Of note, in the group
of ideators with an attempted suicide, parental divorce was more prevalent than parental death.
No significant relationship was found between any of the childhood adversities and lifetime plans in the group
of ideators, although a significant relationship was found between two or more adversities and lifetime plans among those who were ideators (OR 44.5, CI 2.5 to 779.1, p < 0.008).
One - third (33.4 %)
of ideators go on to develop a suicide plan, and 33.9 % make an attempt.
All of these prevalence estimates are higher among girls than boys, with the exception of the proportion
of ideators who go on to develop a plan and the proportion of attempts that are planned vs unplanned.
The proportions
of ideators who go on to make an attempt are 60.8 % of those with a plan compared with 20.4 % of those without a plan, resulting in roughly 60 % of first attempts being planned (57 % among boys and 66 % among girls) and the other 40 % unplanned.
Not exact matches
Finally, the elevated ORs
of comorbidity with suicide attempts in the total sample are due to significant ORs with ideation (1.9) and insignificantly elevated ORs with a plan among
ideators (1.5 - 2.3).
Conditional associations
of mental disorders with attempts among
ideators, controlling for plans, are somewhat weaker and less consistent than with plans (9 disorders have ORs greater than 1.0 [3
of them significant], but with the OR for alcohol abuse significantly less than 1.0).
These findings are consistent with recent findings in epidemiological studies
of adults, in which MDD emerged as the strongest predictor
of suicidal thoughts compared with disorders characterized by anxiety, agitation, and poor behavioral control, which were the strongest predictors
of a suicide attempt among
ideators.22, 40
It is instructive to trace out the significant associations
of type / number
of disorders with suicide attempts in the total sample through more proximal outcomes (ie, ideation, plans among
ideators, and attempts among
ideators with or without a plan).
Having a plan, in comparison, is strongly associated with elevated odds
of an attempt among
ideators (OR = 5.3).
Non-Hispanic blacks have significantly lower odds
of attempts (OR = 0.3) than do non-Hispanic whites, which can be traced to significantly lower odds
of ideation (OR = 0.5) in conjunction with insignificantly lower conditional odds
of plans among
ideators (OR = 0.7) and attempts among both planners (OR = 0.4) and
ideators without a plan (OR = 0.4).
We also found that significant global interactions between type / number
of disorders and plans were predictors
of attempts among
ideators (χ217 = 65.0, P <.001).
Conditional associations
of mental disorders with suicide plans among
ideators are weaker and less consistent (6 disorders have ORs greater than 1.0 [1
of them significant], but with the OR for illicit drug abuse significantly less than 1.0).
To examine transitions among behaviors, we focus on not only predictors
of lifetime suicide attempts but also predictors
of lifetime suicide ideation, lifetime suicide plans among
ideators, and lifetime attempts among
ideators with and without a plan.
Family history
of suicide and high motor impulsivity distinguish suicide attempters from suicide
ideators among college students
None
of the childhood adversities were significantly associated with suicide attempts among
ideators in this age group.
Effects
of childhood trauma on cortisol levels in suicide attempters and
ideators.
Physical abuse was associated with a lower OR
of lifetime suicide plans among
ideators (OR 0.4, p = 0.038; table 5).
Findings from multivariate analysis, therefore, confirm findings
of bivariate analysis for all groups, except for the
ideators.
Instead, the strongest predictors
of suicide attempts among
ideators were disorders characterized by anxiety and impulse - control problems.
An examination
of the predictive associations
of individual disorders in developed countries revealed that depression is among the strongest predictors
of suicide ideation (OR = 3.3), but is much less powerful in predicting progression from ideation to plans (OR = 1.5), planned attempts (OR = 1.5), or unplanned attempts among
ideators (OR = 1.2).