Longitudinal Associations between Suicidality and Biopsychosocial Factors in Adolescence

Importance: Adolescent suicidality poses a significant public health concern, with multifaceted determinants. Global prevalence rates of suicidal ideation in adolescence range between 15-25%; understanding the biopsychosocial context in which suicidality develops is essential for assessment, prevention and treatment efforts. Objective: To determine whether a biopsychosocial model of suicidality, specifically sleep, nutrition, physical exercise, mindfulness, social connectedness, lower socioeconomic status, and sex are uniquely associated with increased suicidality, longitudinally over adolescence. Design: This study utilised self-reported data collected from the same individuals at 4-monthly intervals, for up to 5 years, between 18 July 2018 - 31 January 2024 from the ongoing Longitudinal Adolescent Brain Study (LABS). Setting: Data was collected on-site at the Thompson Institute, University of the Sunshine Coast, or remotely, at the participant’s home when it wasn’t possible to attend in-person (for example during COVID lockdown). A trained researcher was always present.Participants: The Australian adolescent volunteer sample included N=159 participants (n=91 female; 68 male) aged 12 to 15 years at intake who were proficient in English and were not suffering from a major neurological disorder, intellectual disability, or a sustained head injury. Main outcomes and measures: Suicidal Ideation Attributes Scale, Mindful Attention Awareness Scale for Adolescents, Social Connectedness Scale, Food Frequency Questionnaire, Pittsburgh Sleep Quality Index, Moderate-to-Vigorous Physical Activity, Kessler-10, Socio-Economic Indexes for Areas Australia, age and sex.Results: Generalised estimating equations for N=159 adolescents aged 12-17-years identified significant relationships between increased suicidality and biological sex (odds ratio =1.7, 95% CI 1.0-2.7, p = .35), poor sleep (odds ratio 2.7, 95% CI 1.6-4.3, p = <.001), socioeconomic disadvantage (SES Quintile 1: odds ratio 6.7, 95% CI 1.9-24.5, p = .004; SES Quintile 2: odds ratio 10.4, 95% CI 2.6-40.9, p = <.001; SES Quintile 4: odds ratio 3.0, 95% CI 1.1-7.8, p = .025), and higher psychological distress (odds ratio 5.9, 95% CI 2.8-12.4, p = <.001).Conclusions and relevance: This research contributes to our understanding of how biopsychosocial factors can be incorporated into targeted interventions and policies aimed at reducing adolescent suicidality.