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The Association Between General Childhood Psychopathology and Adolescent Suicide Attempt and Self-Harm: A Prospective, Population-Based Twin Study

Journal article
Authors L. M. O'Reilly
E. Pettersson
P. D. Quinn
E. D. Klonsky
Sebastian Lundström
H. Larsson
P. Lichtenstein
B. M. D'Onofrio
Published in Journal of Abnormal Psychology
Volume 129
Issue 4
Pages 364-375
ISSN 0021-843X
Publication year 2020
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Pages 364-375
Language en
Keywords suicide attempt, self-harm, adolescence, twin design, general, psychopathology factor, comorbidities a-tac, bifactor model, risk-factors, environmental, contributions, telephone interview, autism-tics, behavior, ideation, disorders, variance, Psychology, Psychiatry
Subject categories Neurology


Few quantitative behavior genetic studies have examined why psychopathology is associated with suicide attempt (SA) and self-harm (SH) in adolescence. The present study analyzed data from the Child and Adolescent Twin Study in Sweden to examine the extent to which genetic and environmental factors explain SA/SH and its association with psychopathology in childhood, an often-cited risk factor of subsequent SA/SH. When children were 9 or 12 years old (n = 30,444), parents completed the Autism-Tics, AD/HD and other Comorbidities Inventory (Larson et al., 2010) regarding their children's psychiatric problems as part of an ongoing, longitudinal study. At age 18 years (n = 10,269), adolescents completed self-report questionnaires, including SA/SH assessments. In a bifactor model of childhood psychopathology, a general factor of psychopathology was a statistically significant predictor of adolescvnt SA/SH at a higher magnitude (beta, 0.25, 95% confidence interval [CI; 0.15, 0.34] for suicide attempt), as compared with specific factors of inattention, impulsivity, oppositional behavior, and anxiety/emotion symptoms. Quantitative genetic modeling indicated that the additive genetic influences on the general factor accounted for the association with each outcome (beta, 0.24, 95% CI [0.13, 0.34] for suicide attempt). The results remained virtually identical when we fit a higher order factors model. Two additional outcomes demonstrated comparable results. The results extend current literature by revealing the shared genetic overlap between general psychopathology during childhood and adolescent SA/SH.

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