Knowing
someone
who
had
attempted
suicide
was
associated
with
subsequent
attempts
in
teens
and
young
adults,
a
cohort
study
suggested.

Among
people
ages
13
to
22
who
did
not
have
a
prior
suicide
attempt,
exposure
to
a
suicide
attempt
within
one’s
social
network
was
associated
with
greater
odds
of
subsequent
suicide
attempt
onset
(OR
2.78,
95%
CI
1.78-4.33,

P<0.001),
reported
Kimberly
Mitchell,
PhD,
of
the
University
of
New
Hampshire
in
Durham,
and
Victoria
Banyard,
PhD,
of
Rutgers
University
in
New
Brunswick,
New
Jersey.

This
association
remained
significant
after
adjusting
for
depressive
symptoms
(OR
2.43,
95%
CI
1.51-3.91,

P<0.001),
they
wrote

in

JAMA
Network
Open.

In
recent
years,
rates
of

depression
and
anxiety
have
jumped
in
teens
and
young
adults,
as
have
rates
of

suicidal
thoughts
and
behaviors.

“Research
on
suicide
has
documented

contagion
effects
associating
exposure
to
suicide
thoughts
and
behaviors
in
one’s
social
network
with
subsequent
suicidal
ideation
and
attempts,”
Mitchell
and
Banyard
noted.

“We
know
that
suicidal
behavior
does
not
occur
in
a
social
vacuum,”
Mitchell
told

MedPage
Today
in
an
email.
“Adolescence
and
young
adulthood
are
periods
when
peers
and
social
networks
are
especially
influential,
and
young
people’s
social
worlds
now
span
both
in-person
and
online
environments.”

However,
“much
of
the
research
on
suicide
contagion
has
been
cross-sectional,
has
focused
on
suicidal
thoughts,
or
predates
today’s
digital
social
environment,”
she
added.

Of
note,
exposure
to
a
suicide
attempt
in
one’s
social
network
was
not
linked
to
suicidal
ideation
onset.
It
was,
however,
associated
with
higher
depressive
symptoms
over
time
(within-person

b
0.13,
95%
CI
0.08-0.17;
between-person

b
0.46,
95%
CI
0.38-0.54).

“The
distinction
between
suicidal
thoughts
and
suicide
attempts
was
particularly
striking,”
Mitchell
said.
“We
initially
expected
exposure
to
suicide
attempts
within
a
young
person’s
social
network
to
predict
both
new
suicidal
ideation
and
new
suicide
attempts.”

These
findings
suggest
that
this
type
of
exposure
“may
be
relevant
not
simply
to
the
emergence
of
suicidal
thoughts,
but
potentially
to
the
progression
from
vulnerability
to
suicidal
behavior,”
she
noted.

“I
think
that
distinction
is
important,
although
our
study
cannot
tell
us
why
it
occurs,”
she
added.
“Exposure
could
affect
perceptions
about
the
feasibility
of
suicidal
behavior,
transmit
distress
through
social
networks,
reflect
shared
stressful
environments,
or
operate
through
other
social
processes.
Understanding
those
mechanisms
is
an
important
next
step.”

One
implication
of
the
study’s
findings
for
clinicians
is
that
“suicide
risk
assessment
may
benefit
from
looking
beyond
an
individual’s
symptoms
and
asking
about
what
has
recently
happened
within
their
social
network,”
Mitchell
suggested.

However,
“I
would
not
interpret
exposure
as
meaning
that
a
young
person
will
attempt
suicide
—
the
absolute
risk
remains
low,
and
our
findings
are
associations
rather
than
evidence
that
exposure
causes
an
attempt,”
she
said.
“Rather,
recent
exposure
may
be
an
additional
signal
that
warrants
attention,
particularly
when
considered
alongside
other
clinical
and
contextual
risk
factors.”

The
findings
“may
also
have
implications
for
postvention,”
or
interventions
conducted
after
a
suicide,
she
pointed
out.
“Proactive
outreach,
screening,
and
access
to
support
within
schools
and
other
youth-serving
settings
may
help
identify
young
people
who
need
additional
support.”

For
this
longitudinal
study,
Mitchell
and
Banyard
used
three
waves
of
data
(baseline,
12
months,
and
24
months)
from
Project
Lift
Up,
a
survey
of
U.S.
adolescents
and
young
adults
recruited
through
social
media
from
June
2022
through
October
2023.

Among
2,098
participants,
mean
age
was
17.5
years,
60%
were
female,
49.9%
identified
as
a
sexual
minority,
44.8%
identified
as
a
racial
or
ethnic
minority,
and
27.4%
identified
as
a
gender
minority.

Assessment
of
suicide
attempt
among
someone
known
to
the
participant
did
not
distinguish
whether
awareness
resulted
from
direct
observation,
interpersonal
disclosure,
communication
from
others,
or
online
communication,
Mitchell
and
Banyard
noted.

Limitations
to
the
study
included
that
outcome
measures
were
based
on
self-report
and
may
have
been
subject
to
recall
and
reporting
bias.
Residual
confounding
was
also
possible,
the
authors
said.

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