Temperament and adolescent suicide attempts: a case-control study with multi-ethnic Asian adolescents

BACKGROUND: Suicide is the leading cause of death for adolescents in several parts of Asia, including Singapore. This study examines the relationship between temperament and youth suicide attempts in a sample of multi-ethnic Singaporean adolescents. METHODS: A case-control design compared 60 adolescents (M(age) = 16.40, SD(age) = 2.00) with a recent suicide attempt (i.e., past 6 months) with 58 adolescents (M(age) = 16.00, SD(age) = 1.68) without any history of suicide attempts. Presence of suicide attempts was established using the semi-structured interviewer-administered Columbia Suicide Severity Rating Scale. Participants also completed self-report measures on temperament traits, psychiatric diagnoses, stressful life events, and perceived parental rejection in an interview-based format. RESULTS: Psychiatric comorbidity, recent stressful life events, perceived parental rejection, and all five “difficult temperament” traits, were significantly overrepresented among adolescent cases relative to healthy controls. Adjusted logistic regression models revealed significant associations between suicide attempt, MDD comorbidity (OR: 10.7, 95% Cl: (2.24–51.39)), “negative mood” trait (OR: 1.12–1.18, 95% Cl: (1.00–1.27)), and the interaction term of “positive mood” and “high adaptability” traits (OR: 0.943 – 0.955, 95% Cl: (0.900 − 0.986)). Specifically, “positive mood” predicted lower likelihood of a suicide attempt when “adaptability” was high (OR: 0.335 – 0.342, 95% Cl: (0.186 − 0.500)) but not low (OR: 0.968 – 0.993, 95% Cl: (0.797 − 1.31)). CONCLUSION: Temperament screening may be important to identify adolescents at higher or lower risk of suicide at an early stage. More longitudinal and neurobiological research converging on these temperament findings will be helpful in ascertaining temperament screening as an effective suicide prevention methodology for adolescents.