Anxiety Best Exemplifies a Suicide Risk Factor
Among the listed options, anxiety is the characteristic that best exemplifies a suicide risk factor, while the other options (future orientation, firm religious beliefs, having to work, and living with family) are generally considered protective factors against suicide.
Evidence Supporting Anxiety as a Risk Factor
Guideline-Based Evidence
Anxiety disorders consistently increase suicide risk across multiple dimensions of suicidal behavior. The American Academy of Child and Adolescent Psychiatry guidelines establish that:
- Mood and anxiety disorders increase the risk of suicidal ideation in both children and adolescents 1
- Anxiety disorders independently increase the risk of suicide attempts in both sexes, particularly when comorbid with mood disorders 1
- Panic attacks specifically serve as a risk factor for suicidal ideation or attempts in females 1
- Separation anxiety may provoke adolescent ideators to attempt suicide 1
The U.S. Preventive Services Task Force further confirms that increased suicide risk is associated with the presence of mental health disorders, including anxiety disorders, with approximately 87% of patients who die by suicide meeting criteria for one or more mental health disorders 1.
Magnitude of Risk
Research demonstrates that anxiety represents a statistically significant predictor of suicidal behavior:
- Anxiety predicts suicide ideation with an odds ratio of 1.49 (95% CI: 1.18-1.88) 2
- Anxiety predicts suicide attempts with an odds ratio of 1.64 (95% CI: 1.47-1.83) 2
- The strongest associations are observed for PTSD among anxiety disorders 2
- Anxiety sensitivity (fear of anxiety-related sensations) shows moderate associations with suicide risk (r = .35) 3
Why Other Options Are NOT Risk Factors
Protective Factors
The remaining options represent protective factors that reduce suicide risk:
- Future orientation: Having plans and goals for the future is protective, as hopelessness and lack of future orientation are established risk factors 1
- Firm religious beliefs: Religious affiliation and strong spiritual beliefs are well-established protective factors against suicide
- Having to work: Employment and structured activities provide purpose, routine, and social connection—all protective factors
- Living with family: Social support and family connection are protective, whereas social isolation increases risk 1
Clinical Context
The guidelines emphasize that low levels of communication between parents and children act as a significant risk factor 1, but living with family itself (when relationships are functional) provides protective social support. Conversely, isolation, hopelessness, and reluctance to discuss suicidal thoughts distinguish attempters from ideators 1.
Important Clinical Considerations
Anxiety rarely acts as a sole sufficient cause for suicide—it typically functions as a precipitating factor in individuals already at risk due to psychiatric conditions 1. The American Academy of Child and Adolescent Psychiatry emphasizes that more than 90% of adolescents who commit suicide suffered from an associated psychiatric disorder at the time of death 1.
Assessment Priorities
When anxiety is present, clinicians should:
- Evaluate for comorbid mood disorders, which substantially amplify risk 1
- Assess for substance abuse, which significantly increases suicide risk in teenagers aged 16 and older 1
- Screen for previous suicide attempts, the most potent predictor in males (30-fold increased risk) 1
- Identify specific anxiety subtypes, particularly panic attacks in females 1
The presence of anxiety warrants systematic suicide risk assessment, as it represents a modifiable risk factor that responds to evidence-based treatment with SSRIs and cognitive-behavioral therapy 4, 5.