Suicide is the second leading cause of death among young adults between the ages of 15 and 25, accounting for more than 6,000 deaths in the United States annually. Many of these suicides occur in clusters within a single community. In an attempt to isolate the factors leading to teenage suicide and to indicate what behavior patterns might be warning signs, the authors studied two clusters of suicides in medium-sized suburban communities with above-average incomes. For each suicide victim, three teenagers of similar age and background from the same community were selected as control subjects. A questionnaire was given to individuals expected to have intimate knowledge of the case subjects or the control subjects. The questionnaire covered various aspects of personality, lifestyle, and academic and social history, and was given to parents, teachers, therapists, friends and the control teenagers themselves. After analyzing the completed questionnaires, researchers concluded that the teenagers who committed suicide were more likely than the control subjects to have previously attempted or threatened suicide or physically harmed themselves, engaged in interpersonal violence, been hospitalized for mental illness or substance abuse, recently lost a boyfriend or girlfriend, been arrested, attended more than four schools, lived with more than two different parents, or had more than two residences. The suicide victims were judged to be more vulnerable to being hurt or offended and more preoccupied with death; in some cases they had said their 'last goodbyes.' Although the effects on the case subjects of exposure to other suicides, either directly or through coverage in the media, could not be established by the authors, they cautioned that this may be a factor in teenage suicide that is worthy of future research. To prevent teenagers from looking upon suicide as a means of attracting attention from their peers, the authors caution against sensational media coverage and mass memorial services when teenage suicide occurs., ABSTRACT: Two clusters of teenage suicides occurred in Texas between February 1983 and October 1984. The eight suicides from the first cluster and the six from the second were investigated together in a case-control study using a closed-response questionnaire administered to parents. Three control teenagers were matched with each case subject on the basis of school district, grade, race, and sex. Questions concerned the direct and indirect exposures of subject to previous suicides as well as their life circumstances and behaviors. Case subjects were not more likely than control subjects to have had direct exposure to suicide as measured by their acquaintance with a person who committed suicide. Similarly, indirect exposure to suicide through the media was not associated significantly with suicide. Case subjects were more likely to have attempted or threatened suicide previously, to have damaged themselves physically, and to have known someone closely who died violently. Case subjects were more likely to have broken up with their girlfriends or boyfriends recently. They also had moved more often than control subjects, attended more schools, and lived with more parent figures. Identification of high-risk youths through knowledge of relevant risk factors can help to direct preventive services to those young people most susceptible to suicide.