Brain signatures in children who contemplate suicide: learning from the large-scale ABCD study

The Predictive Value of Preadolescent Suicidal Ideation Reporter Discrepancies in the ABCD Study

Little data exist to guide suicide assessment protocols in preadolescent youth. Using the Adolescent Brain Cognitive Development (ABCD) data (N = 10,010) at baseline (ages 9-10) and 24-month follow-up (ages 11-12), this report investigates informant agreement/disagreement in caregiver- and youth- reports of suicidal ideation and their associations with youth sex assigned at birth and symptomatology across preadolescence. Using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) at both timepoints, four informant discrepancy groups were created from caregiver- and youth- reported suicidal ideation: (1) Concordant No; (2) Concordant Yes; (3) Discordant Caregiver Yes, Youth No; (4) Discordant Caregiver No, Youth Yes. Internalizing and externalizing symptoms were measured at the 24-month follow-up using the caregiver-report Child Behavior Checklist and the youth-report ABCD Brief Problem Monitor. Results indicated low-to-fair caregiver-youth agreement for youth suicidal ideation across preadolescence. Suicidal ideation reported by youth, but not caregivers, demonstrated a shift in prevalence at the follow-up, with females surpassing males in self-reported endorsements. Finally, informant groups at both time points were associated with caregiver- and youth-reported youth symptomatology at the 24-month follow-up, and associations varied by reporter. Findings demonstrate the importance of leveraging both caregiver and youth reports to assess preadolescent suicidal ideation and highlight the clinical utility of informant discrepancies in assessing suicide risk. The accurate assessment of suicidal ideation in preadolescents is essential to curb the increasing rates of preadolescent suicide and identify at-risk youth for interventions prior to even larger uptick of suicide in adolescence.

A multi-level examination of impulsivity and links to suicide ideation among Native American youth

BACKGROUND

Despite preliminary evidence that links impulsivity to suicide risk among Native American youth, impulsivity has not been directly studied in relation to suicide ideation (SI) or behaviors in this population. We examined indexes of rapid-response impulsivity (RRI) across multiple levels of analysis (self-report, behavioral, neurobiological) and associations with SI among Native American youth ages 9-10 in the Adolescent Brain Cognitive Development Study.

METHODS

Data from the sample (n = 284) included self-report (UPPS-P), behavioral (Stop Signal Task), and neurobiological (right inferior frontal gyrus activation) indicators of RRI. RRI indicators were modeled using variable-centered (i.e., traditional multivariable regression) and person-centered (i.e., clustering analyses) approaches in measuring their association with SI.

RESULTS

Logistic regression analysis demonstrated that higher negative urgency was associated with higher odds of SI (Adjusted Odds Ratio = 1.23, p = 0.015). Latent profile analysis clustered youth into five profiles based on within-individual variation in RRI indicators. Youth with an elevated self-reported negative and positive urgency profile had higher odds of reporting SI than "normative" youth (Adjusted Odds Ratio = 2.38, p = 0.019).

LIMITATIONS

Limitations of this study include the modest sample size particularly regarding SI (14.1 %), potential bias in estimates of lifetime SI, and generalizability to youth from specific Native American communities.

CONCLUSIONS

Negative urgency may increase risk for SI among Native American youth in late childhood. Clinical implications, including the potential for person-centered RRI profiles to act as candidate markers of suicide risk and resilience in adolescence and inform safety assessments and planning, are discussed.

Sex and age variations in the impact of puberty on cortical thickness and associations with internalizing symptoms and suicidal ideation in early adolescence

PURPOSE

The childhood-to-adolescence transition is a notable period of change including pubertal development, neurodevelopment, and psychopathology onset, that occurs in divergent patterns between sexes. This study examined the effects of sex and puberty on cortical thickness (CT) in children and explored whether CT changes over time related to emergence of psychopathology in early adolescence.

METHODS

We used longitudinal data (baseline ages 9-10 and Year 2 [Y2] ages 11-12) from the ABCD Study (n = 9985). Linear and penalized function-on-function regressions modeled the impact of puberty, as it interacts with sex, on CT. Focusing on regions that showed sex differences, linear and logistic regressions modeled associations between change in CT and internalizing problems and suicide ideation.

RESULTS

We identified significant sex differences in the inverse relation between puberty and CT in fifteen primarily posterior brain regions. Nonlinear pubertal effects across age were identified in the fusiform, isthmus cingulate, paracentral, and precuneus. All effects were stronger for females relative to males during this developmental window. We did not identify associations between CT change and early adolescent clinical outcomes.

CONCLUSION

During this age range, puberty is most strongly associated with regional changes in CT in females, which may have implications for the later emergence of psychopathology.

Self-injurious thoughts and behaviors and alterations in positive valence systems: A systematic review of the literature

Self-injurious thoughts and behaviors (SITBs), which include suicidal ideation (SI), suicide attempts (SA), and nonsuicidal self-injury (NSSI), are prevalent and associated with impairments in functioning and elevated risk of suicide deaths. Preventing suicide is a complex problem, with numerous systems likely contributing to the onset and maintenance of SITBs, and there is a critical need to identify more precise predictors of risk. Positive valence systems (PVS) are an understudied domain with promise for improving understanding of risk processes underlying SITBs. In this systematic review, we evaluate the evidence for the potential role of altered PVS function in SI, SA, and/or NSSI, including alterations in reward responsiveness, learning, and valuation assessed through behavioral, physiological and circuit measures. Results provide preliminary support for associations between distinct aspects of PVS function and alterations in SITBs. Specifically, SI appears to be characterized by low reward responsiveness, whereas little research has examined reward responsiveness in SA, and NSSI has been characterized by hyper-responsiveness to rewards. Alterations in reward learning and valuation are commonly examined in SA, with some evidence that they may be more strongly associated with attempts than SI or NSSI. At the same time, the literature is limited in that some constructs are commonly examined in one form of SITBs but not others. Further, research is predominantly cross-sectional and focused on adults, raising questions about the role of PVS function in developmental pathways to SITBs. We conclude by integrating the research to date and highlighting promising directions for future research.