The task force gathered and examined data and established the following as definite risk factors: substance abuse, both as a direct cause and as an aggravator of psychic disorders which lead to suicidal acts; the specific psychic disorders of schizophrenia and borderline personality; parental loss and family disruption; genetic traits and familial characteristics which predispose individuals towards suicide; low levels of the serotonin metabolite, 5-hydroxyindoleacetic acid (5-HIAA), and the dopamine metabolite homovanillic acid (HVA) in the cerebrospinal fluid. Other factors include homosexuality; intimate involvement or relation to a suicide victim; rapid sociocultural change; social maladjustment, particularly impulsiveness, aggressiveness, inhibition, and anxiety; media emphasis on suicide; and easy access to instruments of suicide, particularly guns. Sixteen commissioned papers cover these risk factors in varying contexts. Recommendations cover 14 points such as conducting long term studies of youth suicide, develop targeted intervention and prevention services, and improve professional treatment standards for adolescent depression and other psychiatric disorders. Tables, references at end of each paper.