1 in 10 Preschoolers Have Suicidal Thoughts, Behaviors
Megan Brooks
|November 24, 2015
About 1 in 10 children as young as age 3 years may have suicidal thoughts or suggestive behaviors, and these linger into middle childhood for 3 of 4 children, particularly for those with depression or externalizing disorders, new research suggests.
Although the meaning of suicidal cognitions and behaviors at this young age remains unclear, the results suggest that they are a "clinically important phenomenon" that should not be ignored, investigators Diana J. Whalen, PhD, and colleagues write.
"Our findings suggest that clinicians may need to start asking about suicidal thoughts and behaviors in young children, particularly among those with early-onset psychiatric disorders. While we do not know exactly what suicidal thoughts and behaviors mean in young children, they are likely a signal of distress and should be taken seriously," Dr Whalen told Medscape Medical News.
The study was published in the November issue of the Journal of the American Academy of Child and Adolescent Psychiatry.
Significant and Robust Predictor
The investigators examined the correlates and consequences of suicidal cognitions and behaviors (SI) in 306 children enrolled in the prospective longitudinal Preschool Depression Study.
The children and their parents completed a baseline assessment when the children were 3 to 7 years of age. At least one follow-up assessment was conducted when the children were 7 to 12 years of age. Many children in the study had early-childhood depression and other forms of psychopathology, the investigators point out.
SI was present in 34 (11%) of the children at baseline; 25 of these children (75%) continued to experience SI at the school-age follow-up assessment (roughly 4 years later), they report.
The findings suggest that early-childhood SI is a "significant and robust predictor" of school-age SI, inasmuch as children aged 3 to 7 years who reported SI were more than three times as likely to continue reporting SI later in childhood, even after controlling for past and current psychiatric diagnoses, demographic factors, and maternal psychopathology, the authors note.
Early-childhood SI was more common in boys and was highly associated with a variety of maternal psychopathology, but not maternal or family history of suicide attempts. Early-childhood SI was also associated with attention-deficit/hyperactivity disorder and oppositional defiant disorder/conduct disorder (ODD/CD).
"This finding extends existing research on early-childhood SI by demonstrating that SI occurring during ages 3 to 7 years confers significant risk for continuation into the school-age period, particularly alongside early ODD/CD," the authors write.
"Despite these findings and a growing body of developmental work, it remains unclear exactly what young children mean when they say that they want to die or harm themselves, and a conceptual understanding of death was not tested in the current study," the investigators write. "Yet, data indicate that death/suicidal statements, behaviors, and actions among young children are strongly associated with distress and psychopathology as well as later suicidal ideation at school age, underscoring the need to attend to this symptom as an important marker of risk," they add.
A key limitation of this study is the relatively small number of young children experiencing childhood SI, the authors note. Also, the children were recruited on the basis of their having pronounced symptoms of depression; therefore, prevalence rates may be higher than would be expected for young children who had fewer symptoms of psychopathology. The SI information relied primarily on parental report, a method with several known shortcomings, including reporter bias, Dr Whalen and colleagues note.
Findings "Striking and Disturbing"
Despite these limitations, the coauthors of a linked editorial say the finding that some children as young as 3 years experience distress and despair to a degree significant enough to lead them to express the wish to die or to attempt to hurt themselves is "striking and disturbing."
The numbers of children who express suicidal thoughts and engage in these behaviors are "larger than we might have guessed," note Charles H. Zeanah, MD, and Mary Margaret Gleason, MD, of the Institute of Infant and Early Childhood Mental Health, Tulane University School of Medicine, New Orleans, Louisiana. "What this investigation could not address but is a central clinical concern is the meaning of suicidal behavior in young children," they point out.
They note that the authors' examples of young children's suicidal cognitions and behaviors include a child who hides a knife under his pillow and repeatedly says that he does not deserve to live, and another child who wants to "go to heaven" to join a beloved grandparent.
"These are quite different scenarios that imply very different levels of concern about risk and would be evaluated differently at different points in development, although contextual details can amplify or diminish concern about risk for self-harm in either of these children," Dr Zeanah and Dr Gleason note.
"The challenge emanating from this report," they conclude, "is neither to dismiss the findings because they violate notions of young children as carefree and happy nor to understand and respond to young children who display suicidal cognitions and behaviors in the same way we understand and respond to older children and adolescents who display suicidality. What the findings do call for is our best clinical efforts to recognize important indicators of serious psychopathology and distress, to discern relevant contextual features, and to intervene immediately when needed to maintain safety and relieve distress and disability."
The study was supported by the National Institutes of Health. Dr Whalen has disclosed no relevant financial relationships. One coauthor has served as a consultant to Pfizer, Amgen, Roche, and Takeda on psychosis-related work.
J Am Acad Child Adolesc Psychiatry. 2015;54:884-885, 926-937. Abstract, Editorial
Shocked that even preschoolers can't just be kids and need disorders.
Preschoolers wanting to off themselves.
How ridiculous.
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A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
My brother was diagnosed with ODD as a child. He says that he has been suicidially depressed since he was 6 years old.
This study seems to support my brother's testimony.
In many sectors of American society, children under 5 years old do not understand that death is final and inevitable. Children, between 5 and 9 years old, who do acknowledge the permanence and inevitability of death see it as something that only applies to older adults.
I remember listening to "All By Myself" and "I Can't Live If Living Is Without You" and crying, thinking about my mother. Its a thing...suicidal, not so much. Its a world view. ..at that age, mama is everything. What preschooler thinks they can live without their mother? Stupid that anyone would think they would kill themselves. ..
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America guarantees equal opportunity, not equal outcome...
I think kids understand death in a rudimentary way. I think fear of death is something that is common. Suicide seems more of something that somehow seems an option to those who perhaps were exposed to it or the concept.
And mental health issues can present early in life. Maybe we really havent looked for it. Doesnt mean it wasnt there.
In many sectors of American society, children under 5 years old do not understand that death is final and inevitable. Children, between 5 and 9 years old, who do acknowledge the permanence and inevitability of death see it as something that only applies to older adults.
flan
Depends on your experience. I think that my brother dying when i was 12 was a very pivotal moment. I think that being confronted with that really affected who i am.
In many sectors of American society, children under 5 years old do not understand that death is final and inevitable. Children, between 5 and 9 years old, who do acknowledge the permanence and inevitability of death see it as something that only applies to older adults.
flan
Depends on your experience. I think that my brother dying when i was 12 was a very pivotal moment. I think that being confronted with that really affected who i am.
I think kids understand death in a rudimentary way. I think fear of death is something that is common. Suicide seems more of something that somehow seems an option to those who perhaps were exposed to it or the concept. And mental health issues can present early in life. Maybe we really havent looked for it. Doesnt mean it wasnt there.
We are talking pre-schoolers here, not teenagers, or even 8 year olds.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
Didnt say it was. Just saying that personal expereince would have an impact.
But there is NO WAY a pre-schooler will interpret those experiences in the same way a 12 year old will. We aren't talking 12 year olds, we are talking pre-schoolers.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
I remember wanting to be gone, and not exist when I was very small, before I really understood death.
Little kids often have desires and emotions they can't understand or articulate, I don't see how suicidal tendencies would be any different.
I remember wanting to be gone, and not exist when I was very small, before I really understood death. Little kids often have desires and emotions they can't understand or articulate, I don't see how suicidal tendencies would be any different.
But that's not the same thing as wanting to harm yourself.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
Of course it can--but seeing grandma in a casket doesn't mean a 3 year old can elucidate thoughts of wanting to kill themselves.
They may have some feelings of wanting to be with grandma or whatever, but that's not the same thing as being able to define what it takes to get there.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
After pawpaw died, my cousin's 3 yr old saw a man who looked an awfully lot like pawpaw. The 3 yr old ran up and hugged this complete stranger.
He had been at pawpaw's viewing and funeral.
He didn't understand death.
So how can a 3 yr old think about death and suicide?
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A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
Yes. And if you have never had someone die you may have a different understanding than one who did. Sheesh.
Everyone has someone die, but pre-schoolers will not have the same concept of death as older children.
I was not touched by death until my mid to late twenties. Even when my grand parents died they were still virtual strangers. I saw one set once a year for five days and the other set once every five years for a weekend. They weren't intricate parts of my life even though they were blood. I know some will say I'm a horrible person for not being horrified over it but it didn't really affect me. The first death that really affected me in a personal way was a patient. We were the same age, both divorced, both raising the same number of kids that were the same age on our own. Our personalities were very much alike. Our dialysis clinic did a lot of interacting with the patients. We had bowling, picnics, kidney walks, and all kinds of things. I knew him in a more personal way than I ever knew my grandparents. It really hit home when he died suddenly of a heart attack.
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“You may shoot me with your words, you may cut me with your eyes, you may kill me with your hatefulness, but still, like air, I'll rise!” ― Maya Angelou
There are kids who get so intensely emotional in the moment and very impulsive. Combine that with some knowledge of suicide and it could be a bad mix.
And drugs.
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“You may shoot me with your words, you may cut me with your eyes, you may kill me with your hatefulness, but still, like air, I'll rise!” ― Maya Angelou
Elementary or middle school is not pre-school. You keep talking about older kids. No one is saying a 7 year old or an 11 year old might not have suicidal thoughts or even attempt it.
3 year olds? No way. If they attempt it, it's accidental.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
After pawpaw died, my cousin's 3 yr old saw a man who looked an awfully lot like pawpaw. The 3 yr old ran up and hugged this complete stranger.
He had been at pawpaw's viewing and funeral.
He didn't understand death.
So how can a 3 yr old think about death and suicide?
Suicidal thoughts and behaviors do not require an understanding of death.
Of course they do--otherwise how can they even be suicidal thoughts or behaviors?
Wanting to to be gone? Feeling so sad and lonely and invisible they want to disappear? Add that to the slightest understanding of the connection between doing dangerous things and people not coming back from that, it is very easy.
After pawpaw died, my cousin's 3 yr old saw a man who looked an awfully lot like pawpaw. The 3 yr old ran up and hugged this complete stranger.
He had been at pawpaw's viewing and funeral.
He didn't understand death.
So how can a 3 yr old think about death and suicide?
Suicidal thoughts and behaviors do not require an understanding of death.
Of course they do--otherwise how can they even be suicidal thoughts or behaviors?
Wanting to to be gone? Feeling so sad and lonely and invisible they want to disappear? Add that to the slightest understanding of the connection between doing dangerous things and people not coming back from that, it is very easy.
Not remotely the same thing.
Suicide is actively taking your own life. Even "wishing" for death is not the same thing as taking action--or even thinking about taking action--to end your life.
Many terminally ill patients "wish" for death--that doesn't mean they want to, or would, kill themselves.
-- Edited by huskerbb on Sunday 29th of November 2015 10:10:09 PM
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
Suicidal thoughts and behaviors are not even the same as suicide attempts.
Suicidal thoughts and behaviors is a broad brush, and no, I don't think it requires a very concrete understanding of death. And even three and four year olds have a basic understanding of death, even if it isn't 100% accurate.
Suicidal thoughts and behaviors are not even the same as suicide attempts. Suicidal thoughts and behaviors is a broad brush, and no, I don't think it requires a very concrete understanding of death. And even three and four year olds have a basic understanding of death, even if it isn't 100% accurate.
But suicidal thoughts still have to be about--you know--suicide which is not what you are describing.
Being "gone" isn't suicide.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
Wanting to do dangerous things so you disappear forever and are no longer sad ? Yeah. Sounds like suicidal thoughts to me.
That's not even what you said--and a pre-schooler does not make the connection between the dangerous thing and disappearing forever.
Well, personal experience and science both disagree with you, soooo
LOL!!! Personal experience? No one remembers that stuff from when they were 3. That's absurd.
I don't believe the junk science, either. I believe they led the questioning--and they are broadly defining suicidal thoughts to fall in line with your nonsensical reasoning.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
Part of the reason that babies cry when mom drops them off at daycare is that they think that mom is gone "forever". It takes awhile to even make them aware that people and things can come and go. Once they learn that, then it takes longer still for them to learn that sometimes--they don't come back.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
Plus, I don't think a 3 year old could even conceptualize a "dangerous activity" and associate it with death. POSSIBLY if they directly witnessed, say, a car/pedestrian accident they might--but that would be VERY FEW kids. Not the numbers postulated in the article.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
When I was five, I wanted to pack mud into my nose and mouth so I couldn't breath because I was having a hard time at home, and just wanted it to stop. Perhaps growing up on a farm gave me a better understanding of death, but I doubt it.
When my nieces cat died, only the baby kept asking for him. The older two, who were only three and 4 1/2 at the time, told her repeatedly that Princess Boy was dead and not coming back, that a car had squished him because he ran out into the road.
So yeah, personal experience. And not just my beices, but a number of cousins 'got it' fairly young as well.
When I was five, I wanted to pack mud into my nose and mouth so I couldn't breath because I was having a hard time at home, and just wanted it to stop. Perhaps growing up on a farm gave me a better understanding of death, but I doubt it. When my nieces cat died, only the baby kept asking for him. The older two, who were only three and 4 1/2 at the time, told her repeatedly that Princess Boy was dead and not coming back, that a car had squished him because he ran out into the road. So yeah, personal experience. And not just my beices, but a number of cousins 'got it' fairly young as well.
Five is not 3. Knowing your cat is dead does not equal suicidal thoughts.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
Plus, I don't think a 3 year old could even conceptualize a "dangerous activity" and associate it with death. POSSIBLY if they directly witnessed, say, a car/pedestrian accident they might--but that would be VERY FEW kids. Not the numbers postulated in the article.
Where are you even getting three? Preschool age can be anything from three to six. That is a wide range of development, and kids mature and learn at wildly different speeds when young.
Plus, I don't think a 3 year old could even conceptualize a "dangerous activity" and associate it with death. POSSIBLY if they directly witnessed, say, a car/pedestrian accident they might--but that would be VERY FEW kids. Not the numbers postulated in the article.
Where are you even getting three? Preschool age can be anything from three to six. That is a wide range of development, and kids mature and learn at wildly different speeds when young.
Yeah. THREE to six--and six is ready to enter kindergarten, so I would not consider them "pre-school" just because the school year has not yet started. Many 5 year olds start kindergarten, also.
So we are basically talking 3 and 4 year olds.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
When I was five, I wanted to pack mud into my nose and mouth so I couldn't breath because I was having a hard time at home, and just wanted it to stop. Perhaps growing up on a farm gave me a better understanding of death, but I doubt it. When my nieces cat died, only the baby kept asking for him. The older two, who were only three and 4 1/2 at the time, told her repeatedly that Princess Boy was dead and not coming back, that a car had squished him because he ran out into the road. So yeah, personal experience. And not just my beices, but a number of cousins 'got it' fairly young as well.
Five is not 3. Knowing your cat is dead does not equal suicidal thoughts.
Wow. Talk about stating the obvious. And deliberately missing the point.
Plus, I don't think a 3 year old could even conceptualize a "dangerous activity" and associate it with death. POSSIBLY if they directly witnessed, say, a car/pedestrian accident they might--but that would be VERY FEW kids. Not the numbers postulated in the article.
Where are you even getting three? Preschool age can be anything from three to six. That is a wide range of development, and kids mature and learn at wildly different speeds when young.
Yeah. THREE to six--and six is ready to enter kindergarten, so I would not consider them "pre-school" just because the school year has not yet started. Many 5 year olds start kindergarten, also.
So we are basically talking 3 and 4 year olds.
Look again. The article specifically states they were looking at three to six.
ETA: My mistake, three to seven.
-- Edited by Dona Worry Be Happy on Sunday 29th of November 2015 10:43:36 PM
When I was five, I wanted to pack mud into my nose and mouth so I couldn't breath because I was having a hard time at home, and just wanted it to stop. Perhaps growing up on a farm gave me a better understanding of death, but I doubt it. When my nieces cat died, only the baby kept asking for him. The older two, who were only three and 4 1/2 at the time, told her repeatedly that Princess Boy was dead and not coming back, that a car had squished him because he ran out into the road. So yeah, personal experience. And not just my beices, but a number of cousins 'got it' fairly young as well.
Five is not 3. Knowing your cat is dead does not equal suicidal thoughts.
Wow. Talk about stating the obvious. And deliberately missing the point.
Your point is nonsense. You think that simply being able to think about death means they can conceptualize how to get there. It doesn't.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
At three? I don't know. Maybe yes, maybe not. My niece certainly seemed to grasp that running out in the road=getting run over=dead=no longer here. And she was only three, just three, when it happened.
And when asked why is was important that she never run out in the road, she was able to express it was because she might get hit by a car, and die.
How well did she get it? I have no idea.
And frankly, if a kid is able to talk about death and verbalize why something us dangerous and should not be done, and be sad when something they love dies because they will never see it again, and demostrates an appreciation for dang er and fear of death, then how on earth can you possibly 'know' that they are incapable of thinking suicidal thoughts? You can't.