Treatment of Adolescent Suicide Attempts Study (TASA): Predictors of Suicide Events in an Open Treatment Trial

• NCJ Number: 228675
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 48 Issue: 10 Dated: October 2009 Pages: 987-996
• Author(s): David A. Brent, M.D.; Laurence L. Greenhill, M.D.; Scott Compton, Ph.D.; Graham Emslie, M.D.; Karen Wells, Ph.D.; John T. Walkup, M.D.; Benedetto Vitiello, M.D.; Oscar Bukstein, M.D.; Barbara Stanley, Ph.D.; Ann Wagner, Ph.D.; Barbara Coffey, M.D.; John S. March, M.D.; Mark Riddle, M.D.; Tina Goldstein, Ph.D.; John Curry, Ph.D.; Shannon Barnett, M.D.; Lisa Capasso, B.A.; Jamie Zelazny, B.S.N.; Jennifer Hughes, B.A.; Sa Shen, Ph.D.; S. Sonia Gugga, M.S.; J. Blake Turner, Ph.D.; Kelly Posner, Ph.D.; Betsy D. Kennard, Psy.D.; Mary F. Cwik, Ph.D.
• Date Published: October 2009
• Length: 10 pages
• Grant Number(s): MH66750; MH66769; MH66762; MH66775; MH66778
• Sponsoring Agency: National Institute of Mental Health
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

In order to identify the predictors of suicidal events and attempts among adolescents with depression participating in an open treatment trial (6 months of psychotherapy, medication, or a combination), study participants were followed up 6 months after treatment intake to collect data on the rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation that required emergency referral).

Abstract

The study found that strong clinical predictors of experiencing a suicidal event were high levels of suicidal ideation and self-reported depression, a history of maltreatment, two or more previous attempts, lower lethality of the index attempt, and lower levels of family cohesion. When participants showed a slower reduction in suicidal ideation, they were also more vulnerable to experiencing a suicidal event. Similar but not identical factors predicted a reattempt. Of the 124 participants enrolled in the study, 24 experienced a suicidal event during the 6 months since entry. Of these 24 participants, 15 made at least 1 suicide reattempt. The hazard of an event and attempt during 6 months after intake was 0.19 and 0.12, respectively, with a median time to an event or attempt of approximately 6 weeks. Approximately 40 percent of events occurred within 4 weeks of entrance into the study. The findings suggest therapeutic approaches that develop distress tolerance and improved emotion regulation, as well as a focus on the residual effects of childhood trauma and the enhancement of protective features in family, school, and social environments. Because a significant proportion of suicidal events occurred shortly after program intake, i.e., before the benefit of any of the interventions could occur, treatment programs should emphasize safety planning and an increase in the intensity of therapeutic contact early in treatment. 4 tables, 4 figures, and 39 references