T1 and T2/T3. In adjusted models, parental suicide attempts and suicide death were associated with offspring negative and positive urgency. In mediation models, parental suicide attempts and suicide death had an indirect effect on offspring first-time suicide ideation at T2/T3 through negative urgency (OR = 1.04; 95% CI, 1.01-1.08) and positive urgency (OR = 1.03, 95% CI, 1.01-1.05). Similar results were found for first-time suicide attempts at T2/T3.
Our findings support an impulsive pathway in the familial transmission of suicide risk. For all youth, interventions that target multiple UPPS-P facets may help prevent or reduce suicide risk. For offspring whose parents have attempted or died by suicide, clinicians should pay particular attention to children who impulsively act on extreme emotions, as they may be at higher suicide risk.
父母自杀未遂和自杀死亡会增加其子女的自杀风险。在自杀高风险家庭中观察到冲动性水平较高。冲动性是一种高度可遗传的特质，在儿童期尤其明显，通常使用UPPS-P冲动行为量表进行测量，该量表包括消极紧迫性、积极紧迫性、寻求刺激、预谋和坚持性。我们的研究考察了UPPS-P各维度与自杀意念（无自杀未遂）以及儿童期基线时和未来两年内首次出现自杀意念及自杀未遂之间的关联。我们还考察了UPPS-P各维度如何介导父母自杀未遂和自杀死亡与子女随访时首次出现自杀意念及自杀未遂之间的关联。
样本来自青少年大脑认知发展（ABCD）研究中的9194名儿童（48.4%为女性；9至10岁），每年评估三次。在时间1（T1），照料者报告亲生父母的自杀未遂和自杀死亡情况（合并统计）。在每个时间点T1以及随访时（T2和/或T3），照料者和儿童报告《儿童版情感障碍及精神分裂症问卷（KSADS-PL）DSM-5》中的自杀意念和自杀未遂情况。简短UPPS-P量表（儿童报告）在T1评估冲动性维度，这些维度被计算为潜在变量。
在T1时，6.7%的儿童有父母自杀未遂或自杀死亡。大多数UPPS-P维度与T1以及T2/T3时的自杀意念和自杀未遂有关。在调整后的模型中，父母自杀未遂和自杀死亡与子女的消极和积极紧迫性有关。在中介模型中，父母自杀未遂和自杀死亡通过消极紧迫性（OR = 1.04；95% CI，1.01 - 1.08）和积极紧迫性（OR = 1.03，95% CI，1.01 - 1.05）对T2/T3时子女首次出现自杀意念有间接影响。在T2/T3时首次出现自杀未遂的情况也发现了类似结果。
我们的研究结果支持自杀风险家族传递中的冲动性途径。对于所有青少年，针对多个UPPS-P维度的干预措施可能有助于预防或降低自杀风险。对于父母有自杀未遂或自杀死亡的子女，临床医生应特别关注那些因极端情绪而冲动行事的儿童，因为他们可能有更高的自杀风险。
