Symposia
Suicide and Self-Injury
Elizabeth Thompson, Ph.D.
Assistant Professor
Rhode Island Hospital/Alpert Medical School of Brown University
Providence, Rhode Island
Sarah Thomas, Ph.D.
Assistant Professor
Alpert Medical School of Brown University
Providence, Rhode Island
Taylor A. Burke, Ph.D.
Member of the Faculty of Psychology in the Department of Psychiatry
Harvard Medical School
Boston, Massachusetts
Jacqueline Nesi, Ph.D.
Assistant Professor
Alpert Medical School of Brown University
Providence, Rhode Island
Heather MacPherson, Ph.D.
Assistant Professor
William James College
Needham, Massachusetts
Alexandra Bettis, PhD
Assistant Professor
Vanderbilt University Medical Center
nashville, Tennessee
Anastacia Y. Kudinova, Ph.D.
Assistant Professor
Alpert Medical School of Brown University
Providence, RI
Katelyn Affleck, PhD
Clinical Psychologist
Bradley Hospital/Alpert Medical School
Riverside, Rhode Island
Jeffrey Hunt, MD
Professor
Brown University
Riverside, RI
Jennifer Wolff, Ph.D.
Associate Professor
Warren Alpert School of Medicine, Department of Psychiatry, Brown University
Providence, RI
Background: The COVID-19 pandemic has disrupted daily life for individuals across the lifespan. Psychiatrically vulnerable teens may be at heightened risk for suicide during the COVID-19 pandemic.
Method: This study characterizes suicidal ideation (SI) and suicide attempts (SA) in a sample of teens (n = 142) psychiatrically hospitalized during COVID-19 (2020). Rates of SI and SA are compared to a historical sample (n = 196) from a matched period in the year prior (2019) on the same hospital unit. Associations between specific stressors and COVID-related SI are also explored in the 2020 sample. This cross-sectional chart review utilizes hospital intake data, including self-reports of past- month and week SA, SI using the Suicidal Ideation Questionnaire-Jr (SIQ-Jr), as well as COVID-related SI and COVID-specific stressors assessed via a COVID-19 survey designed for this study.
Results: The rate of past-week SA was significantly greater in 2020 (n = 35) compared to 2019 (n = 31): 24.6% versus 15.8% (phi = 0.11). The rate of past-month SA was also significantly higher in 2020 (n = 44) compared to 2019 (n = 38): 31.0% versus 19.4% (phi = 0.13). SIQ-Jr scores were significantly greater in 2020 compared to 2019 (Hedges’ g = 0.22). Within the 2020 sample, 47.2% agreed that to some extent, they felt suicidal in relation to COVID-19. There were no differences in past-week or past-month SA rates across those who did and did not endorse COVID-SI. SIQ-Jr scores were significantly greater among those who endorsed COVID-SI versus those who did not (g = 0.80). Stressors related to missing special events (g = 0.43), changes in living circumstances (g = 0.34), financial problems (g = 0.32), and in-home conflict (g = 0.32) were associated with COVID-related SI. Among teens experiencing their first hospitalization, those who endorsed COVID-SI (n = 28/67) had higher ratings for the following stressors: being cutoff from contact with others (g = 0.53), being unable to leave home (g = 0.58), missing events (g = 0.63), and not being able to see people they care about (g = 0.52). Among teens with a history of hospitalization, those who endorsed COVID-SI (n = 39/75) had higher rates of worry about themselves contracting COVID-19 (g = 0.51).
Conclusions: This study offers preliminary evidence that COVID-19 may be contributing to suicidal thoughts and behaviors in high-risk teens. These findings underscore the need for prevention efforts aimed at mitigating the effects of social isolation and loneliness in this age group.