Some study findings were unexpected. A history of at least one previous attempt was not associated with suicide attempt during follow-up and a history of multiple suicide attempts had only a trend association with attempt during follow-up. Although previous studies have found clear associations between suicide attempts, particularly multiple suicide attempts, and subsequent suicide attempts (Gould et al. 1998), the absence of an association in this study may reflect the high level of elevated risk for suicidal behavior among participants. These adolescents were admitted to the hospital due to acute suicide risk and many of the “non-attempters” had clear plans for suicide attempts. This is consistent with the finding of King et al. (1995) who observed the highest rate of suicidal behavior following psychiatric hospitalization (38.5%) among adolescents who were hospitalized because of active and serious suicidal intent rather than for suicidal behavior. A second surprising finding was that a positive history of maternal mental health problems was associated with lower rates of multiple attempts among adolescents at baseline. The association between maternal mental health problems and adolescent multiple attempts
