Sarkisian Katherine L, Hughes Jennifer L, Bridge Jeffrey A
Nationwide Children's Hospital, Columbus, Ohio.
The Ohio State University College of Medicine, Columbus, Ohio.
J Am Acad Child Adolesc Psychiatry. 2025 Mar 17. doi: 10.1016/j.jaac.2025.03.006.
Despite the prevailing perception that preadolescent children do not experience suicidal thoughts and behaviors, 13.2% of children aged 9 to 10 years report that they have experienced suicidal thoughts at some point in their life, 9.1% report a history of nonsuicidal self-injury (NSSI), defined as deliberate self-harming behavior without suicidal intent, and 1.3% report making a suicide attempt. In addition, suicide rates for children aged 8 to 12 years have been increasing since 2008, and suicide is now the fifth leading cause of death in this age group. However, relatively little is known about risk and protective factors for self-injurious thoughts and behaviors (SITBs) among preadolescents. The biological underpinnings of suicidal ideation, suicidal behavior, and NSSI have been studied extensively (see Mann and Currier for a review). Importantly, these studies focus almost exclusively on adolescent and adult samples, and translation of biologically based findings into clinical practice remains a challenge. Across clinical settings, suicide risk screening is increasingly being implemented with preadolescents, but there is a relative lack of developmentally sensitive screening and intervention tools, and detecting child suicide risk as completely and efficiently as possible remains a challenge. Thus, finding ways to bridge biological findings and suicide risk screening is a promising, yet underutilized, approach with great potential. With the emergence of more large, longitudinal studies that capture a combination of biological, psychological, and social risk factors for SITBs, it is becoming increasingly possible to examine an array of risk and protective factors simultaneously and evaluate the relative strength of these predictors.
尽管普遍认为青春期前儿童不会出现自杀念头和行为,但9至10岁的儿童中有13.2%报告称他们在生活中的某个时刻曾有过自杀念头,9.1%报告有非自杀性自伤(NSSI)史,即无自杀意图的故意自我伤害行为,1.3%报告曾有过自杀未遂。此外,自2008年以来,8至12岁儿童的自杀率一直在上升,自杀现在是该年龄组的第五大死因。然而,对于青春期前儿童自我伤害性想法和行为(SITBs)的风险和保护因素,人们了解得相对较少。自杀意念、自杀行为和非自杀性自伤的生物学基础已得到广泛研究(见曼恩和柯里尔的综述)。重要的是,这些研究几乎完全集中在青少年和成人样本上,将基于生物学的研究结果转化为临床实践仍然是一个挑战。在各种临床环境中,越来越多地对青春期前儿童进行自杀风险筛查,但相对缺乏对发育敏感的筛查和干预工具,尽可能全面有效地检测儿童自杀风险仍然是一个挑战。因此,找到将生物学研究结果与自杀风险筛查联系起来的方法是一种有前途但未得到充分利用的方法,具有很大潜力。随着越来越多的大型纵向研究出现,这些研究综合了自我伤害性想法和行为的生物学、心理和社会风险因素,越来越有可能同时检查一系列风险和保护因素,并评估这些预测因素的相对强度。