Family risk factors for suicidal behavior: Opportunities for early identification and intervention

Abstract

In this chapter, the most common and potent familial risk and protective factors for suicidal behavior will be reviewed, namely, family history of psychiatric disorder and suicidal behavior and exposure to family adversity, such as bereavement, divorce, or maltreatment. We then will discuss strategies for identification of families and youth at risk and extant and proposed preventive interventions that could attenuate the risk for youth suicidal behavior. The following schematic (Fig. 30.1) provides a developmental framework for understanding familial risk and protective factors as targets for screening, prevention, and early intervention. Individuals are at risk for suicide and suicide attempts due to family history of suicidal behavior, psychiatric disorders, and impulsive aggression that increase the likelihood that the child will inherit these conditions, which increased offspring’s risk of suicidal behavior. In addition, family history increases the likelihood of perinatal complications, and of family adversity, both of which also increase the likelihood of child risk factors and of suicidal behavior. We first review the relationship of each of these categories of risk to suicidal outcome and then, using this developmental framework, discuss evidence-based preventive and treatment interventions that target these risk factors to decrease the risk of suicidal behavior or one of its precursors.