THE DEVELOPMENT OF SUICIDAL IDEATION AND SELF-HARM IN CHILDHOOD AND ADOLESCENCE
Paul, Elise Kathleen
Theory and research emphasize child maltreatment (child abuse and child neglect) as a factor conferring long-term risk for suicidality, while interpersonal conflicts and losses increase short-term risk in vulnerable individuals. Prior research has been limited by a dearth of studies in young children, cross-sectional designs, and a lack of research examining which risk factors differentially associate with suicidal ideation versus self-harm/suicide attempts. This dissertation is comprised of three papers on child and adolescent suicidal thoughts and behaviors which address each of these limitations. The results in Chapter Two are from a large study of young children at risk for child maltreatment and are congruent with what has been found in studies of adolescents and adults. Namely, that internalizing difficulties increase risk for suicidal ideation, while externalizing problems and attentional dysregulation associate with more severe suicidal behaviors such as self-harm/suicide attempts. Results also suggest that broader exposure to different forms of child maltreatment and the physical neglect subtype “failure to provide” are important for the development of suicidal ideation and self-harm in early childhood, respectively. The strongest associations were between age 4 suicidal ideation and self-harm with these two respective behaviors at age 6. The second paper (Chapter Three) investigated developmental mechanisms involved in the link between child maltreatment and suicidal ideation and self-harm occurring in middle childhood (age 9). Results suggest pathways from parental psychological aggression and neglect in early childhood (age 3) to suicidal ideation and self-harm via comorbid clinical levels of anxious-depressive symptoms and aggressive behaviors (age 5). The analyses in the third study (Chapter Four) demonstrate the importance of interpersonal loss and a greater number of stressful life events for the first transition from thinking about suicide to acting in adolescence. Results from interactions between stressful life events and factors hypothesized to increase and decrease the risk of stressful life events on transitioning from suicidal ideation to suicide attempt provided mixed support for diathesis-stress models of suicide risk. Together, these three papers contribute to our nascent understanding of early contributors for suicidal ideation and self-harm risk in children and adolescents.
adolescents; Developmental psychology; self-harm; suicidal ideation; suicide; Children
Waller, Maureen; Evans, Gary William
Ph. D., Human Development
Doctor of Philosophy
dissertation or thesis