Objective

Suicidal thoughts and behaviors (STBs) represent a significant and escalating public health concern in youth. Evidence that STBs can emerge in the preschool years suggests that some pathways leading to clinically significant STBs begin early in life.

Method

This prospective longitudinal study examined the developmental trajectories of STBs in children from ages 3 to 17, oversampled for preschool-onset depression.

Results

Three unique trajectories of STBs across childhood and adolescence were identified: low class (n = 273) characterized by low rates of STBs, early-persistent class (n = 21) characterized by steadily increasing STBs, and late-onset class (n = 21) characterized by low rates of STBs through age 10 followed by a dramatic increase from ages 11 to 14 years. Preschool measures of depression symptoms, externalizing symptoms, impulsivity, and lower income relative to needs were associated with both high-risk STB classes. Both high-risk STB classes reported greater functional impairment, more externalizing symptoms, and more cumulative stressful life events in adolescence relative to the low class; the late-onset class also reported poorer academic functioning relative to both the early-persistent and low classes.

Conclusion

A significant minority of this prospectively followed group of preschool children evidenced STBs by and/or after age 10. Although relatively rare before age 10, approximately half of the children who experienced STBs in adolescence first exhibited STBs in early childhood and comprised a trajectory suggesting increasing STBs. In contrast, approximately half of children first exhibited STBs in early adolescence. Early screening and identification of at-risk youth during both preschool and late childhood is important for early intervention regarding STBs.

中文翻译：

---

从学龄前到青春期后期的自杀念头和行为轨迹

客观的

自杀念头和行为 (STB) 是青年中一个重要且不断升级的公共卫生问题。STBs 可以在学龄前出现的证据表明，一些导致具有临床意义的 STBs 的途径在生命早期就开始了。

方法

这项前瞻性纵向研究检查了 3 至 17 岁儿童 STB 的发展轨迹，对学龄前抑郁症进行了过度抽样。

结果

确定了儿童和青春期 STB 的三个独特轨迹：以 STB 发生率低为特征的低等级 (n = 273)、以 STB 稳步增加为特征的早期持续等级 (n = 21) 和迟发等级 (n = 21) ) 的特征是 10 岁之前的 STB 发生率很低，然后从 11 岁到 14 岁急剧增加。抑郁症状、外化症状、冲动性和相对于需求的较低收入的学前测量与两个高风险 STB 类别相关。与低级别相比，两个高风险 STB 级别都报告了更严重的功能障碍、更多的外化症状和更多的青春期累积压力生活事件；相对于早发班级和低班级，晚发班级的学业成绩也较差。

结论

在这组前瞻性随访的学龄前儿童中，有相当一部分在 10 岁之前和/或之后出现了 STB。虽然在 10 岁之前相对较少，但大约一半在青春期经历过 STB 的儿童在儿童早期首次出现 STB，并且其轨迹表明增加机顶盒。相比之下，大约一半的儿童在青春期早期首次出现 STB。在学龄前和儿童晚期早期筛查和识别高危青少年对于 STB 的早期干预非常重要。