Child and Adolescent Self-Destructive Thoughts and Behavior: Conceptualizing and Holistic Risk Assessment

This project is based on the recently developed Theory of Adolescent Suicidality and Self-Destruction (external link). The theory proposes that suicidal behavior in youth develops along a continuum from symbolic and passive self-destruction (e.g., negative self-concept, self-neglect, restrictive eating) to active self-harm and, in extreme form, overt suicide attempts. It assumes that suicide risk is rooted in broad and cumulative impairments in holistic well-being characterized by several physical, personal, interpersonal, environmental, and future domains. The theory posits that based on holistic assessment of these domains, risk of suicidality as well as nonsuicidal self-destructive behavior can be detected and their future onset can be predicted. The project will test and refine this theory using large, existing Norwegian datasets on child and adolescent mental health, with a focus on developmental psychopathology, early identification of risk, and clinically meaningful differentiation between passive and active forms of self-destructive behavior. 

Main aims

The overarching aim of the project is to advance a developmental, data-driven, and comprehensive theory of suicidality and self-destructive behavior in children and adolescents that unveils the relationship between different forms of non-suicidal self-destruction with suicidal self-harm. It also aims to translate the research findings into clinically useful risk assessment strategies that do not rely solely on explicit suicide-related self-reports, enabling it to be used at societal scale without requiring sensitive information. Specifically, the project pursues four linked theoretical and clinical aims:

1. To validate whether holistic well-being profiles can distinguish adolescents with passive self-destructive behavior from their peers, without using direct symptom items related to self-destructive tendencies.
    
2. To clarify how passive and active forms of self-destruction differ in their broader well-being and self-regulation profiles, and whether active forms reflect more severe and widespread impairment across the theoretical domains.
    
3. To test whether the posited theory generalizes to children (9–12 years), both in terms of cross-sectional differentiation of self-destructive tendencies and in terms of prediction of later suicidal behavior.
    
4. To examine the developmental trajectory from passive to active self-destruction by testing whether early passive behaviors (such as restrictive eating) predict later active self-harm and suicidality in longitudinal child cohorts.