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Permalink: http://hdl.handle.net/1866/23686

Pathways of association between childhood irritability and adolescent suicidality

Article [Accepted Manuscript]
Thumbnail
Tremblay_2019_ID_6160 .pdf (823.8Kb)
Is part of
Journal of the American academy of child and adolescent psychiatry ; vol. 58, no. 1, pp. 99-107.
Publisher(s)
Elsevier
2018-10-30
Author(s)
Orri, Massimiliano
Galera, Cedric
Turecki, Gustavo
Boivin, Michel
Tremblay, Richard Ernest
Geoffroy, Marie-Claude
Côté, Sylvana
Affiliation
  • Université de Montréal. Faculté des arts et des sciences. Département de psychologie
Keywords
  • Childhood irritability
  • Suicidal ideation
  • Suicide attempt
  • Pathways
  • Longitudinal
Abstract(s)
Objective Childhood irritability predicts suicidal ideation/attempt (suicidality), but it is unclear whether irritability is an independent and direct risk factor for suicidality or a marker of intermediate mental health symptoms associated with suicidality. This study aimed to identify developmental patterns of childhood irritability and to test whether childhood irritability is directly associated with suicidality or indirectly associated with intermediate mental health symptoms. Method One thousand three hundred ninety-three participants from the Québec Longitudinal Study of Child Development were followed from birth to 17 years. Teachers assessed irritability yearly (at 6–12 years) and children self-reported intermediate mental health symptoms (depression, anxiety, disruptiveness, and hyperactivity-impulsivity; at 13 years) and suicidality (at 15 and 17 years). Results Four irritability trajectories were identified: low (74.7%), rising (13.0%), declining (7.4%), and persistent (5.0%). Children following a rising irritability trajectory (versus a low trajectory) were at higher suicidality risk. A large proportion of this association was direct (odds ratio 2.11, 95% CI 1.30–3.43) and a small proportion was indirect by depressive symptoms (accounting for 23% of the association; odds ratio 1.17, 95% CI 1.03–1.34). Children on a persistent irritability trajectory (versus a low trajectory) were at higher risk of suicidality and this association was uniquely indirect by depressive symptoms (accounting for 73% of the association; odds ratio 1.51, 95% CI 1.16–1.97). The declining trajectory was not related to suicidality; no association with anxiety, disruptiveness, and hyperactivity-impulsivity was found. Conclusion Rising irritability across childhood represents a direct risk for suicidality. Persistent irritability appears to be a distal marker of suicidality acting through more proximal depressive symptoms.
Other location(s)
https://doi.org/10.1016/j.jaac.2018.06.034
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  • Faculté des arts et des sciences – Département de psychologie - Travaux et publications [163]

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