The teen years are known as a time of increased suicide risk. Associated factors such as depression, social support, and anxiety were recently studied to understand their relationship to ideation, planning, and suicide attempts.
Researchers at University of North Carolina at Chapel Hill examined how social anxiety is related to risk of suicidal ideation. A group of 144 teens, 12 to 15 years old, were assessed using a number of standard instruments during inpatient psychiatric hospitalization and again nine and 18 months later for suicidal ideation and social anxiety.
They were also assessed for symptoms of two potentially-related mediators: loneliness and perceived social support. The majority of the teens were white, and 72% were female. Household makeup was split: 42% lived in a two-parent household; 29% lived with only their biological mother, and the remaining 29% lived with a biological father only, with extended family, or were in temporary foster care.
The exact reasons for the teens’ hospitalizations were not clear, but they were all related to standard “imminent danger of harm to self or others.” Baseline diagnoses included depression (31.3%), oppositional defiant disorder (25.7%), conduct disorder (17.4%), PTSD (13.2%), social phobia (12.5%), and GAD (6.3%).
Both suicidal and nonsuicidal teens were included in the sample: 48% said they had attempted suicide in the previous year.
Higher levels of suicidal ideation were found at 18 months post-baseline among participants with social anxiety diagnosis at baseline in comparison to those without social anxiety diagnoses, even when accounting for depression and baseline suicidal ideation.
Researchers also found that social anxiety at baseline was related to feelings of loneliness at both follow-ups.
Among those who had both social anxiety at baseline and increased loneliness at nine months, there was higher risk of suicidal ideation at 18 months. Feelings of low social support were not associated with increased suicidal ideation (Gallagher M et al, J Abnorm Child Psychol 2014;online ahead of print).
CCPR’s Take: By using psychiatric inpatients as the sample, researchers were able to see the longitudinal course of suicidal ideation in a group that was already at a heightened risk. With the knowledge that social anxiety and its associated loneliness increases the risk of suicidal ideation, child and adolescent psychiatrists can more effectively screen these teens for suicidality, especially in the period following inpatient hospitalization. This study also shed light on the power of feelings of loneliness in both social anxiety and suicidal ideation.