Is externalizing psychopathology a robust risk factor for suicidal thoughts and behaviors? A meta‐analysis of longitudinal studies

Abstract

Objective Our primary objective was to determine the potency of externalizing psychopathology as a risk factor for suicidal thoughts and behaviors (STBs). Method We conducted a random effects meta‐analysis of 174 prospective studies (839 unique statistical tests) examining externalizing psychopathology and suicidal thoughts and behaviors (STBs) published prior to December 8, 2017. The weighted mean odds ratios for the overall relationship between externalizing psychopathology and STBs were below 2.00 in magnitude, and all risk factor subcategories were also fairly modest predictors of STBs. Taking publication bias into account reduced the magnitude of these associations, particularly for death. Although externalizing psychopathology modestly predicts STBs, this may be due to design limitations of existing studies. Future research should employ shorter follow‐up periods, consider risk factors in combination, and focus on forms of externalizing psychopathology that have not been studied extensively. Results The weighted mean odds ratios for the overall relationship between externalizing psychopathology and STBs were below 2.00 in magnitude, and all risk factor subcategories were also fairly modest predictors of STBs. Taking publication bias into account reduced the magnitude of these associations, particularly for death. Additionally, our results were mostly consistent regardless of sample age, sample severity, follow‐up length, and predictor scale. Conclusions Although externalizing psychopathology modestly predicts STBs, this may be due to design limitations of existing studies. Future research should employ shorter follow‐up periods, consider risk factors in combination, and focus on forms of externalizing psychopathology that have not been studied extensively.

Sleep disturbances as risk factors for suicidal thoughts and behaviours: a meta-analysis of longitudinal studies

“…However, these effects were weak, at least as examined within the methodological constraints of the literature. Our results are consistent with a growing body of evidence which demonstrates that most commonly cited risk factors only weakly predict suicide 53 , 58 , 59 . Odds ratios for each outcome ranged from 1.33 to 1.73, and effects were consistent regardless of study publication date and type of sleep measure used (i.e., self-report, clinical interview, actigraphy, or polysomnography).…”

Prevalence of suicidal ideation and attempted suicide in the general population of Ethiopia: a systematic review and meta-analysis

“…This may be attributed to the high prevalence of sexual violence and depression in female as compared to males or they might have the history of abortion which is associated with higher rates of suicide. This is supported by other evidences [58][59][60]. In Ethiopia, evidence showed the association of sexual violence, early marriage (before 18 years) with suicidal attempt [60].…”

Predicting Imminent Suicidal Thoughts and Nonfatal Attempts: The Role of Complexity

“…Moreover, our ability to predict had not improved since the inception of longitudinal suicide research; that is, it was at near-chance levels in 1965 and remained at that level through 2015 (Franklin et al, 2017). A series of finer-grained metaanalyses echoed these results, demonstrating that the factors most commonly cited as the strongest predictors of future STBs (e.g., prior suicidal behavior, hopelessness, psychopathology) still produced prediction on par with random guessing (Bentley et al, 2016;Chang et al, 2016;Huang et al, 2017a;Ribeiro et al, 2016aRibeiro et al, , 2018Smith, Velkoff, Ribeiro, & Franklin, 2018;Witte, Gauthier, Huang, Ribeiro, & Franklin, 2018).…”