The Role of Adolescence in Development Paths Toward Suicide: Specificities and Shaping of Adversity Trajectories
Charles-Edouard Notredame1,2,3,4*, Nadia Chawky4,5, Guy Beauchamp4, Guillaume Vaiva 1,2,3,6 and Monique Séguin 3,4,5,7
2PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, Lille, France
3Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France
4Réseau Québécois sur le suicide, les troubles de l'humeur et les troubles associés, Douglas University Mental Health Institute, Verdun, QC, Canada
5McGill Group for Suicide Studies, Douglas University Mental Health Institute, Verdun, QC, Canada
6Centre National de Ressources et Résilience pour les Psychotraumatismes (Cn2r), Lille, France
7Department of Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
Purpose: Adolescence is a key period of transitions in the psychological, cognitive, neurobiological and relational domains, which is associated to high susceptibility to adverse life experiences. However, the way adolescent development alters life paths toward suicide remains unclear. Thereby, we aimed at testing whether and how adolescence interfered with the adversity trajectories of individuals who died by suicide.
Methods: In a sample of 303 individuals who died by suicide, longitudinal Burden of Adversity ratings were derived from extensive psychological autopsies and life trajectory narrative interviews conducted with informants. Piecewise Joint Latent Class Models allowed the identification of patterns of adversity trajectories and tested the introduction of breakpoints in life-paths. Classes inferred from the optimal model were compared in terms of socio-demographics, psychopathology, and rate of different adverse life events.
Results: The most accurate model derived 2 trajectory patterns with a breakpoint in early adolescence. In the first class (n = 39), the burden of adversity increased steadily from birth to death, which occurred at 23 (SE = 1.29). In the second class (n = 264), where individuals died at 43 years of age (SE = 0.96), the burden of adversity followed a similar trajectory during infancy but stabilized between 10 and 14 years and started to increase again at about 25. Childhood family instability, dependent events, exposure to suicide, intra-family sexual victimization and affective disorders at death were more frequent in class 1.
Conclusions: A bifurcation in trajectories between early and late suicides occurs during adolescence. The dynamic pattern of adversity during this period is a key issue to understand the developmental heterogeneity in suicide risk.
Article en ligne : https://www.frontiersin.org/articles/10.3389/fpsyt.2020.557131/full