The effect of multigeneration history of suicidality on offspring's neurodevelopment outcomes: evidence from the Adolescent Brain and Cognitive Development (ABCD) cohort

BackgroundParent-child transmission of suicidal behaviors has been widely elucidated, while the three-generation family suicide risk paradigm remains to be explored. This longitudinal study aimed to examine the influences of family history of suicidality (FHoS) among two prior generations on offsprings neurodevelopment. MethodsWe conducted a retrospective, longitudinal study using the Adolescent Brain Cognitive Development (ABCD) study data collected from 2016 to 2021. Participants were allocated into four groups according to their parents (Generation 1 [G1]) and grandparents (Generation 2 [G2]) history of suicidality (G1-G2-; G1+G2-; G1-/G2+; G1+/G2+). We estimated adjusted associations between FHoS and offsprings suicide ideation (SI), psychopathology, impulsivity and brain cortical volumes while controlling for age, sex, parental education, household income and marital status. FindingsA total of 11,875 children aged 9-10 years were observed from baseline to 3-year follow-up. Compared to G1-G2-, higher odds of SI were observed for G1-G2+ (OR=1{middle dot}99, 95% CI [1{middle dot}54-2{middle dot}56]) and G1+G2+ (2{middle dot}25 [1{middle dot}46-3{middle dot}47]) by child-report. Higher odds of SI were also observed for G1+G2- (1{middle dot}54 [1{middle dot}12-2{middle dot}12]), G1-G2+ (2{middle dot}57 [1{middle dot}89-3{middle dot}48]) and G1+G2+ (2{middle dot}70 [1{middle dot}60-4{middle dot}56]) by caregiver-report. Higher odds for psychopathology were also observed (1{middle dot}47 [1{middle dot}11-1{middle dot}96]; 3{middle dot}33 [2{middle dot}57-4{middle dot}33]; 5{middle dot}44 [3{middle dot}42-8{middle dot}66]), while higher family suicide risk was associated with high impulsivity (B=1{middle dot}32 [0{middle dot}48-2{middle dot}17]; 2{middle dot}24 [1{middle dot}32-3{middle dot}15]; 2{middle dot}26 [0{middle dot}47-4{middle dot}05]). Offspring in G1+G2-had higher cortical volumes in 12 brain regions, including the bilateral insula, temporal regions and occipital regions, which were also significantly associated with their lifetime SI. DiscussionA cumulative risk pattern of FHoS in two prior generations was found for offsprings neurodevelopmental outcomes. Earlier preventive interventions are warranted to weaken the familial transmission of suicidal risk.