Hostname: page-component-669899f699-8p65j Total loading time: 0 Render date: 2025-05-04T23:31:17.742Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictors of suicidality across the life span: The Isle of Wight study

Published online by Cambridge University Press: 26 November 2009

A. Pickles*
Affiliation:
Biostatistics, Health Methodology Research Group, Faculty of Medicine and Human Sciences, University of Manchester, Manchester, UK
A. Aglan
Affiliation:
Division of Clinical Psychology, Faculty of Medicine and Human Sciences, University of Manchester, Manchester, UK
S. Collishaw
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, King's College London Institute of Psychiatry, London, UK
J. Messer
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, King's College London Institute of Psychiatry, London, UK
M. Rutter
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, King's College London Institute of Psychiatry, London, UK
B. Maughan
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, King's College London Institute of Psychiatry, London, UK
*
*Address for correspondence: Professor A. Pickles, Department of Biostatistics, Section of Epidemiology and Health Science, Stopford Building,University of Manchester, Oxford RoadManchester M13 9PT,UK. (Email:andrew.pickles@manchester.ac.uk)

Abstract

Background

Data from a representative community sample were used to explore predictors of lifetime suicidality and to examine associations between distal adolescent and more proximal adult risks.

Method

Data are from a midlife follow-up of the Isle of Wight study, an epidemiological sample of adolescents assessed in 1968. Ratings of psychiatric symptoms and disorder, relationships and family functioning and adversity were made in adolescence; adult assessments included lifetime psychiatric history and suicidality, neuroticism and retrospective reports of childhood sexual abuse and harsh parenting.

Results

A wide range of measures of childhood psychopathology, adverse experiences and interpersonal difficulties were associated with adult suicidality; associations were particularly strong for adolescent irritability, worry and depression. In multivariate analyses, substantial proportions of these effects could be explained by their association with adult psychopathology and neuroticism, but additional effects remained for adolescent irritability and worry.

Conclusions

Factors of importance for long-term suicidality risk are evident in adolescence. These include family and experiential adversities as well as psychopathology. In particular, markers of adolescent worry and irritability appeared both potent risks and ones with additional effects beyond associations with adult disorder and adult neuroticism.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Aglan,A,Kerfoot,M,Pickles,A (2007).Pathways from adolescent deliberate self-poisoning to early adult outcomes: A six year follow-up.Journal of Child Psychology and Psychiatry1,1–2.Google Scholar
Alonzo,TA,Pepe,MS,Lumley,T (2003).Estimating disease prevalence in two-phase studies.Biostatistics4,313–326.CrossRefGoogle ScholarPubMed
APA (1994).Diagnostic and Statistical Manual of Mental Disorders,4th edn (DSM-IV).American Psychiatric Publishing Inc.:Washington DC.Google Scholar
Beautrais,AL,Joyce,PR,Mulder,RT (1996a).Risk factors for serious suicide attempts among youths aged 13 through 24 years.Journal of the American Academy of Child and Adolescent Psychiatry35,1174–1182.CrossRefGoogle Scholar
Beautrais,AL,Joyce,PR,Mulder,RT (1999).Personality traits and cognitive styles as risk factors for serious suicide attempts among young people.Suicide and Life-Threatening Behavior29,37–47.CrossRefGoogle ScholarPubMed
Beautrais,AL,Joyce,PR,Mulder,RT,Fergusson,DM,Deavoll,BJ,Nightingale,SK (1996b).Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case-control study.American Journal of Psychiatry153,1009–1014.Google ScholarPubMed
Bifulco,A,Brown,GW,Harris,TO (1994).Childhood experience of care and abuse (CECA): a retrospective interview measure.Journal of Child Psychology and Psychiatry35,1419–1435.CrossRefGoogle ScholarPubMed
Bifulco,A,Kwon,J,Jacobs,C,Moran,PM,Bunn,A,Beer,N (2006).Adult attachment style as mediator between childhood neglect/abuse and adult depression and anxiety.Social Psychiatry and Psychiatric Epidemiology41,796–805.CrossRefGoogle ScholarPubMed
Boden,JM,Fergusson,DM,Horwood,LJ (2007).Anxiety disorders and suicidal behaviours in adolescence and young adulthood: findings from a longitudinal study.Psychological Medicine37,431–440.CrossRefGoogle Scholar
Borges,G,Walters,EE,Kessler,RC (2000).Associations of substance use, abuse, and dependence with subsequent suicidal behavior.American Journal of Epidemiology151,781–789.CrossRefGoogle ScholarPubMed
Brezo,J,Paris,J,Turecki,G (2006).Personality traits as correlates of suicidal ideation, suicide attempts, and suicide completions: a systematic review.Acta Psychiatrica Scandinavica113,180–206.CrossRefGoogle ScholarPubMed
Bridge,JA,Goldstein,TR,Brent,DA (2006).Adolescent suicide and suicidal behavior.Journal of Child and Psychology and Psychiatry47,372–394.CrossRefGoogle ScholarPubMed
Brotman,MA,Kassem,L,Reising,MM,Guyer,AE,Dickstein,DP,Rich,BA,Towbin,KE,Pine,DS,McMahon,FJ,Leibenluft,E (2007).Parental diagnoses in youth with narrow phenotype bipolar disorder or severe mood dysregulation.American Journal of Psychiatry164,1238–1241.CrossRefGoogle ScholarPubMed
Caspi,A (1987).Personality in the life course.Journal of Personality and Social Psychology53,1203–1213.CrossRefGoogle ScholarPubMed
Caspi,A (2000).The child is father of the man: personality continuities from childhood to adulthood.Journal of Personality and Social Psychology78,158–172.CrossRefGoogle ScholarPubMed
Elander,J,Rutter,M (1996).Use and development of the Rutter parents' and teachers' scales.International Journal of Methods in Psychiatric Research6,63–78.3.3.CO;2-M>CrossRefGoogle Scholar
Eysenck,HJ,Eysenck,SB (1991).Manual of the Eysenck Personality Scales (EPS Adult).Hodder & Stoughton:London.Google Scholar
Fava,M,Hwang,I,Rush,AJ,Sampson,N,Walters,EE,Kessler,RC (2009).The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey Replication.Molecular Psychiatry. Published online: 10 March 2009. doi:10.1038/mp.2009.20.Google ScholarPubMed
Fergusson,DM,Beautrais,AL,Horwood,LJ (2003).Vulnerability and resiliency to suicidal behaviours in young people.Psychological Medicine33,61–73.CrossRefGoogle ScholarPubMed
Fergusson,DM,Horwood,LJ,Ridder,EM,Beautrais,AL (2005).Subthreshold depression in adolescence and mental health outcomes in adulthood.Archives of General Psychiatry62,66–72.CrossRefGoogle ScholarPubMed
Fergusson,DM,Lynskey,MT,Horwood,LJ (1996).Childhood sexual abuse and psychiatric disorder in young adulthood: I. Prevalence of sexual abuse and factors associated with sexual abuse.Journal of the American Academy of Child and Adolescent Psychiatry35,1355–1364.CrossRefGoogle ScholarPubMed
Fergusson,DM,Woodward,LJ (2002).Mental health, educational, and social role outcomes of adolescents with depression.Archives of General Psychiatry59,225–231.CrossRefGoogle ScholarPubMed
Fergusson,DM,Woodward,LJ,Horwood,LJ (2000).Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood.Psychological Medicine30,23–39.CrossRefGoogle ScholarPubMed
Foley,DL,Goldston,DB,Costello,EJ,Angold,A (2006).Proximal psychiatric risk factors for suicidality in youth: the Great Smoky Mountains Study.Archives of General Psychiatry63,1017–1024.CrossRefGoogle ScholarPubMed
Fombonne,E,Wostear,G,Cooper,V,Harrington,R,Rutter,M (2001).The Maudsley long-term follow-up of child and adolescent depression. 2. Suicidality, criminality and social dysfunction in adulthood.British Journal of Psychiatry179,218–223.CrossRefGoogle ScholarPubMed
Gunnell,D,Middleton,N (2003).National suicide rates as an indicator of the effect of suicide on premature mortality.Lancet362 (9388),961–962.CrossRefGoogle Scholar
Harel,O,Zhou,X-H (2007).Multiple imputation for the comparison of two screening tests in two-phase Alzheimer studies.Statistics in Medicine26 (2370),2388.CrossRefGoogle ScholarPubMed
Harrington,R,Hill,J,Rutter,M,John,K,Fudge,H,Zoccolillo,M,Weissman,M (1988).The assessment of lifetime psychopathology: a comparison of two interviewing styles.Psychological Medicine18,487–493.CrossRefGoogle ScholarPubMed
Harrington,R,Pickles,A,Aglan,A,Harrington,V,Burroughs,H,Kerfoot,M (2006).Early adult outcomes of adolescents who deliberately poisoned themselves.Journal of the American Academy of Child and Adolescent Psychiatry45,337–345.CrossRefGoogle ScholarPubMed
Hawton,K,Houston,K,Haw,C,Townsend,E,Harriss,L (2003).Comorbidity of axis I and axis II disorders in patients who attempted suicide.American Journal of Psychiatry160,1494–1500.CrossRefGoogle ScholarPubMed
Hawton,K,Sutton,L,Haw,C,Sinclair,J,Harriss,L (2005).Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors.Journal of Clinical Psychiatry66,693–704.CrossRefGoogle ScholarPubMed
Hill,J,Pickles,A,Burnside,E,Byatt,M,Rollinson,L,Davis,R,Harvey,K (2001).Child sexual abuse, poor parental care and adult depression: evidence for different mechanisms.British Journal of Psychiatry179,104–109.CrossRefGoogle ScholarPubMed
Hill,J,Pickles,A,Rollinson,L,Davies,R,Byatt,M (2004).Juvenile- versus adult-onset depression: multiple differences imply different pathways.Psychological Medicine34,1483–1493.CrossRefGoogle ScholarPubMed
Johnson,JG,Cohen,P,Gould,MS,Kasen,S,Brown,J,Brook,JS (2002).Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood.Archives of General Psychiatry59,741–749.CrossRefGoogle ScholarPubMed
Kendler,KS,Thornton,LM,Gardner,CO (2000).Stressful life events and previous episodes in the etiology of major depression in women: an evaluation of the ‘kindling’ hypothesis.American Journal of Psychiatry157,1243–1251.CrossRefGoogle ScholarPubMed
Kessler,RC,Berglund,P,Demler,O,Jin,R,Merikangas,KR,Walters,EE (2005).Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.Archives of General Psychiatry62,593–602.CrossRefGoogle ScholarPubMed
Kessler,RC,Borges,G,Walters,EE (1999).Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey.Archives of General Psychiatry56,617–626.CrossRefGoogle ScholarPubMed
McGee,R,Williams,S,Nada-Raja,S (2001).Low self-esteem and hopelessness in childhood and suicidal ideation in early adulthood.Journal of Abnormal Child Psychology29,281–291.CrossRefGoogle ScholarPubMed
Moffitt,TE,Caspi,A,Taylor,A,Kokaua,J,Milne,BJ,Polanczyk,G,Poulton,R (2009).How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment.Psychological Medicine. Published online: 1 September 2009. doi:10.1017/S0033291709991036.Google ScholarPubMed
Neeleman,J,Wessely,S,Wadsworth,M (1998).Predictors of suicide, accidental death, and premature natural death in a general-population birth cohort.Lancet351 (9096),93–97.CrossRefGoogle Scholar
O'Carroll,PW,Berman,AL,Maris,RW,Moscicki,EK,Tanney,BL,Silverman,MM (1996).Beyond the Tower of Babel: a nomenclature for suicidology.Suicide and Life Threatening Behavior26,237–252.CrossRefGoogle Scholar
Perlis,RH,Fava,M,Trivedi,MH,Alpert,J,Luther,JF,Wisniewski,SR,Rush,AJ (2009).Irritability is associated with anxiety and greater severity, but not bipolar spectrum features, in major depressive disorder.Acta Psychiatrica Scandinavica119,282–289.CrossRefGoogle Scholar
Pickles,A,Dunn,G,Vazquez-Barquero,JL (1995).Screening for stratification in two-phase (‘two-stage’) epidemiological surveys.Statistical Methods in Medical Research4,73–89.CrossRefGoogle ScholarPubMed
Plomin,R,DeFries,JC,Loehlin,JC (1977).Genotype-environment interaction and correlation in the analysis of human behavior.Psychological Bulletin84,309–322.CrossRefGoogle ScholarPubMed
Quinton,D,Pickles,A,Maughan,B,Rutter,M (1993).Partners, peers and pathways: assortative pairing and continuities in conduct disorder.Development and Psychopathology5,763–783.CrossRefGoogle Scholar
Rodgers,B,Pickles,A,Power,C,Maughan,B,Collishaw,S (1999).Validating the Malaise Inventory in epidemiological samples.Social Psychiatry and Psychiatric Epidemiology29,351–366.Google Scholar
Royston,P (2004).Multiple Imputation of missing values.Stata Journal4,227–234.CrossRefGoogle Scholar
Rubin,D (1987).Multiple Imputation for Nonresponse in Surveys.Wiley:New York.CrossRefGoogle Scholar
Rutter,M,Tizard,J,Whitmore,K (1970).Education, Health and Behaviour.Longman and Green:London.Google Scholar
Rutter,M,Tizard,J,Yule,W,Graham,P,Whitmore,K (1976).Research report: Isle of Wight Studies, 1964–1974.Psychological Medicine6,313–332.CrossRefGoogle ScholarPubMed
Sareen,J,Cox,BJ,Afifi,TO,de Graaf,R,Asmundson,GJ,ten Have,M,Stein,MB (2005).Anxiety disorders and risk for suicidal ideation and suicide attempts: a population-based longitudinal study of adults.Archives of General Psychiatry62,1249–1257.CrossRefGoogle ScholarPubMed
Schachar,R (1991).Childhood hyperactivity.Journal of Child Psychology and Psychiatry32,155–191.CrossRefGoogle ScholarPubMed
Skjelstad,DV,Malt,UF,Holte,A (2009).Symptoms and signs of the initial prodrome of bipolar affective disorder: a systematic review.Journal of Affective Disorders. Published online: 31 October 2009. doi:10.1016/j/jad.2009.10.003.Google ScholarPubMed
Sobel,ME (1982). Asymptotic confidence intervals for indirect effects in structural equation models. InSociological Methodology (ed.Leinhardt,S.), pp.290–312.American Sociological Association:Washington DC.Google Scholar
Sourander,A,Klomek,AB,Niemela,S,Haavisto,A,Gyllenberg,D,Helenius,H,Sillanmaki,L,Ristkari,T,Kumpulainen,K,Tamminen,T,Moilanen,I,Piha,J,Almqvist,F,Gould,MS (2009).Childhood predictors of completed and severe suicide attempts: findings from the Finnish 1981 Birth Cohort Study.Archives of General Psychiatry66,398–406.CrossRefGoogle ScholarPubMed
Stringaris,A,Cohen,P,Pine,DS,Leibenluft,E (2009).Adult outcomes of youth irritability: a 20-year prospective community-based study.American Journal of Psychiatry166,1048–1054.CrossRefGoogle ScholarPubMed
Stringaris,A,Goodman,R (2009a).Longitudinal outcome of youth oppositionality: irritable, headstrong, and hurtful behaviors have distinctive predictions.Journal of the American Academy of Child and Adolescent Psychiatry48,404–412.CrossRefGoogle ScholarPubMed
Stringaris,A,Goodman,R (2009b).Mood lability and psychopathology in youth.Psychological Medicine39,1237–1245.CrossRefGoogle ScholarPubMed
van Buuren,S,Boshuizen,HC,Knook,DL (1999).Multiple imputation of missing blood pressure covariates in survival analysis.Statistics in Medicine18,681–694.3.0.CO;2-R>CrossRefGoogle ScholarPubMed
Welch,SS (2001).A review of the literature on the epidemiology of parasuicide in the general population.Psychiatric Services52,368–375.CrossRefGoogle ScholarPubMed
WHO (2004).World Health Statistics Annual.WHO:Geneva.Google Scholar
Windle,M (2004).Suicidal behaviors and alcohol use among adolescents: a developmental psychopathology perspective.Alcohol: Clinical and Experimental Research28 (5 Suppl.),29S–37S.Google ScholarPubMed