Suicidal behavior in elementary school-aged youth: Assessment of familial factors and neurocognitive functioning

Suicide is the 9th leading cause of death in children under 12 years old. Research has suggested risk factors may differ in elementary school-aged children who die by suicide compared to older youth. To date, little research has investigated risk factors in children with suicidal behavior (SB) to confer which factors may be relevant for prevention and intervention efforts. The proposed study intends to fill these gaps in the literature by examining risk factors in children, 6-11 years, with (SB+) and without a history of suicidal (SB-). Within the SB+ group, children with suicidal ideation only (SI+) and children with a history of suicide attempt (SA+) will be recruited. The specific aims and hypotheses are: Aim 1: Examine the association between neurocognitive functioning and SB in elementary school-aged children. Hypothesis 1a: SA+ group will exhibit more neurocognitive deficits compared to the SI+ and SB- groups and the SI+ group will display more neurocognitive deficits compared to SB- group but less than the SA+ group (SA+ > SI+ > SB-). Hypothesis 1b: Parental/caregiver neurocognitive deficits will be positively correlated with child neurocognitive deficits. Aim 2: Investigate the association between familial factors and SB in elementary school-aged children. Hypothesis: SA+ group will have less reported familial cohesion/adaptability, poorer reported parenting behaviors, insecure attachment styles, and express negative social communication/interactions compared to the SI+ and SB- groups. SI+ group will have less reported familial positive attributes (e.g., positive parenting behaviors) when compared to the SB- group (SA+ < SI+ < SB-). Exploratory Aim: Investigate the potential main and moderating effects of ADHD symptomatology on SB in elementary school-aged children. We will also collect information on key risk and protective factors to examine the independent and interactive effects of neurocognitive functioning and familial factors on SB. Measures will include interview questions concerning SB of the child, parent/caregiver, and 1st/2nd degree relatives, interview questions to evaluate motivations of SB in children, computer tasks assessing neurocognitive functioning in both the child and parent/caregiver, computerized measures assessing peer relationship quality, an observational task to evaluate familial interaction and parent/caregiver/child communication, and questionnaires to assess risk factors associated with SB (e.g., depression). The proposed project is in line with AFSP's strategic goals to accelerate progress in the field of suicide research and to reach individuals at risk for suicide and suicidal behavior in order to save lives. Successful completion of this project will contribute to the discovery of specific risk factors associated with SB in elementary school-aged children and provide information to assist with the creation of developmentally appropriate intervention programming for youth at-risk. This proposed study will set the foundation for future research to follow this at-risk group into late childhood/early adolescence to determine which factors are predictive of future SB in youth who experience SB in early childhood.