Suicidal Thoughts and Attempts among High School Students: Trends

Research implying an increase in impulsive suicide attempts among US high school students over the last twenty years may have important implications for the detection of suicide risk among this age group. The authors of this study suggest that health care providers and school suicide prevention program staff who conduct suicide screenings may want to include questions about health-risk behaviors that are strongly associated with suicide (such as interpersonal violence, substance abuse, sexual risk behaviors, and unhealthy weight control behaviors), in addition to the usual questions about mood, ideation, and past attempts.

The authors based their data analysis on results from the bi-annual Youth Risk Behavior Survey (YRBS). Respondents were categorized as being at low, medium, or high risk for death by suicide based whether they reported suicidal ideation or attempts in the previous year. The study found that there was a large decrease in suicidal thoughts among both female and male students over the years 1991-2011. During this period, there was no change in the prevalence of suicide attempts among male students and a small decrease among female students. According to the authors, this “suggests that impulsive or unplanned suicide attempts may have become more common.” They also report that “consistent with other research, we found the strongest associations between suicide attempts and the types of health-risk behaviors that may be associated with poor impulse control and aggression, including substance abuse, community- and school-related violence, and unhealthy weight control/disordered eating.”  Students at moderate or high risk of suicide were also found to have been less likely to use condoms than students judged to be at low risk. The health-risk behaviors most strongly associated with high risk for suicide among girls included injection drug use, carrying weapons on school property, and methamphetamine use. Among boys, the highest risk factors included injection drug use, attempting to control weight by vomiting or using laxatives, and having been forced to have sex.

Lowry, R., Crosby, A.E., Brener, N.D., and Kann, L. (2014). Suicidal thoughts and attempts among US high school students: Trends and associated helth-risk behaviors, 1991-2011. Journal of Adolescent Health 54(1): 100-108.

SPRC Commentary

To learn how you can find and interpret data from the Youth Risk Behavior Survey and other online data sources, take the free SPRC online course “Locating and Understanding Data for Suicide Prevention.”