Exploring Preteens' Understanding of Death and Suicide: Age-Related Differences and Implications for Suicide Assessment

PROJECT SUMMARY Suicide is a leading cause of death for youth in the United States and is notoriously difficult to assess, predict, and treat. Recent United States trends indicate preteen youth are dying by suicide at an alarming rate; however, little is known or understood about how children conceptualize death by suicide. This has made it difficult to determine if traditional approaches to suicide assessment, which typically presume respondents' clear understanding of suicide, are developmentally appropriate for preteen youth. Thus, research on preteens' understanding of suicide and death warrants further study and may have important implications for clinical assessment and intervention. The proposed study will examine how preteen youth uniquely perceive death and suicide, and how such perceptions relate to responses on traditional suicide assessments. Specifically, we will examine age-related differences in understanding of death (Aim 1), test whether preteen understanding of death is dependent on the cause of death (Aim 2), and explore how preteens with suicidal thoughts and behaviors conceptualize death (Aim 3). Self-report data on death conceptualizations and traditional suicide assessments will be collected from two research studies examining suicide among preteen youth. Both studies will employ a newly developed measure designed for preteens, the Continuity of Functioning After Death Interview (CoFAD), to assess biological and non-biological domains of death and suicide. Traditional self- report measures will be used to evaluate for the presence of suicidal ideation. Results will offer the foundational understanding needed to create more developmentally appropriate suicide assessments and may uncover malleable intervention targets addressing preteen suicide.