Strengthening associations between psychotic like experiences and suicidal ideation and behavior across middle childhood and early adolescence

Background Understanding risk factors related to suicidal ideation (SI) and suicidal behaviors (SB) in youth is important for informing prevention and intervention efforts. While it appears that psychotic-like experiences (PLEs) are strongly associated with both SI and SB at different points across the lifespan, the longitudinal nature of this relationship in middle childhood and early adolescence is understudied. Methods The study used the unique longitudinal Adolescent Brain Cognitive Development Study data. Mixed effects linear models examined associations between PLEs and SI and SB over time using three time points of data from ages 9-13. Results First, analyses indicated that endorsement of SI and SB increased as youth grew older for those with increased distressing PLEs. Analyses found evidence of bidirectional relationships between PLEs with SI and SB, with evidence that PLEs at baseline were associated with worsening SI and SB over time, including a transition from SI to SB (beta = 0.032, FDRp = 0.002). Exploratory analyses showed consistent evidence for strengthened associations over time for higher delusional ideation with both SI and SB (beta s > 0.04, FDRps < 0.001), and for perceptual distortions with SB (beta s = 0.046, FDRp < 0.001). When accounting for general psychopathology, for SB, the strengthened associations over time was significantly stronger for PLEs (beta = 0.053, FDRp < 0.001) compared to general psychopathology (beta = 0.022, FDRp = 0.01). Conclusions The present study indicates both SI and SB show strengthened associations with PLEs over time, and that baseline PLEs may predict worsening of suicidality over time. The findings are important clarifications about the nature of the associations between youth-reported PLEs and suicidality over time.

Automated summary

This study examines the longitudinal relationship between psychotic-like experiences (PLEs) and suicidal ideation (SI) and suicidal behaviors (SB) in middle childhood and early adolescence. The findings suggest that PLEs are associated with increased risk of SI and SB over time, and baseline PLEs may predict worsening of suicidality. The study highlights the importance of understanding the association between youth-reported PLEs and suicidality over time.