Publications
Search results for 'suicide'
Childhood sexual abuse and pervasive problems across multiple life domains: Findings from a five-decade study | 2024
Guiney, H. Caspi, A. Ambler, A. Belsky, J. Kokaua,
... Show all »
Development and Psychopathology, 2024, 36(1), 219-235.
10.1017/s0954579422001146
Our ref: RO807
The aim of this study was to use longitudinal population-based data to examine the associations between childhood sexual abuse (CSA) and risk for adverse outcomes in multiple life domains across adulthood. In 937 individuals followed from birth to age 45y, we assessed associations between CSA (retrospectively reported at age 26y) and the experience of 22 adverse outcomes in seven domains (physical, mental, sexual, interpersonal, economic, antisocial, multi-domain) from young adulthood to midlife (26 to 45y). Analyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault, and considered different definitions of CSA. After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in adulthood. In sum, CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors, and the risk for particular problems incremented with CSA severity. The higher risk for most specific problems was small to moderate, but the cumulative long-term effects across multiple domains reflect considerable individual and societal burden.
« Hide abstract
Psychotic experiences and schizotypy in early adolescence predict subsequent suicidal ideation trajectories and suicide attempt outcomes from 18- to 38-years | 2020
Kirstie J. M. O’Hare, Richie Poulton, Richard J. Linscott
Schizophrenia Bulletin, 2020, .
https://doi.org/10.1093/schbul/sbaa151
Link to full publication »
Our ref: RO741
Subclinical risk markers for schizophrenia predict suicidality, but little is known about the nature of the relationship. Suicidal ideation is often considered homogenous, but distinguishing passive from active ideation (i.e. thoughts of death vs thoughts of killing oneself) and different temporal patterns may further understanding of risk factors. We tested whether schizotypy and psychotic experiences (PE) in early adolescence predict subsequent growth trajectories of suicidal ideation and suicide attempt outcomes. Participants were 1037 members of the population-representative Dunedin Study cohort. PE was measured at 11 years; schizotypy at 13 and 15 years. Outcomes were passive and active suicidal ideation, and suicide attempt, measured at 18, 21, 26, 32, and 38 years. Passive ideation was best represented by two trajectories, including persistent and transient ideation classes. Schizotypy predicted membership in the smaller persistent class (OR = 1.21, p = .041), whereas PE was not associated with class membership. Probability of suicide attempt was 13.8% in the persistent ideation class, compared to 1.8% in the transient class. Active ideation was best represented by a one-class model, the intercept of which was predicted by schizotypy (OR = 1.23, p = .015). Suicide attempts were predicted by schizotypy (OR = 1.53, p = .040) and PE (OR = 3.42, p = .046), and this was partially mediated by indirect effects via the active ideation trajectory. Findings indicate adolescent schizotypy and PE are related to subsequent suicidal ideation and attempts. Suicidal ideation is heterogenous, and schizotypy is specifically related to a persistent passive ideation subgroup.
« Hide abstract
Non-suicidal self-injury and suicide attempts in a New Zealand birth cohort | 2017
Coppersmith, D. D. L. Nada-Raja, S. Beautrais, A. L.
Journal of Affective Disorders, 2017, 221 89-96.
10.1016/j.jad.2017.06.029
Link to full publication »
Our ref: RO711
Background: Non-suicidal self-injury (NSSI) and suicide attempts are related, but distinct behaviors. The primary aim of the current study was to identify factors that distinguish those with different lifetime histories of selfinjury. A secondary aim was to test whether lifetime history of self-injury at age 26 predicted current suicide ideation at age 32.
Methods: Participants were 26 year olds from a large birth cohort with a lifetime history of no self-injury (n = 466), a lifetime history of NSSI (n = 191), or a lifetime history of NSSI and a suicide attempt (NSSI+ SA; n = 52). They were compared on a history of psychiatric disorders, 12-month suicide ideation, lifetime history of childhood sexual abuse, and lifetime exposure to suicide.
Results: An anxiety disorder, a substance dependence disorder, suicide ideation, and a history of childhood sexual abuse distinguished the NSSI+ SA and NSSI only groups. Longitudinal results demonstrated that a history of NSSI predicted future suicide ideation after adjusting for other selected risk factors.
Limitations: The majority of analyses are cross-sectional which limits inferences about causality. The retrospective self-report for lifetime behavior could be subject to reporting biases.
Conclusions: Adults with a history of NSSI and adults with a history of NSSI and a suicide attempt are clinically distinct groups that are both at risk of future suicide ideation. Identifying and treating NSSI could be a key preventive factor in reducing subsequent suicide risk.
« Hide abstract
Suicide attempt in young people: A signal for long-term healthcare and social needs | 2014
Goldman-Mellor, S., Caspi, A., Harrington,
... Show all »
JAMA Psychiatry, 2014, 71(2), 119-127.
10.1001/jamapsychiatry.2013.2803
Link to full publication »
Our ref: RO647
Importance Suicidal behavior has increased since the onset of the global recession, a trend that may have long-term health and social implications. Objective To test whether suicide attempts among young people signal increased risk for later poor health and social functioning above and beyond a preexisting psychiatric disorder. Design We followed up a cohort of young people and assessed multiple aspects of their health and social functioning as they approached midlife. Outcomes among individuals who had self-reported a suicide attempt up through age 24 years (young suicide attempters) were compared with those who reported no attempt through age 24 years (nonattempters). Psychiatric history and social class were controlled for. Setting and Participants The population-representative Dunedin Multidisciplinary Health and Development Study, which involved 1037 birth cohort members comprising 91 young suicide attempters and 946 nonattempters, 95% of whom were followed up to age 38 years. Main Outcomes and Measures Outcomes were selected to represent significant individual and societal costs: mental health, physical health, harm toward others, and need for support. Results As adults approaching midlife, young suicide attempters were significantly more likely to have persistent mental health problems (eg, depression, substance dependence, and additional suicide attempts) compared with nonattempters. They were also more likely to have physical health problems (eg, metabolic syndrome and elevated inflammation). They engaged in more violence (eg, violent crime and intimate partner abuse) and needed more social support (eg, long-term welfare receipt and unemployment). Furthermore, they reported being lonelier and less satisfied with their lives. These associations remained after adjustment for youth psychiatric diagnoses and social class. Conclusions and Relevance Many young suicide attempters remain vulnerable to costly health and social problems into midlife. As rates of suicidal behavior rise with the continuing global recession, additional suicide prevention efforts and long-term monitoring and after-care services are needed.
« Hide abstract
Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: a birth cohort study | 2013
Fisher, H.L., Caspi, A., Poulton,
... Show all »
Psychological Medicine, 2013, 43(43), 2077-2086.
doi:10.1017/S0033291712003091
Our ref: RO631
Background. Childhood psychotic symptoms have been used as a subclinical phenotype of schizophrenia in etiological research and as a target for preventative interventions. However, recent studies have cast doubt on the specificity of these symptoms for schizophrenia, suggesting alternative outcomes such as anxiety and depression. Using a prospective longitudinal birth cohort we investigated whether childhood psychotic symptoms predicted a diagnosis of schizophrenia or other psychiatric disorders by 38 years of age. Method. Participants were drawn from a birth cohort of 1037 children from Dunedin, New Zealand, who were followed prospectively to 38 years of age (96% retention rate). Structured clinical interviews were administered at age 11 to assess psychotic symptoms and study members underwent psychiatric assessments at ages 18, 21, 26, 32 and 38 to obtain past-year DSM-III-R/IV diagnoses and self-reports of attempted suicides since adolescence. Results. Psychotic symptoms at age 11 predicted elevated rates of research diagnoses of schizophrenia and post- traumatic stress disorder (PTSD) and also suicide attempts by age 38, even when controlling for gender, social class and childhood psychopathology. No significant associations were found for persistent anxiety, persistent depression, mania or persistent substance dependence. Very few of the children presenting with age-11 psychotic symptoms were free from disorder by age 38. Conclusions. Childhood psychotic symptoms were not specific to a diagnosis of schizophrenia in adulthood and thus future studies of early symptoms should be cautious in extrapolating findings only to this clinical disorder. However, these symptoms may be useful as a marker of adult mental health problems more broadly.
« Hide abstract
Victimization, posttraumatic stress disorder symptomatology and later non-suicidal self-harm in a birth cohort | 2011
Nada-Raja, S. , Skegg, K. M.
Journal of Interpersonal Violence, 2011, 26(26), 3667�3681.
DOI: 10.1177/0886260511403757 http://jiv.sagepub.com/content/26/18/3667.full.pdf+html
Our ref: RO614
This longitudinal population-based study examined pathways to nonsuicidal self-harm (NSSH) in relation to childhood sexual abuse (CSA), assault victimization in early adulthood, posttraumatic stress disorder symptomatology (PTSD), and other mental disorders. At age 21,476 men and 455 women completed interviews on assaultvictimization, PTSD, andother mental disorders. At age 26, they completed independent interviews on self-harm and childhood sexual abuse (CSA). Multivariate logistic regression analyses were conducted to determine predictors for NSSH at age 26. For men, anxiety and depressive disorders at age 21 were the only significant predictors of NSSH at age 26. For women, victimization, PTSD, and other anxiety disorders at age 21 all significantly predicted NSSH. CSA predicted later NSSH only indirectly, by increasing the risk of anxiety disorders among men and of assault victimization among women. In conclusion, pathways to nonsuicidal self-harm differed by sex. For women there were direct links with assault victimization and PTSD in early adulthood, whereas for men only internalizing disorders predicted future NSSH.
« Hide abstract
Effective strategies for suicide prevention in New Zealand: A review of the evidence | 2007
Beautrais, A.L., Fergusson, D.M., Cogan,
... Show all »
New Zealand Medical Journal, 2007, 120(120), 1-13.
http://www.nzma.org.nz/journal/120-1251/2459/
Our ref: NZ92
A national suicide prevention strategy for New Zealand was developed in 2006. There is relatively little strong evidence for the efficacy of many existing suicide prevention initiatives, and this area has frequently been captured by strong claims about the effectiveness of programmes that have not been adequately evaluated. This paper provides a conceptual framework for classifying suicide prevention initiatives, reviews evidence for their effectiveness, and makes recommendations for initiatives to be undertaken as part of suicide prevention activities in New Zealand. The available evidence thus far suggests that the most promising interventions likely to be effective in reducing suicidal behaviours are medical practitioner and gatekeeper education, and restriction of access to lethal means of suicide. This evidence also suggests a clear agenda for research, which includes evaluating interventions and prevention programmes, developing model and demonstration projects, identifying meaningful outcome measures, and refining and identifying the critical elements of effective programmes.
« Hide abstract
Is cigarette smoking associated with suicidal ideation among young people? | 2005
McGee, R., Williams, S.M., Nada-Raja,
... Show all »
American Journal of Psychiatry, 2005, 162(162), 619-620.
Our ref: RO475
OBJECTIVE The authors examined the association between suicidal ideation in early adulthood and daily tobacco smoking in a community sample of adolescents. METHOD Participants were enrolled in a longitudinal study of health and development. The factors of disadvantage, impulsiveness, stress, depressed mood, tobacco smoking, other substance use, and parental attachment were included in multivariate modelling of suicidal ideation. RESULTSData on tobacco use were available for 764 participants. Early tobacco smoking was significantly predictive of later suicidal ideation, but there was no longer a significant relationship when high levels of stress and depression and low levels of parental attachment in adolescence were included in the multivariate model. CONCLUSIONS Tobacco smoking in adolescence does not appear to elevate the risk of later suicidal ideation
« Hide abstract
Self-harm and psychiatric disorder: A population-based study | 2004
Skegg, K.M., Nada-Raja, S., Moffitt,
... Show all »
Suicide and Life-Threatening Behavior, 2004, 34(34), 187-196.
Link to full publication »
Our ref: RO464
Abstract: Little is known about the extent to which minor self-harm in the general population is associated with psychiatric disorder. A population-based sample of 980 young adults was interviewed independently about past-year suicidal and self-harm behavior and thoughts, and psychiatric disorders. Self-harm included self-harmful behaviors such as self-battery, as well as traditional methods of suicide (ICD [International Classification of Diseases] self-harm). All with ICD self-harm and most with other self-harmful behavior met the criteria for DSM-IV disorder. Suicidal/self-harmful thoughts increased the odds for self-harm, even in men without psychiatric disorder (odds ratio 4.9, 95% confidence interval 1.3 - 17.9). Young adults engaging in even minor self-harm warrant screening for psychiatric disorder.
« Hide abstract
Self-harmful behaviours in a population-based sample of young adults | 2004
Nada-Raja, S., Skegg, K.M., Langley,
... Show all »
Suicide and Life-Threatening Behavior, 2004, 34(34), 177-186.
Our ref: RO463
A birth cohort of 472 women and 494 men aged 26 years was inter-viewed about a range of self-harmful behaviors first and then asked about suicidal intent. Lifetime prevalence of self-harm using traditional methods of suicide (ICD [International Classification of Diseases] self-harm) was 13%, with 9% of the sample describing at least one such episode as attempted suicide. Other self-harmful behaviors were common; 14% of women and 33% of men reported self-battery. ICD self-harm over the past year was reported by 3%, mostly without suicidal intent. ICD self-harm and even lesser behaviors were associated with high odds of reporting suicidal ideation. The findings suggest that studies of self-harm should include behaviors not necessarily associated with suicidal intent.
« Hide abstract
A population-based study of help-seeking for self-harm in young adults | 2003
Nada-Raja, S., Morrison, D.N., Skegg,
... Show all »
Australian and New Zealand Journal of Psychiatry, 2003, 37(37), 600-605.
Our ref: RO451
Objective: To examine help-seeking for self-harm in a population-based sample of young adults. Method: Nine hundred and sixty-five participants aged 26 years were interviewed about help-seeking and barriers to help-seeking for a range of self-harmful behaviours. Self-harm included the traditional methods of suicide ( ICD-9 self-harm) and other self-harmful behaviours such as self-battery and self-biting. Results: Just over half of the 25 in the ICD-self-harm group ( based on ICD-9 self-harm criteria) and one-fifth of the 119 in the other self-harmful behaviour group had sought professional help. Counsellors, psychologists, and general practitioners were the commonest sources of help. Most participants rated help received from health services favourably, however, emergency services were rated less favourably than other health services. Among 77 self-harm participants who did not seek help, just over one-third reported attitudinal barriers. Conclusions: To encourage help-seeking by young adults who self-harm, especially young men who are at high risk for self-harm and suicide, it may be necessary to identify ways to reduce attitudinal barriers.
« Hide abstract
Sexual orientation and self-harm in men and women | 2003
Skegg, K.M., Nada-Raja, S., Dickson,
... Show all »
American Journal of Psychiatry, 2003, 160(160), 541-546.
Our ref: RO433
OBJECTIVE: Recent studies of homosexual people have found higher rates of nonfatal suicidal behavior than among heterosexuals. The purpose of this study was to determine associations between self-harm and sexual orientation for men and women separately, defining sexual orientation by sexual attraction rather than by behavior. METHOD: In a birth cohort of 1,019 New Zealand young adults eligible to be interviewed at age 26 years, 946 participated in assessments of both sexual attraction and self-harm. RESULTS: Both women and men who had experienced same-sex attraction had higher risks of self-harm. The odds ratios for suicidal ideation in the past year were 3.1 for men and 2.9 for women. Odds ratios for ever having deliberately self-harmed were 5.5 for men and 1.9 for women. Men with same-sex attraction were also significantly more likely to report having attempted suicide. In both sexes, a greater degree of same-sex attraction predicted increasing likelihood of self-harm, with over one-third of men and women with persistent major same-sex attraction reporting this. Men with even a minor degree of same-sex attraction had high rates of self-harm and resulting physical injury. One-quarter of deliberate self-harm among men and one-sixth among women was potentially attributable to same-sex attraction. CONCLUSIONS: This study provides evidence of a link between increasing degrees of same-sex attraction and self-harm in both men and women, with the possibility of some difference between the sexes that needs to be explored further.
« Hide abstract
Behavioral observations at age 3 predict adult psychiatric disorders: longitudinal evidence from a birth cohort | 1996
Caspi, A., Moffitt, T.E., Newman,
... Show all »
Archives of General Psychiatry, 1996, 53(53), 1033-1039.
Our ref: RO282
Background: This study provides, to our knowledge, the first empirical test of whether behavioral differences among children in the first 3 years of life are linked to specific adult psychiatric disorders: anxiety and mood disorders, antisocial personality disorder, recidivistic and violent crime, alcoholism, and suicidal behavior. Methods: In a longitudinal-epidemiological study, 3-year-old children were classified into groups based on examiner observations of their behavior. At age 21 years, they were reassessed for psychopathologic functioning using standardized interviews based on DSM-III-R criteria. Results: Although effect sizes were small, undercontrolled (includes children who are impulsive, restless, and distractible) and inhibited (includes children who are shy, fearful, and easily upset) children differed significantly from comparison children in young adulthood. Under-controlled 3-year-olds were more likely at 21 years to meet diagnostic criteria for antisocial personality disorder and to be involved in crime. Inhibited 3-year-olds were more likely at 21 years to meet diagnostic criteria for depression. Both groups were more likely to attempt suicide, and boys in both groups had alcohol-related problems. Controls for family social class did not change the findings. Conclusion: Some forms of adult psychopathologic abnormality are meaningfully linked, albeit weakly, to behavioral differences observed among children in the third year of life.
« Hide abstract
Purposely self-inflicted injuries resulting in death and hospitalisation | 1990
Langley, J.D., Johnston, S.E.
Community Health Studies, 1990, 14(14), 190-199.
Our ref: RO150
This study reported national data on morbidity and mortality relating to self inflicted injuries. Incidence rates for various groups in the population for fatalities and hospitalisations are reported. Personal factors, methods used to inflict injury and place of occurrence are described, together with a discussion of implications for prevention. Limiting the availability and lethality of agents in self inflicted injuries is recommended.
« Hide abstract
