SUICIDAL THOUGHTS AND BEHAVIORS AMONG FIRST-YEAR COLLEGE STUDENTS - RESULTS FROM THE WMH-ICS PROJECT

Philippe Mortier, Randy Auerbach, Jordi Alonso, Jason Bantjes, Corina Benjet, Pim Cuijpers, David Ebert, Jennifer Greif Green, Penelope Hasking, Matt Nock, Siobhan M. O'Neill, Stephanie Pinder-Amaker, Nancy Sampson, Gemma Vilagut, Alan Zaslavsky, Ronny Bruffartes, Ron Kessler

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objective: College entrance may be a strategically well-placed “point of capture” for detecting late adolescents with suicidal thoughts and behaviors (STB). However, a clear epidemiological picture of STB among incoming college students is lacking. We present the first cross-national data on prevalence as well as socio-demographic and college-related correlates for STB among first-year college students.Method: Web-based self-report surveys were obtained from 13,984 first-year students (response rate 45.5%) across 19 colleges in eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States).Results: Lifetime prevalence of suicidal ideation, plans, and attempts was 32.7%, 17.5%, and 4.3%, respectively. Twelve-month prevalence was 17.2%, 8.8%, and 1.0%, respectively. About 75% of STB cases had onset before the age of 16 years (Q3 = 15.8), with persistence figures in the range 41-53%. About half (53.4%) of lifetime ideators transitioned to a suicide plan; 22.1% of lifetime planners transitioned to an attempt. Attempts among lifetime ideators without plan were less frequent (3.1%). Significant correlates of lifetime STB were cross-nationally consistent and generally modest in effect size (median adjusted OR [aOR] = 1.7). Non-heterosexual orientation (aOR range 3.3-7.9) and heterosexual orientation with some same-sex attraction (aOR range 1.9-2.3) were the strongest correlates of STB, and of transitioning from ideation to plans and/or attempts (aOR range 1.6-6.1). Conclusion: The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile. Multivariate risk algorithms based on a high number of risk factors are indicated to efficiently link high-risk status with effective preventive interventions.
LanguageEnglish
JournalJournal of the American Academy of Child and Adolescent Psychiatry
VolumeN/A
Early online date13 Feb 2018
DOIs
Publication statusE-pub ahead of print - 13 Feb 2018

Fingerprint

Students
Demography
Northern Ireland
Suicidal Ideation
Belgium
Heterosexuality
South Africa
Mexico
Age of Onset
Spain
Self Report
Suicide
Germany

Keywords

  • Students
  • suicidal behaviour
  • mental health

Cite this

Mortier, Philippe ; Auerbach, Randy ; Alonso, Jordi ; Bantjes, Jason ; Benjet, Corina ; Cuijpers, Pim ; Ebert, David ; Greif Green, Jennifer ; Hasking, Penelope ; Nock, Matt ; O'Neill, Siobhan M. ; Pinder-Amaker, Stephanie ; Sampson, Nancy ; Vilagut, Gemma ; Zaslavsky, Alan ; Bruffartes, Ronny ; Kessler, Ron. / SUICIDAL THOUGHTS AND BEHAVIORS AMONG FIRST-YEAR COLLEGE STUDENTS - RESULTS FROM THE WMH-ICS PROJECT. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2018 ; Vol. N/A.
@article{009374a24d3040e38a1b59875d9c9e41,
title = "SUICIDAL THOUGHTS AND BEHAVIORS AMONG FIRST-YEAR COLLEGE STUDENTS - RESULTS FROM THE WMH-ICS PROJECT",
abstract = "Objective: College entrance may be a strategically well-placed “point of capture” for detecting late adolescents with suicidal thoughts and behaviors (STB). However, a clear epidemiological picture of STB among incoming college students is lacking. We present the first cross-national data on prevalence as well as socio-demographic and college-related correlates for STB among first-year college students.Method: Web-based self-report surveys were obtained from 13,984 first-year students (response rate 45.5{\%}) across 19 colleges in eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States).Results: Lifetime prevalence of suicidal ideation, plans, and attempts was 32.7{\%}, 17.5{\%}, and 4.3{\%}, respectively. Twelve-month prevalence was 17.2{\%}, 8.8{\%}, and 1.0{\%}, respectively. About 75{\%} of STB cases had onset before the age of 16 years (Q3 = 15.8), with persistence figures in the range 41-53{\%}. About half (53.4{\%}) of lifetime ideators transitioned to a suicide plan; 22.1{\%} of lifetime planners transitioned to an attempt. Attempts among lifetime ideators without plan were less frequent (3.1{\%}). Significant correlates of lifetime STB were cross-nationally consistent and generally modest in effect size (median adjusted OR [aOR] = 1.7). Non-heterosexual orientation (aOR range 3.3-7.9) and heterosexual orientation with some same-sex attraction (aOR range 1.9-2.3) were the strongest correlates of STB, and of transitioning from ideation to plans and/or attempts (aOR range 1.6-6.1). Conclusion: The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile. Multivariate risk algorithms based on a high number of risk factors are indicated to efficiently link high-risk status with effective preventive interventions.",
keywords = "Students, suicidal behaviour, mental health",
author = "Philippe Mortier and Randy Auerbach and Jordi Alonso and Jason Bantjes and Corina Benjet and Pim Cuijpers and David Ebert and {Greif Green}, Jennifer and Penelope Hasking and Matt Nock and O'Neill, {Siobhan M.} and Stephanie Pinder-Amaker and Nancy Sampson and Gemma Vilagut and Alan Zaslavsky and Ronny Bruffartes and Ron Kessler",
note = "Reference text: REFERENCES 1. Nock MK, Green JG, Hwang I, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry. 2013;70(3):300-310. 2. Steinhausen HC, Bosiger R, Metzke CW. Stability, correlates, and outcome of adolescent suicidal risk. J Child Psychol Psychiatry. 2006;47(7):713-722. 3. Thompson M, Kuruwita C, Foster EM. Transitions in suicide risk in a nationally representative sample of adolescents. J Adolesc Health. 2009;44(5):458-463. 4. Organisation for Economic Co-operation and Development (OECD) (2012). Education at a Glance 2012: OECD Indicators. (https://www.oecd.org/edu/EAG{\%}202012_e-book_EN_200912.pdf). Accessed 27 September 2017. 5. Mortier P, Kiekens G, Auerbach RP, et al. A Risk Algorithm for the Persistence of Suicidal Thoughts and Behaviors During College. J Clin Psychiatry. 2017;78(7):e828-e836. 6. Wilcox HC, Arria AM, Caldeira KM, Vincent KB, Pinchevsky GM, O'Grady KE. Prevalence and predictors of persistent suicide ideation, plans, and attempts during college. J Affect Disord. 2010;127(1-3):287-294. 7. Han B, Compton WM, Eisenberg D, Milazzo-Sayre L, McKeon R, Hughes A. Prevalence and mental health treatment of suicidal ideation and behavior among college students aged 18-25 years and their non-college-attending peers in the United States. J Clin Psychiatry. 2016;77(6):815-24.. 8. Caine ED. Forging an agenda for suicide prevention in the United States. Am J Public Health. 2013;103(5):822-829. 9. Harrod CS, Goss CW, Stallones L, DiGuiseppi C. Interventions for primary prevention of suicide in university and other post-secondary educational settings. Cochrane Database Syst Rev. 2014;10:Cd009439. 10. Mortier P, Cuijpers P, Kiekens G, et al. The prevalence of suicidal thoughts and behaviours among college students: a meta-analysis. Psychological Medicine. 2017 [Published online]. 11. Dueweke AR, Schwartz-Mette RA. Social-Cognitive and Social-Behavioral Correlates of Suicide Risk in College Students: Contributions from Interpersonal Theories of Suicide and Depression. Arch Suicide Res. 2017:1-17. 12. Wolford-Clevenger C, Elmquist J, Brem M, Zapor H, Stuart GL. Dating Violence Victimization, Interpersonal Needs, and Suicidal Ideation Among College Students. Crisis. 2015:1-8. 13. Eisenberg D, Gollust SE, Golberstein E, Hefner JL. Prevalence and correlates of depression, anxiety, and suicidality among university students. Am J Orthopsychiat. 2007;77:534-542. 14. Gillman JL, Kim HS, Alder SC, Durrant LH. Assessing the risk factors for suicidal thoughts at a nontraditional commuter school. J Am Coll Health. 2006;55(1):17-26. 15. Lee HS, Kim S, Choi I, Lee KU. Prevalence and risk factors associated with suicide ideation and attempts in korean college students. Psychiatry Investig. 2008;5(2):86-93. 16. Foo XY, Mohd Alwi MN, Ismail SIF, Ibrahim N, Jamil Osman Z. Religious Commitment, Attitudes Toward Suicide, and Suicidal Behaviors Among College Students of Different Ethnic and Religious Groups in Malaysia. J Relig Health. 2014; 53(3):731-46. 17. Reed E, Prado G, Matsumoto A, Amaro H. Alcohol and drug use and related consequences among gay, lesbian and bisexual college students: role of experiencing violence, feeling safe on campus, and perceived stress. Addictive behaviors. 2010;35:168-171. 18. The WHO World Mental Health Surveys International College Student Project (WMH-ICS) (2015) (https://www.hcp.med.harvard.edu/wmh/college_student_survey.php). Accessed 27 September 2017. 19. Posner K, Brown GK, Stanley B, et al. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168(12):1266-1277. 20. SAS/STATR Software [computer program]. SAS Institute Inc; 2010. 21. Groves RM, Couper MP. Nonresponse in Household Interview Surveys. New York: Wiley; 1998. 22. van Buuren S. Flexible Imputation of Missing Data. Boca Raton London New York: CRC Press (Taylor & Francis Group); 2012. 23. Collett D. Modeling Survival Data in Medical Research. London: Chapman & Hall; 1994. 24. Benjamini Y, Hochberg Y. Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. Journal of the Royal Statistical Society. 1995;57:289-300. 25. Evans E, Hawton K, Rodham K, Deeks J. The prevalence of suicidal phenomena in adolescents: a systematic review of population-based studies. Suicide Life Threat Behav. 2005;35(3):239-250. 26. Glenn CR, Lanzillo EC, Esposito EC, Santee AC, Nock MK, Auerbach RP. Examining the Course of Suicidal and Nonsuicidal Self-Injurious Thoughts and Behaviors in Outpatient and Inpatient Adolescents. Journal of abnormal child psychology. 2017; 45(5):971-983. 27. Rueter MA, Holm KE, McGeorge CR, Conger RD. Adolescent suicidal ideation subgroups and their association with suicidal plans and attempts in young adulthood. Suicide Life Threat Behav. 2008;38(5):564-575. 28. Peyre H, Hoertel N, Stordeur C, et al. Contributing Factors and Mental Health Outcomes of First Suicide Attempt During Childhood and Adolescence: Results From a Nationally Representative Study. J Clin Psychiatry. 2017;78(6):e622-e630. 29. McKinnon B, Gariepy G, Sentenac M, Elgar FJ. Adolescent suicidal behaviours in 32 low- and middle-income countries. Bull World Health Organ. 2016;94(5):340-350F. 30. Borges G, Benjet C, Medina-Mora ME, Orozco R, Nock M. Suicide ideation, plan, and attempt in the Mexican adolescent mental health survey. J Am Acad Child Adolesc Psychiatry. 2008;47(1):41-52. 31. Nock MK, Borges G, Bromet EJ, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008;192(2):98-105. 32. Saffer BY, Klonsky ED. The Relationship of Self-reported Executive Functioning to Suicide Ideation and Attempts: Findings from a Large U.S.-based Online Sample. Arch Suicide Res. 2016:1-18. 33. Gujral S, Ogbagaber S, Dombrovski AY, Butters MA, Karp JF, Szanto K. Course of cognitive impairment following attempted suicide in older adults. Int J Geriatr Psychiatry. 2016;31(6):592-600. 34. Szanto K, Bruine de Bruin W, Parker AM, Hallquist MN, Vanyukov PM, Dombrovski AY. Decision-making competence and attempted suicide. J Clin Psychiatry. 2015;76(12):e1590-1597. 35. Horesh N. Self-report vs. computerized measures of impulsivity as a correlate of suicidal behavior. Crisis. 2001;22(1):27-31. 36. Dour HJ, Cha CB, Nock MK. Evidence for an emotion-cognition interaction in the statistical prediction of suicide attempts. Behav Res Ther. 2011;49(4):294-298. 37. Sheftall AH, Davidson DJ, McBee-Strayer SM, et al. Decision-making in adolescents with suicidal ideation: A case-control study. Psychiatry Res. 2015;228(3):928-931. 38. Kosidou K, Dalman C, Fredlund P, Magnusson C. School performance and the risk of suicidal thoughts in young adults: population-based study. PloS one. 2014;9(10):e109958. 39. Auerbach RP, Alonso J, Axinn WG, et al. Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychol Med. 2016:46(14):2955-2970. 40. Marshal MP, Dietz LJ, Friedman MS, et al. Suicidality and depression disparities between sexual minority and heterosexual youth: a meta-analytic review. J Adolesc Health. 2011;49(2):115-123. 41. Miranda-Mendizabal A, Castellvi P, Pares-Badell O, et al. Sexual orientation and suicidal behaviour in adolescents and young adults: systematic review and meta-analysis. Br J Psychiatry. 2017;211(2):77-87. 42. Mathy RM, Cochran SD, Olsen J, Mays VM. The association between relationship markers of sexual orientation and suicide: Denmark, 1990-2001. Soc Psychiatry Psychiatr Epidemiol. 2011;46(2):111-117. 43. Hatzenbuehler ML, Bellatorre A, Lee Y, Finch BK, Muennig P, Fiscella K. Structural stigma and all-cause mortality in sexual minority populations. Soc Sci Med. 2014;103:33-41. 44. Arnett JJ. Emerging Adulthood. The winding road from the late teens through the twenties. Second Edition ed. New York: Oxford University Press; 2015. 45. Tetreault PA, Fette R, Meidlinger PC, Hope D. Perceptions of campus climate by sexual minorities. Journal of homosexuality. 2013;60(7):947-964. 46. Warriner K, Nagoshi CT, Nagoshi JL. Correlates of homophobia, transphobia, and internalized homophobia in gay or lesbian and heterosexual samples. J Homosex. 2013;60(9):1297-1314. 47. Heatherington L, Lavner JA. Coming to terms with coming out: review and recommendations for family systems-focused research. J Fam Psychol. 2008;22(3):329-343. 48. Kessler RC, Bromet EJ. The Epidemiology of Depression Across Cultures. Annu Rev Public Health. 2013;34:119–138. 49. Helzer JE, Canino GJ, Yeh EK, et al. Alcoholism - North America and Asia. A comparison of population surveys with the Diagnostic Interview Schedule. Arch Gen Psychiatry. 1990;47(4):313-9. 50. Weisz JR, Sandler IN, Durlak JA, et al. Promoting and protecting youth mental health through evidence-based prevention and treatment. Am Psychol. 2005;60(6):628-48. 51. Mortier P, Demyttenaere K, Auerbach RP, et al. First onset of suicidal thoughts and behaviours in college. J Affect Disord. 2016;207:291-299. 52. Ebert DD, Cuijpers P, Mu{\~n}oz RF, Baumeister H. Prevention of Mental Health Disorders using Internet and mobile-based Interventions: a narrative review and recommendations for future research. Front Psychiatry. 2017; 10;8:116. 53. Buntrock C, Ebert DD, Lehr D, et al. Effect of a Web-Based Guided Self-help Intervention for Prevention of Major Depression in Adults With Subthreshold Depression: A Randomized Clinical Trial. JAMA. 2016;315(17):1854-1863. 54. Josephine K, Josefine L, Philipp D, David E, Harald B. Internet- and mobile-based depression interventions for people with diagnosed depression: A systematic review and meta-analysis. J Affect Disord. 2017;223:28-40. 55. van Hout BA, Al MJ, Gordon GS, Rutten FF. Costs, effects and C/E-ratios alongside a clinical trial. Health Econ. 1994;3(5):309-319. 56. Groves RM. Nonresponse Rates and Nonresponse Bias in Household Surveys. Public Opin Q. 2006;70:646-675. 57. De Luca S, Yan Y, Lytle M, Brownson C. The associations of race/ethnicity and suicidal ideation among college students: a latent class analysis examining precipitating events and disclosure patterns. Suicide Life Threat Behav. 2014;44(4):444-456. 58. Kurth AE, Martin DP, Golden MR, et al. A comparison between audio computer-assisted self-interviews and clinician interviews for obtaining the sexual history. Sex Transm Dis. 2004;31(12):719-726. 59. Viguera AC, Milano N, Laurel R, et al. Comparison of Electronic Screening for Suicidal Risk With the Patient Health Questionnaire Item 9 and the Columbia Suicide Severity Rating Scale in an Outpatient Psychiatric Clinic. Psychosomatics. 2015;56(5):460-469. 60. Hankin A, Haley L, Baugher A, Colbert K, Houry D. Kiosk versus in-person screening for alcohol and drug use in the emergency department: patient preferences and disclosure. West J Emerg Med. 2015;16(2):220-228. 61. Barendregt JJ, Doi SA, Lee, YY, et al. Meta-analysis of prevalence. J Epidemiol Community Health. 2013;67:974-8. 62. Marusic A. History and geography of suicide: could genetic risk factors account for the variation in suicide rates? Am J Med Genet C Semin Med Genet. 2005;133C:43-7. 63. Nock MK, Green JG, Hwang I, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry. 2013;70:300-10. 64. Kraemer HC, Gardner C, Brooks JOI, Yesavage JA. Advantages of excluding underpowered studies in meta-analysis: Inclusionist versus exclusionist viewpoints. Psychological Methods. 1998;3:23-31. 65. Eisenberg D, Hunt J, Speer N. Mental health in American colleges and universities: variation across student subgroups and across campuses. J Nerv Ment Dis. 2013;201:60-7.",
year = "2018",
month = "2",
day = "13",
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language = "English",
volume = "N/A",
journal = "Journal of the American Academy of Child and Adolescent Psychiatry",
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Mortier, P, Auerbach, R, Alonso, J, Bantjes, J, Benjet, C, Cuijpers, P, Ebert, D, Greif Green, J, Hasking, P, Nock, M, O'Neill, SM, Pinder-Amaker, S, Sampson, N, Vilagut, G, Zaslavsky, A, Bruffartes, R & Kessler, R 2018, 'SUICIDAL THOUGHTS AND BEHAVIORS AMONG FIRST-YEAR COLLEGE STUDENTS - RESULTS FROM THE WMH-ICS PROJECT', Journal of the American Academy of Child and Adolescent Psychiatry, vol. N/A. https://doi.org/10.1016/j.jaac.2018.01.018

SUICIDAL THOUGHTS AND BEHAVIORS AMONG FIRST-YEAR COLLEGE STUDENTS - RESULTS FROM THE WMH-ICS PROJECT. / Mortier, Philippe; Auerbach, Randy; Alonso, Jordi; Bantjes, Jason; Benjet, Corina; Cuijpers, Pim; Ebert, David; Greif Green, Jennifer; Hasking, Penelope; Nock, Matt; O'Neill, Siobhan M.; Pinder-Amaker, Stephanie; Sampson, Nancy; Vilagut, Gemma; Zaslavsky, Alan; Bruffartes, Ronny; Kessler, Ron.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. N/A, 13.02.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - SUICIDAL THOUGHTS AND BEHAVIORS AMONG FIRST-YEAR COLLEGE STUDENTS - RESULTS FROM THE WMH-ICS PROJECT

AU - Mortier, Philippe

AU - Auerbach, Randy

AU - Alonso, Jordi

AU - Bantjes, Jason

AU - Benjet, Corina

AU - Cuijpers, Pim

AU - Ebert, David

AU - Greif Green, Jennifer

AU - Hasking, Penelope

AU - Nock, Matt

AU - O'Neill, Siobhan M.

AU - Pinder-Amaker, Stephanie

AU - Sampson, Nancy

AU - Vilagut, Gemma

AU - Zaslavsky, Alan

AU - Bruffartes, Ronny

AU - Kessler, Ron

N1 - Reference text: REFERENCES 1. Nock MK, Green JG, Hwang I, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry. 2013;70(3):300-310. 2. Steinhausen HC, Bosiger R, Metzke CW. Stability, correlates, and outcome of adolescent suicidal risk. J Child Psychol Psychiatry. 2006;47(7):713-722. 3. Thompson M, Kuruwita C, Foster EM. Transitions in suicide risk in a nationally representative sample of adolescents. J Adolesc Health. 2009;44(5):458-463. 4. Organisation for Economic Co-operation and Development (OECD) (2012). Education at a Glance 2012: OECD Indicators. (https://www.oecd.org/edu/EAG%202012_e-book_EN_200912.pdf). Accessed 27 September 2017. 5. Mortier P, Kiekens G, Auerbach RP, et al. A Risk Algorithm for the Persistence of Suicidal Thoughts and Behaviors During College. J Clin Psychiatry. 2017;78(7):e828-e836. 6. Wilcox HC, Arria AM, Caldeira KM, Vincent KB, Pinchevsky GM, O'Grady KE. Prevalence and predictors of persistent suicide ideation, plans, and attempts during college. J Affect Disord. 2010;127(1-3):287-294. 7. Han B, Compton WM, Eisenberg D, Milazzo-Sayre L, McKeon R, Hughes A. Prevalence and mental health treatment of suicidal ideation and behavior among college students aged 18-25 years and their non-college-attending peers in the United States. J Clin Psychiatry. 2016;77(6):815-24.. 8. Caine ED. Forging an agenda for suicide prevention in the United States. Am J Public Health. 2013;103(5):822-829. 9. Harrod CS, Goss CW, Stallones L, DiGuiseppi C. Interventions for primary prevention of suicide in university and other post-secondary educational settings. Cochrane Database Syst Rev. 2014;10:Cd009439. 10. Mortier P, Cuijpers P, Kiekens G, et al. The prevalence of suicidal thoughts and behaviours among college students: a meta-analysis. Psychological Medicine. 2017 [Published online]. 11. Dueweke AR, Schwartz-Mette RA. Social-Cognitive and Social-Behavioral Correlates of Suicide Risk in College Students: Contributions from Interpersonal Theories of Suicide and Depression. Arch Suicide Res. 2017:1-17. 12. Wolford-Clevenger C, Elmquist J, Brem M, Zapor H, Stuart GL. Dating Violence Victimization, Interpersonal Needs, and Suicidal Ideation Among College Students. Crisis. 2015:1-8. 13. Eisenberg D, Gollust SE, Golberstein E, Hefner JL. Prevalence and correlates of depression, anxiety, and suicidality among university students. Am J Orthopsychiat. 2007;77:534-542. 14. Gillman JL, Kim HS, Alder SC, Durrant LH. Assessing the risk factors for suicidal thoughts at a nontraditional commuter school. J Am Coll Health. 2006;55(1):17-26. 15. Lee HS, Kim S, Choi I, Lee KU. Prevalence and risk factors associated with suicide ideation and attempts in korean college students. Psychiatry Investig. 2008;5(2):86-93. 16. Foo XY, Mohd Alwi MN, Ismail SIF, Ibrahim N, Jamil Osman Z. Religious Commitment, Attitudes Toward Suicide, and Suicidal Behaviors Among College Students of Different Ethnic and Religious Groups in Malaysia. J Relig Health. 2014; 53(3):731-46. 17. Reed E, Prado G, Matsumoto A, Amaro H. Alcohol and drug use and related consequences among gay, lesbian and bisexual college students: role of experiencing violence, feeling safe on campus, and perceived stress. Addictive behaviors. 2010;35:168-171. 18. The WHO World Mental Health Surveys International College Student Project (WMH-ICS) (2015) (https://www.hcp.med.harvard.edu/wmh/college_student_survey.php). Accessed 27 September 2017. 19. Posner K, Brown GK, Stanley B, et al. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168(12):1266-1277. 20. SAS/STATR Software [computer program]. SAS Institute Inc; 2010. 21. Groves RM, Couper MP. Nonresponse in Household Interview Surveys. New York: Wiley; 1998. 22. van Buuren S. Flexible Imputation of Missing Data. Boca Raton London New York: CRC Press (Taylor & Francis Group); 2012. 23. Collett D. Modeling Survival Data in Medical Research. London: Chapman & Hall; 1994. 24. Benjamini Y, Hochberg Y. Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. Journal of the Royal Statistical Society. 1995;57:289-300. 25. Evans E, Hawton K, Rodham K, Deeks J. The prevalence of suicidal phenomena in adolescents: a systematic review of population-based studies. Suicide Life Threat Behav. 2005;35(3):239-250. 26. Glenn CR, Lanzillo EC, Esposito EC, Santee AC, Nock MK, Auerbach RP. Examining the Course of Suicidal and Nonsuicidal Self-Injurious Thoughts and Behaviors in Outpatient and Inpatient Adolescents. Journal of abnormal child psychology. 2017; 45(5):971-983. 27. Rueter MA, Holm KE, McGeorge CR, Conger RD. Adolescent suicidal ideation subgroups and their association with suicidal plans and attempts in young adulthood. Suicide Life Threat Behav. 2008;38(5):564-575. 28. Peyre H, Hoertel N, Stordeur C, et al. Contributing Factors and Mental Health Outcomes of First Suicide Attempt During Childhood and Adolescence: Results From a Nationally Representative Study. J Clin Psychiatry. 2017;78(6):e622-e630. 29. McKinnon B, Gariepy G, Sentenac M, Elgar FJ. Adolescent suicidal behaviours in 32 low- and middle-income countries. Bull World Health Organ. 2016;94(5):340-350F. 30. Borges G, Benjet C, Medina-Mora ME, Orozco R, Nock M. Suicide ideation, plan, and attempt in the Mexican adolescent mental health survey. J Am Acad Child Adolesc Psychiatry. 2008;47(1):41-52. 31. Nock MK, Borges G, Bromet EJ, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008;192(2):98-105. 32. Saffer BY, Klonsky ED. The Relationship of Self-reported Executive Functioning to Suicide Ideation and Attempts: Findings from a Large U.S.-based Online Sample. Arch Suicide Res. 2016:1-18. 33. Gujral S, Ogbagaber S, Dombrovski AY, Butters MA, Karp JF, Szanto K. Course of cognitive impairment following attempted suicide in older adults. Int J Geriatr Psychiatry. 2016;31(6):592-600. 34. Szanto K, Bruine de Bruin W, Parker AM, Hallquist MN, Vanyukov PM, Dombrovski AY. Decision-making competence and attempted suicide. J Clin Psychiatry. 2015;76(12):e1590-1597. 35. Horesh N. Self-report vs. computerized measures of impulsivity as a correlate of suicidal behavior. Crisis. 2001;22(1):27-31. 36. Dour HJ, Cha CB, Nock MK. Evidence for an emotion-cognition interaction in the statistical prediction of suicide attempts. Behav Res Ther. 2011;49(4):294-298. 37. Sheftall AH, Davidson DJ, McBee-Strayer SM, et al. Decision-making in adolescents with suicidal ideation: A case-control study. Psychiatry Res. 2015;228(3):928-931. 38. Kosidou K, Dalman C, Fredlund P, Magnusson C. School performance and the risk of suicidal thoughts in young adults: population-based study. PloS one. 2014;9(10):e109958. 39. Auerbach RP, Alonso J, Axinn WG, et al. Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychol Med. 2016:46(14):2955-2970. 40. Marshal MP, Dietz LJ, Friedman MS, et al. Suicidality and depression disparities between sexual minority and heterosexual youth: a meta-analytic review. J Adolesc Health. 2011;49(2):115-123. 41. Miranda-Mendizabal A, Castellvi P, Pares-Badell O, et al. Sexual orientation and suicidal behaviour in adolescents and young adults: systematic review and meta-analysis. Br J Psychiatry. 2017;211(2):77-87. 42. Mathy RM, Cochran SD, Olsen J, Mays VM. The association between relationship markers of sexual orientation and suicide: Denmark, 1990-2001. Soc Psychiatry Psychiatr Epidemiol. 2011;46(2):111-117. 43. Hatzenbuehler ML, Bellatorre A, Lee Y, Finch BK, Muennig P, Fiscella K. Structural stigma and all-cause mortality in sexual minority populations. Soc Sci Med. 2014;103:33-41. 44. Arnett JJ. Emerging Adulthood. The winding road from the late teens through the twenties. Second Edition ed. New York: Oxford University Press; 2015. 45. Tetreault PA, Fette R, Meidlinger PC, Hope D. Perceptions of campus climate by sexual minorities. Journal of homosexuality. 2013;60(7):947-964. 46. Warriner K, Nagoshi CT, Nagoshi JL. Correlates of homophobia, transphobia, and internalized homophobia in gay or lesbian and heterosexual samples. J Homosex. 2013;60(9):1297-1314. 47. Heatherington L, Lavner JA. Coming to terms with coming out: review and recommendations for family systems-focused research. J Fam Psychol. 2008;22(3):329-343. 48. Kessler RC, Bromet EJ. The Epidemiology of Depression Across Cultures. 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PY - 2018/2/13

Y1 - 2018/2/13

N2 - Objective: College entrance may be a strategically well-placed “point of capture” for detecting late adolescents with suicidal thoughts and behaviors (STB). However, a clear epidemiological picture of STB among incoming college students is lacking. We present the first cross-national data on prevalence as well as socio-demographic and college-related correlates for STB among first-year college students.Method: Web-based self-report surveys were obtained from 13,984 first-year students (response rate 45.5%) across 19 colleges in eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States).Results: Lifetime prevalence of suicidal ideation, plans, and attempts was 32.7%, 17.5%, and 4.3%, respectively. Twelve-month prevalence was 17.2%, 8.8%, and 1.0%, respectively. About 75% of STB cases had onset before the age of 16 years (Q3 = 15.8), with persistence figures in the range 41-53%. About half (53.4%) of lifetime ideators transitioned to a suicide plan; 22.1% of lifetime planners transitioned to an attempt. Attempts among lifetime ideators without plan were less frequent (3.1%). Significant correlates of lifetime STB were cross-nationally consistent and generally modest in effect size (median adjusted OR [aOR] = 1.7). Non-heterosexual orientation (aOR range 3.3-7.9) and heterosexual orientation with some same-sex attraction (aOR range 1.9-2.3) were the strongest correlates of STB, and of transitioning from ideation to plans and/or attempts (aOR range 1.6-6.1). Conclusion: The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile. Multivariate risk algorithms based on a high number of risk factors are indicated to efficiently link high-risk status with effective preventive interventions.

AB - Objective: College entrance may be a strategically well-placed “point of capture” for detecting late adolescents with suicidal thoughts and behaviors (STB). However, a clear epidemiological picture of STB among incoming college students is lacking. We present the first cross-national data on prevalence as well as socio-demographic and college-related correlates for STB among first-year college students.Method: Web-based self-report surveys were obtained from 13,984 first-year students (response rate 45.5%) across 19 colleges in eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States).Results: Lifetime prevalence of suicidal ideation, plans, and attempts was 32.7%, 17.5%, and 4.3%, respectively. Twelve-month prevalence was 17.2%, 8.8%, and 1.0%, respectively. About 75% of STB cases had onset before the age of 16 years (Q3 = 15.8), with persistence figures in the range 41-53%. About half (53.4%) of lifetime ideators transitioned to a suicide plan; 22.1% of lifetime planners transitioned to an attempt. Attempts among lifetime ideators without plan were less frequent (3.1%). Significant correlates of lifetime STB were cross-nationally consistent and generally modest in effect size (median adjusted OR [aOR] = 1.7). Non-heterosexual orientation (aOR range 3.3-7.9) and heterosexual orientation with some same-sex attraction (aOR range 1.9-2.3) were the strongest correlates of STB, and of transitioning from ideation to plans and/or attempts (aOR range 1.6-6.1). Conclusion: The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile. Multivariate risk algorithms based on a high number of risk factors are indicated to efficiently link high-risk status with effective preventive interventions.

KW - Students

KW - suicidal behaviour

KW - mental health

U2 - 10.1016/j.jaac.2018.01.018

DO - 10.1016/j.jaac.2018.01.018

M3 - Article

VL - N/A

JO - Journal of the American Academy of Child and Adolescent Psychiatry

T2 - Journal of the American Academy of Child and Adolescent Psychiatry

JF - Journal of the American Academy of Child and Adolescent Psychiatry

SN - 0890-8567

ER -