LAUSR

ross-sectional studies of adolescent suicidal thoughts/behaviors (STBs) (ideation or attempts) C have long demonstrated a strong association with a wide range of contemporaneous risk factors (such as Axis I and II psychiatric diagnoses, subsyndromal behavioral difficulties, and educational problems), as well as pre-existing family background factors (such as economic adversity, poor family functioning, and parental psychopathology). In recent years, the steady accretion of data from several longrunning prospective, population-based studies has shed new light on the lifespan implications and long-term sequelae of adolescent suicidality and provided a corrective to what has been described as the “strangely a-developmental” nature of much earlier suicide research, which paid little regard to the complex interaction of systems across development. Among the most productive community-based prospective studies in this regard have been the Christchurch, Dunedin, and Great Smoky Mountains studies. In this issue of the Journal, the report by Copeland et al. of the latest findings from the Great Smoky Mountains Study exemplifies the power of this methodology and highlights several important conclusions: (1) adolescent STBs are an ongoing risk factor for future suicidal behaviors and a broader host of psychosocial difficulties in adulthood; (2) the worrisome long-term prognostic implications of adolescent STBs are likely not due to adolescent STB per se but rather the host of background family and childhood factors that predisposed youngsters to adolescent STB in the first place; (3) youngsters with only suicidal ideation/plan (but no attempts) fared as poorly as those who had made an actual suicide attempt in adolescence; (4) the combination of childhood depression and adolescent STB poses an especially high risk for adult suicidal behavior; but (5) most participants with adult suicidality had neither childhood depression nor childhood suicidal behavior. The Great Smoky Mountains Study has now followed the vicissitudes of a population-based sample of 1,420 youngsters, originally ages 9 to 13 years, up through the age of 30, using periodic structured interviews and other data collection. In this most recent examination of the data, STB in adolescence was associated with adult anxiety disorder or STB in adulthood, as well as poor adult functioning in the areas of finance, health, social relations, and risky/illegal behaviors. Once adjustments were made, however, for background factors (gender, race, low socioeconomic status, childhood maltreatment, family instability/dysfunction, and peer victimization; and diagnosis of a childhood depression,