Does depression moderate the relationship between pain and suicidality in adolescence? A moderated network analysis

Hinze, Verena; Ford, Tamsin; Crane, Catherine; Haslbeck, Jonas M B; Hawton, Keith; Gjelsvik, Bergljot; Allwood, Matt; Aukland, Louise; Casey, Tríona; Wilde, Katherine De; Farley, Eleanor-Rose; Fletcher, Katie; Kappelmann, Nils; Kuyken, Willem; Laws, Suzannah; Lord, Liz; Medlicott, Emma; Montero-Marín, Jesús; Nuthall, Elizabeth; palmer, lucy; Petit, Ariane; Philips, Alice; Pryor-Nitsch, Isobel; Radley, Lucy; Raja, Anam; Shackleford, Jeremy; Sonley, Anna; Taylor, Laura K.; Warriner, Lucy; Williams, Joanne; Bennett, Marc; Dalgleish, Tim; Dunning, Darren L.; Griffiths, Kirsty; Knight, Rachel; Vainre, Maris; Ahmed, Saz; Blakemore, Sarah‐Jayne; Pi‐Sunyer, Blanca Piera; Foulkes, Lucy; Leung, Jovita Tung; Sakhardande, Ashok; Ukoumunne, Obioha C; Ball, Susan; Byford, Sarah; Ganguli, Poushali; Greenberg, Mark T.; Viner, Russell; Wainman, Brian

doi:10.1016/j.jad.2021.05.100

Cited by 9 publications

(6 citation statements)

References 57 publications

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“…Although this is not unexpected given suicidality rates both within and outside of the adolescent chronic pain population, it does make it difficult to compare individuals that reported suicidality with those that did not. To increase statistical power, suicidal ideation, and suicidal behavior were combined to create one dichotomous variable of suicidality 32,33. However, suicidal ideation and suicidal behavior are distinct constructs.…”

Section: Discussionmentioning

confidence: 99%

“…Reports of suicidal ideation and/or suicide behavior were aggregated in the current study to indicate an overall score of lifetime suicidality. Previous research has also grouped together experiences of suicidal ideation and/or suicide behavior as a dichotomous variable to improve statistical power 32,33…”

Section: Methodsmentioning

confidence: 99%

“…Previous research has also grouped together experiences of suicidal ideation and/or suicide behavior as a dichotomous variable to improve statistical power. 32,33 Depression Depression was measured both categorically and continuously. The categorical variable for depression was taken from the KSADS interview, 31 which asks several questions about the participant's past and current depressive symptoms, including, "Have you ever felt sad, blue, down, or empty?"…”

Section: Suicidalitymentioning

confidence: 99%

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The Relationship Between Chronic Pain, Depression, Psychosocial Factors, and Suicidality in Adolescents

Wildeboer

Chambers

Soltani

et al. 2023

The Clinical Journal of Pain

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Background: Chronic pain in youth is often associated with social conflict, depression, and suicidality. The interpersonal theory of suicide posits that there are psychosocial factors, such as peer victimization and lack of fear of pain, that may also influence suicidality. Objectives: The objective of this study was to determine whether depressive symptoms, peer victimization, and lack of fear of pain predict suicidality in adolescents with chronic pain. It was hypothesized that higher levels of depressive symptoms and peer victimization, and lower levels of fear of pain, would predict a higher lifetime prevalence of suicidality. Methods: Participants consisted of 184 youth with primary chronic pain conditions (10 to 18 y, M = 14.27 y). Measures included diagnostic clinical interviews assessing suicidality and self-report questionnaires assessing depressive symptoms, peer victimization, and fear of pain. Results: Forty-two (22.8%) participants reported suicidality. Regression analyses demonstrated that the occurrence of suicidality was associated with higher rates of depressive symptoms (β = 1.03, P = 0.020, 95% CI: 1.01, 1.06) and peer victimization (β = 2.23, P < 0.05, 95% CI: 1.07, 4.63), though there was no association between lower fear of pain and suicidality. Discussion: These results suggest that depressive symptoms and peer victimization are significant predictors of suicidality in adolescents with chronic pain; however, lower fear of pain was not shown to be a significant predictor. Given these findings, depression and peer victimization should be further explored and considered in the design and implementation of prevention and early intervention strategies that target chronic pain and suicidality in youth.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Suicidalitymentioning

confidence: 99%

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The Relationship Between Chronic Pain, Depression, Psychosocial Factors, and Suicidality in Adolescents

Wildeboer

Chambers

Soltani

et al. 2023

The Clinical Journal of Pain

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“…Suicidality may be classified into three stages-ideation, planning, and attempt-with each successive stage more severe than and theorized to be causally progressing from its preceding stage 12 . Research has suggested that the pathway to suicidality in an individual, particularly suicidal ideation, may begin from episodes of psychological distress or pain such as those triggered by stressful life events [13][14][15] . Studies have long observed that prolonged psychological distress may lead to conditions such as depression, anxiety, feelings of hopelessness, lack of sleep, and poor interpersonal relationships 12,16,17 , which are themselves wellestablished risk factors of suicidality [18][19][20][21][22] .…”

Section: Introductionmentioning

confidence: 99%

Preventing comorbidity between distress and suicidality: a network analysis

Junus

Yip

2023

npj Mental Health Res

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Suicidality among individuals between 10 and 35 years of age may be poised to exert massive burdens on society through decreased economic productivity and increased incidence of chronic physical conditions in the individuals’ later years, thereby necessitating early prevention of suicide. While research suggests that the pathway to suicidality may begin from episodes of psychological distress, such pathway may involve complex interplays between intermediary psychiatric symptoms and external stimuli that are not easily delineated through conventional means. This study applies the network approach to psychopathology to elucidate this complexity. Comorbidity between psychological distress and suicidality in 1968 community-dwelling individuals is analyzed with regularized partial correlation networks to identify their bridge symptoms and links. Temporal relationships between symptoms are analyzed through temporal symptom network formed from 453 individuals who completed subsequent follow-up surveys. Network analysis shows that feelings of hopelessness and the presence of suicidal ideation are the strongest bridge symptoms in the comorbidity symptom network, and form the only prominent link that bridges psychological distress and suicidality. Effects of sleep troubles, anxiety, and poor social relationships on suicidal ideation appear to be mediated by hopelessness. The same observations hold among individuals with and without diagnoses of psychiatric disorders, as well as young people (10–24 year-olds) and young adults (25–35 year-olds). The edge between hopelessness and suicidal ideation remains the strongest bridge link after controlling for effects of symptoms from the previous time point. Findings here provide an evidence base for both professional training in caregiving professions as well as gatekeeper training in community members to emphasize more on how to effectively recognize hopelessness, and instill hope, in young people and young adults for various types of distress.

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“… 4 Pain is associated with psychiatric comorbidities, including depression and anxiety, 5 and at its worst suicidality, even in the absence of depression. 6 , 7 The term ‘Suicidality’ will be used as an umbrella term, referring to the full spectrum of suicidal risk, ranging from thoughts about suicide and self-harm to the enactment of these thoughts. Thoughts and acts of self-harm, defined as intentional self-injury or self-poisoning irrespective of suicidal intent, 8 are also a major concern in adolescence (10–30%).…”

Section: Introductionmentioning

confidence: 99%

Service use and costs in adolescents with pain and suicidality: a cross-sectional study

et al. 2023

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Does depression moderate the relationship between pain and suicidality in adolescence? A moderated network analysis

Cited by 9 publications

References 57 publications

The Relationship Between Chronic Pain, Depression, Psychosocial Factors, and Suicidality in Adolescents

The Relationship Between Chronic Pain, Depression, Psychosocial Factors, and Suicidality in Adolescents

Preventing comorbidity between distress and suicidality: a network analysis

Service use and costs in adolescents with pain and suicidality: a cross-sectional study

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