Spears Angela Page, Shin Ki Eun, Cha Christine B
Teachers College, Columbia University, New York, New York.
Long Island University Post, Brookville, New York.
JAACAP Open. 2025 Feb 20;3(3):496-505. doi: 10.1016/j.jaacop.2024.12.005. eCollection 2025 Sep.
Despite immense public concern around youth suicide, there remain countless young people whose suicide risk remain undetected. Some adolescents deliberately choose not to disclose suicide-related experiences, even to their family and peers who could play a key role in connecting them to clinical assessment and care. Studying this population is scientifically challenging, as those adolescents who are prone to nondisclosure are the exact individuals who may not typically opt into research studies. The current investigation explores the frequency, reasons for, and correlates of adolescents' nondisclosure tendencies.
We recruited 154 adolescents (aged 13-17 years; mean = 15.98; SD = 1.04) with a lifetime history of suicidal thoughts and/or behaviors from across the United States to participate in a study requiring only adolescent self-consent. Adolescents were predominantly female (92.21%), White (72.08%), and bisexual (35.06%). We administered a brief, Web-based, anonymous survey assessing lifetime history of suicidal thoughts and behaviors, and nondisclosure of such suicide-related experiences.
Other family members of suicidal adolescents were the most common primary confidant identified to whom adolescents deliberately chose not to disclose their suicide-related experiences, closely followed by parents. Adolescents tended not to disclose to certain confidants because of their fear of negative reactions and sense of self-reliance. Those adolescents who had never disclosed to anyone tended to experience more frequent suicidal thoughts, to be closer with their primary confidants, and to cite distinct reasons for nondisclosure.
Some adolescents remain silent about their suicide-related experiences, either toward select confidants or all of the people in their life. Understanding the distinct profiles of and reasons for nondisclosure may inform ways to connect underserved youth to care.
DIVERSITY & INCLUSION STATEMENT: We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
尽管公众对青少年自杀问题极为关注，但仍有无数青少年的自杀风险未被发现。一些青少年故意选择不透露与自杀相关的经历，甚至不向那些能在帮助他们获得临床评估和护理方面发挥关键作用的家人和同龄人透露。研究这一人群在科学上具有挑战性，因为那些倾向于不透露的青少年恰恰是通常不会选择参与研究的个体。本研究探讨青少年不透露倾向的频率、原因及相关因素。
我们从美国各地招募了154名有过自杀念头和/或行为经历的青少年（年龄在13 - 17岁之间；平均年龄 = 15.98岁；标准差 = 1.04），参与一项仅需青少年自行同意的研究。青少年中女性占主导（92.21%），白人占72.08%，双性恋者占35.06%。我们进行了一项简短的、基于网络的匿名调查，评估自杀念头和行为的终生经历，以及此类与自杀相关经历的不透露情况。
有自杀行为的青少年故意选择不向其透露自杀相关经历的最常见主要知己是其他家庭成员，其次是父母。青少年往往因担心负面反应和自我依赖感而不向某些知己透露。那些从未向任何人透露过的青少年往往有更频繁的自杀念头，与主要知己关系更亲密，且不透露的原因也各不相同。
一些青少年对其与自杀相关的经历保持沉默，要么是对特定知己，要么是对生活中的所有人。了解不透露情况的不同特征和原因可能为将服务不足的青少年与护理联系起来提供方法。
我们努力确保研究问卷以包容的方式编制。我们努力确保在招募人类参与者时考虑种族、民族和/或其他类型的多样性。我们努力确保在招募人类参与者时实现性别平衡。本文的一位或多位作者自我认定为科学领域中一个或多个历史上代表性不足的种族和/或民族群体的成员。本文的一位或多位作者自我认定为科学领域中一个或多个历史上代表性不足的性取向和/或性别群体的成员。本文的一位或多位作者自我认定为残疾人士。我们积极努力促进科学领域中历史上代表性不足的种族和/或民族群体纳入我们的作者群体。本文的作者名单包括研究开展地点和/或社区的贡献者，他们参与了数据收集、设计、分析和/或工作解读。
