Current research indicates that exposure to suicide is a risk factor for suicidality; however, we know little about the mechanisms through which exposure confers this risk. In this study, we address this gap by examining the role of meaning-making after a suicide death in moderating individual's vulnerability to suicide. We draw on interview data with suicide bereaved individuals in the USA (N = 48), the majority of whom engaged in intense meaning-making processes after their loss. Many reported an increased awareness of suicide as a 'something that actually happens,' a realization that impacted their lives and relationships with others (N = 37). For 7 participants, all women, their loss appeared to trigger increased suicidality, as they not only felt overwhelmed by grief, but also came to see suicide as something they, too, could do. However, for 19 participants, witnessing the profound impact of suicide on others made them feel that suicide was something they could never do. Thus, in our data, how exposure impacted vulnerability was tied to how individuals made sense of and experienced their loss. For some, suicide was re-framed as more of an option, while for others it was re-framed as not just the killing-of-oneself, but as the harming-of-others through grief and trauma, which in turn diminished their view of suicide's acceptability. Collectively, our findings suggest that exposure to suicide itself is not inherently risky, though it may be inherently distressing; instead, whether it results in increased vulnerability depends on the meaning an individual makes of the experience and likely the context surrounding the death. We discuss the implications of our findings for theories of suicide contagion, suicide itself, and suicide prevention.

This study examined the relationship between adolescents' beliefs about the prevalence of youth suicide ideation (ideation descriptive norms) and suicide attempts (attempt descriptive norms) with self-reported suicide ideation and attempts. Descriptive norms, suicide ideation, and suicide attempts as well as gender, race/ethnicity, and exposure to family, peer, and others' suicide were assessed in 2,109 students at six suburban New York State high schools. After controlling for demographic variables and exposure to suicide, elevated ideation descriptive norms and attempt descriptive norms were associated with higher rates of suicide ideation and lifetime suicide attempts among adolescents. Adolescents who believed suicide ideation and attempts to be more widespread among peers (i.e., elevated ideation and attempt descriptive norms) were more likely to endorse suicide ideation and attempts. Correcting these descriptive norms may be a worthwhile goal for school-based suicide prevention programs.

Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suicide attempts. We review this "gender paradox" in youth, and in particular, the age-dependency of these sex/gender differences and the developmental mechanisms that may explain them. Epidemiologic, genetic, neurodevelopmental and psychopathological research have identified suicidal behaviour risks arising from genetic vulnerabilities and sex/gender differences in early adverse environments, neurodevelopment, mental disorder and their complex interconnections. Further, evolving sex-/gender-defined social expectations and norms have been thought to influence suicide risk. In particular, how youth perceive and cope with threats and losses (including conforming to others' or one's own expectations of sex/gender identity) and adapt to pain (through substance use and help-seeking behaviours). Taken together, considering brain plasticity over the lifespan, these proposed antecedents to youth suicide highlight the importance of interventions that alter early environment(s) (e.g., childhood maltreatment) and/or one's ability to adapt to them. Further, such interventions may have more enduring protective effects, for the individual and for future generations, if implemented in youth.