Exposure to suicide attempts linked to higher odds of later attempts in young people

A US study found that adolescents and young adults who knew someone in their social network had attempted suicide were more likely to attempt suicide themselves later.

Abstract editorial illustration accompanying the article: Exposure to suicide attempts linked to higher odds of later attempts in young people

Editorial illustration — not from the study.

Researchers analyzed three surveys taken over 24 months from 2,098 US participants aged 13 to 22 who had not previously attempted suicide. Participants were recruited through social media and reported whether someone in their social network had attempted suicide, along with their own symptoms and behaviors.

Those who reported such exposure had higher odds of a later suicide attempt, even after researchers accounted for depressive symptoms. Exposure was also associated with higher depressive symptoms over time, while larger in-person social networks were associated with fewer depressive symptoms.

What the study found

Among 2,098 participants without a prior suicide attempt, exposure to a suicide attempt within their social network was associated with greater odds of a subsequent suicide attempt: the odds ratio was 2.78 before adjustment and 2.43 after adjustment for depressive symptoms. The study did not find an association between this exposure and the onset of suicidal ideation.

Exposure was associated with higher depressive symptoms over time. The association was present both within individuals over time and between participants who differed in their exposure levels. Larger in-person social networks were associated with fewer depressive symptoms.

Why exposure matters

The findings suggest that asking young people about recent exposure to suicide attempts may identify some individuals with elevated suicide risk who might not be identified through symptom-based screening alone. The link with later attempts remained after accounting for depressive symptoms, indicating that exposure may provide information beyond current mood symptoms, although the study does not show that exposure caused the later attempts.

Evidence and limits

This was a national longitudinal cohort study using three waves of survey data collected at baseline, 12 months and 24 months. It followed US adolescents and young adults recruited through social media, and the main analysis included participants without a lifetime suicide attempt at baseline. The study relied on participants' self-reports and observational data, so it can show associations over time but cannot establish that exposure caused later suicide attempts or depressive symptoms.

The findings may not apply to young people who were not represented in the social-media-recruited sample or to people outside the United States. The abstract does not provide details about how exposure to each attempt occurred or whether the reported social-network events were independently verified.

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