Genetic and environmental pathways to suicidal behavior: Reflections of a genetic epidemiologist.

This paper presents a tentative typology of genetic and environmental pathways to suicidal behavior. Ten pathways are proposed and briefly illustrated: (i) direct effects from psychiatric disorders; (ii) direct effects from personality; (iii) direct effects of early adversity; (iv) direct effects of current adversity; (v) indirect effects of genes on selection into adversity (gene-environment correlation); (vi) interactions between genetic risk and current adversity: gene-environment interaction; (vii) interactions between early and current adversity: environment-environment interaction; (viii) interactions between culture and genes; (ix) dynamic developmental pathways involving causal loops from genes to environment and back again; and (x) gene x environment x development interaction.