- Previous research on suicide has suggested contagion effects linking exposure to suicide thoughts and behaviors in one’s social network with subsequent suicidal ideation and attempts.
- Among teens and young adults in a cohort study who did not have a prior suicide attempt, exposure to a suicide attempt within one’s social network was associated with greater odds of subsequent suicide attempt onset.
- Of note, exposure to a suicide attempt in one’s social network was not linked to suicidal ideation onset.
Knowing someone who had attempted suicide was associated with subsequent attempts in teens and young adults, a cohort study suggested.
Among people ages 13 to 22 who did not have a prior suicide attempt, exposure to a suicide attempt within one’s social network was associated with greater odds of subsequent suicide attempt onset (OR 2.78, 95% CI 1.78-4.33, P<0.001), reported Kimberly Mitchell, PhD, of the University of New Hampshire in Durham, and Victoria Banyard, PhD, of Rutgers University in New Brunswick, New Jersey.
This association remained significant after adjusting for depressive symptoms (OR 2.43, 95% CI 1.51-3.91, P<0.001), they wrote in JAMA Network Open.
In recent years, rates of depression and anxiety have jumped in teens and young adults, as have rates of suicidal thoughts and behaviors.
“Research on suicide has documented contagion effects associating exposure to suicide thoughts and behaviors in one’s social network with subsequent suicidal ideation and attempts,” Mitchell and Banyard noted.
“We know that suicidal behavior does not occur in a social vacuum,” Mitchell told MedPage Today in an email. “Adolescence and young adulthood are periods when peers and social networks are especially influential, and young people’s social worlds now span both in-person and online environments.”
However, “much of the research on suicide contagion has been cross-sectional, has focused on suicidal thoughts, or predates today’s digital social environment,” she added.
Of note, exposure to a suicide attempt in one’s social network was not linked to suicidal ideation onset. It was, however, associated with higher depressive symptoms over time (within-person b 0.13, 95% CI 0.08-0.17; between-person b 0.46, 95% CI 0.38-0.54).
“The distinction between suicidal thoughts and suicide attempts was particularly striking,” Mitchell said. “We initially expected exposure to suicide attempts within a young person’s social network to predict both new suicidal ideation and new suicide attempts.”
These findings suggest that this type of exposure “may be relevant not simply to the emergence of suicidal thoughts, but potentially to the progression from vulnerability to suicidal behavior,” she noted.
“I think that distinction is important, although our study cannot tell us why it occurs,” she added. “Exposure could affect perceptions about the feasibility of suicidal behavior, transmit distress through social networks, reflect shared stressful environments, or operate through other social processes. Understanding those mechanisms is an important next step.”
One implication of the study’s findings for clinicians is that “suicide risk assessment may benefit from looking beyond an individual’s symptoms and asking about what has recently happened within their social network,” Mitchell suggested.
However, “I would not interpret exposure as meaning that a young person will attempt suicide — the absolute risk remains low, and our findings are associations rather than evidence that exposure causes an attempt,” she said. “Rather, recent exposure may be an additional signal that warrants attention, particularly when considered alongside other clinical and contextual risk factors.”
The findings “may also have implications for postvention,” or interventions conducted after a suicide, she pointed out. “Proactive outreach, screening, and access to support within schools and other youth-serving settings may help identify young people who need additional support.”
For this longitudinal study, Mitchell and Banyard used three waves of data (baseline, 12 months, and 24 months) from Project Lift Up, a survey of U.S. adolescents and young adults recruited through social media from June 2022 through October 2023.
Among 2,098 participants, mean age was 17.5 years, 60% were female, 49.9% identified as a sexual minority, 44.8% identified as a racial or ethnic minority, and 27.4% identified as a gender minority.
Assessment of suicide attempt among someone known to the participant did not distinguish whether awareness resulted from direct observation, interpersonal disclosure, communication from others, or online communication, Mitchell and Banyard noted.
Limitations to the study included that outcome measures were based on self-report and may have been subject to recall and reporting bias. Residual confounding was also possible, the authors said.
