Reasons Why: Contributors of Suicide Risk among a Community Sample of Young People with Psychosis-like Experiences

Abstract

Adolescents and young adults who experience higher levels of psychosis-like experiences (PLEs) also experience elevated rates of suicidal thoughts, suicide attempts, and deaths by suicide, as compared to the general population. Though there has been a recent burst of literature examining the relation between PLEs and suicidal thoughts and behaviors (STB), there is still a limited understanding of the factors that contribute to the heightened risk for STB among people with higher levels of PLEs. Among a sample of young people with higher levels of PLEs (N = 234), this study introduced The Suicide History Assessment for People with Psychosis-spectrum Experiences (SHAPE), a suicide risk assessment developed to measure relevant general and psychosis-spectrum-specific risk factors of STB. The present study (1) evaluated the relation between subtypes of PLEs and STB, (2) compared clinical characteristics of youth who reported that their PLEs impacted their suicidal thoughts to those who did not report a connection, (3) identified participant-rated general risk factors of suicidal thoughts among youth who experienced higher levels of PLEs, and (4) examined the sum of participant-identified general risk factors as a mediator of the relation between PLEs and STB. Hypotheses were partially supported. Results from this pilot study confirmed a relation between PLEs and suicide risk severity, as well as differential relations between PLE subtypes and suicide risk severity. A subset of participants reported that subtypes of PLEs impacted their suicidal thoughts, and this subsample presented with more clinically severe symptoms than those who did not identify a connection between symptoms. General suicide risk factors contributed to suicidal thoughts among people with high levels of PLEs, and these risk factors differed based on whether participants experienced high versus low levels of PLEs. Finally, the sum of these risk factors mediated the relation between distressing PLEs and suicide risk severity. Information gleaned from this study informed revisions and additions to the SHAPE and helped to identify relevant risk factors for STB among people with PLEs.