The Life Paths That Lead Teenagers to Attempted Suicide:Trajectories of Proximal Adversity

Study Overview
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Brief Summary
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Suicidal behaviors seriously alter the vital and functional prognosis of adolescents. Although the literature has lighted out a considerable number of risk factors for suicide attempts in youth, theoretical models - among which bio-psycho-social models - still lack empirical evidence. More specifically, the way adverse life events dynamically interact together and with the individual's diathesis to precipitate suicidal attempts remains unclear. Studies of life trajectories have opened an alternative approach to traditional linear epidemiological analysis to capture such a complex process. To date, adverse trajectories approaches never have been applied to the period immediately preceding the occurrence of the suicidal gesture (proximal adverse trajectories).

Official Title
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The Life Paths That Lead Teenagers to Attempted Suicide: Trajectories of Proximal Adversity

Conditions
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Suicide, Attempted

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Inclusion criteria for cases Youth aged 15-24 inclusive Who stayed at the hospital or in the emergency room for less than 15 days after a first suicide attempt Who were discharged less than 15 days ago Who gave their informed consent for majors, or whose parents gave their informed consent for minors Inclusion criteria for controls Youth aged 15-24 inclusive Who have never experienced any suicidal ideation or suicide attempt Who gave their informed consent for majors, or whose parents gave their informed consent for minors Inclusion criteria for informants Close relatives of the participant Who are major Who lived in the same household as the participant or have interacted with him/her for more than half the weeks of the year preceding the index suicide attempt Exclusion Criteria: No consent or consent withdrawal for majors and/or their parents for minors Neurological or psychiatric condition altering the capacity to understand

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 24 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Suicide attempt cases<br>Adolescents and young adults who attempted suicide between 7 and 30 days prior the inclusion | |
| Non-suicidal controls<br>Adolescents and young adults without history of suicide attempt or ideation | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Growth parameters of the patterns of proximal adverse trajectories in adolescents who attempted suicide, as compared to non-suicidal adolescents | We will build growth mixture models to account for the 1-year longitudinal evolution of the Burden of Adversity values. Each group will be characterized by the parameters (intercepts and slopes) of the best-fitting model. We will the compare the parameters of the 2 groups to search for statistical differences | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Statistical tests comparing the sociodemographic, vulnerabily and psychopathological indicators between the sub-group of adolescents identified from the mixture model. | Growth mixture models will allow for identifying sub-groups of individuals who are similar as regards to their burden of adversity trajectories. We will compare the characteristics of theses subgroups | 1 year | 
| Growth parameters of the patterns of evolution of psychological pain | Parallel to the burden of adversity growth models, we will build, for each group, growth models to predict the longitudinal evolution of psychological pain. We will then test whether the growth parameters of the ideation/pain trajectories correlate with those of the adversity trajectories | 1 year | 
| Growth parameters of the patterns of evolution of suicidal ideation intensity | Parallel to the burden of adversity growth models, we will build, for each group, growth models to predict the longitudinal evolution of the severity of the suicidal ideations. We will then test whether the growth parameters of the ideation/pain trajectories correlate with those of the adversity trajectories | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Suicide attempt, adolescence, adverse life event, developmental model, trajectories