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Parental Psychiatric Disease and Risks of Attempted Suicide and Violent Criminal Offending in Offspring: A Population-Based Cohort Study.

ABSTRACT: Importance:Self-directed and interpersonal violence share some common risk factors such as a parental history of mental illness. However, relationships between the full spectrum of parental psychiatric disease and these 2 related outcomes are unclear. Objective:To examine associations between the full spectrum of parental psychiatric disease and risks of attempted suicide and violent offending among offspring. Design, Setting, and Participants:Population-based cohort study of all persons born in Denmark 1967 through 1997, followed up from their 15th birthday until occurrence of adverse outcome or December 31, 2012, whichever came first. Exposures:Array of parental psychiatric disorders and parental suicide attempt, delineated from records of secondary care treatments. Main Outcomes and Measures:Using survival analyses techniques, incidence rate ratios were estimated for offspring suicide attempt and violent offending. Results:We examined 1?743?525 cohort members (48.7% female; total follow-up, 27.2 million person-years). Risks for offspring suicide attempt and violent offending were elevated across virtually the full spectrum of parental psychiatric disease. Incidence rate ratios were the most elevated for parental diagnoses of antisocial personality disorder (suicide attempt, 3.96; 95% CI, 3.72-4.21; violent offending, 3.62; 95% CI, 3.41-3.84) and cannabis misuse (suicide attempt, 3.57; 95% CI, 3.25-3.92; violent offending, 4.05; 95% CI, 3.72-4.39), and for parental suicide attempt (suicide attempt, 3.42; 95% CI, 3.29-3.55; violent offending, 3.31; 95% CI, 3.19-3.44). Parental mood disorders (and bipolar disorder in particular) conferred more modest risk increases. A history of mental illness or suicide attempt in both parents was associated with double the risks compared with having just 1 affected parent. Associations between parental psychiatric disease and offspring violent offending were stronger for female than for male offspring, whereas little sex difference in risk was found for offspring suicide attempt. Conclusions and Relevance:The similarities in risk patterns observed between the 2 outcomes may evidence a shared etiology. Early interventions to tackle parental mental disorders may be beneficial to both parents and children.

SUBMITTER: Mok PL

PROVIDER: S-EPMC5079483 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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Parental Psychiatric Disease and Risks of Attempted Suicide and Violent Criminal Offending in Offspring: A Population-Based Cohort Study.

Mok Pearl L H PL Pedersen Carsten Bøcker CB Springate David D Astrup Aske A Kapur Nav N Antonsen Sussie S Mors Ole O Webb Roger T RT

JAMA psychiatry 20161001 10

<h4>Importance</h4>Self-directed and interpersonal violence share some common risk factors such as a parental history of mental illness. However, relationships between the full spectrum of parental psychiatric disease and these 2 related outcomes are unclear.<h4>Objective</h4>To examine associations between the full spectrum of parental psychiatric disease and risks of attempted suicide and violent offending among offspring.<h4>Design, setting, and participants</h4>Population-based cohort study ...[more]

PMID: 27580483

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Project description:Importance:Childhood adversity (CA) is associated with an increased risk of suicide in young adulthood that might be explained by maladaptive trajectories during adolescence. Although adolescent violent offending is linked with suicide, little is known about its role in the association between CA and suicide. Objective:To examine whether adolescent violent offending mediates the association between CA and suicide in early adulthood. Design, Setting, and Participants:This population-based, longitudinal cohort study with a follow-up time spanning 5 to 9 years included 476?103 individuals born in Sweden between 1984 and 1988. The study population was prospectively followed up from 20 years of age until December 31, 2013, with respect to suicide. Data analysis was performed from January 1, 1984, to December 31, 2013. Exposures:Register-based CAs included parental death, parental substance abuse and psychiatric disorder, parental criminal offending, parental separation, public assistance recipiency, child welfare intervention, and residential instability. Adolescent violent offending was defined as being convicted of a violent crime between the ages of 15 and 19 years. Main Outcomes and Measures:Estimates of risk of suicide after 20 years of age (from 2004 if born in 1984 and from 2008 if born in 1988) until the end of 2013 were calculated as incidence rate ratios (IRRs) with 95% CIs using Poisson regression analysis. Adjustments were made for demographics and psychiatric disorder. In addition, binary mediation analysis with logistic regression was used. Results:A total of 476?103 individuals (231 699 [48.7%] female) were included in the study. Those with a conviction for violent offending had been exposed to all CAs to a greater extent than those with no violent offending. Cumulative CA was associated with risk of suicide in nonconvicted (adjusted IRR, 2.4; 95% CI, 1.5-3.9) and convicted youths, who had a higher risk of suicide (adjusted IRR, 8.5; 95% CI, 4.6-15.7). Adolescent violent offending partly mediated the association between CA and suicide. Conclusions and Relevance:Individuals with a history of CA who also engage in violent offending in adolescence have a high risk of suicide. Interventions to prevent externalizing behavior during childhood and increased support to youths with delinquent behavior may have the potential to prevent suicide related to CA.

Project description:ImportanceLead is a neurotoxin with well-documented effects on health. Research suggests that lead may be associated with criminal behavior. This association is difficult to disentangle from low socioeconomic status, a factor in both lead exposure and criminal offending.ObjectiveTo test the hypothesis that a higher childhood blood lead level (BLL) is associated with greater risk of criminal conviction, recidivism (repeat conviction), conviction for violent offenses, and variety of self-reported criminal offending in a setting where BLL was not associated with low socioeconomic status.Design, setting, and participantsA total of 553 individuals participated in a prospective study based on a population-representative cohort born between April 1, 1972, and March 31, 1973, from New Zealand; the Dunedin Multidisciplinary Health and Development Study observed participants to age 38 years (December 2012). Statistical analysis was performed from November 10, 2016, to September 5, 2017.ExposuresBlood lead level measured at age 11 years.Main outcomes and measuresOfficial criminal conviction cumulative to age 38 years (data collected in 2013), single conviction or recidivism, conviction for nonviolent or violent crime, and self-reported variety of crime types at ages 15, 18, 21, 26, 32, and 38 years.ResultsParticipants included 553 individuals (255 female and 298 male participants) who had their blood tested for lead at age 11 years. The mean (SD) BLL at age 11 years was 11.01 (4.62) μg/dL. A total of 154 participants (27.8%) had a criminal conviction, 86 (15.6%) had recidivated, and 53 (9.6%) had a violent offense conviction. Variety scores for self-reported offending ranged from 0 to 10 offense types at each assessment; higher numbers indicated greater crime involvement. Self-reported offending followed the well-established age-crime curve (ie, the mean [SD] variety of self-reported offending increased from 1.99 [2.82] at age 15 years to its peak of 4.24 [3.15] at age 18 years and 4.22 [3.02] at age 21 years and declined thereafter to 1.10 [1.59] at age 38 years). Blood lead level was a poor discriminator between no conviction and conviction (area under the curve, 0.58). Overall, associations between BLL and conviction outcomes were weak. The estimated effect of BLL was lower for recidivism than for single convictions and lower for violent offending than for nonviolent offending. Sex-adjusted associations between BLL reached statistical significance for only 1 of the 6 self-reported offending outcomes at age 15 years (r = 0.10; 95% CI, 0.01-0.18; P = .02).Conclusions and relevanceThis study overcomes past limitations of studies of BLL and crime by studying the association in a place and time where the correlation was not confounded by childhood socioeconomic status. Findings failed to support a dose-response association between BLL and consequential criminal offending.

Project description:BackgroundViolence is one of the leading causes of injury and death in the United States. One-way society attempts to eliminate violence is through criminal punishment. Yet, in many contexts, punishment fails to reduce violence and may cause other harms. Current research on violence often suffers from same-source bias which can produce spurious associations. This study assesses the associations of different forms of criminal punishment (monetary sanctions, incarceration, and probation) with violent injuries in two unique datasets.MethodsThis study examines a unique combination of hospital discharge data and court administrative data, two Minnesota county-level data sources. First, we assess the spatial distribution of the three criminal punishment variables and two violent injury variables, violent injury overall and violent injury in children by county from 2010 to 2014, using Moran's I statistic and Local Indicators of Spatial Autocorrelation. Then we assess the association of criminal punishment on violent injury and child abuse injury using a two-way fixed effects panel models.ResultsChild abuse injuries are relatively rare in our data but are significantly concentrated geographically, unlike violent injuries which are more dispersed throughout Minnesota. Incarceration and probation are significantly geographically concentrated in similar regions while monetary sanctions are not geographically concentrated. We find a link between probation loads and violent injury, specifically, with a 1 day increase in per capita probation supervision associated with a 0.044 increase in violent injury incidence per 1000 people. In contrast, monetary sanctions and incarceration loads have little association with either violent injury or child abuse injury incidence.ConclusionsCriminal punishment is intended to reduce harm in society, but many argue that it may bring unintended consequences such as violence. This study finds that county-level probation has a modest positive association with county-level violent injury rates, but monetary sanctions and incarceration are less associated with violence injury rates. No measure of criminal punishment was associated with a reduction in violence. This study addresses a gap in previous literature by examining the association of punishment and violence in two unrelated datasets. High rates of criminal punishment and violent injury are both urgent public health emergencies. Further individual-level investigation is needed to assess potential links.

Project description:CONTEXT Previous studies have suggested that children who experience parental suicide at earlier ages are at higher risk of future hospitalization for suicide attempt. However, how the trajectories of risk differ by offspring age at the time of parental suicide is currently unknown. OBJECTIVE To study time at risk to suicide attempt hospitalization among offspring of suicide decedents as compared with offspring of unintentional injury decedents by their developmental period at the time of parental death. DESIGN Population-based retrospective cohort study. SETTING Sweden. PARTICIPANTS Twenty-six thousand ninety-six offspring who experienced parental suicide and 32 395 offspring of unintentional injury decedents prior to age 25 years between the years 1973 and 2003. MAIN OUTCOME MEASURE Parametric survival analysis was used to model the time to hospitalization for suicide attempt among offspring who lost a parent during early childhood (0-5 years old), later childhood (6-12 years old), adolescence (13-17 years old), and young adulthood (18-24 years old). RESULTS The risk in offspring who lost a parent to suicide or an unintentional injury during childhood surpassed the other age groups' risk approximately 5 years after the origin and, for the youngest group, continued to rise over decades. Offspring who lost a parent during adolescence or young adulthood were at greatest risk within 1 to 2 years after parental death, and risk declined over time. Offspring who lost a parent to suicide in childhood and young adulthood had earlier onset of hospitalization for suicide attempt compared with offspring who lost a parent to an unintentional injury. CONCLUSIONS The hospitalization risk for suicide attempt in offspring who lost a parent during their childhood is different from those who lost a parent later in development. The results suggest critical windows for careful monitoring and intervention for suicide attempt risk, especially 1 to 2 years after parental death for the older age groups and over decades for childhood survivors of parental death.

Project description:ObjectiveThe propensity of people vulnerable to suicide to make poor life decisions is increasingly well documented. Do they display an extreme degree of decision biases? The present study used a behavioral-decision approach to examine the susceptibility of low-lethality and high-lethality suicide attempters to common decision biases that may ultimately obscure alternative solutions and deterrents to suicide in a crisis.MethodWe assessed older and middle-aged (42-97 years) individuals who made high-lethality (medically serious) (n = 31) and low-lethality suicide attempts (n = 29). Comparison groups included suicide ideators (n = 30), nonsuicidal depressed participants (n = 53), and psychiatrically healthy participants (n = 28). Attempters, ideators, and nonsuicidal depressed participants had nonpsychotic major depression (DSM-IV criteria). Decision biases included sunk cost (inability to abort an action for which costs are irrecoverable), framing (responding to superficial features of how a problem is presented), underconfidence/overconfidence (appropriateness of confidence in knowledge), and inconsistent risk perception. Data were collected between June 2010 and February 2014.ResultsBoth high- and low-lethality attempters were more susceptible to framing effects as compared to the other groups included in this study (P ≤ .05, ηp2 = 0.06). In contrast, low-lethality attempters were more susceptible to sunk costs than both the comparison groups and high-lethality attempters (P ≤ .01, ηp2 = 0.09). These group differences remained after accounting for age, global cognitive performance, and impulsive traits. Premorbid IQ partially explained group differences in framing effects.ConclusionsSuicide attempters' failure to resist framing may reflect their inability to consider a decision from an objective standpoint in a crisis. Failure of low-lethality attempters to resist sunk cost may reflect their tendency to confuse past and future costs of their behavior, lowering their threshold for acting on suicidal thoughts.

Project description:OBJECTIVE:The aims of this study were to examine whether dispositional interpersonal callousness, negative emotionality, and hyperactivity/impulsivity uniquely influence the development of childhood-onset conduct problems and persistent criminal behavior in males, and to determine whether specific facets of negative emotionality (dysregulated anger versus anxiety) in childhood are differentially associated with the development of chronic antisocial behavior. METHOD:Childhood dispositional features and conduct problems were assessed semiannually using parent- and teacher-report measures across 9 consecutive assessments in a school-based sample of 503 boys (?7-11 years of age). Participants' criminal behavior was assessed using official records from adolescence into the early 30s. RESULTS:Interpersonal callousness, dysregulated anger, and hyperactivity/impulsivity were uniquely associated with the development of childhood-onset conduct problems. None of these features significantly predicted official records of juvenile offending after controlling for co- occurring conduct problems. However, interpersonal callousness was robustly and uniquely associated with a pattern of persistent and violent adult offending that continued into the early 30s. In contrast, anxiety problems were inversely associated with criminal offending in adolescence and adulthood after controlling for conduct problems and the other dispositional factors. CONCLUSION:Findings are consistent with theoretical models indicating that interpersonal callousness, dysregulated anger, and hyperactivity/impulsivity influence the development of childhood conduct problems. In contrast, anxiety problems in childhood tend to reduce the likelihood that boys will engage in later criminal offending. Results suggest that delinquency prevention programs should target children exhibiting features of interpersonal callousness, given that they are at high risk for engaging in chronic and violent offending in adulthood.

Dataset Information

Parental Psychiatric Disease and Risks of Attempted Suicide and Violent Criminal Offending in Offspring: A Population-Based Cohort Study.

Publications

Parental Psychiatric Disease and Risks of Attempted Suicide and Violent Criminal Offending in Offspring: A Population-Based Cohort Study.

Similar Datasets

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