Indicators of Suicidal Outcomes Among 6 to 12-Year-Old Treatment Seeking Youth

Abstract

Suicide among elementary school-age youth is vastly understudied, partially because of a misconception about children’s capacity to understand the gravity of death, and partially because of the relatively low base rates of this behavior. Nevertheless, this topic remains a major health concern. This study seeks to investigate both a mediation model and a moderation model to elucidate the nature of risk factors for suicide by examining the effect emotion dysregulation (in the domains of anger, sadness, and worry) has on the relation between ADHD symptoms (i.e. hyperactivity/impulsivity and inattention) and suicidal outcomes (e.g. suicide behavior and risk for suicide). Participants include 232 children ranging from ages 6 to 12 and their primary caregiver who sought services and consented to research at a small Midwest outpatient training clinic. Anger dysregulation was positively associated with risk for suicide. Further, when accounting for sex, age, depressive symptoms, and emotion dysregulation in all three domains, high levels of hyperactivity/impulsivity were associated with high levels of suicide behavior. In contrast, high levels of inattention were associated with low levels of suicide behavior. Finally, two interaction effects were evident for suicide risk. An interaction effect between hyperactivity and sadness dysregulation was found for suicide risk, and an interaction effect between hyperactivity and worry dysregulation was found for suicide risk. At low levels of sadness and worry dysregulation, hyperactivity was positively associated with risk for suicide. However, at high levels of sadness and worry dysregulation, hyperactivity was not related to risk for suicide. Findings support moderation over mediation. Emotion dysregulation and hyperactivity are discussed as potentially important intervention targets for youth suicide prevention.