220676 Bio-social interaction amplifies risk for self-harm/suicidal behavior in adolescents: Family history screening can improve public health practice

Tuesday, November 9, 2010 : 12:45 PM - 1:00 PM

Daniel Belsky, BA , Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
Self-harm/suicidal behavior (SH/SB) runs in families and is linked with harsh treatment during childhood, but little is known about comorbidity among these risk factors or synergies between them. Such synergies, superadditive increases in risk associated with comorbidity among risk factors, are suggested by studies of bio-social interaction in the etiology of SH/SB-linked psychopathology. Bio-social interactions can amplify otherwise modest risk factors and are therefore relevant to public health practice. Our study used data from a nationally representative birth cohort of 2,232 British twins followed prospectively over ages 5-12 years. We investigated synergies in risk for mother reported SH/SB at age-12 years (N=62) between family history of SH/SB or psychiatric hospitalization (N=565) and harsh treatment during childhood: history of physical maltreatment (N=93) and maternal negative expressed emotion toward the child at age-5 years (coded from speech samples by trained raters). Biometric modeling techniques were used to partition variance in SH/SB into components due to additive genetic factors, environments shared by twins in a family, and environments not shared by twins in a family. We tested for unmeasured confounding using comparisons of twins within families. We assessed synergies using the 4x2 table method. Harsh treatment during childhood was more common among children with positive family history. Positive family history and harsh treatment during childhood were associated with excess risk for SH/SB at age-12 years individually and, when comorbid, exhibited synergy consistent with bio-social interaction. Family history information can help identify youth at higher risk for SH/SB following exposure to harsh treatment.

Learning Areas:
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Name risks for suicidal/self-harming behavior during adolescence that can be identified earlier in childhood. Discuss the relevance of gene-environment interaction research to public health service delivery in the mental health field. Describe how public health practitioners can use knowledge of “synergies” between risk factors to better identify children at risk for self-harming/suicidal behavior.

Keywords: Adolescent Health, Suicide

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an author on an abstract of this content because I have worked in behavioral health research for several years, completed comprehensive exams in areas of research methods, econometrics, and theories of life course development, and have several years experience in behavioral health research. In addition, I have completed seminars specifically related to gene-environment interaction and children's health and development and have worked in this specific research area with some of the leaders in the field.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4206.0: Adolescent mental health