Investigating the role of hallucinatory experiences in the transition from suicidal thoughts to attempts

E. Hielscher, J. DeVylder, M. Connell, P. Hasking, G. Martin, J. G. Scott

Research output: Contribution to journalArticlepeer-review


Objective: Psychotic experiences, including auditory hallucinatory experiences (HEs), are strongly associated with both suicidal thoughts and behaviour. This study examined their role in the ideation-to-attempt transition in adolescents, including their direct and indirect effect via potential mediators. Method: Participants were from an Australian prospective longitudinal cohort of 1669 adolescents (12–17 years); of which a subsample endorsing baseline suicidal ideation (n = 216) was the focus of most analyses. Suicidal thoughts and behaviours were measured using the Self-Harm Behaviour Questionnaire. The Diagnostic Interview Schedule for Children was used to assess auditory HEs. Potential mediators of interest were psychological distress and Interpersonal Theory of Suicide (IPTS) constructs. Results: Among adolescents reporting suicidal ideation at baseline (n = 216), 6.5% had attempted suicide during follow-up. The size of auditory HEs’ univariate effect suggests a possible strong relationship with increased risk of incident suicide attempts (OR = 2.40; 95%CI = 0.76–7.56); however, there was inadequate statistical power to produce a precise estimate. When HEs were accompanied by distress there was a nine-fold increased risk of acting on suicidal thoughts. Distress was independently associated with risk of attempt transition (OR = 4.09), whereas IPTS constructs were poor explanatory variables in most models. Conclusion: Adolescents with psychological distress and auditory HEs are at high risk of incident suicide attempts. Further investigations on the role of negative/distressing content of hallucinations in the ideation-to-attempt transition are warranted.

Original languageEnglish (US)
Pages (from-to)241-253
Number of pages13
JournalActa Psychiatrica Scandinavica
Issue number3
StatePublished - Mar 1 2020


  • hallucinations
  • interpersonal theory of suicide
  • psychotic experiences
  • self-injurious behaviour
  • suicide

ASJC Scopus subject areas

  • Psychiatry and Mental health


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