Using Preventive Interventions to Better Understand Etiological Mechanisms and Risk for Suicide

Suicide is the 3rd leading cause of death for youth aged 10-24 (2nd leading cause for ages 25-34).  The 2011 Youth Risk Behavior Surveillance System found that, annually: 2.4% of high school students made a suicide attempt that resulted in medical treatment; 7.8% had attempted suicide one or more times, and 12.8%  had made a plan about how they would attempt suicide.  It is likely that preventing attempts and self-harm ideation would result in a reduction in youth suicide deaths, as well as reduce the health care and social burden associated with suicidal behavior.  Suicide and suicidal behavior is multi-determined, with both distal and proximal risk factors yet we have little understanding as to the developmental trajectories that contribute to risk or protection for suicidal behavior in late adolescence and young adulthood.  There is also a gap in our understanding of how early prevention programs might mediate these long-term risks, and also possibly moderate the potential toxic effects of precipitating events.   For example, the population attributable risk for childhood abuse and neglect attributed to suicide attempts is 9-20% (IOM, 2002).  Little is known as to whether interventions that reduce children’s exposure to, and negative outcomes from abusive parenting, also yield lower rates of suicide attempts.  Youth, compared to adults, are more susceptible to social environments, so the understanding of how various preventive interventions affect youth's social environments could refine intervention approaches. While preventive interventions have demonstrated reductions in risk factors, there are still unanswered questions regarding which youth-based prevention efforts are effective in reducing suicidal behaviors in later adolescence and young adulthood. Researchers have begun to propose a matrix of childhood and adolescent preventive interventions for social contexts (e.g,. family households) and settings (e.g., schools) that hold potential for reducing suicide risk and associated negative outcomes and for building skills needed for successful school and social relationships.   This roundtable discussion will bring together prevention scientists and methodologists who designed and tested preventive interventions that were not intended to target the outcome of suicide risk but whose impact may extend to this crossover area.   Strategies for re-examining data and synthesizing data collection efforts from multiple trials will be discussed.   The roundtable will have implications for prevention science across a range out outcomes as the concept of cross-over effects extends beyond the example of suicide and suicidal behavior.