Identifying Research Priorities in Child Suicide Risk

Sponsor(s): NIMH Office of the Director , Office of Behavioral and Social Sciences Research (OBSSR)

May 9: 9am – 5pm
May 10: 9am – 3pm

Location: Neuroscience Center
Conference Room A1/A2
6001 Executive Boulevard
Bethesda, MD
WebEx

Background and Purpose

According to the Centers for Disease Control and Prevention (CDC), rates of suicide  attempts and deaths - including among children - have been increasing in the United States over the past decade. However, very little research has been conducted on suicide risk in children relative to adolescents and adults. This National Institute of Mental Health and the NIH Office of Behavioral and Social Sciences Research supported workshop to foster discussion among experts in the field with the goal of identifying future research priorities in the area of child suicide risk.

Participants

Meeting participants included expert research investigators in the following areas:

• Suicide risk in children and adolescents
• Ethics of suicide-related research
• Developmental psychology
• Mechanisms underlying psychopathology
• Longitudinal research

Meeting Structure

The meeting format consisted of presentations and discussion panels.

Presentations were delivered by experts on topics related to the epidemiology of child and adolescent suicide, studying the development of suicide risk in the context of longitudinal cohort studies, and ethical considerations related to conducting research in this area.

Discussion panels focused on the following topic areas:

• Clinical Manifestations of Child Suicide-Related Thoughts and Behaviors
• Measurement of Child Suicide Risk
• Mechanisms of Child Suicide Risk
• Groups at High Risk for Suicide-Related Thoughts and Behaviors During Childhood
• Expanding a Program of Research to Include the Study of Child Suicide-Related Constructs

Discussion

Panel discussions and summary sessions provided ample opportunity for in-depth conversations about the workshop’s focus areas. Some of the key issues raised in discussions and wrap-up sessions are described below.

There is a need for developmentally appropriate measures and methods for identifying and eliciting suicidal thoughts and behaviors for younger children. This is necessary both to facilitate research in this area, as well as to give clinicians appropriate guidance in how to assess these issues in a developmentally sensitive manner.

Uniform standards should be adopted for assessing intent of suicide in medical examiner reports of the deaths of children. Misattribution of death by suicide to accidental causes (possibly driven by the assumption that true suicidal intent is not possible in young children or by an effort to spare families the stigma associated with suicide) may lead to an underestimate of the scope of the issue and may hinder clinical and research efforts in this area.

Research efforts should be expanded to include more diverse samples of children assessed for suicidal thoughts and behaviors to better understand relationships to risk factors at different stages of development. This may include encouraging assessments of suicidal or self-harming thoughts and behaviors in research projects not explicitly focused on suicide, that include both ‘normal’ as well as various high-risk samples (children with abuse histories; children with various mental disorders).

Obstacles to suicide research in younger children need to be addressed, including: Institutional Review Board concerns about risk, parent/clinical staff apprehensions about communicating about suicide with young children, and limited availability of developmentally appropriate measures of suicidal intent and understanding.

Finally, because detection of suicide risk may require clinical actions, the need for developmentally appropriate interventions for children endorsing suicidal thoughts or behaviors was also identified as a research gap.

Full Meeting Agenda:

Thursday May 9th

Friday May 10th