Exposure to suicide attempts within one’s social network = subsequent suicide attempts

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Also see: https://www.nber.org/papers/w35603?utm_campaign=ntwh&utm_medium=email&utm_source=ntwg14

The mental health of adolescents and young adults has been described as a public health crisis, with escalating rates of depression and anxiety¹ and high rates of suicide thoughts and behaviors.² Research on suicide has documented contagion effects associating exposure to suicide thoughts and behaviors in one’s social network with subsequent suicidal ideation and attempts.³ These effects have been explained using models including media copycat effects,⁴ social learning,⁵ and assortative relating⁶ and have been supported by both cross-sectional and longitudinal studies.^7,8

A systematic review examined research on exposure to suicide and subsequent suicidal behavior, with the overall evidence suggesting elevated risk among exposed individuals, although findings varied across study designs and outcomes.⁹ However, findings have not always been consistent regarding whether exposure is mainly associated with the emergence of suicidal thoughts, with the transition from thoughts to behaviors, or both. For example, Bearman and Moody¹⁰ found that exposure to friends’ suicide attempts was associated with suicidal ideation among adolescents, whereas evidence regarding progression to suicide attempts has been less consistent. Studies have also varied considerably in design, developmental period examined, exposure measurement, and the extent to which they accounted for individual mental health risk factors and broader social contexts.¹¹ Accordingly, reviews have emphasized the need for longitudinal studies that distinguish between suicidal ideation and suicide attempt outcomes and examine how social network characteristics shape risk over time.⁹

Suicide prevention practices, especially in communities of young people, often mobilize strategies to minimize contagion.¹² However, contagion effects are not distributed equally across young people. Communities facing higher levels of risky social determinants of health and young people identifying with groups that experience disproportionate adversities, including discrimination, also have greater contagion rates.¹³ Although prior studies have documented associations between exposure and suicidality,^9,11 fewer have examined whether exposure predicts suicide attempt onset independent of depressive symptoms or whether exposure is associated with changes in mental health over time. In addition, much of the suicide contagion literature predates contemporary digital social environments or does not account for online social engagement,^4,14 despite the increasingly central role of digital networks in adolescents’ and young adults’ social lives. Furthermore, adolescence and young adulthood are developmental periods characterized by heightened sensitivity to peer influence,¹⁵ making social network exposures particularly relevant for understanding suicide risk.

This longitudinal cohort study examined whether exposure to suicide attempts in respondents’ social networks was prospectively associated with suicide attempt onset, suicidal ideation onset, and depressive symptoms across 2 waves of follow-up. 

Result of study: Exposure to suicide attempts within one’s social network was associated with subsequent suicide attempt onset and higher depressive symptoms over time.