Factors differentiating adolescents who consider suicide and those who attempt: Results from a National Survey of Australian Adolescents

Objective: Few studies have assessed factors which may influence an individual's risk of acting on their suicidal thoughts. The current study explores whether affective, behavioural or interpersonal factors are effective in discriminating between adolescents who only think about suicide, and those who attempt suicide. Method: From a sample of 2,655 families randomly selected across Australia, several putative risk factors were compared between adolescents aged 12–17 years who had only thought about suicide, (N = 146; female = 69.4%, average age = 15.3) and those who attempted suicide (N = 74; female = 68.7%, average age = 15.6) using multivariate logistic regression. Results: Poor family functioning (OR = 10.1), weekly cigarette smoking (OR = 4.5) and the number of mental health disorders (β = 1.7) were all associated with an increased risk of acting on suicidal thoughts. The model performed adequately in differentiating those who think about suicide and those who attempt (AUC = 85.1, PPV = 60.1%, sensitivity = 51.5%, specificity = 83.3%). Detection of suicide attempts among the full sample was lower (AUC = 0.94, PPV = 60.0%, sensitivity = 30.9%, specificity = 99.4%). Conclusions: Risk assessments and interventions for suicide may benefit from taking into account interpersonal and behavioural difficulties an adolescent may have. Future research is needed to further understand what drives the transition from suicidal thoughts to suicide attempts.