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The MoMA once invited me as part of a series on powerful women. So there I was, sitting beside Chantal Akerman and people like that. I often face total incomprehension. Or a parody even. People insist that an artwork should be about something, but that is nonsense.

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What is Porgy and Bess about? The story was just an occasion for George Gershwin to write music. Dark Shadows by Tim Burton. What else? That is a normal human ambition: you give birth to a child, you create an artwork and you hope that it lives and thrives.

But the only way to fulfil that ambition is to approach reality in a different way, to say this is true and this is not true simultaneously.


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Wes Anderson who made Grand Budapest Hotel is one of the rare film directors who is still able to do that today. The nouvelle vague? Try watching some of those films again. One dud a er another! In , he debuted as a film director with the historical drama Monsieur Hawarden. It was and all the film journalists — who are often wrong — were crazy about the nouvelle vague. That movement gave the impression that anybody could make a film. But just try watching some of those films again. One dud after another! It was only when Monsieur Hawarden was hailed as one of the ten best films of the year in England that I started getting respect in Flanders.

They suggested I make a low-budget commercial film. It had to be erotic and it had to have impact. But what should the story be? Pierre liked the idea. He wanted to cast the French film star Delphine Seyrig as the lead. This is reflected in the youth suicide literature, which mostly indicates group differences on discrete and largely isolated constructs. A different but equally important disconnect is that between mechanisms and environmental impact, with very few studies exploring epigenetic mechanisms among youth.

More work is needed to close these gaps. Second, much of the suicide literature focuses on relatively long-term effects. First, future research efforts are encouraged to integrate findings along multiple units of analyses. This can be done by engaging in cross-disciplinary collaborations, particularly those that integrate across disciplines of genetics, molecular biology, neuroscience, physiology, psychology, and psychiatry. Frameworks such as RDoC may be helpful in guiding potentially fruitful intersections.

The field of youth suicide research would also benefit from reaching beyond traditional tools used in psychology research, such as the integration of computer science and engineering approaches e. Kessler et al. Machine learning may be particularly helpful with meaningfully integrating the many small to modest effects from risk factors and correlates observed in the field Franklin et al.

Second, we encourage greater emphasis on the short-term prediction of suicidal thoughts and behaviours. There are several ways to achieve this, whether that is through sampling e.

Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment.

Relevant to the latter, recent work in Ecological Momentary Assessment EMA suggests that monitoring suicidal thoughts multiple times a day shows the high variability and shown-term volatility of this clinical outcome, and the importance of monitoring risk factors within similar short-term time frames Kleiman et al. The ubiquity of smartphone and mobile technology use introduces a rich source of real-time data that may also help identify a variety of short-term behavioural signatures of suicide risk i.

Although many of the reviewed studies have examined the correlates of suicide risk among youth, they mostly fail to consider the developmental nature of suicide risk itself.


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Most of the studies reviewed here include either individuals under or over 18 years of age. This approach of grouping individuals into age categories obscures the contribution of normative developmental shifts to suicide risk. There is little to be said about patterns observed within a specific developmental period if not compared to or studied alongside comparison age groups. Practical issues such as subject recruitment severely limit progress that could be made by conducting studies examine risk that occurs as a function, in part, of the biopsychosocial transitions that accompany development.

First and foremost, more longitudinal studies that study novel psychobiological processes are needed. Within-person studies that emphasize variables which change over time may allow for a clearer understanding of the complex, interacting roles of biology and the environment in their prediction of suicide. Second, cross-sectional samples should include wider age ranges, preferably encompassing the typical developmental shifts that occur across age.

The timing of pubertal transitions is a potentially critical consideration during adolescence, since for instance late puberty has been linked to greater likelihood of self-injury and suicide attempt even after adjusting for age and grade level Patton et al. How or why this is the case e. High-risk sociodemographic populations are not sufficiently represented in the suicide literature Cha et al.

Relatedly, the geographic distribution of suicide research shows limited correspondence with global suicide rates. The case of sexual minority youth is another poignant example. Despite evidence of increased risk for suicide ideation and attempt in this population compared to heterosexual counterparts, this sociodemographic group is accounted for in only 1.

It is critical to examine LGBTQ status more frequently as sexual orientation disparities have indeed been observed e. Similar concerns apply to treatment and prevention research.

Introduction

Yet there is indication that cultural factors may influence treatment engagement behaviours in suicidal youth. For example, family members of adolescent suicide attempters belonging to a U. Relatedly, specific cross-cultural factors may also impact implementation feasibility for treatment or prevention programs. For example, studies exploring community response to mental health and suicide prevention programs in American Indian and Alaska Native youth have observed resistance to interventions that do not acknowledge local cultural beliefs and practices e.

Future work is encouraged to sufficiently account for high-risk demographic groups—both when sampling and when reporting sample characteristics. It is similarly important to target high risk settings, considering both geography e. The combination of these approaches will help perpetuate consideration of the generalizability of findings throughout the literature. This perspective will also be critical once the field has well-established efficacious interventions to understand implications for effectiveness across different national and local cultural contexts.

In sum, the youth suicide literature has made significant advances in the areas of epidemiology, potential etiological mechanisms, as well as treatment and prevention. The field at present has developed a firm and increasingly cross-national knowledge base regarding the epidemiology of suicidal thoughts and behaviours; identified select environmental and psychological risk factors and novel biological correlates; and has taken promising steps forward to develop and begin testing intervention and prevention strategies.

Importantly, there remain gaps sorely in need of attention. Acknowledging these gaps represents a critical first step to prompt innovative and promising directions for future work.


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Preparation of this paper was supported in part by the National Institute of Mental Health contract no. The authors have declared that they have no competing or potential conflicts of interest. Instead, they are compared to other countries with high completeness and quality of cause-of-death assignment according to the Global Health Estimates Summary Tables WHO, Countries with low completeness of data or low quality of cause-of-death assignment were not counted in the present rankings.

Of note, this includes countries e. For the purposes of this review, psychological processes with emotional valence are primarily discussed within affective processes. These effects, however, are tentative, minimal, and often nonsignificant. As work within and beyond the RDoC expands our knowledge of mechanisms, we expect and encourage the field of youth suicide research to evolve accordingly.

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Read article at publisher's site DOI : BMC Psychiatry , 20 1 , 28 Jul J Abnorm Child Psychol , 48 1 , 01 Jan Cited by: 1 article PMID: To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation.

Curr Opin Pediatr , 21 5 , 01 Oct Cited by: 64 articles PMID: Pelkonen M , Marttunen M. Paediatr Drugs , 5 4 , 01 Jan Cited by: 97 articles PMID: J Affect Disord , , 06 Mar Free to read. J Youth Adolesc , 46 7 , 14 Nov Coronavirus: Find the latest articles and preprints. Europe PMC requires Javascript to function effectively.