The current prospective naturalistic study is designed to study the course, predictors, and covariates over time of suicidal behavior among presumably high risk adolescents. One hundred and eighty adolescents previously admitted to an inpatient psychiatric unit will be repeatedly assessed with standardized measures at regular six month time intervals for 36 to 48 months following their discharge from the hospital. Approximately half of these adolescents will have made previous suicide attempts and half will not have histories of suicidal behavior. Risk for suicide attempts will be examined both as a function of variables assessed at hospitalization, and variables assessed repeatedly over the follow-up interval. Psychiatric variables to be examined in relation to suicidal behavior include previous history of suicidal behavior, psychiatric diagnosis, severity of mood and psychiatric symptomatology, and family psychiatric history. Cognitive variables include interpersonal problem-solving ability, hopelessness, and perceived reasons for living. To account for their potentially additive and interacting effects, a number of sociodemographic variables will also be assessed including gender, race, age, and socioeconomic status and family composition. The study is the first study to use repeated assessments longitudinal methodology to more accurately determine the degree to which adolescent inpatients with a history of suicide attempts are at continued risk over time for future suicide attempts. In addition, this study uses a psychiatrically hospitalized control group to examine in a prospective manner the degree to which previously suicidal youth are at greater risk than other behaviorally disturbed youth referred for psychiatric hospitalization, the degree to which any increased risk is constant of fluctuates over time. The study also will use repeated measures methodology to examine the degree to which psychiatric and cognitive variables predict later suicide attempts, the stability over time of purported psychiatric and cognitive risk factors for suicide attempts, and the interrelationship of purported psychiatric and cognitive predictors of suicidal behavior over time. Last, because an integral part of the proposed study is the repeated psychiatric interview data, the study allows for the prospective investigation of the course of various psychiatric disorders in relation to risk for suicide attempts.
