Pathways From ADHD Symptoms to Suicidal Ideation During College Years: A Longitudinal Study on the i-Share Cohort

Abstract

Objective: To estimate the association between ADHD symptoms and suicidal ideation in college students, and to test mediation by depressive symptoms or self-esteem. Method: Based on the i-Share cohort (prospective cohort of 2,331 college students in France). Self-reported measures included ADHD symptoms at baseline, self-esteem and depressive symptoms at 3 months, and suicidal ideation at 1-year follow-up. We conducted path analysis to estimate total, direct, and indirect effect. Results: Participants with high ADHD symptoms were more likely to report suicidal ideation 1 year later ( p < .0001). Indirect effects through depressive symptoms ( p < .0001) and self-esteem ( p < .0001) explained 44% and 25% of this association, respectively. An indirect pathway via a combination of self-esteem, then depressive symptoms, was also identified ( p < .0001), explaining 19% of the total effect. The direct effect was not significant ( p = .524). Conclusion: ADHD symptoms seem to have no direct but indirect effect through both self-esteem and depressive symptoms on suicidal ideation.

The Mediating Roles of Mental Health and Substance Use on Suicidal Behavior Among Undergraduate Students With ADHD

“…The influence of depression in the context of ADHD may place individuals at high risk for SI, plans, attempts, and NSSI. This finding is in concordance with findings presented by Van Eck et al (2015) , Arsandaux et al (2021) , and Zhong et al (2021) . Furthermore, the current study demonstrates the indirect role that substance use plays in the association between ADHD and SI, plans, and attempts.…”

“…Direct links between ADHD and suicidality have been reported and even after adjusting for the presence of co-morbid disorders, individuals with ADHD demonstrated an increased risk of suicide ( Chen et al, 2019 ; Eddy et al., 2020 ; Ljung et al, 2014 ). Nevertheless, alternative findings imply that this association is in fact entirely mediated by the presence of co-morbid disorders, particularly mood and anxiety disorders ( Arsandaux et al, 2021 ; Balazs et al, 2014 ; Zhong et al, 2021 ). Indeed, associations between depression and suicidality have been well established and mood and anxiety disorders are some of the strongest predictors of suicidal behavior in young adults ( Boden et al, 2007 ; Wang et al, 2019 ).…”

A machine learning approach for predicting suicidal thoughts and behaviours among college students

“…Low self-esteem is known to be a part of social anxiety, and to overlap with depression, both of which are associated with STB 44 . Self-esteem, which is an important marker of psychological vulnerability in young adults 45 – 47 has also been found associated with suicidality 48 . Our study showed that self-esteem is an independent and prominent predictive marker of STB and should therefore be used in a screening tool.…”

Predicting suicidal thoughts and behaviors among college students: a machine learning approach

“…Low self-esteem is known to be a part of social anxiety, and to overlap with depression, both of which are associated with STB. 28 Selfesteem, which is an important marker of psychological vulnerability in young adults [29][30][31] has also been found associated with suicidality. 32 Our study showed that self-esteem is an independent and prominent predictive marker of STB and should therefore be used in a screening tool.…”