TY - JOUR PY - 2019// TI - The role of hallucinatory experiences in the transition from suicidal thoughts to attempts: a theoretical and data-driven approach to examining the association JO - Acta psychiatrica Scandinavica A1 - Hielscher, Emily A1 - DeVylder, Jordan A1 - Connell, Melissa A1 - Hasking, Penelope A. A1 - Martin, Graham A1 - Scott, James G. SP - ePub EP - ePub VL - ePub IS - ePub N2 - OBJECTIVE: Psychotic experiences, including auditory hallucinatory experiences (HEs), are strongly associated with both suicidal thoughts and behaviour. This study examined their role in the ideation-to-attempt transition in adolescents, including their direct and indirect effect via potential mediators.

METHODS: Participants were from an Australian prospective longitudinal cohort of 1669 adolescents (12-17 years); of which a subsample endorsing baseline suicidal ideation (n=216) was the focus of most analyses. Suicidal thoughts and behaviours were measured using the Self-Harm Behaviour Questionnaire. Diagnostic Interview Schedule for Children was used to assess auditory HEs. Potential mediators of interest were psychological distress and Interpersonal Theory of Suicide (IPTS) constructs.

RESULTS: Among adolescents reporting suicidal ideation at baseline (n=216), 6.5% had attempted suicide during follow-up. The size of auditory HEs' univariate effect suggests a possible strong relationship with increased risk of incident suicide attempts (OR=2.40; 95%CI=0.76-7.56); however, there was inadequate statistical power to produce a precise estimate. When HEs were accompanied by distress there was a nine-fold increased risk of acting on suicidal thoughts. Distress was independently associated with risk of attempt transition (OR=4.09), whereas IPTS constructs were poor explanatory variables in most models.

CONCLUSION: Adolescents with psychological distress and auditory HEs are at high risk of incident suicide attempts. Further investigations on the role of negative/distressing content of hallucinations in the ideation-to-attempt transition are warranted.

© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Language: en

LA - en SN - 0001-690X UR - http://dx.doi.org/10.1111/acps.13128 ID - ref1 ER -