Pediatrics. 2026 Mar 23:e2025071631. doi: 10.1542/peds.2025-071631. Online ahead of print.
ABSTRACT
BACKGROUND AND OBJECTIVES: Suicidal ideation (SI) significantly increases during the transition from childhood to adolescence, serving as a key predictor of future suicidal behaviors. Despite this, research focusing on preadolescents is scarce and often overlooks immediate risk factors, which hampers the predictive accuracy regarding future suicidality. We examine the dynamic impact of late childhood factors on SI during the transition to early adolescence.
METHODS: This study used data from the Adolescent Brain Cognitive Development study. SI was assessed via the Kiddie Schedule for Affective Disorders and Schizophrenia semistructured interview, while factors were evaluated across demographic, psychological, cognitive, and environmental domains. An improved random forest algorithm was employed for predictive modeling and feature selection, ensuring a robust analysis of contributing factors.
RESULTS: The study included 9743 unrelated children, with female children accounting for 47.4%. Psychopathology was the most significant contributor to both newly onset (weight = 27.2%) and recurrent SI (35.0%), maintaining a stable impact throughout follow-up (27.7% to 29.9%). The influence of impulsive traits (16.4% to 19.5%) and cognitive functioning (12.6% to 19.5%) increased over time, emphasizing their dynamic role. The impact of the childhood rearing environment diminished (19.1% to 10.1%) but remained critical for the incidence of SI (26.1%).
CONCLUSIONS: These findings highlight the importance of understanding the dynamic influences of late childhood factors to inform early identification and intervention strategies aimed at preventing SI during this pivotal transition.
PMID:41866044 | DOI:10.1542/peds.2025-071631
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