Parental suicide attempt and offspring educational attainment during adolescence in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort

Neurocognition and academic achievement among bereaved children in the Generation R Cohort

Childhood bereavement is an adverse event, yet children demonstrate considerable variability in health outcomes. Bereaved children are at risk of lower lifelong educational attainment, though the contribution of neurocognitive performance is yet to be investigated. Using data from the population-based Generation R Study wherein nearly 10,000 pregnant mothers were recruited between 2002 and 2006, we estimated the association of bereavement by age 10 years with four subtests of cognitive function and academic achievement at 13 years. Bereavement by 10 years of age was experienced by n = 796 (37.3%) of youth and was associated with a 1.12-point (SD = 0.55; p-value = 0.04) lower full-scale IQ at 13 years, which was mainly driven by lower matrix reasoning scores (βadjusted = -0.27, SE = 0.11, p < 0.02). There were no differences in academic achievement or other subtests of neurocognitive function between bereaved and non-bereaved children. Secondary analyses adjusting for pre-bereavement nonverbal cognitive ability and mental health problems revealed an overall association between bereavement and subsequent full-scale IQ and matrix reasoning, but only among those youth whose caregivers reported that the loss had an emotional influence on the child. These novel findings leveraging prospective assessments in a population-based birth cohort highlight risk and resilience mechanisms warranting further research.

Connection between maternal suicide attempt and chronic morbidity in children

BACKGROUND

Maternal suicide attempts are associated with adverse psychosocial outcomes in children, but the association with chronic morbidity is poorly understood. We examined the relationship between maternal suicide attempt and risk of hospitalization for potentially preventable conditions in offspring.

METHODS

We analyzed a longitudinal cohort of 1 032 210 children born in Quebec, Canada between 2006 and 2019. The main exposure measure was maternal suicide attempt before or during pregnancy. Outcomes included child hospitalizations for potentially preventable conditions, including infectious diseases, dental caries, atopy, and injury up to 14 years after birth. We used adjusted Cox proportional hazards regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of maternal suicide attempt with risk of hospitalization for these outcomes.

RESULTS

Compared with no suicide attempt, children whose mothers attempted suicide had an increased risk of hospitalization for infectious diseases (HR 1.11, 95% CI 1.06-1.16), dental caries (HR 1.31, 95% CI 1.15-1.48), and injury (HR 1.16, 95% CI 1.03-1.31). Risk of hospitalization for any of these outcomes was greater if mothers attempted suicide by hanging (HR 1.46, 95% CI 1.22-1.75), had their first attempt between the age of 25 and 34 years (HR 1.27, 95% CI 1.13-1.42), and had 3 or more attempts (HR 1.56, 95% CI 1.27-1.91). Maternal suicide attempts were more strongly associated with child hospitalization before 10 years of age.

CONCLUSIONS

Children whose mothers have a history of suicide attempt have an elevated risk of hospitalization for potentially preventable conditions.

Association between family history of suicide attempt and neurocognitive functioning in community youth

BACKGROUND

Suicidal behavior is highly familial. Neurocognitive deficits have been proposed as an endophenotype for suicide risk that may contribute to the familial transmission of suicide. Yet, there is a lack of research on the neurocognitive functioning of first-degree biological relatives of suicide attempters. The aim of the present study is to conduct the largest investigation to date of neurocognitive functioning in community youth with a family history of a fatal or nonfatal suicide attempt (FH).

METHODS

Participants aged 8-21 years from the Philadelphia Neurodevelopmental Cohort completed detailed clinical and neurocognitive evaluations. A subsample of 501 participants with a FH was matched to a comparison group of 3,006 participants without a family history of suicide attempt (no-FH) on age, sex, race, and lifetime depression.

RESULTS

After adjusting for multiple comparisons and including relevant clinical and demographic covariates, youth with a FH had significantly lower executive function factor scores (F[1,3432] = 6.63, p = .010) and performed worse on individual tests of attention (F[1,3382] = 7.08, p = .008) and language reasoning (F[1,3387] = 5.12, p = .024) than no-FH youth.

CONCLUSIONS

Youth with a FH show small differences in executive function, attention, and language reasoning compared to youth without a FH. Further research is warranted to investigate neurocognitive functioning as an endophenotype for suicide risk. Implications for the prevention and treatment of suicidal behaviors are discussed.

Systematic Literature Review of Attempted Suicide and Offspring

Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic literature search. Results: The search resulted in a total of 1275 article titles, of which all abstracts were screened. Out of these, 72 full text papers were read, and a final four articles were included. Three of the included papers described parts of the same study from an emergency department in The Hague, where a protocol was implemented for monitoring and referring children of parents attempting suicide. The fourth article described the association between maternal attempted suicide and risk of abuse or neglect of their children. Conclusions: The lack of research in this particular area is striking. The circumstances surrounding a parent’s suicide attempt call for appropriate familial care.

Is adolescent alcohol use associated with self-reported hypomanic symptoms in adulthood? - Findings from a prospective birth cohort

High rates of alcohol use disorder (AUD) are reported in people with major depression (MD) and bipolar disorder (BD). Substance abuse problems in adolescence may also indicate risk for future onset of mood disorders, especially BD. Data collected from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large UK birth cohort, allowed information to be collected over several different time points and to test whether problematic alcohol use at age 16 was predictive of vulnerability to hypomanic symptoms at age 23. Controlling for a participant's gender, SES, marital status of the mother, a likely history of maternal depression, and adolescents' level of depressive symptoms at age 16, a hierarchical linear regression revealed that self-reported alcohol use in adolescence predicted the future onset of hypomanic/manic symptoms. Limitations include attrition and relying solely on self-ratings. Despite these limitations, the results suggest problematic alcohol use in adolescence predicts a vulnerability to hypomanic or manic symptoms.