While the results from these studies support the role of genetic influences on suicidal behavior 9, 29, 30, adoption studies have several limitations (e.g., matching adoptees to families of higher socioeconomic status) 31 and have not formally examined the intergenerational transmission of suicidal behavior. To date, adoption studies have been the primary research design used to account for unmeasured factors. Stated differently, the transmission of suicidal behavior between parent and offspring may not be specific to the exposure of parental suicidal behavior, but explained by behavioral health problems (e.g., being raised by a parent with psychopathology may result in a chaotic home environment), which is a common risk factor for suicidality 26.Īlthough previous studies have statistically adjusted for measured covariates (e.g., parental psychiatric disorder), attempts to draw causal inferences about the intergenerational association have been limited due to the inability to rigorously adjust for unmeasured genetic and environmental factors 26, 27, 28. The comorbidity between psychopathology and suicidal behavior 25 also suggests that parental behavioral health problems may confound the association. Twin, family, and adoption studies have consistently indicated that suicidal behavior is heritable 7, 21, 22, 23, 24. Parents also share genetic makeup with their offspring consequently, the association between parental and offspring suicidal behavior may be confounded by genetic factors (i.e., passive gene-environment correlation) 20. Researchers have proposed potential causal mechanisms including contagion 5, 6, 7, 8, 9 and exposure to adverse environments 10, 11, 12, 13, 14, 15, 16, 17, 18, 19. However, it is unclear how the risk of family history of suicidal behavior is transmitted 2, 3, 4. A recent meta-analysis concluded that family history of self-injurious behaviors was moderately associated with offspring suicide attempt (odds ratio, 1.57) 3. Research has consistently suggested that offspring of suicidal parents are at greater risk for suicidal behavior themselves 1, 2. This study found that the intergenerational transmission of suicidal behavior is largely due to shared genetic factors, as well as factors associated with parental behavioral health problems and environmental factors associated with parental suicidal behavior. ![]() Cox hazard models demonstrated a similar pattern between paternal and offspring suicidal behavior. After adjustment for familial factors and measured covariates, associations attenuated but remained elevated for offspring of discordant half-siblings (HR, 1.57 ) and full-siblings (HR, 1.62 ). Cox hazard models similarly found that offspring were at a 2.74-fold increased risk ) of suicidal behavior if their mothers attempted/died by suicide. Statistical adjustment for parental behavioral health problems partially attenuated the environmental association however, the results were no longer statistically significant. Quantitative behavior genetic analyses found that 29.2% (95% confidence interval, 5.29, 53.12%) of the intergenerational association was due to environmental factors associated with exposure to maternal suicidal behavior, with the remainder due to genetic factors. The analyses also adjusted for numerous measured covariates (e.g., parental severe mental illness). ![]() We conducted two sets of analyses with offspring of half- and full-siblings: (1) quantitative behavior genetic models analyzing maternal suicidal behavior and (2) fixed-effects Cox proportional hazard models analyzing maternal and paternal suicidal behavior. ![]() We used a Swedish cohort of 2,762,883 offspring born 1973–2001. We examined the extent to which genetic factors shared across generations, measured covariates, and environmental factors associated with parental suicidal behavior (suicide attempt or suicide) account for the association between parental and offspring suicidal behavior.
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