Developmental model of suicide trajectories

Background Most developmental studies on suicide do not take into account individual variations in suicide trajectories. Aims Using a life course approach, this study explores developmental models of suicide trajectories. Method Two hundred and fourteen suicides were assessed with mixed methods. Statistical analysis using combined discrete-time survival (DTS) and growth mixture modelling (GMM) generated various trajectories, and path analysis (Mplus) identified exogenous and mediating variables associated with these trajectories. Results Two groups share common risk factors, and independently of these major risk factors, they have different developmental trajectories: the first group experienced a high burden of adversity and died by suicide in their early 20s; and the second group experienced a somewhat moderate or low burden of adversity before they took their own life. Structural equation modelling identified variables specific to the early suicide trajectory: conduct and behavioural difficulties, social isolation/conflicts mediated by school-related difficulties, the end of a love relationship, and previous suicide attempts. Conclusions Psychosocial adversity between 10 and 20 years of age may warrant key periods of intervention.