ArticleNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology2018
HPA axis response and psychosocial stress as interactive predictors of suicidal ideation and behavior in adolescent females: a multilevel diathesis-stress framework.
Article in Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 3 of them syntheses that pooled it.
What it found
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The trial behind it
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Who cites it
43 citing papers in PubMed, 3 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Pooled it
- The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis.Community mental health journal · 2024Pooled it
- Physiological responses to acute psychological stress as a biomarker for depression: A systematic review and meta-analysis.Psychological bulletinPooled it
- Mood computational mechanisms underlying increased risk behavior in adolescent suicidal patients.eLife · 2026Article
- Stress-induced IL-6 response patterns amplify the link between daily negative affect and later depressive symptoms during bereavement.Brain, behavior, and immunity · 2026Article
- Direct and Indirect Effects of Body Dysmorphic Concern on Psychotic Symptoms Through Suicidal Ideation in Patients With First-Episode Schizophrenia.Early intervention in psychiatry · 2026Article
- Development of a Machine Learning-Based Model for Classifying Depression Using Physiological and Psychological Indicators.Psychiatry investigation · 2026Article
- Molecular Mechanisms of Menstrual Cycle-Related Suicide Risk: A Selective Review of Promising Candidate Systems.Biological psychiatry · 2026Review
- Physiological and cognitive reactivity to social exclusion among emerging adults with versus without a suicide attempt history.Psychiatry research communications · 2025Article
- Proinflammatory gene expression is associated with prospective risk for adolescent suicidal thoughts and behaviors over twelve months.Development and psychopathology · 2025Article
- Temporal dynamics of inflammatory, platelet, and neurotrophic markers during social stress in relation to suicidal ideation and suicide attempt history.Brain, behavior, & immunity - health · 2025Article
- Peripheral biological correlates of suicidality in children and adolescents: A systematic review and meta-analysis.iScience · 2025Article
- Do Cortisol Levels Play a Role in Suicidal Behaviors and Non-Suicidal Self-Injuries in Children and Adolescents?-A Narrative Review.Brain sciences · 2025Review
- Stress reactivity moderates the association between early experiences of unpredictability and emotional problems in adolescents.Neurobiology of stress · 2025Article
- Association between serum oxidative stress indicators, inflammatory indicators and suicide attempts in adolescents with major depressive disorder.Frontiers in psychiatry · 2025Article
- Influences of sleep, cortisol reactivity, and risk/reward-based decision-making on suicide.Journal of behavior therapy and experimental psychiatry · 2024Article
- A longitudinal investigation of caregiving and adolescent post-traumatic stress symptoms during COVID-19: evidence for high resting RSA as a susceptibility factor.Psychological medicine · 2024Article
- Neural Markers of Emotion Reactivity and Regulation Before and After a Targeted Social Rejection: Differences Among Girls With and Without Suicidal Ideation and Behavior Histories.Biological psychiatry · 2024Article
- Exploratory Clinical Trial of a Depression Diagnostic Software That Integrates Stress Biomarkers and Composite Psychometrics.Psychiatry investigation · 2024Article
- Article
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
Abstract
Prior studies suggest that hypothalamic-pituitary-adrenal (HPA) axis stress response is a relatively stable risk factor for suicidal behavior in adults, and also that fluctuations in developmentally salient social stress (i.e., peer stress) predict acute suicidal ideation and behavior in adolescent females. Here, we test the hypothesis that periods of high peer stress are prospectively associated with concurrent episodes of suicidal ideation and behavior, but that abnormal cortisol responses to stress at baseline act as a diathesis that strengthens this stressor-suicidality link, using a longitudinal, multi-wave study design. We measured cortisol responses to an adolescent modification of the Trier Social Stress Test in 220 adolescent females recruited for mental health concerns, and measured stress (peer, academic, and mother-child) and suicidal ideation and behaviors repeatedly across 18 months. Logistic multilevel models revealed the predicted interaction between altered cortisol response and elevated periods of peer stress in predicting suicidal behavior, but not ideation. Higher-than-usual peer stress predicted suicidal ideation regardless of HPA function, but predicted suicide attempt only among those with blunted cortisol responses. Results suggest that peer stress serves to trigger suicidal ideation among female youth, but only triggers suicidal behavior among those with blunted cortisol reactivity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.