Self-injurious Thoughts and Behaviors among Preteens in the Child Welfare System - ABSTRACT.
Suicide is the eighth leading cause of death in children ages 5-11, and recent evidence suggests that rates of
suicide are rising disproportionately in Black children. Further, self-injurious thoughts and behaviors (SITB) –
which increase risk for suicide death -- account for a rising proportion of children's hospital emergency
department and inpatient visits. Preteens in the child welfare system (CWS) are at even greater risk for suicide
than those in the general population. However, few studies have investigated risk and protective factors,
adolescent outcomes, or examined change in SITB over time in preteens involved in the CWS. Understanding
the pathways between child maltreatment (CM) and SITB in preteens, as well as trajectories and adolescent
outcomes of preteen SITB is critical to identify and prevent suicide in CWS-involved children. The proposed
exploratory/developmental study will integrate two rich, longitudinal datasets that followed children involved
in the CWS, which is the entity that investigates CM when a report is made. These data allow for exploration of
risk pathways, outcomes, and longitudinal patterns of change within CWS-involved children. Further, because
the two studies were so consistent in design and measures, data integration will allow for more nuanced
investigations of preteen SITB in the CWS. The proposed study will identify mechanisms that confer
vulnerability to child suicide risk, discover novel targets for future therapeutic intervention, and identify early
signs of risk that could represent targets for future prevention and treatment studies. Findings from this study
will advance the science on preteen suicide risk—an area urgently in need of investigation. Importantly, the
study will help to identify targets for suicide prevention among children in the CWS, a vulnerable and
underserved group.