Neurocognitive and Temperament Predictors of Changes in Child and Adolescent Suicidal Thoughts and Behaviors for Youths With and Without Attention-Deficit/Hyperactivity Disorder

Abstract

Suicidal thoughts and behaviors (STBs) are an urgent concern, with elevated risk in attention-deficit/hyperactivity disorder (ADHD). Drawing on the developmental psychopathology framework and socio-ecological model of suicide risk, this study examined trajectories of STBs in youth with and without ADHD and their prediction via individual and interpersonal factors. Data from 849 participants (nADHD=509), aged 7–13, were collected over 13 years using multiple informants (parent, teacher, youth) and methods (cognitive tasks, self-report, five-minute speech sample). Trajectories were best captured by a piecewise latent growth curve model representing STBs in childhood and adolescence. Higher parental criticism predicted persisting childhood STBs. In adolescence, female sex and less temperamental fear predicted increasing adolescent STBs, while greater temperamental openness predicted increasing adolescent STBs for females and youth with lower baseline working memory. ADHD symptoms alone did not drive risk; instead, individual and interpersonal factors emerged as key predictors. Prevention efforts should integrate these multidimensional considerations.