Bridge, Jeffrey A.; Goldstein, Tina R.; Brent, David A.
This review examines the descriptive epidemiology, and risk and protective factors for youth suicide and suicidal behavior. A model of youth suicidal behavior is articulated, whereby suicidal behavior ensues as a result of an interaction of socio-cultural, developmental, psychiatric, psychological, and family-environmental factors. On the basis of…
Gover, F. Jill
There is a great deal of concern about teenage suicide. This study obtained a prevalence rate of suicidal behaviors among non-psychiatric early adolescents (ages 11-16) and investigated personal and family variables that may characterize the young teenagers who report varying degrees of suicidal behavior. A self-report questionnaire was…
Jena, S.; Sidhartha, T.
In the USA, suicide ranked as the third leading cause of death for adolescents in 1999. Non-fatal suicidal behaviours are suicidal thought, specific suicidal plan and suicide attempt. Prospective studies have emphasized the high subsequent suicide rates in clinically presenting suicide attempters. This study was planned to critically review the existing international literature on this area, and compare, if possible, with the Indian data. Both electronic and manual search for published and unpublished works was done for the review of this area. Both international and Indian studies on prevalence, risk factors, management, and prevention of non-fatal suicidal behaviours in adolescents were collected, analysed and reviewed. The study concludes that professionals, like general practitioners, paediatricians, school teachers, school counselors, need to be trained in identifying non-fatal suicidal behaviours in adolescents, and know when to refer them to a mental health professional or mental health service for thorough assessment and effective management. Timely and efficient management of non-fatal suicidal behaviors can prevent future suicidal attempts and completed suicide in most of this highly vulnerable population. Indian studies are very few and without robust study design. Systematic studies in India on this important topic are required. PMID:21206789
O’Brien, Kimberly H. McManama; Singer, Jonathan B.; LeCloux, Mary; Duarté-Vélez, Yovanska; Spirito, Anthony
Despite the prevalence of suicidal thoughts and behaviors among adolescents, there is limited knowledge of effective interventions to use with this population. This paper reviews the findings of studies on behavioral interventions for adolescents who are at acute suicide risk, as well as outpatient treatment and risk management strategies with suicidal adolescents. The importance of addressing comorbid behaviors and enhancing protective factors are discussed. Cultural considerations in working with suicidal adolescents and strategies for conducting culturally competent treatment are explored. PMID:26279646
Holmes, Kristin; Sher, Leo
The aim of this paper is to assess the possible consequences of adolescent physical, emotional and sexual dating violence through a review of the literature on the topic. An electronic search of major biomedical bibliographic databases (Pubmed, ISI, PsycINFO) was used to retrieve articles providing information on the prevalence rates, risk factors, associated consequences and possible preventive measures for adolescent dating violence across different populations. Currently, there have been few longitudinal studies conducted to identify potential risk factors for entering a violent dating relationship in adolescence. Risky behaviors such as early sexual intercourse may predispose someone for victimization. Dating violence itself is also a predictor of future dating violence. Adolescent dating violence was associated with an increase in other violence-related behaviors, substance use, depression, poorer educational outcomes, posttraumatic stress, unhealthy weight control and risky sexual behavior. The association between adolescent dating violence and an increase in suicidal behavior is a major public health concern. Future research should focus on longitudinal studies so that a causal relationship between dating violence and suicidality may be better understood.
Spirito, Anthony; Esposito-Smythers, Christianne; Wolff, Jennifer; Uhl, Kristen
Synopsis CBT has emerged as a well-established treatment for depression in children and adolescents but treatment trials for adolescents with suicidality are few in number, and their efficacy to date is rather limited. Although a definitive treatment for adolescent suicide attempters has yet to be established, the limited literature suggests that suicidal thoughts and behavior should be directly addressed for optimal treatment outcome. This chapter reviews the rationale underlying the use of CBT for the treatment of depression and suicidality in adolescents, the literature supporting the efficacy of CBT for depressed adolescents, and whether CBT for depression reduces suicidal thoughts and behavior. A description of some of the core cognitive, affective, and behavioral techniques used in CBT treatments of suicidal ideation and behavior in depressed adolescents is included. PMID:21440850
Lincoln, Sarah Hope; Norkett, Emily; Graber, Kelsey; Tembulkar, Sahil; Morelli, Nicholas; Gonzalez-Heydrich, Joseph; D'Angelo, Eugene
Suicide is the leading cause of premature death in individuals with psychotic disorders. Risk for onset of suicidal behaviors tends to begin in adolescence, remaining high into young adulthood. The present study aims to evaluate the interplay of early onset psychosis and suicide risk by examining suicidal behaviors (ideation, planning, and attempts) in children and adolescents with psychotic disorders (PD) compared to typically developing peers (TD). Twenty five youths were recruited and were diagnostically evaluated for psychosis. We found that the PD children exhibited significantly higher levels of suicidal behaviors than TD children, even when parsed into individual at-risk behaviors.
Joseph, Hanna Bar; Reznik, Ilya; Mester, Roberto
In the last two decades the incidence of adolescent suicides has been very high (though it has been on the decrease in the U.S.A. over the last four years), giving rise to a multitude of empirical and theoretical studies. The extensive knowledge that has accumulated regarding adolescent suicidal behavior has led to a more differentiated attitude. Many studies try to clarify specific needs, motivations and the conceptualization of death and suicide in various adolescent subgroups (minorities, females, homosexuals), thereby enabling more specific and exact methods of evaluation, prevention and intervention. Adolescent girls' suicidal behavior is different in many aspects from boys' suicidal behavior: Girls mortality rate from suicide is a 3-5 times lower rate than boys, but their attempted suicide rate is four to hundreds time higher. Girls suicide mainly by drugs and their suicide is mainly in reaction to interpersonal difficulties. Their motivation is often a cry for help. The comorbidity of suicide and depression is much higher for adolescent girls than boys. These differences generate a different understanding and separate treatment strategies. Two theoretical approaches that may explain the profile which characterizes suicidal girls will be presented. One has a psychological developmental context, and the other a social cultural context. Implications for specific prevention measures include legal action on pack sizes of analgesics, compulsory registration of attempted suicide and more gender specific treatment and prevention programs.
Juon, H S; Nam, J J; Ensminger, M E
The purpose of this study was to estimate the prevalence of suicidal behaviors and their relation to background characteristics, social integration, academic stress, psychological distress, and substance use in a stratified random sample of 9886 high school students in Korea. In a multiple logistic regression, we found that depression was the strongest predictor of suicidal behaviors. The other factors significantly associated with suicidal behaviors were gender, academic stress, hostility and substance use. These results indicate that early identification of risk factors for suicidal behaviors may have potential for reducing possible future suicides.
Katz, Laurence Y.; Cox, Brian J.; Gunasekara, Shiny; Miller, Alec L.
Objective: To evaluate the feasibility of dialectical behavior therapy (DBT) implementation in a general child and adolescent psychiatric inpatient unit and to provide preliminary effectiveness data on DBT versus treatment as usual (TAU). Method: Sixty-two adolescents with suicide attempts or suicidal ideation were admitted to one of two…
Cavaiola, Alan A.; Lavender, Neil
Study explores distinctions between chemically dependent suicide attempters, chemically dependent nonsuicidal adolescents, and high school students with no history of chemical dependency (N=250). Results reveal that there were significant differences between the chemically dependent groups. It was also found that the majority of suicidal gestures…
Thorlindsson, Thorolfur; Bernburg, Jón Gunnar
The current study examines the contextual effects of community structural characteristics, as well as the mediating role of key social mechanisms, on youth suicidal behavior in Iceland. We argue that the contextual influence of community structural instability on youth suicidal behavior should be mediated by weak attachment to social norms and values (anomie), and contact with suicidal others (suggestion-imitation). The data comes from a national survey of 14-16 years old adolescents. Valid questionnaires were obtained from 7018 students (response rate about 87%). The findings show that the community level of residential mobility has a positive, contextual effect on adolescent suicidal behavior. The findings also indicate that the contextual effect of residential mobility is mediated by both anomie and suggestion-imitation. The findings offer the possibility to identify communities that carry a substantial risk for adolescent suicide as well as the mechanisms that mediate the influence of community structural characteristics on adolescent risk behavior.
Watt, Toni Terling; Sharp, Susan F.
Investigated suicidal strains contributing to suicidal behaviors among adolescents by race. Data from the Add Health Project support the presence of process differences by race and delineate the specific nature of these differences. For example, Blacks experience more status strains, but they are more religious than Whites (which serves to…
Ganz, D; Sher, L
Recently, the prevalence of post-traumatic stress disorder (PTSD) in adolescence is higher than the prevalence of PTSD in adult populations. PTSD and suicidality are often found in populations of adolescents presenting with other emotional disorders (particularly mood disorders), traumatic grief, childhood abuse, and/or a family or peer history of suicide. The reasons and developments of the association between PTSD and suicidality in adolescence, however, remain unclear. Core psychobiological changes contributing to PTSD affect emotion, arousal, perception of the self and the world, irritability, impulsivity, anger, aggression and depression. There is evidence that the aforementioned factors, as well as alcohol and other drug use may act to moderate the influence of stressful life events and lead to eventual suicidality. Both PTSD and suicidality in adolescents have also been hypothesized to be a result of exposure to violence and negative coping styles. There are many treatment challenges for these populations, yet the most promising prevention and treatments include suicide risk screenings, suicide education, Dialectical Behavioral Therapy, addressing associated coping mechanisms and prescribing anti-depressant and anti-anxiety medications. However, when prescribing medications, physicians do need to be careful to consider the weaknesses and strengths of each of the pharmacological options as they apply to adolescents presenting with PTSD and suicidality.
Bossarte, Robert M.; Simon, Thomas R.; Swahn, Monica H.
To understand the co-occurrence of multiple types of violence, the authors developed a behavioral typology based on self-reports of suicidal behaviors, physical violence, and psychological abuse. Using a sample of dating adolescents from a high-risk school district, they identified five clusters of behaviors among the 1,653 students who reported…
The adolescent at risk for suicidal preoccupation and behavior has become an increasing concern for schools and communities. This paper presents some of the causes of teen suicide, things adults should know about adolescent suicide prevention, and what can be done to help such youth. The transition to adolescence is a complex time when many values…
Bernburg, Jon Gunnar; Thorlindsson, Thorolfur; Sigfusdottir, Inga D
Despite the longstanding interest of social researchers in the social factors that influence suicide and suicidal behavior, multilevel research on this topic has been limited. Using nested survey data on 5331 Icelandic adolescents (born in 1990 and 1991) in 83 school-communities, the current study examines the contextual effect of community household poverty on adolescent suicidal behavior (suicide ideation and suicide attempt). The findings show that the concentration of household poverty in the school-community has a significant, contextual effect on adolescent suicidal behavior. Furthermore, we test an "epidemic" explanation for this effect, examining the mediating role of suicide suggestion (contact with suicidal others). We find that suicide suggestion mediates a substantial part of the contextual effect of community household poverty on suicide attempt, while mediation is modest in the case of suicide ideation. The findings indicate that community household poverty increases the risk of adolescent suicidal behavior in part because communities in which household poverty is common entail a higher risk for adolescents of associating with suicidal others. The study demonstrates how the concentration of individual problems can have macrolevel implications, creating social mechanisms that cannot be reduced to the circumstances or characteristics of individuals.
Opperman, Kiel; Czyz, Ewa K; Gipson, Polly Y; King, Cheryl A
The interpersonal theory of suicidal behavior emphasizes the constructs of perceived burdensomeness, thwarted belongingness, and acquired capacity, which warrant investigation in adolescents at risk for suicide due to interpersonal stressors. This study examined one component of the interpersonal theory of suicidal behavior, "suicidal desire" (suicidal ideation), in 129 adolescents (12-15 years) recruited from a general medical emergency department who screened positive for bully victimization, bully perpetration, or low interpersonal connectedness. Greater perceived burdensomeness combined with low family connectedness was a significant predictor of suicidal ideation. This suggests the importance of addressing connectedness and perceptions of burdensomeness in prevention and early intervention efforts with at-risk adolescents.
Adam, Kenneth S.; And Others
Adolescents in psychiatric treatment (N=133) participated in a case-comparison study investigating the association of attachment patterns with a history of suicidal behaviors. Attachment patterns were assessed using the Adult Attachment Interview. In accordance with definitions provided in the scoring system, 86% of case and 78% of comparison…
Pan, Lisa A.; Batezati-Alves, Silvia C.; Almeida, Jorge R. C.; Segreti, AnnaMaria; Akkal, Dalila; Hassel, Stefanie; Lakdawala, Sara; Brent, David A.; Phillips, Mary L.
Objectives: Impaired attentional control and behavioral control are implicated in adult suicidal behavior. Little is known about the functional integrity of neural circuitry supporting these processes in suicidal behavior in adolescence. Method: Functional magnetic resonance imaging was used in 15 adolescent suicide attempters with a history of…
Gulbas, Lauren E.; Hausmann-Stabile, Carolina; De Luca, Susan M.; Tyler, Tee R.; Zayas, Luis H.
To date, there is little research to validate empirically differences between non-suicidal self-injurious behavior (NSSI) and attempted suicide among Latina adolescents. Understanding the characteristics and contextual features of self-harmful behaviors among Latina teens is a critical public health and social justice matter given the disproportionate rates of attempted suicide and anticipated population growth of this vulnerable group. In this article, we draw on an ecodevelopmental model to focus attention on factors in the sociocultural environment that shape suicidal and non-suicidal self-injurious behaviors. Through analysis of qualitative interviews conducted with girls who used NSSI (n = 18), attempted suicide (n = 29), used NSSI and attempted suicide (n = 8,) and had no reported lifetime history of self-harm (n = 28), we describe the sociocultural factors that shaped psychosocial vulnerabilities and gave rise to decisions to use NSSI or attempt suicide. Our analysis revealed that adolescents who engaged in NSSI perceived their negative feelings as something that could be controlled through self-injurious acts, whereas powerlessness was a theme underlying the emotional states of girls who attempted suicide. When NSSI ceased to function as a mechanism for control, girls came to sudden decisions to attempt suicide. Most teens identified specific, and often multiple, situations that induced these intense affective states and shaped decisions to inflict self-harm. Two situational experiences emerged as particularly salient and promising for subsequent studies on self-harmful behaviors among Latina adolescents: transnational stress and bullying. We describe each of these and offer suggestions for future research and practice. PMID:26052816
Abrutyn, Seth; Mueller, Anna S
Though Durkheim argued that strong social relationships protect individuals from suicide, we posit that these relationships have the potential to increase individuals' vulnerability when they expose them to suicidality. Using three waves of data from the National Longitudinal Study of Adolescent Health, we evaluate whether new suicidal thoughts and attempts are in part responses to exposure to the suicide attempts of role models, specifically friends and family. We find that the suicide attempts of role models do in fact trigger new suicidal thoughts and in some cases attempts, even after significant controls are introduced. Moreover, we find that these effects fade with time, that girls are more vulnerable to them than boys, and that the relationship to the role model-for teenagers at least-matters. Friends appear to be more salient role models for both boys and girls. Our findings suggest that exposure to suicidal behaviors in significant others may teach individuals new ways to deal with emotional distress, namely by becoming suicidal. This reinforces the idea that the structure - and content - of social networks conditions their role in preventing suicidality. Specifically, social ties can be conduits of not just social support, but also anti-social behaviors, like suicidality.
Abrutyn, Seth; Mueller, Anna S.
Though Durkheim argued that strong social relationships protect individuals from suicide, we posit that these relationships have the potential to increase individuals’ vulnerability when they expose them to suicidality. Using three waves of data from the National Longitudinal Study of Adolescent Health, we evaluate whether new suicidal thoughts and attempts are in part responses to exposure to the suicide attempts of role models, specifically friends and family. We find that the suicide attempts of role models do in fact trigger new suicidal thoughts and in some cases attempts, even after significant controls are introduced. Moreover, we find that these effects fade with time, that girls are more vulnerable to them than boys, and that the relationship to the role model—for teenagers at least—matters. Friends appear to be more salient role models for both boys and girls. Our findings suggest that exposure to suicidal behaviors in significant others may teach individuals new ways to deal with emotional distress, namely by becoming suicidal. This reinforces the idea that the structure – and content – of social networks conditions their role in preventing suicidality. Specifically, social ties can be conduits of not just social support, but also anti-social behaviors, like suicidality. PMID:26069341
Pettit, Jeremy W.; Green, Kelly L.; Grover, Kelly E.; Schatte, Dawnelle J.; Morgan, Sharon T.
Little is known about the role of chronic stress in youth suicidal behaviors. This study examined the relations between specific domains of chronic stress and suicidal behaviors among 131 inpatient youth (M age = 15.02 years) who completed measures of stress, suicidal ideation, suicide attempt, and suicide intent. After controlling for…
Zschoche, Maria; Schlarb, Angelika Anita
Purpose Sleep disturbances are a common problem during adolescence. Often there is a relationship with the mental health of the affected person. The existing literature concerning the link between sleep disturbances and aggressive behavior and sleep disturbances and suicidality during adolescence shows no clear results. The present study tested a mediation model to prove the relation between sleep problems, aggressive behavior, and suicidality during adolescence. To take the link between suicidality and depression into account, the amount of depressive symptoms was included into the mediation model. Methods A sample of 93 adolescents aged 14–18 years (30% male) was studied. A survey was conducted to interview the adolescents about their mental health, sleep-related behaviors, aggressive behavior, and suicidality. Results Sleep problems and suicidality measures were significantly related to each other. Furthermore, aggressive behavior and suicidality showed a significant relationship. The expected link between sleep problems and aggressive behavior was not significant. For the mediation model, no significant influence of aggressive behavior on the relationship between the amount of sleep problems and suicidality was found. However, the impact of depressive symptoms on the relationship between sleep problems and suicidality was significant. Conclusion Sleep problems and overall suicidality in adolescents are significantly connected, even after adjusting for several possible influencing factors. Aggressive behavior could not be confirmed as a mediator for the association between sleep problems and suicidality in adolescents. Further studies to examine the link between insomnia symptoms, aggressive behavior, and suicidality in adolescents are necessary. PMID:25767409
Sharma, Rahul; Grover, Vijay L.; Chaturvedi, Sanjay
Objective: To study the prevalence of suicidal behavior and its epidemiological correlates amongst adolescent students in south Delhi. Settings and Design: A cross-sectional study in three schools and two colleges in south Delhi. Participants: A total of 550 adolescent students aged 14 to 19 years selected by cluster sampling. Statistical Analysis: Proportions, chi square test, bivariate logistic regression. Results: About 15.8% reported having thought of attempting suicide, while 28 (5.1%) had actually attempted suicide, both being more in females than in males. Statistically significant associations were observed with the age of the student, living status of parents, working status of mother, and whether the student was working part-time. The two variables found significant on multivariate analysis were female gender and the number of role models the student had ever seen smoking or drinking. Conclusion: The prevalence of suicide-risk behavior was found to be quite high and is a matter that should evoke public health concern. PMID:19771304
Shek, Daniel T. L.; Yu, Lu
The present paper examined the prevalence and psychosocial correlates of adolescent deliberate self-harm (DSH) and suicidal behavior in a representative sample of 3,328 secondary school students in Hong Kong. With reference to the previous year, 32.7% of the students reported at least one form of DSH, 13.7% of the respondents had suicide thoughts, 4.9% devised specific suicidal plans, and 4.7% had actually attempted suicide. Adolescent girls had significantly higher rates of DSH and suicidal behavior than did adolescent boys. Having remarried parents was related to an increased likelihood of DSH and suicide. While high levels of family functioning, overall positive youth development, and academic and school performance predicted low rates of DSH and suicidal behavior, cognitive and behavioral competencies were unexpectedly found to be positively associated with DSH and suicidal behavior. Theoretical and practical implications of the findings are discussed. PMID:22566783
Weeks, Murray; Colman, Ian
We examined risk factors for suicidal behaviors (i.e., suicidal ideation and suicide attempts) in the absence of depression during adolescence. Using 6,788 adolescents from the National Longitudinal Survey of Children and Youth (NLSCY), we identified participants with "no recent history of depression." We then tested the effects of risk factors at age 14-15 on suicidal behaviors at age 16-17. Absence of recent depression history negatively predicted both suicidal ideation and suicide attempt. However, among those with no history of depression, substance use and the presence of a chronic illness both increased the risk of suicidal behaviors. Suicidal behavior in adolescents in the absence of depression history may be explained by factors such as substance use and chronic illness.
Pettit, Jeremy W; Green, Kelly L; Grover, Kelly E; Schatte, Dawnelle J; Morgan, Sharon T
Little is known about the role of chronic stress in youth suicidal behaviors. This study examined the relations between specific domains of chronic stress and suicidal behaviors among 131 inpatient youth (M age = 15.02 years) who completed measures of stress, suicidal ideation, suicide attempt, and suicide intent. After controlling for demographics, diagnostic status, past history of attempt, and life event stress, the predictors of suicidal ideation were chronic stress in family relationships, close friendship, and physical health. Chronic close friendship stress also predicted suicide intent among attempters after controlling for covariates. No domain robustly predicted the presence of an attempt or moderated the relation between life event stress and suicidal behaviors. These findings highlight the role of certain domains of chronic stress in suicidal ideation and suicide intent.
Harel-Fisch, Yossi; Abdeen, Ziad; Walsh, Sophie D; Radwan, Qasrowi; Fogel-Grinvald, Haya
Based conceptually on Problem Behavior Theory, Normalization Theory and theories of adolescent ethnic identity formation this study explores relationships between individual and cumulative multiple risk behaviors and suicidal ideation and behavior among mid-adolescents in three different populations in the Middle East. Data from the 2004 Health Behavior in School-Aged Children in the Middle-East (HBSC-ME) study included 8345 10th-grade pupils in three populations: Jewish Israelis (1770), Arab Israelis (2185), and Palestinians in Gaza and the West Bank (4390). We considered risk behaviors and factors including tobacco use, bullying, medically-attended injuries, excessive time with friends, parental disconnectedness, negative school experience, truancy and poor academic performance. Substantial population differences for suicidal tendency and risk behaviors were observed, with notably high levels of suicidal ideation and behavior among Arab-Israeli youth and higher levels of risk behaviors among the Jewish and Arab-Israeli youth. For all populations suicidal tendency was at least 4 times higher among adolescents reporting 4+ risk behaviors, suggesting that similar psychosocial determinants affect patterns of risk behaviors and suicidal tendency. Results highlight the importance of understanding cultural contexts of risk behaviors and suicidal ideation and behavior.
Liu, Xianchen; Zhao, Zhongtang; Jia, Cunxian
The aim of this study was to examine insomnia symptoms, behavioral problems, and suicidality among adolescents of insomniac parents (IP) and non-insomniac parents (NIP). A family survey of sleep and health was conducted among 1090 adolescents and their parents in Jinan, China. Adolescents completed a sleep and health questionnaire to report their sleep and mental health problems. Parents reported their insomnia symptoms and history of mental disorders. Insomnia, behavioral problems, and suicidal behavior were compared between IP adolescents and NIP adolescents. IP adolescents were more likely than NIP adolescents to report insomnia symptoms, use of sleep medication, suicidal ideation, suicide plan, and suicide attempt. IP adolescents scored significantly higher than NIP adolescents on withdrawn and externalizing behavioral problems. After adjustment for demographics and behavioral problems, parental insomnia remained to be significantly associated with adolescent suicidal ideation and suicide plan. Our findings support the need for early screening and formal assessment of sleep and mental health in adolescents of insomniac parents.
Wells, Karen C.; Heilbron, Nicole
A considerable research base underscores the importance of family functioning in the risk for and treatment of adolescent suicidal thoughts and behaviors. This paper reviews the extant empirical literature documenting associations between features of the family context and adolescent suicidal thoughts and behaviors. A case example is provided to…
Litwiller, Brett J; Brausch, Amy M
The impact of bullying in all forms on the mental health and safety of adolescents is of particular interest, especially in the wake of new methods of bullying that victimize youths through technology. The current study examined the relationship between victimization from both physical and cyber bullying and adolescent suicidal behavior. Violent behavior, substance use, and unsafe sexual behavior were tested as mediators between two forms of bullying, cyber and physical, and suicidal behavior. Data were taken from a large risk-behavior screening study with a sample of 4,693 public high school students (mean age = 16.11, 47 % female). The study's findings showed that both physical bullying and cyber bullying associated with substance use, violent behavior, unsafe sexual behavior, and suicidal behavior. Substance use, violent behavior, and unsafe sexual behavior also all associated with suicidal behavior. Substance use and violent behavior partially mediated the relationship between both forms of bullying and suicidal behavior. The comparable amount of variance in suicidal behavior accounted for by both cyber bullying and physical bullying underscores the important of further cyber bullying research. The direct association of each risk behavior with suicidal behavior also underscores the importance of reducing risk behaviors. Moreover, the role of violence and substance use as mediating behaviors offers an explanation of how risk behaviors can increase an adolescent's likelihood of suicidal behavior through habituation to physical pain and psychological anxiety.
Horwitz, Adam G.; Hill, Ryan M.; King, Cheryl A.
The coping strategies used by adolescents to deal with stress may have implications for the development of depression and suicidal ideation. This study examined coping categories and specific coping behaviors used by adolescents to assess the relation of coping to depression and suicidal ideation. In hierarchical regression models, the specific…
Gal, Gilad; Levav, Itzhak; Gross, Raz
The association between childhood and adolescent abuse and suicidal behavior, and the possible contribution of abuse to sex differences in non lethal suicidal behavior, was investigated. Data were extracted from the Israel-based component of the WHO World Mental Health Survey (Kessler & Utsun, 2008a). Increased risk for ideation, plan, and suicidal attempt were associated with childhood abuse, and increased risk for attempt was associated also with abuse at adolescence. No associations with sex or sex by abuse interactions were observed. The higher frequency of childhood abuse among women could account in part for their higher rates of suicidal attempts as compared to men.
Gal, Gilad; Levav, Itzhak; Gross, Raz
The association between childhood and adolescent abuse and suicidal behavior, and the possible contribution of abuse to sex differences in non lethal suicidal behavior, was investigated. Data were extracted from the Israel-based component of the WHO World Mental Health Survey (Kessler & Utsun, 2008a). Increased risk for ideation, plan, and…
Thorlindsson, Thorolfur; Bernburg, Jon Gunnar
The current study examines the contextual effects of community structural characteristics, as well as the mediating role of key social mechanisms, on youth suicidal behavior in Iceland. We argue that the contextual influence of community structural instability on youth suicidal behavior should be mediated by weak attachment to social norms and…
Kim, Sun Mi; Han, Doug Hyun; Trksak, George H; Lee, Young Sik
Suicide among adolescents is an emerging global public health problem as well as a socioeconomic problem. Stress-coping strategies have been shown to be associated with suicidal ideation. We examined coping behaviors related to suicidal ideation and gender differences in adolescents using the data from the 2010 Korea Youth Risk Behavior Survey (ages 12-19 years; N = 73,238). Logistic regression analysis was used to evaluate associations between suicidal ideation and specific coping behaviors while controlling for potentially confounding variables. In both male and female groups, the coping behavior "drinking alcoholic beverages" and "smoking cigarettes" were positively associated with suicidal ideation. "Watching TV," "playing online/mobile games," and "sleeping" were negatively associated with suicidal ideation in both groups. In males, "engaging in sports" was negatively related to suicidal ideation. In females, "venting by talking to others" and "eating" were negatively related to suicidal ideation. The results indicate that there are gender differences in the effects of coping behaviors on adolescent suicidal ideation, and that developing adaptive coping strategies may function to reduce suicidality. Future studies are needed to examine whether improving coping skills can reduce suicidal ideation in a gender-specific manner.
Nock, Matthew K.; Borges, Guilherme; Bromet, Evelyn J.; Cha, Christine B.; Kessler, Ronald C.; Lee, Sing
Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior. PMID:18653727
Radeloff, Daniel; Lempp, Thomas; Rauf, Amna; Bennefeld-Kersten, Katharina; Kettner, Mattias; Freitag, Christine M
Following accidents, suicide is the second leading cause of death in adolescence. This stage of life has the most suicide attempts of all age groups. In addition to mentally ill juveniles, adolescent delinquents represent a high-risk group for suicidal behavior and completed suicide. In particular, the population of detainees, an extreme form of juvenile delinquency, have a 16- to 18-fold higher risk of suicidal behavior and suicide compared to the general population. Because the composition of juvenile detainees differs greatly from that of detained adults, age-specific scientific approaches and prevention programs are needed. This task cannot be addressed by juvenile detention staff alone, but rather demands close cooperation between adolescent psychiatrists, psychologists, prison medical staff, legal experts and prison officers to use the opportunity for suicide prevention in juvenile detention facilities.
Cash, Scottye J.; Bridge, Jeffrey A.
Purpose of Review Suicide is the third leading cause of death among young people in the U.S. and represents a significant public health problem worldwide. This review focuses on recent developments in our understanding of the epidemiology and risk factors for adolescent suicide and suicidal behavior. Recent Findings The suicide rate among children and adolescents in the U.S. has increased dramatically in recent years and has been accompanied by substantial changes in the leading methods of youth suicide, especially among young girls. Much work is currently underway to elucidate the relationships between psychopathology, substance use, child abuse, bullying, internet use, and youth suicidal behavior. Recent evidence also suggests sex-specific and moderating roles of gender in influencing risk for suicide and suicidal behavior. Summary Empirical research into the causal mechanisms underlying youth suicide and suicidal behavior is needed to inform early identification and prevention efforts. PMID:19644372
Molock, Sherry Davis; Puri, Rupa; Matlin, Samantha; Barksdale, Crystal
This study investigated whether hopelessness and depression were risk factors for suicidal thoughts and behaviors in African American adolescents and looked at whether religious participation and religious coping protected these students from suicidality. Participants were 212 African American high school students (133 females, 79 males). The…
Brausch, Amy M.; Decker, Kristina M.; Hadley, Andrea G.
This study examined adolescent participation in self-asphyxial risk-taking behaviors (SAB), sometimes known as the "choking game," and its relationship with other adolescent risk behaviors, including non-suicidal self-injury (NSSI). Researchers proposed that participation in SAB and NSSI would be associated with suicidal behavior, disordered…
Matsumoto, Toshihiko; Tsutsumi, Atsuro; Izutsu, Takashi; Imamura, Fumi; Chiba, Yasuhiko; Takeshima, Tadashi
The present study examined the prevalence of suicidal behavior and sexual abuse history in delinquent and non-delinquent adolescents aged 15-17 years. Results showed that delinquent adolescents, particularly girls, more frequently reported histories of suicidal behavior and sexual abuse than non-delinquent adolescents.
Groschwitz, Rebecca C; Kaess, Michael; Fischer, Gloria; Ameis, Nina; Schulze, Ulrike M E; Brunner, Romuald; Koelch, Michael; Plener, Paul L
Non-suicidal self-injury (NSSI) and suicidal behaviors frequently occur among adolescent psychiatric patients. Although those behaviors are distinct with regards to intent, NSSI has been shown to be an important risk-factor for suicide attempts. However, the association of NSSI and Suicidal Behavior Disorder (SBD) according to DSM-5 criteria has not yet been investigated. For investigating distinctive features and mutual risk-factors of NSSI-disorder and SBD, adolescent psychiatric inpatients (N=111, aged 12-19 years; 65.8% females) were interviewed using the Self-Injurious-Thoughts-And-Behaviors-Interview-German (SITBI-G). NSSI started significantly earlier in life (M=12.5 years, SD=2.2) than first suicide attempts (M=14.1 years, SD=2.0). Patients meeting NSSI-disorder and/or SBD were significantly more likely to be female and to be diagnosed with an affective disorder. NSSI-disorder and SBD seem to have several distinctive features (i.e. age of onset or frequency), but also seem to share certain mutual risk-factors (i.e. affective disorders, female gender). While both NSSI and SBD seem to be maintained by mainly automatic negative reinforcement, positive automatic and social functions were rated significantly higher for NSSI. Most importantly, NSSI seems to be a strong risk factor for the occurrence of SBD (even when controlling for suicidal ideation) and should therefore always be assessed when dealing with psychiatric adolescent patients.
Gulbas, Lauren E; Hausmann-Stabile, Carolina; De Luca, Susan M; Tyler, Tee R; Zayas, Luis H
To date, there is little research to validate empirically differences between nonsuicidal self-injurious behavior (NSSI) and attempted suicide among Latina adolescents. Understanding the characteristics and contextual features of self-harmful behaviors among Latina teens is a critical public health and social justice matter given the disproportionate rates of attempted suicide and anticipated population growth of this vulnerable group. In this article, we draw on an ecodevelopmental model to focus attention on factors in the sociocultural environment that shape suicidal behaviors and NSSIs. Through analysis of qualitative interviews conducted with girls who used NSSI (n = 18), attempted suicide (n = 29), used NSSI and attempted suicide (n = 8,) and had no reported lifetime history of self-harm (n = 28), we describe the sociocultural factors that shaped psychosocial vulnerabilities and gave rise to decisions to use NSSI or attempt suicide. Our analysis revealed that adolescents who engaged in NSSI perceived their negative feelings as something that could be controlled through self-injurious acts, whereas powerlessness was a theme underlying the emotional states of girls who attempted suicide. When NSSI ceased to function as a mechanism for control, girls came to sudden decisions to attempt suicide. Most teens identified specific, and often multiple, situations that induced intense affective states and shaped decisions to inflict self-harm. Two situational experiences emerged as particularly salient and promising for subsequent studies on self-harmful behaviors among Latina adolescents: transnational stress and bullying. We describe each of these and offer suggestions for future research and practice.
Fischer, Sarah; Peterson, Claire
There are few published randomized controlled trials examining treatment for symptoms of bulimia nervosa (BN) in adolescents. Additionally, many adolescents presenting for treatment for BN symptoms endorse co-occurring mood disturbances, suicidality, and nonsuicidal self-injury (NSSI), and may not meet full Diagnostic and Statistical Manual-IV-Text Revision (DSM-IV-TR) diagnostic criteria for BN. In addition to the limited number of randomized controlled trials, published treatment studies of BN symptoms in adolescence do not specifically address the multiple comorbid symptoms that these adolescents often report. The purpose of this pilot study was to examine the feasibility and effectiveness of an outpatient dialectical behavior therapy (DBT) program for adolescents with symptoms of BN, suicide attempts, and NSSI. Ten eligible participants enrolled in the study; 3 dropped within 4 weeks of initiating treatment. In addition to binge eating and suicidal behavior, participants also endorsed a number of other comorbid mood disorders and substance abuse. Seven participants completed 6 months of treatment and 6-month follow-up assessments. Treatment included access to a crisis management system, individual therapy, skills training, and a therapist consultation team. At posttreatment, participants had significantly reduced self-harm; (Cohen's d = 1.35), frequency of objective binge episodes (Cohen's d = .46), frequency of purging (Cohen's d = .66), and Global Eating Disorder Examination scores (Cohen's d = .64). At follow-up, 6 participants were abstinent of NSSI; 3 participants were abstinent from binge eating. At follow-up, treatment gains were maintained and enhanced. Results indicate that it is feasible to address multiple forms of psychopathology during the treatment of BN symptoms in this age-group.
Litwiller, Brett J.; Brausch, Amy M.
The impact of bullying in all forms on the mental health and safety of adolescents is of particular interest, especially in the wake of new methods of bullying that victimize youths through technology. The current study examined the relationship between victimization from both physical and cyber bullying and adolescent suicidal behavior. Violent…
Grover, Kelly E; Green, Kelly L; Pettit, Jeremy W; Monteith, Lindsey L; Garza, Monica J; Venta, Amanda
The present study examined the unique and interactive effects of stress and problem-solving skills on suicidal behaviors among 102 inpatient adolescents. As expected, life event stress and chronic stress each significantly predicted suicidal ideation and suicide attempt. Problem solving significantly predicted suicidal ideation, but not suicide attempt. Problem solving moderated the associations between life event stress and suicidal behaviors, as well as between chronic stress and suicidal ideation, but not chronic stress and suicide attempt. At high levels of stress, adolescents with poor problem-solving skills experienced elevated suicidal ideation and were at greater risk of making a nonfatal suicide attempt. The interactive effects decreased to non-significance after controlling for depressive symptoms and hopelessness. Clinical implications are discussed.
Roh, Beop-Rae; Yoon, Yoewon; Kwon, Ahye; Oh, Seunga; Lee, Soyoung Irene; Ha, Kyunghee; Shin, Yun Mi; Song, Jungeun; Park, Eun Jin; Yoo, Heejung; Hong, Hyun Ju
Objective This study had two main goals: to examine the structure of co-occurring peer bullying experiences among adolescents in South Korea from the perspective of victims and to determine the effects of bullying on suicidal behavior, including suicidal ideation and suicide attempts, among adolescents. Method This study used data gathered from 4,410 treatment-seeking adolescents at their initial visits to 31 local mental health centers in Gyeonggi Province, South Korea. The structure of peer bullying was examined using latent class analysis (LCA) to classify participants’ relevant experiences. Then, a binomial logistic regression adjusted by propensity scores was conducted to identify relationships between experiences of being bullied and suicidal behaviors. Results The LCA of experiences with bullying revealed two distinct classes of bullying: physical and non-physical. Adolescents who experienced physical bullying were 3.05 times more likely to attempt suicide than those who were not bullied. Victims of (non-physical) cyber bullying were 2.94 times more likely to attempt suicide than were those who were not bullied. Conclusions Both physical and non-physical bullying were associated with suicide attempts, with similar effect sizes. Schools and mental health professionals should be more attentive than they currently are to non-physical bullying. PMID:26619356
Post-traumatic stress disorder (PTSD) is a common psychiatric disorder which is frequently comorbid with major depressive disorder (MDD). It has been suggested that some or all individuals diagnosed with comorbid PTSD and MDD have a separate psychobiological condition that can be termed ''post-traumatic mood disorder'' (PTMD). The idea was based on the fact that a significant number of studies suggested that patients suffering from comorbid PTSD and MDD differed clinically and biologically from individuals with PTSD alone or MDD alone. Individuals with comorbid PTSD and MDD are characterized by greater severity of symptoms and the higher level of impairment in social and occupational functioning compared to individuals with PTSD alone or MDD alone. Neurobiological evidence supporting the concept of PTMD includes the findings from neuroendocrine challenge, cerebrospinal fluid, neuroimaging, sleep and other studies. It has been demonstrated that child abuse increases the risk for PTSD, MDD, and suicidal behavior in adolescents and adults. Many victims of childhood abuse develop comorbid PTSD and depression, i.e., they develop PTMD. PTMD is associated with suicidal behavior. The link between childhood abuse, suicidal behavior in adolescents and PTMD indicates that it is important to develop interventions to prevent PTMD in victims of child abuse; to develop measures to prevent suicidal behavior in adolescents with PTMD; and to study psychobiology of PTMD in order to develop treatments for PTMD. Priorities for intervening to reduce adolescent suicidal behavior lie with interventions focused upon the improved recognition, treatment and management of adolescents with psychiatric disorders including PTMD.
... like a victim Feelings of rejection, loss, or loneliness Suicidal behaviors may occur when there is a ... dismiss the person as just trying to get attention. Prevention Avoiding alcohol and drugs (other than prescribed ...
Nickerson, Amanda B.; Slater, Evan D.
This study examined the extent to which violent behavior and peer victimization were associated with suicidal ideation, plans, and attempts in a nationally representative sample of 11,113 adolescents who completed the 2005 Youth Risk Behavior Survey. Boys were more likely to be involved in physical fighting and weapon carrying, whereas girls were…
Crow, Scott; Eisenberg, Marla E.; Story, Mary; Neumark-Sztainer, Dianne
Disordered eating, body dissatisfaction, and obesity have been associated cross sectionally with suicidal behavior in adolescents. To determine the extent to which these variables predicted suicidal ideation and attempts, the authors examined these relationships in a longitudinal design. The study population included 2,516 older adolescents and…
Duarté-Vélez, Yovanska; Torres-Dávila, Paloma; Spirito, Anthony; Polanco, Norka; Bernal, Guillermo
Adolescents in Puerto Rico are at an increased risk for suicide attempts, though evidence-based treatments specifically for this group have not been tested. The current study was designed to develop and pilot test a culturally sensitive, manualized outpatient treatment for Puerto Rican adolescents who have experienced a suicidal crisis. The study was divided into phases. Phase 1 consisted of developing a socio-cognitive behavioral treatment for suicidal behavior. Phase 2 tested the treatment protocol in an open trial with 11 (6 male and 5 female) Puerto Rican adolescents. Active treatment had an approximate duration of 3-6 months. An initial assessment, process measures, and posttreatment assessment were completed with each participant to measure treatment feasibility as well as suicidality, symptoms, and risk factors. Participants were very satisfied with treatment and reported relevant clinical benefits. The retention rate was 73% (8 out of 11). For those who completed the treatment protocol, the goal of reducing further suicide risk was achieved; 2 showed reliable clinical changes in suicidal ideation, while 6 maintained low levels during treatment. All treatment completers had either a partial or total remission of their pretreatment diagnosis and half had reliable improvements in at least 1 risk factor. A theory-driven treatment protocol was developed according to patient's needs, but further research is needed to continue its development and to explore its efficacy.
Czyz, Ewa K; Berona, Johnny; King, Cheryl A
The challenge of identifying suicide risk in adolescents, and particularly among high-risk subgroups such as adolescent inpatients, calls for further study of models of suicidal behavior that could meaningfully aid in the prediction of risk. This study examined how well the Interpersonal-Psychological Theory of Suicidal Behavior (IPTS)--with its constructs of thwarted belongingness (TB), perceived burdensomeness (PB), and an acquired capability (AC) for lethal self-injury--predicts suicide attempts among adolescents (N = 376) 3 and 12 months after hospitalization. The three-way interaction between PB, TB, and AC, defined as a history of multiple suicide attempts, was not significant. However, there were significant 2-way interaction effects, which varied by sex: girls with low AC and increasing TB, and boys with high AC and increasing PB, were more likely to attempt suicide at 3 months. Only high AC predicted 12-month attempts. Results suggest gender-specific associations between theory components and attempts. The time-limited effects of these associations point to TB and PB being dynamic and modifiable in high-risk populations, whereas the effects of AC are more lasting. The study also fills an important gap in existing research by examining IPTS prospectively.
Hartley, Chelsey M; Pettit, Jeremy W; Castellanos, Daniel
The empirical literature on the association between reactive aggression and suicide-related behaviors in children and adolescents was reviewed. A narrative review of seven studies that met inclusion/exclusion criteria is followed by a preliminary meta-analysis to provide insight into the strength of the association between reactive aggression and suicide-related behaviors. Each of the seven studies reported a statistically significant association between reactive aggression and suicide-related behaviors, including suicide, nonfatal suicide attempt, and suicide ideation. Results from the meta-analysis indicated a consistent, medium-sized association (k = 7; N = 4,693; rbar = .25). The narrative review and results of the preliminary meta-analysis support the promise of pursuing future research on reactive aggression and suicide-related behaviors in children and adolescents. A theoretical model is proposed to guide the development of future research.
Ruby, Eugene; Sher, Leo
Post-traumatic stress disorder (PTSD) is significantly associated with an increased risk for suicidal behavior among adolescents. Suicide is one of the top three causes of adolescent deaths worldwide. Despite the strong relationship between PTSD and suicidal behavior, precise causal pathways linking PTSD to suicide in adolescents remains unclear. A slew of mediating factors and variables commonly present themselves with both suicide and PTSD, including co-morbid psychiatric disorders, exposure to different forms of trauma and stressful life events, core neurobiological changes, and mental, emotional, and physiological states such as hyperarousal, impulsivity, and aggression. Because youth is such a critical stage of development, it is very important that at-risk adolescents are identified and referred for treatment. With many treatment challenges in these populations, effective implementation and use of prevention methods are of increasing importance. The most proven prevention methods include physician education, means restriction, and gatekeeper training. Other strategies that have received empirical support are public education campaigns and implementing guidelines for the media, including those for television, print media, and the Internet.
Storch, Eric A.; Hanks, Camille E.; Mink, Jonathan W.; McGuire, Joseph F.; Adams, Heather R.; Augustine, Erika F.; Vierhile, Amy; Thatcher, Alyssa; Bitsko, Rebecca; Lewin, Adam B.; Murphy, Tanya K.
Objective Despite evidence of elevated risk factors for suicidal thoughts and behavior in youth with Tourette syndrome and chronic tic disorders (CTD), few studies have actually examined that relationship. This study documented the frequency and clinical correlates of suicidal thoughts and behaviors in a sample of children and adolescents with CTD (N=196; range 6-18 years old). Method Youth and parents completed a battery of measures that assessed co-occurring psychiatric diagnoses, child emotional and behavioral symptoms, and impairment due to tics or co-occurring conditions. Results A structured diagnostic interview identified that 19 youths with CTD (9.7%) experienced suicidal thoughts and/or behaviors, which was elevated compared to three youths (3%) who experienced these thoughts in a community control sample (N=100; range 6-18 years old; p = 0.03). For youth with CTD, suicidal thoughts and behaviors were frequently endorsed in the context of anger and frustration. The Child Behavior Checklist (CBCL) anxious/depressed, withdrawn, social problems, thought problems, and aggressive behavior subscales, as well as the total internalizing problems scale were associated with the presence of suicidal thoughts and/or behaviors. Suicidal thoughts and/or behaviors were significantly associated with tic symptom severity, tic-related impairment, and obsessive-compulsive, depressive, anxiety, and attention-deficit/hyperactivity disorder symptom severity. CBCL anxiety/depression scores mediated the relationship between tic severity and suicidal thoughts and behaviors. Conclusions Findings suggest that about 1 in 10 youth with CTD experience suicidal thoughts and/or behaviors, which are associated with a more complex clinical presentation and often occur in the presence of anger and frustration. PMID:25711415
Grandclerc, Salome; De Labrouhe, Diane; Spodenkiewicz, Michel; Lachal, Jonathan; Moro, Marie-Rose
Nonsuicidal self-injury (NSSI) and suicidal behaviors, both important issues in adolescent health care, are frequently associated and possibly clinically related. Our objective was to explore the views of relations between nonsuicidal self-injury and suicidal behaviors during adolescence and young adulthood (11-25 years) expressed in the scientific (medical and psychological) literature. We adopted a textual approach to the process of synthesis to tell the story of the findings from the included studies. Our narrative systematic review of 64 articles found that they share the same risk factors. Integrated models envision nonsuicidal self-injury as a gateway enabling teens to acquire the capability for suicide. Because suicidal behavior short-circuits thought, it is difficult to conceive an intention to die during adolescents' acts of self-injury. Intention is constructed by the narrative of the act, influenced by numerous elements from the psychopathologic, cultural, religious, and philosophic context. Techniques of mentalizing-based treatments and work on the meaning that adolescents attribute to their behaviors might improve care.
Grandclerc, Salome; De Labrouhe, Diane; Spodenkiewicz, Michel
Nonsuicidal self-injury (NSSI) and suicidal behaviors, both important issues in adolescent health care, are frequently associated and possibly clinically related. Our objective was to explore the views of relations between nonsuicidal self-injury and suicidal behaviors during adolescence and young adulthood (11–25 years) expressed in the scientific (medical and psychological) literature. We adopted a textual approach to the process of synthesis to tell the story of the findings from the included studies. Our narrative systematic review of 64 articles found that they share the same risk factors. Integrated models envision nonsuicidal self-injury as a gateway enabling teens to acquire the capability for suicide. Because suicidal behavior short-circuits thought, it is difficult to conceive an intention to die during adolescents' acts of self-injury. Intention is constructed by the narrative of the act, influenced by numerous elements from the psychopathologic, cultural, religious, and philosophic context. Techniques of mentalizing-based treatments and work on the meaning that adolescents attribute to their behaviors might improve care. PMID:27089157
Bridge, Jeffrey A.; McBee-Strayer, Sandra M.; Cannon, Elizabeth A.; Sheftall, Arielle H.; Reynolds, Brady; Campo, John V.; Pajer, Kathleen A.; Barbe, Remy P.; Brent, David A.
Objective: Decision-making deficits have been linked to suicidal behavior in adults. However, it remains unclear whether impaired decision making plays a role in the etiopathogenesis of youth suicidal behavior. The purpose of this study was to examine decision-making processes in adolescent suicide attempters and never-suicidal comparison…
Hardan, Antonio; Sahl, Robert
A study examined suicidality in 223 children with developmental disorders (ages 4 to 18) and comorbid psychiatric disorders. Twenty percent experienced either suicidal ideation, threats of, or attempts at suicide, with hanging being most frequently considered. Suicidality was most often encountered in individuals with oppositional defiant…
Brausch, Amy M; Decker, Kristina M; Hadley, Andrea G
This study examined adolescent participation in self-asphyxial risk-taking behaviors (SAB), sometimes known as the "choking game," and its relationship with other adolescent risk behaviors, including non-suicidal self-injury (NSSI). Researchers proposed that participation in SAB and NSSI would be associated with suicidal behavior, disordered eating, and substance use. Using a large community-based sample, results revealed preliminary associations between SAB and other risk-taking behaviors. Adolescents who had engaged in both SAB and NSSI reported more concurrent risk behaviors than adolescents who participated in only one of the behaviors or neither behavior. Results indicate that greater awareness of SAB is important, and continued research can evaluate the possible link between the behavior and risk for suicide.
Rotheram-Borus, Mary J.; And Others
In contrast to attempted suicide rates of 9-12% among adolescents in community-based studies, attempted suicide was reported by 39% of 138 self-identified gay and bisexual adolescent males presenting in a social service agency for lesbian and gay adolescents. Findings suggest that gay youths are at increased risk for attempting suicide. (TJQ)
Kim, Kerri L; Cushman, Grace K; Weissman, Alexandra B; Puzia, Megan E; Wegbreit, Ezra; Tone, Erin B; Spirito, Anthony; Dickstein, Daniel P
Prominent theoretical models and existing data implicate interpersonal factors in the development and maintenance of suicidal behavior and non-suicidal self-injury (NSSI). However, no known study has yet used computerized behavioral tasks to objectively assess responses to interpersonal conflict/collaboration among teens engaged in NSSI or having made a suicide attempt. The current study, therefore, compared interpersonal functioning indexed by the Prisoner's Dilemma (PD) task among three mutually exclusive groups, adolescents (ages 13-17): engaged in NSSI only without history of a suicide attempt (n=26); who made a suicide attempt without history of NSSI (n=26); and typically developing controls (n=26). Participants also completed the Interpersonal Sensitivity Measure to assess their general sensitivity to/awareness of others' behaviors and feelings. No significant between-group differences were found in PD task performance; however, compared to typically developing control participants and those who had made a suicide attempt, the NSSI group reported significantly more stress during the task. Additionally, NSSI participants rated themselves as more interpersonally sensitive compared to both attempters and typically developing controls. Given the lack of knowledge about whether these groups either differentially activate the same circuitry during stressful interpersonal interactions or instead rely on alternative, compensatory circuits, future work using event-related functional magnetic resonance imaging is warranted.
Falgares, Giorgio; Marchetti, Daniela; De Santis, Sandro; Carrozzino, Danilo; Kopala-Sibley, Daniel C.; Fulcheri, Mario; Verrocchio, Maria Cristina
Insecure attachment and the personality dimensions of self-criticism and dependency have been proposed as risk factors for suicide in adolescents. The present study examines whether self-criticism and dependency mediate the relationship between insecure attachment styles and suicidality. A sample of 340 high-school students (73.2% females), ranging in age from 13 to 20 years (M = 16.47, SD = 1.52), completed the Depressive Experiences Questionnaire for Adolescents, the Depressive Experiences Questionnaire for Adolescents, the Attachment Style Questionnaire, and the Suicidal Behaviors Questionnaire-Revised. The results partially support the expected mediation effects. Self-criticism, but not dependency, mediates the link between insecure attachment (anxiety and avoidance) and suicide-related behaviors. Implications for suicide risk assessment and management are discussed. PMID:28344562
Kerr, David C. R.; Reinke, Wendy M.; Eddy, J. Mark
We examined associations between adolescent problem trajectories and suicide risk outcomes in 361 community participants. Depressive symptoms (self-report) and externalizing behaviors (parent report) were assessed six times from grades 5 to 10. Parallel process linear growth curves indicated that lifetime suicide attempt history assessed to age 25…
Muehlenkamp, Jennifer J.; Gutierrez, Peter M.
Data from 390 high school students were collected to examine potential differences between adolescents who had attempted suicide and those who engaged in self-injurious behavior on measures of depression, suicidal ideation, and attitudes toward life and death. Significant differences were found between controls and the self-harm groups on all…
Kuhlberg, Jill A.; Pena, Juan B.; Zayas, Luis H.
Adolescent Latinas continue to report higher levels of suicide attempts than their African-American and White peers. The phenomenon is still not understood and is theorized to be the result of the confluence of many cultural, familial, and individual level factors. In Latino cultures, belief in the importance of the family, the value known as…
Esposito-Smythers, Christianne; Weismoore, Julie T.; Renshaw, Keith D.
A large body of research suggests that child maltreatment (CM) is associated with adolescent suicidal ideation and attempts. These studies, however, have not been critically examined and summarized in a manner that allows us to draw firm conclusions and make recommendations for future research and clinical work in this area. In this review, we evaluated all of the research literature to date examining the relationship between CM and adolescent suicidal ideation and attempts. Results generally suggest that childhood sexual abuse, physical abuse, emotional abuse, and neglect are associated with adolescent suicidal ideation and attempts across community, clinical, and high-risk samples, using cross-sectional and longitudinal research designs. In most studies, these associations remain significant when controlling for covariates such as youth demographics, mental health, family, and peer-related variables. When different forms of CM are examined in the same multivariate analysis, most research suggests that each form of CM maintains an independent association with adolescent suicidal ideation and suicide attempts. However, a subset of studies yielded evidence to suggest that sexual abuse and emotional abuse may be relatively more important in explaining suicidal behavior than physical abuse or neglect. Research also suggests an additive effect—each form of CM contributes unique variance to adolescent suicide attempts. We discuss the current limitations of this literature and offer recommendations for future research. We conclude with an overview of the clinical implications of this research, including careful, detailed screening of CM history, past suicidal behavior, and current suicidal ideation, as well as the need for integrated treatment approaches that effectively address both CM and adolescent suicidal ideation and suicide attempts. PMID:23568617
Capuzzi, Dave; Golden, Larry
This book deals with the realities of adolescent suicide. It consists of 15 chapters organized under 5 major headings: The Problem of Adolescent Suicide (chapters 1 and 2); A Profile of the Attempter (chapters 3-6); Assessing Lethality (chapters 7 and 8); Prevention and Intervention (chapters 9-14); and Legal Issues (chapter 15). Individual…
Hidalgo-Rasmussen, Carlos; Martín, Alfredo Hidalgo-San
The study of pre-suicidal behaviors is important not only because of their association with suicide but also because of their impact on quality of life (QOL). Given the scarcity of information regarding this relationship in adolescence, the objective of this study was to analyze the association between suicidal-related behavior and QOL according to gender in adolescent Mexican high school students. This cross-sectional study was conducted with participants between 14 and 18 years of age. A translated version of the Youth Risk Behavior Survey and the Spanish version of the Youth Quality of Life Research - Instrument version were used. Non-parametric tests were applied. Informed consent was obtained from parents and students, and ethical committee approval was sought. The developmental-transactional model of suicidal behavior in adolescents by Bridge et al. was used. Separate analyses were conducted for males and females to show the suicidal-related behaviors associated with QOL. The behavior of having felt sad or hopeless generally presented the greatest effect sizes. The regression models showed that some suicidal-related behaviors increase the probability of a lower QOL even after adjusting for covariates.
Shaffer, David; And Others
Examined relationship between suicidal behavior and homosexuality in adolescence in an unselected, matched sample. Found no evidence that suicide is a common characteristic of gay youth, or that when suicide does occur among gay teenagers, that it is a direct consequence of stigmatization or lack of support. (JBJ)
Lewis, Andrew J.; Bertino, Melanie D.; Bailey, Catherine M.; Skewes, Joanna; Lubman, Dan I.; Toumbourou, John W.
Background: Informant discrepancies have been reported between parent and adolescent measures of depressive disorders and suicidality. We aimed to examine the concordance between adolescent and parent ratings of depressive disorder using both clinical interview and questionnaire measures and assess multi-informant and multi-method approaches to classification. Method: Within the context of assessment of eligibility for a randomized clinical trial, 50 parent–adolescent pairs (mean age of adolescents = 15.0 years) were interviewed separately with a structured diagnostic interview for depression, the KID-SCID. Adolescent self-report and parent-report versions of the Strengths and Difficulties Questionnaire, the Short Mood and Feelings Questionnaire and the Depressive Experiences Questionnaire were also administered. We examined the diagnostic concordance rates of the parent vs. adolescent structured interview methods and the prediction of adolescent diagnosis via questionnaire methods. Results: Parent proxy reporting of adolescent depression and suicidal thoughts and behavior is not strongly concordant with adolescent report. Adolescent self-reported symptoms on depression scales provide a more accurate report of diagnosable adolescent depression than parent proxy reports of adolescent depressive symptoms. Adolescent self-report measures can be combined to improve the accuracy of classification. Parents tend to over report their adolescent’s depressive symptoms while under reporting their suicidal thoughts and behavior. Conclusion: Parent proxy report is clearly less reliable than the adolescent’s own report of their symptoms and subjective experiences, and could be considered inaccurate for research purposes. While parent report would still be sought clinically where an adolescent refuses to provide information, our findings suggest that parent reporting of adolescent suicidality should be interpreted with caution. PMID:25101031
Kwon, Ahye; Song, Jungeun; Yook, Ki-Hwan; Jon, Duk-In; Jung, Myung Hun; Hong, Narei; Hong, Hyun Ju
We examined predictors of suicide attempts in clinically depressed adolescents in Korea and gender differences in suicidal behavior. In total, 106 adolescents diagnosed with depressive disorder were recruited in South Korea. We assessed various variables that might affect suicide attempts, and used a structured interview for the diagnosis of depression and comorbidities and to evaluate suicidality. Demographic and clinical characteristics of the subjects were compared between suicide attempt and non-suicide attempt groups and we examined significant predictors of suicide attempts. Gender differences in suicidal ideation and suicidal behavior were also analyzed. Among 106 depressed participants, 50 (47.2%) adolescents were classified in the suicide attempt group. Generally, the suicide attempt and non-suicide attempt group shared similar clinical characteristics. The suicide attempt group had more females, more major depressive disorder diagnoses, more depressive episodes, and higher suicidal ideation than the non-suicide attempt group. Suicidal ideation was the only significant predictor of suicidal attempt, regardless of gender. Higher suicidal ideation frequency scores and more non-suicidal self-injurious behaviors were shown in the female suicide attempt group than the male suicide attempt group. It is recommended that suicidal ideation be assessed regularly and managed rigorously to decrease suicide risks in depressive adolescents. PMID:27776392
The suicide rate of young people in the United States rose 237 percent between 1960 and 1980. This paper addresses three related issues: epidemic versus artifact; stress in adolescence; and the distinctive traits of the lifestyles or careers of a random sample of young Chicago suicides. (Author/BL)
The recent trend in suicide mortality has made it the second-most-common cause of death in adolescence. The recognition of depressed adolescents, especially males, is made difficult by their low utilization of health services and by the variety of modes of presentation. The family physician's ability to play an effective role in helping the depressed adolescent and preventing the occurrence of suicide depends on the establishment of rapport, obtaining a detailed history, and being prepared to offer continuity of care. In most depressed adolescents there is limited need for hospitalization, medication or psychiatric treatment. PMID:21267225
Bagley, C; Bolitho, F; Bertrand, L
Adolescent women (N = 1,025) in grades 7 through 12 in a stratified random sample of Alberta high schools completed measures of emotional problems and suicidal behavior in the past six months, and of frequency and type of sexual assault (including sexual harassment) experienced in school. It was found that 23% has experienced at least one event of assault (sexual touching, sexual threats or remarks, or an incident of indecent exposure); 4% had "often" experienced one or more of these assaults or harassments. Those experiencing a high number of sexual assaults or harassments were significantly more likely to have clinical profiles on the measures of emotional disorder; 15% of 38 women experiencing frequent, unwanted sexual touching had "often" made suicidal gestures or attempts in the previous six months, compared with 2% of 824 women with no experience of sexual assault.
Rates of adolescent attempted suicide were correlated with social indicators over the electoral wards of Edinburgh (Scotland). Rates were found to be higher in wards where child neglect and misbehavior were more common. Rates of attempted suicide in the total population also were related to the housing pattern/social class of the wards. The importance of identifying similarities and differences in the patterns of suicidal behavior of adolescents and adults was noted.
Gispert, M; Wheeler, K; Marsh, L; Davis, M S
Suicide attempts among adolescents are occurring more frequently and their evaluation is a difficult task. The factors related to suicide attempts in eighty-two adolescents, ages 12 to 18 were examined. They had been admitted to the adolescent unit of a large, urban general hospital for evaluation of self-destructive behavior. A systematic review of the patients' charts was performed to gather information about family structure, functioning in school, suicidal risk, degree of depression, and stressful life events. Although most were moderately depressed, a significant proportion denied having tried to harm themselves. While some repressed their anger, the majority expressed anger openly, tended to feel sad and to carry out premeditated as well as more serious suicide attempts. Most had experienced family disruption, and nearly half were functioning poorly in school. Suicide risk correlated only with current stress, while depression correlated with life-long as well as current stress. Results suggest that identification of the suicide attempt and the contributory factors, especially the degree of overt anger and depression, are crucial in deciding appropriate interventions, providing adequate treatment, and avoiding recurrence.
Novick, Lloyd F; Cibula, Donald A; Sutphen, Sally M
This case-prevention of adolescent suicide-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. This teaching case examines the issue of prevention of adolescent and young adult suicide both at an individual and at a population or community level, using data from the Onondaga County Health Department. In the first section of the case, students are asked to determine whether five deaths related to falling or jumping at a local shopping mall should be considered to be suicidal deaths. Students then develop skills in the reporting as well as in the epidemiology of adolescent suicidal deaths in Onondaga County. As the case progresses, students analyze the results of a local surveillance study of suicidal attempts and ideation. The case concludes with students evaluating a hypothetical screening study intended to reduce the risk of suicidal death and discussing a research design to examine the effectiveness of this prevention strategy.
Morrison, Julia; Schwartz, Thomas L
Suicide is one of the major causes of morbidity and mortality amongst children and adolescents. In 2004 the Food and Drug Administration (FDA) issued a "black-box" warning for antidepressants in children and adolescents, stating that these drugs may increase suicidality, a term encompassing both suicidal thoughts and behavior, especially in the first few weeks of treatment. The warning was extended in 2007 to antidepressants prescribed to adults aged 25 and under. The evidence behind this decision stemmed from meta-analyses of antidepressant clinical trials that demonstrated a slight increase in suicidality in those receiving antidepressants versus those treated with a placebo. Due to methods of this pooled data compilation, the relationship between antidepressants and suicidality remains controversial. This report investigates a case where a 14 year old with major depressive disorder (MDD) developed suicidal ideation shortly after being prescribed a selective serotonin reuptake inhibitor (SSRI). Investigating the role antidepressants may play in suicidality suggests the need to explore the neurobiological mechanisms within the serotonin system. This case and its theoretical explanations attempt to bridge the gap between neurobiology and pharmacology in order to better delineate the etiology of this adverse effect.
Wyman, Peter A.
The 2012 National Strategy for Suicide Prevention expands the current suicide prevention paradigm by including a strategic direction aimed at promoting healthy populations. Childhood and adolescence are key suicide prevention window periods, yet knowledge of suicide prevention pathways through universal interventions is limited (Aspirational Goal 11). Epidemiologic evidence suggests that prevention programs in normative social systems such as schools are needed for broad suicide prevention impact. Prevention trial results show that current universal prevention programs for children and young adolescents are effective in reducing adolescent emotional and behavioral problems that are risk factors for suicidal behavior, and in the case of the Good Behavior Game, suicide attempts. A developmentally sequenced upstream suicide prevention approach is proposed: (a) childhood programs to strengthen a broad set of self-regulation skills through family and school-based programs, followed by (b) adolescent programs that leverage social influences to prevent emerging risk behaviors such as substance abuse and strengthen relationships and skills. Key knowledge breakthroughs needed are evidence linking specific intervention strategies to reduced suicidal behaviors and mortality and their mechanisms of action. Short- and long-term objectives to achieve these breakthroughs include combining evidence from completed prevention trials, increasing motivators for prevention researchers to assess suicide-related outcome, and conducting new trials of upstream interventions in populations using efficient designs acceptable to communities. In conclusion, effective upstream prevention programs have been identified that modify risk and protective factors for adolescent suicide, and key knowledge breakthroughs can jump-start progress in realizing the suicide prevention potential of specific strategies. PMID:25145747
Nishimura, Stephanie T; Goebert, Deborah A; Ramisetty-Mikler, Suhasini; Caetano, Raul
Research on suicide has focused on gender, age, ethnicity, and psychiatric profiles. However, few studies have examined alcohol use and its relationship to suicide among Native Hawaiians and other Asian American/Pacific Islanders. This study analyzes data from the 1997 and 1999 Hawaii Youth Risk Behavior Survey to examine whether alcohol problems increase the risk for suicide indicators (as evidenced by responses to questions asking whether an individual has considered, planned, attempted, or required treatment for a suicide attempt). Drinking pattern was the best predictor for all suicide indicators. School and community-based programs can help to increase an adolescent's knowledge about the consequences of alcohol use and prevention of suicide.
Dukes, Richard L.; Lorch, Barbara (Day)
Among junior and senior high school students (N=6,428), adolescent emotional and ideological disparity with parents and disparity between importance adolescent placed on academic achievement and satisfaction with academic achievement were linked to suicide ideation through intervening variables of self-esteem, purpose in life, and two forms of…
Berlin, I N
Suicide has become a major concern of many Indian tribes and pueblos, as the rates in these tribes have increased dramatically in the last decade. One of the critical research questions is how to explain the vastly different rates of adolescent suicide among tribes. Research has identified some common patterns in experience and behavior among Indian adolescent suicides; these patterns are similar in many ways to those found in Los Angeles suicide research of Teicher (1979). Chronic versus acute stress factors in suicide are examined. Recent research has also identified a number of factors characterizing tribes with high suicide rates; these include failure to adhere to traditional ways of living, to traditional religion, and to clans and societies, and the resulting chaotic family structure and adult alcoholism. The roles of adoption of Indian children, boarding schools, and high unemployment in many tribes are also discussed. Suicide prevention and intervention programs are briefly described.
More than 800 000 people die every year from suicide, and about 20 times more attempt suicide. In most countries, suicide risk is highest in older males, and risk of attempted suicide is highest in younger females. The higher lethal level of suicidal acts in males is explained by the preference for more lethal methods, as well as other factors. In the vast majority of cases, suicidal behavior occurs in the context of psychiatric disorders, depression being the most important one. Improving the treatment of depression, restricting access to lethal means, and avoiding the Werther effect (imitation suicide) are central aspects of suicide prevention programs. In several European regions, the four-level intervention concept of the European Alliance Against Depression (www.EAAD.net), simultaneously targeting depression and suicidal behavior, has been found to have preventive effects on suicidal behavior. It has already been implemented in more than 100 regions in Europe. PMID:27489458
More than 800 000 people die every year from suicide, and about 20 times more attempt suicide. In most countries, suicide risk is highest in older males, and risk of attempted suicide is highest in younger females. The higher lethal level of suicidal acts in males is explained by the preference for more lethal methods, as well as other factors. In the vast majority of cases, suicidal behavior occurs in the context of psychiatric disorders, depression being the most important one. Improving the treatment of depression, restricting access to lethal means, and avoiding the Werther effect (imitation suicide) are central aspects of suicide prevention programs. In several European regions, the four-level intervention concept of the European Alliance Against Depression (www.EAAD.net), simultaneously targeting depression and suicidal behavior, has been found to have preventive effects on suicidal behavior. It has already been implemented in more than 100 regions in Europe.
Hausmann-Stabile, Carolina; Gulbas, Lauren; Zayas, Luis H.
Parents’ aspirations and expectations are communicated to their offspring. Children internalize their parents’ aspirations and accept some of the expectations while rejecting others, all part of the developmental process and identity-consolidation. When the aspirations and expectations of youth and parents are incongruent, the outcomes in youths’ behavior can be deleterious, such as when adolescents manifest suicidal behaviors. We examined aspirations expressed by 12 Latina adolescent suicide attempters and their parents and compared them to 12 non-suicidal Latinas and parents. Qualitative analyses revealed that incongruence of aspirations between girls and their parents were greater among suicidal teens. Suicidal and non-suicidal Latinas presented contrasting aspirations: the former on gaining independence and the latter on completing their education and pursuing careers. Findings may inform developmental research and ways in which clinicians and policymakers can help Latinas achieve their own and their parents’ aspirations. PMID:24013464
Klomek, Anat Brunstein; Marrocco, Frank; Kleinman, Marjorie; Schonfeld, Irvin S.; Gould, Madelyn S.
Objective: To assess the association between bullying behavior and depression, suicidal ideation, and suicide attempts among adolescents. Method: A self-report survey was completed by 9th-through 12th-grade students (n = 2342) in six New York State high schools from 2002 through 2004. Regression analyses were conducted to examine the association…
Hart, Nancy Ann
The trend of increased adolescent death by suicide is an international problem. Discusses why it happens and what motivates a young person who is on the threshold of life that he would rather die than live. Gives statistical data and behavior theories related to suicide. (Author/RK)
Suicide is the leading cause of death among South Korean adolescents. The purpose of this study was to examine the relationship between suicidal thoughts (ST) and suicidal attempts (SA) with the level of physical activity (PA) among South Korean adolescents. Based on data from the eighth Korea Youth Risk Behaviors Web-Based Survey, 74,186 South Korean adolescents were evaluated in terms of their relationship between meeting guidelines for vigorous PA (VPA), moderate PA (MPA), and low PA (LPA) and in respect of ST and SA status. The adjusted odds ratio in adolescents who thought about suicide increased significantly with PA levels (1.02 in males, 1.21 in females with VPA, 1.10 in males, 1.18 in females with MPA, and 1.16 in males, 1.20 in females with LPA) compared to participants who did not think about suicide. In addition, the AOR in adolescents who attempted suicide increased significantly with PA levels (1.16 in males, 1.36 in females with VPA, 1.13 in males, 1.15 in females with MPA, and 1.26 in males, 1.15 in females with LPA) compared to participants who did not attempt suicide. These results show that VPA, MPA, and LPA are positively associated with ST and SA prevention in South Korean adolescents. Therefore, to prevent suicide of South Korean adolescents, we support public health program including PA participation. Key Points South Korean male adolescents, compared to female adolescents, showed relatively high values for physical activity-related variables such as vigorous, moderate, and low PA. Regardless of gender, more physical activity participation is positively associated with prevention of suicidal thought and attempts of South Korean adolescents. To prevent suicide of South Korean adolescents, we support public health program including meeting guidelines for vigorous, moderate, and low physical activity. PMID:25435782
Duarte-Velez, Yovanska; Bernal, Guillermo
Suicide is the cause of 11.7% of all deaths among youth and young adults aged 10 to 24 years in the United States (J. A. Grunbaum et al., 2004). Suicide is third leading cause of death for young Latinos/as aged 10 to 24 years (National Institute of Mental Health, 2001). Latino/a youth are at a greater risk of suicide behavior than other ethnic…
Brausch, Amy M.; Gutierrez, Peter M.
As suicide attempts and self-injury remain predominant health risks among adolescents, it is increasingly important to be able to distinguish features of self-harming adolescents from those who are at risk for suicidal behaviors. The current study examined differences between groups of adolescents with varying levels of self-harmful behavior in a…
Shpigel, Maya S; Diamond, Gary M; Diamond, Guy S
This study examined whether Attachment-Based Family Therapy (ABFT) was associated with decreases in maternal psychological control and increases in maternal psychological autonomy granting, and whether such changes were associated with changes in adolescents' attachment schema and psychological symptoms. Eighteen suicidal adolescents and their mothers received 12 weeks of ABFT. Maternal psychological control and autonomy granting behaviors were observationally coded at sessions 1 and 4. Adolescents' reports of perceived maternal care and control, attachment-related anxiety and avoidance, and depressive symptoms and suicidal ideation were collected at baseline, 6, 12 weeks (posttreatment), and 36 weeks. Results indicated that from session 1 to session 4, maternal psychological control decreased and maternal psychological autonomy granting increased. Increases in maternal autonomy granting were associated with increases in adolescents' perceived parental care from pre to mid-treatment and decreases in attachment-related anxiety and avoidance from pre to 3 months posttreatment. Finally, decreases in adolescents' perceived parental control during the treatment were associated with reductions in adolescents' depressive symptoms from pretreatment to 12 weeks posttreatment. This is the first study examining the putative change mechanisms in ABFT.
Gispert, Maria; And Others
Examined factors (family structure, functioning in school, suicidal risk, depression, and stressful life events) related to suicide attempts in 82 adolescents. Suicide risk correlated with current stress, while depression correlated with life-long and current stress. Results indicated most were depressed, angry, and experienced family disruption,…
Hufford, M R
Alcohol dependence and alcohol intoxication are important risk factors for suicidal behavior. However, the mechanism for the relationship remains unclear. This review presents a conceptual framework relating alcohol to suicidal behavior. Distal risk factors create a statistical potential for suicide. Alcohol dependence, as well as associated comorbid psychopathology and negative life events, act as distal risk factors for suicidal behavior. Proximal risk factors determine the timing of suicidal behavior by translating the statistical potential of distal risk factors into action. The acute effects of alcohol intoxication act as important proximal risk factors for suicidal behavior among the alcoholic and nonalcoholic alike. Mechanisms responsible for alcohol's ability to increase the proximal risk for suicidal behavior include alcohol's ability to: (1) increase psychological distress, (2) increase aggressiveness, (3) propel suicidal ideation into action through suicide-specific alcohol expectancies, and (4) constrict cognition which impairs the generation and implementation of alternative coping strategies. Moreover, the proximal risk factors associated with acute intoxication are consistent with Baumeister's (1990) escape theory of suicide. Suggestions for additional research are discussed, including the possibility that a nonlinear cusp catastrophe model characterizes the relationship between alcohol intoxication and suicidal behavior.
This study aimed at investigating the effects of individualistic-collectivistic value orientations on non-fatal suicidal behavior and attitudes in Turkish adolescents and young adults. A questionnaire containing measures of individualism, collectivism (INDCOL), non-fatal suicidal behaviors and suicidal attitudes was used to collect the data. The results showed that both suicidal ideation and attempts were significantly more frequent in participants classified as individualist than those who were classified as collectivist on the basis of INDCOL scale scores. Participants with individualistic tendencies displayed more permissive attitudes toward suicide than those with collectivistic tendencies but collectivists believed to a greater extent than the individualists that people should communicate suicidal problems to others. Participants with collectivistic tendencies showed more accepting and helping reactions to an imagined suicidal friend than those with individualistic tendencies. Suicidal ideation and attempts were more common among adolescents than young adults. The findings suggest that individualistic and collectivistic value orientations and developmental status specific stressors play a role in the distribution of nonfatal suicidal behavior and the nature of suicidal attitudes.
Prinstein, Mitchell J.; Nock, Matthew K.; Simon, Valerie; Aikins, Julie Wargo; Cheah, Charissa S. L.; Spirito, Anthony
Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric…
Groholt, Berit; Ekeberg, Oivind; Haldorsen, Tor
Predictors for repetition of suicide attempts were evaluated among 92 adolescent suicide attempters 9 years after an index suicide attempt (90% females). Five were dead, two by suicide. Thirty-one (42%) of 73 had repeated a suicide attempt. In multiple Cox regression analysis, four factors had an independent predictive effect: comorbid disorders,…
Everett, Bethany G.; Heath, Ryan D.; Elsaesser, Caitlin E.; Neilands, Torsten B.
Abstract Purpose: Sexual minority youth (SMY) are at higher risk for victimization and suicide than are heterosexual youth (HY). Relatively little research has examined which types of victimization are most closely linked to suicide, which is necessary to develop targeted prevention interventions. The present study was conducted to address this deficit. Methods: The data come from the 2011 Chicago Youth Risk Behavior Survey (n = 1,907). Structural equation modeling (SEM) in Mplus evaluated the direct, indirect, and total effects of sexual orientation on a latent indicator of suicidal ideation and behaviors via seven types of victimization. Four indicators of victimization were school-specific (e.g., harassment due to sexual orientation or gender identity (SO/GID), bullying, threatened or injured with a weapon, and skipping school due to safety concerns), and three indicators assessed other types of victimization (e.g., electronic bullying, intimate partner violence, and sexual abuse). Results: Thirteen percent of youth were classified as SMY. Significantly more SMY than HY reported suicidal ideation (27.95% vs. 13.64%), a suicide plan (22.78% vs. 12.36%), and at least one suicide attempt (29.92% vs. 12.43%) in the past year (all P < .001). A greater percentage of SMY reported SO/GID-related harassment, skipping school, electronic bullying, and sexual abuse. Sexual orientation was not directly related to suicidal ideation and behaviors in SEM. Rather, SMY's elevated risk of suicidality functioned indirectly through two forms of school-based victimization: being threatened or injured with a weapon (B = .19, SE = .09, P ≤ .05) and experiencing SO/GID-specific harassment (B = .40, SE = .15, P ≤ .01). There also was a trend for SMY to skip school as a strategy to reduce suicide risk. Conclusion: Although SMY experience higher rates of victimization than do HY, school-based victimization that involves weapons or is due to one's SO
Kostenuik, Marcia; Ratnapalan, Mohana
Abstract OBJECTIVE To provide family physicians with an approach to suicide prevention in youth. SOURCES OF INFORMATION A literature review was performed using Ovid MEDLINE with the key words suicide, attempted suicide, and evaluation studies or program evaluation, adolescent. MAIN MESSAGE Youth suicide might be prevented by earlier recognition and treatment of mental illness. Family physicians can and should screen for mental illness in youth; there are many diagnostic and treatment resources available to assist with this. CONCLUSION Earlier detection and treatment of mental illness are the most important ways family physicians can reduce morbidity and mortality for youth who are contemplating suicide. PMID:20705879
Predicting and preventing suicide represent very difficult challenges for clinicians. The awareness of adolescent suicide as a major social and medical problem has increased over the past years. However, many health care professionals who have frequent contact with adolescents are not sufficiently trained in suicide evaluation techniques and approaches to adolescents with suicidal behavior. Suicide prevention efforts among adolescents are restricted by the fact that there are five key problems related to the evaluation and management of suicidality in adolescents: 1. Many clinicians underestimate the importance of the problem of adolescent suicidal behavior and underestimate its prevalence. 2. There is a misconception that direct questioning of adolescents about suicidality is sufficient to evaluate suicide risk. 3. Another misconception is that adolescents with non-psychiatric illnesses do not need to be evaluated for suicidality. 4. Many clinicians do not know about or underestimate the role of contagion in adolescent suicidal behavior. 5. There is a mistaken belief that adolescent males are at lower suicide risk than adolescent females. Educating medical professionals and trainees about the warning signs and symptoms of adolescent suicide and providing them with tools to recognize, evaluate, and manage suicidal patients represent a promising approach to adolescent suicide prevention.
Kim, Dong-Sik; Cho, Youngtae; Cho, Sung-Il; Lim, In-Sook
Background: This study examined the mediating function of body weight perception (BWP) in the relation between body mass index (BMI) and unhealthy weight control behaviors (UWCBs; eg, fasting, using diet pills, or laxatives), and between BMI and suicidal ideation. It also explored the correlation between exposure to multiple UWCBs and suicidal…
Brown, Brenda H.
Intended for use as part of an inservice program, this guide was designed to provide insight into adolescent suicide and to serve as a reference tool. It begins with an overview of suicide, citing society's desensitization to death, rapid changes in society, success codes, and the disappearance of the extended family as factors in the increase of…
Kernberg, P F
Acute and chronic styles of suicidal behaviors require different psychotherapeutic approaches--the former needs a supportive-cognitive-focused approach, the latter (chronic or characterological) style needs an expressive insight-oriented psychotherapy with supportive elements to address the adolescent's developmental requirements for structure within the sessions. The psychotherapist needs to be appraised of the epidemiological, dynamic factors as well as the sources of external support the patient can count upon. It is interesting to note that psychodynamic factors alone or psychopathology alone are not sufficient to estimate the ebb and flow of the suicidal risk. A combination of all these factors must be taken into account in estimating suicidal risk at any point in treatment. It is advisable that an independent clinician's consultation be sought during treatment in the case of suicidal attempts as the therapist can easily overestimate or underestimate suicidal risks. Individual treatment requires family intervention from counseling to therapy. Particular problems addressed in the paper are countertransference reactions created by the suicidal behavior in the clinician such as rejection and withdrawal. The psychotherapy should address the resolution of aggressive, envious introjected images, issues of omnipotent control and interpersonal skills deficits. To transform suicidal behavior into reenactment of the aggression within the relationship to the therapist is the main immediate goal. A critical caveat; a patient who lies by commission or omission represents an obstacle for individual therapy on an outpatient basis as he will disguise his suicidal intentions and plans, excluding them from the therapeutic process.
King, Keith A.; Strunk, Catherine M.; Sorter, Michael T.
Background: Suicide ranks as the third leading cause of death among youth aged 15-24 years. Schools provide ideal opportunities for suicide prevention efforts. However, research is needed to identify programs that effectively impact youth suicidal ideation and behavior. This study examined the immediate and 3-month effect of Surviving the Teens[R]…
Siyez, Digdem Müge; Bas, Asli Uz
The aim of the study was to investigate the knowledge of Turkish high school counsellors and counselling students about adolescence suicide. The sample consisted of 71 school counsellors and 82 third and fourth year psychology counselling students who completed the Adolescent Suicide Behavior Questionnaire. The results showed that although…
Zhao, Yue; Montoro, Richard; Igartua, Karine; Thombs, Brett D.
Objective: To compare risk of suicide ideation and attempts in adolescents with 1) gay, lesbian, or bisexual (GLB) identity, 2) "unsure" identity, or 3) heterosexual identity with same-sex attraction/fantasy or behavior, to heterosexual identity without same-sex attraction/fantasy or behavior. Method: A total of 1,856 students 14 years…
Togo, Fumiharu; Okazaki, Yuji; Nishida, Atsushi; Sasaki, Tsukasa
Purpose Being bullied is associated with the manifestation of suicidal feelings, which sharply increase in middle(-late) adolescence. Whether or not bullied middle(-late) adolescents with suicidal feelings seek help is therefore a critical issue, given that help-seeking plays a key role in the prevention of suicide. The aim of the present study is to investigate the effects of bullying, suicidal feelings and the interaction between these two factors on help-seeking behavior in adolescents. Methods Japanese middle(-late) adolescents (aged 15–18 years; n = 9484) were studied using self-report questionnaires. The rate of adolescents who actually sought help was examined for bullying status and suicidal feelings. Results The rate of adolescents who sought help was significantly higher when they were bullied (p<0.001) and also when they had mild suicidal feelings (p<0.001), but not when they displayed serious suicidal feelings. In the case of adolescents who were bullied, however, having suicidal feelings significantly decreased the rate of help-seeking (OR = 0.47, p<0.05 and OR = 0.32, p = 0.002 for having mild and serious suicidal feelings, respectively). The decrease was remarkable when suicidal feelings were serious. Specifically, the decrease was significant in seeking help from peers and family members, who are the most frequent source of the help for adolescents, when they had serious suicidal feelings (OR = 0.21, p<0.01 and OR = 0.13, p<0.001, respectively). Conclusions Suicidal feelings may interfere with help-seeking behavior, which could be critical in suicide prevention in bullied middle(-late) adolescents. PMID:25188324
Kuehn, Kevin; Tezanos, Katherine; Weinstock, Lauren M.; Solomon, Joel; Spirito, Anthony
Abstract Objective: The present study investigates the longitudinal relationship between perceived family and peer invalidation and adolescent suicidal events (SE) and self-mutilation (SM) in a 6 month follow-up (f/u) study of adolescents admitted to an inpatient psychiatric unit for suicide risk. Methods: Adolescents (n=119) and their parent(s) were administered interviews and self-report assessments at baseline and at a 6 month f/u, with 99 (83%) completing both assessments. The Adolescent Longitudinal Interval Follow-Up Evaluation (A-LIFE) was modified to provide weekly ratings (baseline and each week of f/u) for perceived family and peer invalidation. Regression analyses examined whether: 1) Prospectively rated perceived family and peer invalidation at baseline predicted SE and SM during f/u; and 2) chronicity of perceived invalidation operationalized as proportion of weeks at moderate to high invalidation during f/u was associated with SE and SM during f/u. Results: Multiple regression analyses, controlling for previously identified covariates, revealed that perceived family invalidation predicted SE over f/u for boys only and perceived peer invalidation predicted SM over f/u in the overall sample. This was the case for both baseline and f/u ratings of perceived invalidation. Conclusions: Our results demonstrate the adverse impact of perceived family and peer invalidation. Specifically, boys who experienced high perceived family invalidation were more likely to have an SE over f/u. Both boys and girls who experienced high perceived peer invalidation were more likely to engage in SM over f/u. PMID:25264807
Chau, Kénora; Kabuth, Bernard; Chau, Nearkasen
The risk of suicide behaviors in immigrant adolescents varies across countries and remains partly understood. We conducted a study in France to examine immigrant adolescents’ likelihood of experiencing suicide ideation in the last 12 months (SI) and lifetime suicide attempts (SA) compared with their native counterparts, and the contribution of socioeconomic factors and school, behavior, and health-related difficulties. Questionnaires were completed by 1559 middle-school adolescents from north-eastern France including various risk factors, SI, SA, and their first occurrence over adolescent’s life course (except SI). Data were analyzed using logistic regression models for SI and Cox regression models for SA (retaining only school, behavior, and health-related difficulties that started before SA). Immigrant adolescents had a two-time higher risk of SI and SA than their native counterparts. Using nested models, the excess SI risk was highly explained by socioeconomic factors (27%) and additional school, behavior, and health-related difficulties (24%) but remained significant. The excess SA risk was more highly explained by these issues (40% and 85%, respectively) and became non-significant. These findings demonstrate the risk patterns of SI and SA and the prominent confounding roles of socioeconomic factors and school, behavior, and health-related difficulties. They may be provided to policy makers, schools, carers, and various organizations interested in immigrant, adolescent, and suicide-behavior problems. PMID:27809296
Mikami, Katsunaka; Onishi, Yuichi; Matsumoto, Hideo
Although the suicide risk of autism spectrum disorder (ASD) has been suggested to be higher than previously recognized, there are few case reports focusing on the process for preventing suicide reattempts. We reported that a 17-year-old male who had attempted suicide by jumping was admitted to our emergency department and hospitalized for lumbar spine fracture. In addition to the diagnosis of adjustment disorder, he was diagnosed as ASD according to his life history. This article presents the characteristics of the suicidal behaviors and the process for preventing a suicide reattempt associated with an adolescent with ASD who attempted suicide.
Shpigel, Maya S.; Diamond, Gary M.; Diamond, Guy S.
This study examined whether Attachment-Based Family Therapy (ABFT) was associated with decreases in maternal psychological control and increases in maternal psychological autonomy granting, and whether such changes were associated with changes in adolescents' attachment schema and psychological symptoms. Eighteen suicidal adolescents and their…
Sharma, Bimala; Nam, Eun Woo; Kim, Ha Yun; Kim, Jong Koo
The study examines the prevalence of suicidal ideation and suicide attempt, and associated factors among school-going urban adolescents in Peru. A cross-sectional survey was conducted in a sample of 916 secondary school adolescents in 2014. A structured questionnaire adapted from Global School-based Student Health Survey was used to obtain information. Data were analyzed using logistic regression models at 5% level of significance. Overall, 26.3% reported having suicidal ideation, and 17.5% reported having attempted suicide during the past 12 months. Multivariate logistic regression analysis showed that female sex, being in a fight, being insulted, being attacked, perceived unhappiness, smoking and sexual intercourse initiation were significantly associated with increased risk of suicidal ideation, while female sex, being in a fight, being insulted, being attacked, perceived unhappiness, alcohol and illicit drug use were related to suicide attempt. The prevalence of suicidal ideation and suicide attempts observed in the survey area is relatively high. Female adolescents are particularly vulnerable to report suicidal ideation and suicide attempt. Interventions that address the issue of violence against adolescents, fighting with peers, health risk behaviors particularly initiation of smoking, alcohol and illicit drug use and encourage supportive role of parents may reduce the risk of suicidal behaviors.
Sharma, Bimala; Nam, Eun Woo; Kim, Ha Yun; Kim, Jong Koo
The study examines the prevalence of suicidal ideation and suicide attempt, and associated factors among school-going urban adolescents in Peru. A cross-sectional survey was conducted in a sample of 916 secondary school adolescents in 2014. A structured questionnaire adapted from Global School-based Student Health Survey was used to obtain information. Data were analyzed using logistic regression models at 5% level of significance. Overall, 26.3% reported having suicidal ideation, and 17.5% reported having attempted suicide during the past 12 months. Multivariate logistic regression analysis showed that female sex, being in a fight, being insulted, being attacked, perceived unhappiness, smoking and sexual intercourse initiation were significantly associated with increased risk of suicidal ideation, while female sex, being in a fight, being insulted, being attacked, perceived unhappiness, alcohol and illicit drug use were related to suicide attempt. The prevalence of suicidal ideation and suicide attempts observed in the survey area is relatively high. Female adolescents are particularly vulnerable to report suicidal ideation and suicide attempt. Interventions that address the issue of violence against adolescents, fighting with peers, health risk behaviors particularly initiation of smoking, alcohol and illicit drug use and encourage supportive role of parents may reduce the risk of suicidal behaviors. PMID:26610536
Rubinstein, D H
Suicide rates since 1960 in Micronesia (the U.S. Trust Territory of the Pacific Islands) have undergone an epidemic-like increase. This phenomenon is focused narrowly within the 15--24-year male age-group. Extremely high rates and culturally patterned motives and methods are now characteristic of this group. Survey research throughout Micronesia suggests that the epidemic increase in adolescent male suicide is a cohort effect among the first post-war generation. Traditional adolescent socialization in pre-war Micronesia largely involved village-level subsistence activities organized around communal lineage-houses. This extra-familial level of socialization served as a cultural solution to the residential and psychological distance post-pubertal males maintained from their domestic families. With the post-war social change in Micronesia, the communal village-level of organization has largely disintegrated, causing adolescent socialization functions to be absorbed by the nuclear family. The resulting situations of intergenerational domestic discord appear the primary social triggers for adolescent suicide. At the same time, suicides have acquired subcultural significance among male youth, giving rise to fad-like and imitative acts. A 3-year research project is now being undertaken to conduct an ethnographic study of factors contributing to adolescent stress and suicide in one Micronesian community.
Sood, Aradhana Bela; Linker, Julie
Youth transitioning to adulthood have unique developmental tasks that make them vulnerable to suicide. Brain development, life stressors, and psychological adjustments during the transition contribute to a high rate of suicidal gestures. To reduce the incidence of self-harm in this age group, a public health approach that identifies and reduces risk factors and enhances protective factors should be used. Institutions and employment arenas should consider structural supports to facilitate this transition of youth into adulthood, with a particular focus on youth with self-harm thoughts, and should provide education about suicide, evidence-based resources, and intervention programs to encourage help seeking.
Ganz, Debora; Sher, Leo
The act of adolescent suicide continues to threaten adolescent populations in New York City (NYC). Consistent positive correlations have been found between a plethora of risk factors present in NYC adolescent populations and suicidal ideations and behaviors. Psychiatric conditions that may contribute to the rate of adolescent suicide in NYC include depression, bipolar disorder, substance abuse and schizophrenia. Unique factors that have been found to contribute to increased rates of completed suicides in NYC include the phenomena of railway suicides and suicide tourism. Homelessness and income inequality in NYC have also been consistently correlated with increased suicidality; with one study finding suicide attempts reported by a significant percentage of new admissions to homeless shelters. Adolescent populations in NYC that have been identified as particularly vulnerable to suicidality include runaway youth, homosexual youth, victimized adolescents and adolescents with a recent history of posttraumatic stress disorder (PTSD). Longitudinal studies in NYC have found that physical and sexual abuse is highly predictive of adolescent suicidality, with variations by ethnic group. Currently, there is a disturbing lack of sufficient research on adolescent suicide in NYC, specifically regarding causal factors, the effects of television on suicide, comorbid suicidality and drug abuse, and cultural factors contributing to suicide. This dearth of literature may be related to the ethical problems inherent in suicide research, self reports and/or post mortem analyses.
Glenn, Catherine R.; Nock, Matthew K.
Suicidal behaviors increase dramatically during adolescence. In order to effectively intervene and ultimately prevent suicide in youth, the field needs to be able to identify and predict which adolescents are at greatest suicide risk. However, present knowledge of risk factors for suicide and techniques for identifying at-risk youth are insufficient. The purpose of the current manuscript is to highlight some of the key, yet unanswered, questions about the prediction of suicidal behavior in youth, and to suggest the types of research advances needed to move the field forward. PMID:23850053
Yen, Shirley; Gagnon, Kerry; Spirito, Anthony
The diagnosis of borderline personality disorder (BPD) in adolescents has been controversial. Thus, few studies have examined BPD in suicidal adolescents, even though it is strongly associated with suicidal behaviours in adults. This study examines differences between suicidal adolescents with (n = 47) and without (n = 72) BPD on history and characteristics of suicidal behaviour, Axis I co-morbidity, affect regulation and aggression. Assessments were completed with both adolescents and parents, and consensus ratings based on best available data were analysed. BPD participants were more likely to have a history of suicide attempts and to have been admitted because of a suicide attempt (vs. suicidal ideation). There were no significant differences in self-injurious behaviours or degree of suicidal ideation. BPD participants also had more psychiatric co-morbidity and higher aggression scores but no significant differences in affective dysregulation compared with suicidal adolescents without BPD. Diagnostic stability over 6 months was modest. Our results demonstrate that, compared with other acutely suicidal adolescents, the clinical profile of BPD participants is unique and suggests an increased risk for suicidal behaviours. This extends upon other studies that support the construct validity of BPD during adolescence and suggests that BPD should be considered in suicide risk assessment for adolescents.
Suicide is the second leading cause of death among adolescents and young adults between the ages of 15-25. Every day, over 1,000 young adults attempt to destroy themselves. Although adolescents contemplate suicide for many reasons, research suggests that depression is the number one risk factor in suicide. Accordingly, this paper describes many of…
Maimon, David; Browning, Christopher R; Brooks-Gunn, Jeanne
The suicide rate among American adolescents between the ages of 14-25 has dramatically increased during the last 50 years, and this fact has been the focus of extensive social-scientific investigation. To date, however, research focusing on the joint effects of mental health, family, and contextual-level predictors on adolescents' suicidal behaviors is scarce. Drawing on Durkheim's classic macro-level approach to suicide and collective efficacy theory, we use data from the Project on Human Development in Chicago Neighborhoods (PHDCN) to examine the effect of informal social controls on adolescents' suicide attempts. Analyzing reports from 990 youth, we examine the hypothesis that neighborhood-level collective efficacy and family-level integration and social control independently affect suicide attempts. We also examine the extent to which they interact in their effects on suicidal behavior. Overall, results from multilevel logit models support the Durkheimian expectation that family attachment reduces the probability that adolescents will attempt suicide. The effect of collective efficacy is interactive in nature. Specifically, we find that collective efficacy significantly enhances the protective effect of family attachment and support on adolescent suicidal behaviors. We discuss findings within the context of social control theory.
Virupaksha, H. G.; Muralidhar, Daliboyina; Ramakrishna, Jayashree
Background: Suicide rate and suicidal tendencies among transgender persons are considerably high compared to general population. Hence, this review is an attempt to understand the issues around the suicide and suicidal behavior among transgender persons. Methodology: The literature search conducted using three sources, i.e., electronic databases (PubMed, ProQuest, Google Scholar, PsycInfo), manual search (library catalog), and gray literature (consultation with experts). Results: The suicide attempt rate among transgender persons ranges from 32% to 50% across the countries. Gender-based victimization, discrimination, bullying, violence, being rejected by the family, friends, and community; harassment by intimate partner, family members, police and public; discrimination and ill treatment at health-care system are the major risk factors that influence the suicidal behavior among transgender persons. Conclusion: In spite of facing a number of hardships in their day-to-day life, the transgender community holds a number of resiliency factors. Further, this community needs to be supported to strengthen their resiliency factors and draw culturally sensitive and transgender-inclusive suicide prevention strategies and increase protective factors to tackle this high rate of suicidality. PMID:28031583
Drummond, Wilhelmina J.
Explores causes of the high teenage suicide rate in New Zealand by looking at environmental-social factors. Examines the problems these youth face, such as depression and alcohol use, and discusses their risk-taking behaviors. Findings are linked to current theory on adolescent suicide. Prevention, intervention, and treatment strategies are…
Beck-Cross, Cathy; Cooper, Robyn
Suicide is the third leading cause of death among young people ages 15 to 19 years, with male adolescents four times more likely to die than their female peers. This study used Bronfenbrenner's bioecological model to examine micro- and macrosystems as predictors of suicidal behaviors through responses by male adolescents (N = 9,910) to a statewide…
Stewart, Jeremy G.; Esposito, Erika C.; Glenn, Catherine R.; Gilman, Stephen E.; Pridgen, Bryan; Gold, Joseph; Auerbach, Randy P.
Adolescent non-suicidal self-injury (NSSI) and suicidality are serious health concerns; however, factors that contribute to the transition from NSSI to suicide ideation and suicide attempts are unclear. To address this gap, we investigated whether demographic characteristics, child maltreatment, and psychiatric factors are associated with the level suicidality among adolescents with a history of self-injury. Participants were three groups of adolescent inpatient self-injurers (n = 397, 317 female), aged 13–18 years (M = 15.44, SD = 1.36): (a) non-ideators (n = 96; no current suicide ideation and no lifetime suicide attempts), (b) suicide ideators (n = 149; current ideation and no lifetime attempts), and (c) suicide attempters (n = 152; current ideation and at least one lifetime attempt). Participants completed interviews assessing psychiatric diagnoses, suicidality, and NSSI characteristics, as well as questionnaires on childhood trauma, psychiatric symptoms, and risky behavior engagement. Depression severity was associated with greater odds being a suicide ideator (p < 0.001, OR = 1.04) and an attempter (p < 0.001, OR = 1.05) compared to a non-ideator. Suicide attempters used more NSSI methods and reported greater risky behavior engagement than non-ideators (p = 0.03, OR = 1.29 and p = 0.03, OR = 1.06, respectively) and ideators (p = 0.015, OR = 1.25 and p = 0.04, OR = 1.05, respectively); attempters used more severe NSSI methods (e.g., burning). Our results identify a wide range of risk markers for increasing lethality in a sample at high risk for suicide mortality; future research is needed to refine risk assessments for adolescent self-injurers and determine the clinical utility of using risk markers for screening and intervention. PMID:27716512
Jiang, Qingmei; Czyz, Ewa K.; Kerr, David C. R.
Clinicians commonly incorporate adolescents’ self-reported suicidal ideation into formulations regarding adolescents’ risk for suicide. Data are limited, however, regarding the extent to which adolescent boys’ and girls’ reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys’ and girls’ self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13–17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children’s Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization. PMID:23996157
Goldstein, Tina R.; Bridge, Jeffrey A.; Brent, David A.
We examined sleep difficulties preceding death in a sample of adolescent suicide completers as compared with a matched sample of community control adolescents. Sleep disturbances were assessed in 140 adolescent suicide victims with a psychological autopsy protocol and in 131 controls with a similar semistructured psychiatric interview. Rates of…
Kocourkova, Jana; Dudova, Iva; Koutek, Jiri
Asperger syndrome hinders adaptation to developmental challenges during childhood and adolescence, particularly with regard to interpersonal relationships. Individuals with Asperger syndrome display lack of empathy and limited ability to understand social and emotional exchanges with other people. Individuals with Asperger syndrome are significantly exposed to the risk of suicidal behavior, especially during adolescence. The authors describe cases of suicidal behavior in two adolescent boys with Asperger syndrome.
Kocourkova, Jana; Dudova, Iva; Koutek, Jiri
Asperger syndrome hinders adaptation to developmental challenges during childhood and adolescence, particularly with regard to interpersonal relationships. Individuals with Asperger syndrome display lack of empathy and limited ability to understand social and emotional exchanges with other people. Individuals with Asperger syndrome are significantly exposed to the risk of suicidal behavior, especially during adolescence. The authors describe cases of suicidal behavior in two adolescent boys with Asperger syndrome. PMID:24294002
Russell, Stephen T.; Joyner, Kara
Used data from the National Longitudinal Study of Adolescent Health to investigate links between sexual orientation and suicidality. There was a strong link between adolescent sexual orientation and suicidal thoughts and behaviors. This relationship was mediated by critical youth suicide risk factors (depression, hopelessness, alcohol abuse,…
Silva, Roberto Jerônimo dos Santos; dos Santos, Fabio Alexandre Lima; Soares, Nara Michelle Moura; Pardono, Emerson
This study aimed to identify the prevalence and factors associated with suicidal ideation among Brazilian adolescents. The instrument designed for the research was used considering three models with outcomes that identified the following: (a) adolescent had considered suicide, (b) adolescents have planned suicide, and (c) adolescents have attempted suicide. Logistic Regression was used in all models with significance level of 5%. An association between being female and suicidal ideation (OR = 2.18, CI 95% 1.60 to 2.97), suicide planning (OR = 1.80, CI 95% = 1.26–2.56), and suicide attempt (OR = 2.91, CI 95% 1.79 to 4.75) was found. Violent behavior/involvement in fights was associated with thinking about suicide (OR = 2.00, CI 95% = 1.43 to 2.81), suicide planning (OR = 1.65, CI 95% = 1.10–2.46), and suicide attempt (OR = 2.35, CI 95% = 1.49 to 3.70). For cigarette consumption, association was found with suicide ideation (OR = 1.62, CI 95% 1.03 to 2.55), planning (OR = 1.88, CI 95% = 1.15 to 3.08), and attempt (OR = 2.35, CI 95% 1.37 to 4.03). For alcohol consumption, association was found with suicide ideation (OR = 1.93, CI 95% 1.47 to 2.54), planning (OR = 2.22, CI 95% 1.61 to 3.08), and attempt (OR = 1.73, CI 95% 1.15 to 2.59). It was concluded that suicidal ideation was associated with female sex, involvement in fights, and illicit drug use. PMID:25506613
Brausch, Amy M; Gutierrez, Peter M
As suicide attempts and self-injury remain predominant health risks among adolescents, it is increasingly important to be able to distinguish features of self-harming adolescents from those who are at risk for suicidal behaviors. The current study examined differences between groups of adolescents with varying levels of self-harmful behavior in a sample of 373 high school students with a mean age of 15.04 (SD = 1.05). The sample was 48% female and the distribution of ethnicity was as follows: 35% Caucasian, 37.2% African-American, 16% Multi-ethnic, 9.2% Hispanic, and 2.3% Asian. The sample was divided into three groups: no history of self-harm, non-suicidal self-injury (NSSI) only, and NSSI in addition to a suicide attempt. Differences in depressive symptoms, suicidal ideation, social support, self-esteem, body satisfaction, and disordered eating were explored. Results indicated significant differences between the three groups on all variables, with the no self-harm group reporting the lowest levels of risk factors and highest levels of protective factors. Further analyses were conducted to examine specific differences between the two self-harm groups. Adolescents in the NSSI group were found to have fewer depressive symptoms, lower suicidal ideation, and greater self-esteem and parental support than the group that also had attempted suicide. The clinical implications of assessing these specific psychosocial correlates for at-risk adolescents are discussed.
Liu, Richard T; Jones, Richard N; Spirito, Anthony
Despite the strong association between suicidal ideation and suicidal behavior, a relative minority of ideators transition to attempting suicide. Clarifying the latent structure of suicidal ideation has direct implications for theory, as well as suicidal risk assessment and prevention efforts. Taxometric analysis is a statistical technique specifically designed to assess whether a latent construct is taxonic (i.e., categorical) or continuous (i.e., dimensional) in nature. Although this statistical approach has been increasingly used over the past decade to elucidate the latent structure of various forms of psychopathology and related risk factors, there are no taxometric studies to date of suicidal ideation. The aim of the current project is to apply taxometric methods to a sample of clinically depressed, treatment-seeking adolescents (n = 334). Current suicidal ideation was measured using the Suicidal Ideation Questionnaire-Jr., (SIQ-Jr.). The results of two mathematically non-redundant taxometric approaches (i.e., MAXEIG and L-Mode) are consistent with a continuous latent structure for suicidal ideation. The current findings suggest that suicidal ideation in depressed adolescents is dimensional. The implication of these findings for research, theory, and suicidal risk assessment strategies are discussed.
Liu, Richard T.; Jones, Richard N.; Spirito, Anthony
Despite the strong association between suicidal ideation and suicidal behavior, a relative minority of ideators transition to attempting suicide. Clarifying the latent structure of suicidal ideation has direct implications for theory, as well as suicidal risk assessment and prevention efforts. Taxometric analysis is a statistical technique specifically designed to assess whether a latent construct is taxonic (i.e., categorical) or continuous (i.e., dimensional) in nature. Although this statistical approach has been increasingly used over the past decade to elucidate the latent structure of various forms of psychopathology and related risk factors, there are no taxometric studies to date of suicidal ideation. The aim of the current project is to apply taxometric methods to a sample of clinically depressed, treatment-seeking adolescents (n =334). Current suicidal ideation was measured using the Suicidal Ideation Questionnaire-Jr., (SIQ-Jr.). The results of 2 mathematically non-redundant taxometric approaches (i.e., MAXEIG and L-Mode) are consistent with a continuous latent structure for suicidal ideation. The current findings suggest that suicidal ideation in depressed adolescents is dimensional. The implication of these findings for research, theory, and suicidal risk assessment strategies are discussed. PMID:25904059
Miller, Adam B.; Esposito-Smythers, Christianne; Weismoore, Julie T.; Renshaw, Keith D.
A large body of research suggests that child maltreatment (CM) is associated with adolescent suicidal ideation and attempts. These studies, however, have not been critically examined and summarized in a manner that allows us to draw firm conclusions and make recommendations for future research and clinical work in this area. In this review, we…
Berman, Alan L.; And Others
Presents two cases chosen to draw attention to marital and developmental dynamics of suicidal behavior. Both case vignettes are based on individual interviews with suicidal persons and their spouses during the suicidal person's psychiatric hospitalization, and both include observations of the marital interaction. Case vignettes are followed by…
Lu, Tsung-Hsueh; Chang, Wan-Ting; Lin, Jin-Jia; Li, Chung-Yi
Suicide method used by adolescents was examined to determine if it was the same as that employed by their suicidal parents. Six hundred eighty adolescents completed suicide between 1997 and 2007, of whom 12 had parents who had previously died by suicide. The suicide method used by these adolescents was compared with that employed by their suicidal…
King, Cheryl A.; Merchant, Christopher R.
This article reviews the empirical literature concerning social and interpersonal variables as risk factors for adolescent suicidality (suicidal ideation, suicidal behavior, death by suicide. It also describes major social constructs in theories of suicide and the extent to which studies support their importance to adolescent suicidality. PsychINFO and PubMed searches were conducted for empirical studies focused on family and friend support, social isolation, peer victimization, physical/sexual abuse, or emotional neglect as these relate to adolescent suicidality. Empirical findings converge in documenting the importance of multiple social and interpersonal factors to adolescent suicidality. Research support for the social constructs in several major theories of suicide is summarized and research challenges are discussed. PMID:18576200
Obando Medina, Claudia María; Herrera, Andres; Kullgren, Gunnar
Background: Suicide and suicidal expressions among young people represent a major public health problem worldwide. Most studies are from high-income countries, and it remains unclear whether prevalence and risk factors show a similar pattern in other settings. This study aims to assess the prevalence of suicidal expressions and serious suicidal expressions (ideation, plans and attempts) among adolescents in Nicaragua, in relation to previously reported risk factors, such as exposure to suicide in significant others (parents, siblings, partners or friends) and mental health problems. Methods: 368 adolescents aged 15-18 years were randomly selected from public secondary schools in León, Nicaragua. Data was collected using Attitude Towards Suicide (ATTS) and Youth Self-Report questionnaires (YSR). Bivariate and multivariate analyses were conducted. Results: Suicide ideation prevalence in the past year was 22.6%, suicide plans 10.3%, and suicide attempts 6.5%. Girls were significantly more likely to report suicidal ideation. Multivariate analyses showed that anxious/depressed, somatic complaints and exposure to suicidal behavior in significant others were significantly associated with own serious suicidal expressions. Conclusions: The prevalence of serious suicidal expressions among young people in Nicaragua is within the range reported from Western high-income countries. An attempted or completed suicide in someone close, is associated with own suicidal expressions even in the absence of increased mental distress. Furthermore, somatic complaints should alert health care professionals of the possibility of increased suicide risk. PMID:21559237
Greening, Leilani; Stoppelbein, Laura; Luebbe, Aaron
Given that parenting practices have been linked to suicidal behavior in adolescence, examining the moderating effect of parenting styles on suicidal behavior early in development could offer potential insight into possible buffers as well as directions for suicide prevention and intervention later in adolescence. Hence, the moderating effects of…
Sheftall, Arielle H; Mathias, Charles W; Furr, R Michael; Dougherty, Donald M
Theories of suicidal behavior suggest that the desire to die can arise from disruption of interpersonal relationships. Suicide research has typically studied this from the individual's perspective of the quality/frequency of their social interactions; however, the field of attachment may offer another perspective on understanding an individual's social patterns and suicide risk. This study examined attachment along with broader family functioning (family adaptability and cohesion) among 236 adolescent psychiatric inpatients with (n = 111) and without (n = 125) histories of suicide attempts. On average, adolescents were 14 years of age and Hispanic (69%). Compared to those without suicide attempts, adolescent attempters had lower self-reported maternal and paternal attachment and lower familial adaptability and cohesion. When comparing all three types of attachment simultaneously in the logistic regression model predicting suicide attempt status, paternal attachment was the only significant predictor. Suicide attempt group was also significantly predicted by self-rated Cohesion and Adaptability; neither of the parent ratings of family functioning were significant predictors. These findings are consistent with the predictions of the Interpersonal Theory of Suicide about social functioning and support the efforts to develop attachment-based interventions as a novel route towards suicide prevention.
Sheftall, Arielle H.; Mathias, Charles W.; Furr, R. Michael; Dougherty, Donald M.
Theories of suicidal behavior suggest that the desire to die can arise from disruption of interpersonal relationships. Suicide research has typically studied this from the individual's perspective of the quality/frequency of their social interactions; however, the field of attachment may offer another perspective on understanding an individual’s social patterns and suicide risk. This study examined attachment along with broader family functioning (family adaptability and cohesion) among 236 adolescent psychiatric inpatients with (n = 111) and without (n = 125) histories of suicide attempts. On average, adolescents were 14 years of age and Hispanic (69%). Compared to those without suicide attempts, adolescent attempters had lower self-reported maternal and paternal attachment and lower familial adaptability and cohesion. When comparing all 3 types of attachment simultaneously in the logistic regression model predicting suicide attempt status, paternal attachment was the only significant predictor. Suicide attempt group was also significantly predicted by self-rated Cohesion and Adaptability; neither of the parent ratings of family functioning were significant predictors. These findings are consistent with the predictions of the Interpersonal Theory of Suicide about social functioning and support the efforts to develop attachment-based interventions as a novel route towards suicide prevention. PMID:23560608
Khanipour, Hamid; Hakim shooshtari, Mitra; Bidaki, Reza
Background Suicidal attempt and non-suicidal self-injury are very common in adolescents with a history of childhood maltreatment. By identifying correlates of these kinds of high-risk behaviors, it is possible to prevent and decrease completed suicide. Objectives The aims of this study were: 1) to compare adolescents with a history of childhood maltreatment with non-suicidal self injury (NSSI) or past suicidal attempt in terms of suicide probability, and 2) to investigate the association between NSSI, forms of self-criticism, emotion regulation difficulties, and suicide probability. Patients and Methods Participants were 169 adolescents living in Iranian social welfare centers who had a history of childhood maltreatment. The Suicide Probability Scale, Difficulties in Emotion Regulation Scale, Forms of Self-criticism, and the Non-Suicidal Self injury (NSSI) checklist were used for assessment. Results Adolescents with NSSI and suicidal attempts had higher rates of suicide ideation than adolescents with NSSI-only (P < 0.05). Feelings of inadequacy, self-hatred, difficulty with impulse control, and frequency of NSSI can predict 50% variance of suicide probability (P < 0.001). Conclusions Adolescents with histories of suicidal attempts and NSSI, compared with adolescents with NSSI-only, were more prone to suicide. Self-criticism, poor impulse control, and the frequency of NSSI were the main risk factors associated with suicide probability in adolescents with a history of childhood maltreatment. PMID:27622166
Background To date, there are no empirically validated treatments of good quality for adolescents showing suicidality and non-suicidal self-injurious behavior. Risk factors for suicide are impulsive and non-suicidal self-injurious behavior, depression, conduct disorders and child abuse. Behind this background, we tested the main hypothesis of our study; that Dialectical Behavioral Therapy for Adolescents is an effective treatment for these patients. Methods Dialectical Behavioral Therapy (DBT) has been developed by Marsha Linehan - especially for the outpatient treatment of chronically non-suicidal patients diagnosed with borderline personality disorder. The modified version of DBT for Adolescents (DBT-A) from Rathus & Miller has been adapted for a 16-24 week outpatient treatment in the German-speaking area by our group. The efficacy of treatment was measured by a pre-/post- comparison and a one-year follow-up with the aid of standardized instruments (SCL-90-R, CBCL, YSR, ILC, CGI). Results In the pilot study, 12 adolescents were treated. At the beginning of therapy, 83% of patients fulfilled five or more DSM-IV criteria for borderline personality disorder. From the beginning of therapy to one year after its end, the mean value of these diagnostic criteria decreased significantly from 5.8 to 2.75. 75% of patients were kept in therapy. For the behavioral domains according to the SCL-90-R and YSR, we have found effect sizes between 0.54 and 2.14. During treatment, non-suicidal self-injurious behavior reduced significantly. Before the start of therapy, 8 of 12 patients had attempted suicide at least once. There were neither suicidal attempts during treatment with DBT-A nor at the one-year follow-up. Conclusions The promising results suggest that the interventions were well accepted by the patients and their families, and were associated with improvement in multiple domains including suicidality, non-suicidal self-injurious behavior, emotion dysregulation and
Sapp, Allen D.
This report outlines the extent of the problem of adolescent suicide in the United States, noting that suicide is the third leading cause of death among adolescents in this country and that the rate of suicide by adolescents is expected to continue to increase in the future. It examines one adolescent suicide, using the case study method, to…
Gutstein, Steven E.; Rudd, M. David
This booklet describes Houston's Systemic Crisis Intervention Program (SCIP), an outpatient-based program for adolescents who have attempted suicide, used during the suicidal crisis period and based on the premise that children need a healthy kin system to serve as a buffer to the all too frequent crises of adolescence. The introduction presents…
Yalch, Matthew M; Hopwood, Christopher J; Fehon, Dwain C; Grilo, Carlos M
Suicide is a leading cause of death among adolescents and suicidal behavior is one of the primary risk factors for youth psychiatric hospitalizations. A number of studies indicate that depression and substance abuse are associated with suicide risk in this population, but less is known about the role of borderline personality features or their incremental influence over other known risk factors in indicating suicidal behavior among adolescents. This study examined whether borderline features were associated with suicide risk when controlling for symptoms of depression and substance abuse in a sample of adolescents hospitalized in an inpatient psychiatric facility. Self-report data from 477 adolescent psychiatric inpatients were used to test hypotheses about the association of borderline features with suicide risk after controlling for other common risk factors. Borderline features were significantly related to suicide risk even after accounting for symptoms of depression and substance abuse. These findings underscore the clinical value of routinely assessing borderline features among adolescents.
Pompili, Maurizio; Serafini, Gianluca; Innamorati, Marco; Dominici, Giovanni; Ferracuti, Stefano; Kotzalidis, Giorgio D.; Serra, Giulia; Girardi, Paolo; Janiri, Luigi; Tatarelli, Roberto; Sher, Leo; Lester, David
Suicide is an escalating public health problem, and alcohol use has consistently been implicated in the precipitation of suicidal behavior. Alcohol abuse may lead to suicidality through disinhibition, impulsiveness and impaired judgment, but it may also be used as a means to ease the distress associated with committing an act of suicide. We reviewed evidence of the relationship between alcohol use and suicide through a search of MedLine and PsychInfo electronic databases. Multiple genetically-related intermediate phenotypes might influence the relationship between alcohol and suicide. Psychiatric disorders, including psychosis, mood disorders and anxiety disorders, as well as susceptibility to stress, might increase the risk of suicidal behavior, but may also have reciprocal influences with alcohol drinking patterns. Increased suicide risk may be heralded by social withdrawal, breakdown of social bonds, and social marginalization, which are common outcomes of untreated alcohol abuse and dependence. People with alcohol dependence or depression should be screened for other psychiatric symptoms and for suicidality. Programs for suicide prevention must take into account drinking habits and should reinforce healthy behavioral patterns. PMID:20617037
Emelianchik-Key, Kelly; Byrd, Rebekah J.; La Guardia, Amanda C.
Issues regarding the diagnosis and treatment of non-suicidal self-injury (NSSI) continue to be of increasing concern to practitioners in educational and mental health settings. Given this rising concern, it is important to note that the majority of research regarding self-injury has focused on the symptomology and treatment of Caucasian females;…
Asarnow, Joan Rosenbaum; Berk, Michele; Hughes, Jennifer L; Anderson, Nicholas L
The purpose of this article is to describe feasibility, safety, and outcome results from a treatment development trial of the SAFETY Program, a brief intervention designed for integration with emergency services for suicide-attempting youths. Suicide-attempting youths, ages 11 to 18, were enrolled in a 12-week trial of the SAFETY Program, a cognitive-behavioral family intervention designed to increase safety and reduce suicide attempt (SA) risk (N = 35). Rooted in a social-ecological cognitive-behavioral model, treatment sessions included individual youth and parent session-components, with different therapists assigned to youths and parents, and family session-components to practice skills identified as critical in the pathway for preventing repeat SAs in individual youths. Outcomes were evaluated at baseline, 3-month, and 6-month follow-ups. At the 3-month posttreatment assessment, there were statistically significant improvements on measures of suicidal behavior, hopelessness, youth and parent depression, and youth social adjustment. There was one reported SA by 3 months and another by 6 months, yielding cumulative attempt rates of 3% and 6% at 3 and 6 months, respectively. Treatment satisfaction was high. Suicide-attempting youths are at high risk for repeat attempts and continuing mental health problems. Results support the value of a randomized controlled trial to further evaluate the SAFETY intervention. Extension of treatment effects to parent depression and youth social adjustment are consistent with our strong family focus and social-ecological model of behavior change.
Vander Stoep, Ann; Adrian, Molly; Mc Cauley, Elizabeth; Crowell, Sheila E.; Stone, Andrea; Flynn, Cynthia
This study investigates the early manifestation of co-occurring depression and conduct problems as a predictor of heightened risk for later suicidal ideation and behavior in a community sample of 521 adolescents. Self-reported symptoms of depression and conduct problems were evaluated in early 6th grade. Suicidal thoughts and behaviors were…
Seymour, Karen E; Jones, Richard N; Cushman, Grace K; Galvan, Thania; Puzia, Megan E; Kim, Kerri L; Spirito, Anthony; Dickstein, Daniel P
Little is known about the bio-behavioral mechanisms underlying and differentiating suicide attempts from non-suicidal self-injury (NSSI) in adolescents. Adolescents who attempt suicide or engage in NSSI often report significant interpersonal and social difficulties. Emotional face recognition ability is a fundamental skill required for successful social interactions, and deficits in this ability may provide insight into the unique brain-behavior interactions underlying suicide attempts versus NSSI in adolescents. Therefore, we examined emotional face recognition ability among three mutually exclusive groups: (1) inpatient adolescents who attempted suicide (SA, n = 30); (2) inpatient adolescents engaged in NSSI (NSSI, n = 30); and (3) typically developing controls (TDC, n = 30) without psychiatric illness. Participants included adolescents aged 13-17 years, matched on age, gender and full-scale IQ. Emotional face recognition was evaluated using the diagnostic assessment of nonverbal accuracy (DANVA-2). Compared to TDC youth, adolescents with NSSI made more errors on child fearful and adult sad face recognition while controlling for psychopathology and medication status (ps < 0.05). No differences were found on emotional face recognition between NSSI and SA groups. Secondary analyses showed that compared to inpatients without major depression, those with major depression made fewer errors on adult sad face recognition even when controlling for group status (p < 0.05). Further, compared to inpatients without generalized anxiety, those with generalized anxiety made fewer recognition errors on adult happy faces even when controlling for group status (p < 0.05). Adolescent inpatients engaged in NSSI showed greater deficits in emotional face recognition than TDC, but not inpatient adolescents who attempted suicide. Further results suggest the importance of psychopathology in emotional face recognition. Replication of these preliminary results and examination of the role
[The association of bullying with suicide ideation, plan, and attempt among adolescents with GLB or unsure sexual identity, heterosexual identity with same-sex attraction or behavior, or heterosexual identity without same-sex attraction or behavior].
Montoro, Richard; Thombs, Brett; Igartua, Karine J
Context Bullying is a known risk factor for suicidality, and suicide is the second leading cause of death for adolescents. Both are increased in sexual minority youth (SMY). As SMY are comprised of youth who self-identify as gay, lesbian, bisexual (GLB) or who have same-sex attractions or behaviors, our previous finding that different subgroups have different risks for suicidality is understandable. Given that the difference was along sexual identity lines (GLB vs heterosexual SMY), the analysis of bullying data in the same subgroups was felt to be important.Objective To compare the association of bullying and suicide among heterosexual students without same-sex attractions or behaviors, heterosexual students with same-sex attractions and behaviors, and students with gay, lesbian or bisexual (GLB) or unsure sexual identities.Design The 2004 Quebec Youth Risk Behavior Survey (QYRBS) questionnaire was based on the 2001 Center for Disease Control Youth Risk Behavior Survey, and included items assessing the three dimensions of sexual orientation (identity, attraction and behavior), health risk behaviors, experiences of harassment, and suicidal ideation, plans and attempts.Methods A total of 1852 students 14-18 years of age from 14 public and private high schools in Montréal Québec were surveyed anonymously during the 2004-2005 academic year.Main outcome measure Self reports of suicidal ideation, suicidal plan and suicide attempts in the last 12 months.Results In all, 117 students (6.3%) had a non-heterosexual identity (GLB or unsure) and 115 students (6.3%) had a heterosexual identity with same-sex attraction or behavior. Bullying occurred in 24% of heterosexual students without same-sex attraction or behavior, 32% of heterosexual students with same-sex attraction or behavior, and 48% of non-heterosexually identified students. In multivariable analysis, the common risk factors of age, gender, depressed mood, drug use, fighting, physical and sexual abuse, and
... Exposure to friends’/family members’ suicide xii Low self-esteem xiii Protective Factors Family and school connectedness iii ... Reduced access to firearms vii Academic achievement ix Self-esteem xi Talking to teens about suicide does not ...
Lu, Tsung-Hsueh; Chang, Wan-Ting; Lin, Jin-Jia; Li, Chung-Yi
Suicide method used by adolescents was examined to determine if it was the same as that employed by their suicidal parents. Six hundred eighty adolescents completed suicide between 1997 and 2007, of whom 12 had parents who had previously died by suicide. The suicide method used by these adolescents was compared with that employed by their suicidal parent and that of a matched peer control adolescent with no exposure to parental suicide and living in the same area. In 10 of the 12 suicidal parent-adolescent dyads, the same suicide method was employed by parent and adolescent. Of seven adolescents whose age at parental suicide was 15 years or above, six used the same suicide method as their suicidal parent had. On the contrary, of 12 exposure-nonexposure suicidal adolescent dyads, the same method was used in only four. Adolescents exposed to parental suicide are more likely to use the suicide method employed by their suicidal parents than the method used by adolescent peers with no exposure to parental suicide.
Eggert, Leona L.; And Others
Describes an instrument designed to assess the suicide potential of youth (ages 14-18) who are at risk for suicidal behaviors. Two samples were used to examine psychometric properties of the Measure of Adolescent Potential for Suicide (MAPS). Results revealed strong validity (content, criterion, construct) and reliability (internal consistency)…
Russell, Stephen T; Toomey, Russell B
There is strong consensus in the research literature that adolescent and adult men who report same-sex sexual orientations, identities, and behaviors are at higher risk for suicide. Recent studies of general adolescent suicide risk have identified developmental trajectories that peak during the teenage years. Because the adolescent years are characterized by the development and heightened awareness of gender roles and sexual scripts closely tied to dominant cultural ideals of masculinity and heterosexuality, an adolescent-focused developmental trajectory for suicide risk might be particularly relevant for males with adolescent same-sex sexual orientations. We provide the first prospective examination of adolescent-specific risk for suicidality based on adolescent same-sex sexual orientation using data from the United States, the National Longitudinal Study of Adolescent Health. Tracing suicide ideation and attempts across four assessments from adolescence (Wave 1 average age 15.3 years) to young adulthood (Wave 4 average age 28.2), we documented that the risk for suicidal thoughts and attempts for adolescent same-sex attracted males is developmental in nature. Specifically, the risk for suicidal thoughts and attempts for males with same-sex attractions is largely limited to the adolescent years. These results offer new insights for suicide prevention and intervention for male adolescents and adults with same-sex sexual orientations.
Czyz, Ewa K; Liu, Zhuqing; King, Cheryl A
This study examined the extent to which posthospitalization change in connectedness with family, peers, and nonfamily adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Participants were 338 inpatient suicidal adolescents, ages 13 to 17, who were assessed at 3, 6, and 12 months posthospitalization. General liner models were fitted for depressive symptoms and suicidal ideation outcomes, and logistic regression was used for the dichotomous suicide attempt outcome. The moderating effects of gender and multiple attempt history were examined. Adolescents who reported greater improvements in peer connectedness were half as likely to attempt suicide during the 12-month period. Improved peer connectedness was also associated with less severe depressive symptoms for all adolescents and with less severe suicidal ideation for female individuals, but only at the 3-month assessment time point. Improved family connectedness was related to less severe depressive symptoms and suicidal ideation across the entire year; for suicidal ideation, this protective effect was limited to nonmultiple suicide attempters. Change in connectedness with nonfamily adults was not a significant predictor of any outcome when changes in family and peer connectedness were taken into account. These results pointing to improved posthospitalization connectedness being linked to improved outcomes following hospitalization have important treatment and prevention implications given inpatient suicidal adolescents' vulnerability to suicidal behavior.
Woo, Jong-Min; Okusaga, Olaoluwa; Postolache, Teodor T.
A seasonal suicide peak in spring is highly replicated, but its specific cause is unknown. We reviewed the literature on suicide risk factors which can be associated with seasonal variation of suicide rates, assessing published articles from 1979 to 2011. Such risk factors include environmental determinants, including physical, chemical, and biological factors. We also summarized the influence of potential demographic and clinical characteristics such as age, gender, month of birth, socioeconomic status, methods of prior suicide attempt, and comorbid psychiatric and medical diseases. Comprehensive evaluation of risk factors which could be linked to the seasonal variation in suicide is important, not only to identify the major driving force for the seasonality of suicide, but also could lead to better suicide prevention in general. PMID:22470308
Wietecha, Linda A.; Wang, Shufang; Buchanan, Andrew S.; Kelsey, Douglas K.
Abstract Objective: This meta-analysis examined suicide-related events in the acute phases of double-blind, placebo-controlled atomoxetine trials in pediatric and adult patients with attention-deficit/hyperactivity disorder (ADHD). Methods: A total of 3883 pediatric and 3365 adult patients were included. Potential events were identified from the adverse events database using a text-string search. Mantel–Haenszel risk ratios (MHRR) were calculated for potential suicide-related events categorized according to United States Food and Drug Administration defined codes. Results: In this data set, no completed suicides were reported in the pediatric or adult populations. One pediatric (attempted suicide) (and no adult patient events) was categorized as suicidal behavior in the atomoxetine group. The frequency of combined suicidal behavior or ideation with atomoxetine treatment was 0.37% in pediatric patients (vs. 0.07% with placebo) and 0.11% in adults (vs. 0.12% with placebo) and the risk compared with placebo was not statistically significant (MHRR=1.57; p=0.42 and MHRR=0.96; p=0.96, respectively). In pediatric patients, suicidal ideation only was reported more frequently compared with placebo (MHRR=1.63; p=0.41). Conclusions: Overall in this data set, no completed suicides and 1 pediatric patient suicidal behavior event were reported in atomoxetine-treated pediatric and adult patients. Suicidal ideation was uncommon among atomoxetine-treated pediatric and adult patients, although it was reported more frequently in atomoxetine-treated pediatric patients compared with placebo; the reporting rate difference was not statistically significant. The MHRR of suicidal ideation was consistent with a previous meta-analysis of similar design. There was no evidence of increased risk for suicidal behavior in atomoxetine-treated pediatric or adult patients. Clinical trial registration information: http://www.clinicaltrials.gov. The data reported are from an analysis of 23 pediatric
Dryden, Annabelle; Jones, Rosemary
Presents lesson plans that have students explore and discuss various aspects of adolescent suicide as a means of coping with their depressive or suicidal feelings and as a preparation for them to help their peers. Each plan contains goals, objectives, activities, and suggested evaluation. Teacher information is included. (CT)
Malkesman, Oz; Pine, Daniel S; Tragon, Tyson; Austin, Daniel R; Henter, Ioline D; Chen, Guang; Manji, Husseini K
Although antidepressants are moderately effective in treating major depressive disorder (MDD), concerns have arisen that selective serotonin-reuptake inhibitors (SSRIs) are associated with suicidal thinking and behavior, especially in children, adolescents and young adults. Almost no experimental research in model systems has considered the mechanisms by which SSRIs might be associated with this potential side effect in some susceptible individuals. Suicide is a complex behavior and impossible to fully reproduce in an animal model. However, by investigating traits that show strong cross-species parallels in addition to associations with suicide in humans, animal models might elucidate the mechanisms by which SSRIs are associated with suicidal thinking and behavior. Traits linked with suicide in humans that can be successfully modeled in rodents include aggression, impulsivity, irritability and hopelessness/helplessness. Modeling these relevant traits in animals can help to clarify the impact of SSRIs on these traits, suggesting avenues for reducing suicide risk in this vulnerable population.
Karakoç Demirkaya, Sevcan; Tutkunkardaş, Mustafa Deniz; Mukaddes, Nahit Motavalli
Objectives Considering that suicide is one of the most common reasons of adolescent death worldwide, there is a lack of clinical awareness on suicidal behaviors of children and adolescents with autism spectrum disorder (ASD). The present study aims to assess the rate of suicidality (suicidal ideation, behaviors and attempts) and associated risk factors for suicidality in high functioning ASD. Methods Medical records of 55 adolescents (six girls, 49 boys), aged between 7–20 years, with diagnosis of ASD were reviewed. The participants were all able to speak fluently and had no significant limitations in intellectual functioning. Clinical assessment of participants was carried out on the basis of Diagnostic and Statistical Manual of Mental Disorders 4th Edition, Text Revision criteria and Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Eskin’s Suicide Screening Questionnaire and sociodemographic data form including detailed history of suicidal behaviors were used. The study group was also divided into suicidal and non-suicidal groups for the purpose of comparing the results. Results The rate of suicidal behaviors was 29% and suicide attempt was 12.7%. Types of suicidality were behaviors (43.7%), thoughts (37.5%), and verbal declarations (18.7%). A number of bizarre acts were recorded. Rates of comorbid psychiatric disorders such as mood disorders, anxiety disorders and disruptive behaviors were 23.6%, 43.6% and 65.4% respectively. Groups with the psychotic features, positive family history for suicidal behaviors and completed suicide showed more suicidality than the non-suicidal group. Conclusion Consistent with the previous findings, rate of suicidality is higher in individuals with ASD. The type of suicidal behaviors showed some differences compared to typically developing individuals. The presence of psychotic features and positive family history for suicidality may be risk factors for suicidality in
Joe, Sean; Baser, Raymond S.; Neighbors, Harold W.; Caldwell, Cleopatra H.; Jackson, James S.
The data from the National Survey of American life on the suicidal behavior of 1,170 African American and Caribbean black adolescents aged 13 to 17 shows that black adolescents report having a lifetime prevalence of 7.5 percent for suicidal ideation and 2.7 percent for attempts. The 12-month prevalence of suicidal ideation is 3.2 percent and…
Suicide and suicidal behaviors are complex, heterogeneous phenomena that are thought to result from the interactions among distal factors increasing predisposition and proximal factors acting as precipitants. Epigenetic factors are likely to act both distally and proximally. Aspirational Goal 1 aims to find clear targets for suicide and suicidal behavior intervention through greater understanding of the interplay among the biological, psychological, and social risk and protective factors associated with suicide. This paper discusses Aspirational Goal 1, focusing on the research pathway related to epigenetics, suicide, and suicidal behaviors. Current knowledge on epigenetics factors associated with suicide and suicidal behaviors is reviewed and avenues for future research are discussed. Epigenetic factors are a promising area of further investigation in the understanding of suicide and suicidal behaviors and may hold clues to identifying targets or avenues for intervention. PMID:25145732
Chen, Peter Y.; Cigularov, Konstantin P.; Tomazic, Rocco G.
Gender-variant-based victimization is victimization based on the way others perceive an individual to convey masculine, feminine, and androgynous characteristics through their appearance, mannerisms, and behaviors. Previous work identifies gender-variant-based victimization as a risk factor for health-risking outcomes among same-sex attracted youths. The current study seeks to examine this relationship among other-sex attracted youths and same-sex attracted youth, and determine if gender-variant-based victimization is similarly or differentially associated with poor outcomes between these two groups. Anonymous data from a school-based survey of 2,438 racially diverse middle and high school students in the Eastern U.S. was examined. For other-sex attracted adolescents, gender-variant-based victimization was associated with a higher odds of suicidal thoughts and behaviors, regular use of cigarettes, and drug use. When compared to same-sex attracted adolescents, the harmful relationship between gender-variant-based victimization and each of these outcomes was similar in nature. These findings suggest that gender-variant-based victimization has potentially serious implications for the psychological wellbeing and substance use of other-sex attracted adolescents, not just same-sex attracted adolescents, supporting the need to address gender expression as a basis for victimization separate from sexuality- or gender-minority status. The impact that gender-variant-based victimization has on all adolescents should not be overlooked in research and interventions aimed at addressing sexual orientation-based and gender-variant-based victimization, substance use, and suicide prevention. PMID:26068796
Czyz, Ewa K.; Liu, Zhuqing; King, Cheryl A.
Objective This study examined the extent to which post-hospitalization change in connectedness with family, peers, and non-family adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Method Participants were 338 inpatient suicidal adolescents, ages 13-17, who were assessed at three, six, and 12 months post hospitalization. General liner models were fitted for depressive symptoms and suicidal ideation outcomes, and logistic regression was used for the dichotomous suicide attempt outcome. The moderating effects of gender and multiple attempt history were examined. Results Adolescents who reported greater improvements in peer connectedness were half as likely to attempt suicide during the 12-month period. Improved peer connectedness was also associated with less severe depressive symptoms for all adolescents and with less severe suicidal ideation for females, but only at the three-month assessment time point. Improved family connectedness was related to less severe depressive symptoms and suicidal ideation across the entire year; for suicidal ideation, this protective effect was limited to non-multiple suicide attempters. Change in connectedness with non-family adults was not a significant predictor of any outcome when changes in family and peer connectedness were taken into account. Conclusions These results pointing to improved post-hospitalization connectedness being linked to improved outcomes following hospitalization have important treatment and prevention implications given inpatient suicidal adolescents’ vulnerability to suicidal behavior. PMID:22417194
Li, Dongping; Zhang, Wei; Li, Xian; Li, Nini; Ye, Baojuan
In a sample of 1252 Chinese adolescents (mean age = 15.00 years), this study examined the direct relations between gratitude and adolescents' suicidal ideation and suicide attempts. This study also examined indirect relations between gratitude and suicidal ideation and suicide attempts via two self-system beliefs--coping efficacy and self-esteem.…
Stanley, Barbara; Brown, Gregory; Brent, David A.; Wells, Karen; Poling, Kim; Curry, John; Kennard, Betsy D.; Wagner, Ann; Cwik, Mary F.; Klomek, Anat Brunstein; Goldstein, Tina; Vitiello, Benedetto; Barnett, Shannon; Daniel, Stephanie; Hughes, Jennifer
Objective: To describe the elements of a manual-based cognitive-behavioral therapy for suicide prevention (CBT-SP) and to report its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide. Method: The CBT-SP was developed using a risk reduction and relapse prevention approach and…
Stone, Lindsey B; Liu, Richard T; Yen, Shirley
Adolescents with a history of suicidal behavior are especially vulnerable for future suicide attempts, particularly following discharge from an inpatient psychiatric admission. This study is the first to test whether adolescents׳ tendency to generate stress, or report more dependent events to which they contributed, was predictive of prospective suicide events. Ninety adolescent psychiatric inpatients who were admitted for recent suicide risk, completed diagnostic interviews, assessments of history of suicidal behavior, and a self-report questionnaire of major life events at baseline. Participants were followed over the subsequent 6 months after discharge to assess stability vs. onset of suicide events. Cox proportional hazard regressions were used to predict adolescents׳ time to suicide events. Results supported hypothesis, such that only recent greater dependent events, not independent or overall events, predicted risk for prospective suicide events. This effect was specific to adolescent girls. Importantly, dependent events maintained statistical significance as a predictor of future suicide events after co-varying for the effects of several established risk factors and psychopathology. Results suggest that the tendency to generate dependent events may contribute unique additional prediction for adolescent girls׳ prospective suicide risk, and highlight the need for future work in this area.
Saz, Ulas Eylem; Arslan, Mehmet Tayyip; Egemen, Ayten
Introduction: Depression is an important cause of suicide in adolescents. It has been speculated that antidepressants themselves can increase the risk of suicide. Method: Cases of adolescents admitted to the Ege University Pediatric Emergency Department in Turkey due to suicide attempt were assessed. Results: Nine of 13 suicide attempts during…
Peach, Larry; Reddick, Thomas L.
Asserts that school counselors can play vital role in the prevention of adolescent suicide. Lists warning signs of suicide risk and characteristics of at-risk students. Presents set of guidelines for helping potential suicide victims. Sees key to teenage suicide prevention to be communication skills. Identifies components for suicide prevention…
Dhawan, Anju; Balhara, Yatan Pal Singh; Natasha, M. Phil.
Adolescent substance abuse is a major public health concern. It is associated with an increased incidence of various psychiatric disorders like depressive disorders, anxiety disorders, attention deficit hyperactivity disorder, and conduct disorders and the relationship between mental and behavioral disorders and the substance use problems seems…
Valente, Sharon M.; And Others
For adolescents faced with many developmental tasks, a loved one's death by suicide is a tragic event linked with increased morbidity, death fears, and psychopathology. Adolescents struggle to master tasks such as refining abstract thought, achieving independence, developing values, exploring intimacy in social and sexual relations, and becoming…
Sun, Rachel C. F.; Hui, Eadaoin K. P.
This study aimed to investigate the family, school, peer and psychological factors that contribute to adolescent suicidal ideation. The participants were 1,358 (680 boys and 678 girls) Hong Kong Chinese adolescents who were divided into younger (12.3 years, n = 694) and older (15.4 years, n = 664) age groups. By using structural equation modeling,…
Robinson, W. LaVome; Case, Mary H.; Whipple, Christopher R.; Gooden, Adia S.; Lopez-Tamayo, Roberto; Lambert, Sharon F.; Jason, Leonard A.
Suicide is an often-overlooked manifestation of violence among African American youth that has become more prevalent in the last two decades. This article reports on the process used to culturally adapt a cognitive-behavioral coping with stress prevention intervention for African American adolescents. We implemented this adapted school-based suicide prevention intervention with 758 African American 9th, 10th and 11th grade students at four high schools in a large Midwestern city. The findings presented are preliminary. The adolescents in this sample endorsed high levels of suicide risk, with females endorsing significantly more suicide risk than males. Those receiving the prevention intervention evidenced an 86% relative suicide risk reduction, compared to the standard care control participants. The presented model of adaptation and resulting culturally-grounded suicide prevention intervention significantly reduced suicide risk among African American adolescents. Clinical, research and policy implications are discussed. PMID:27517094
Robinson, W LaVome; Case, Mary H; Whipple, Christopher R; Gooden, Adia S; Lopez-Tamayo, Roberto; Lambert, Sharon F; Jason, Leonard A
Suicide is an often-overlooked manifestation of violence among African American youth that has become more prevalent in the last two decades. This article reports on the process used to culturally adapt a cognitive-behavioral coping with stress prevention intervention for African American adolescents. We implemented this adapted school-based suicide prevention intervention with 758 African American 9(th,) 10(th) and 11(th) grade students at four high schools in a large Midwestern city. The findings presented are preliminary. The adolescents in this sample endorsed high levels of suicide risk, with females endorsing significantly more suicide risk than males. Those receiving the prevention intervention evidenced an 86% relative suicide risk reduction, compared to the standard care control participants. The presented model of adaptation and resulting culturally-grounded suicide prevention intervention significantly reduced suicide risk among African American adolescents. Clinical, research and policy implications are discussed.
Liu, Xianchen; Tein, Jenn-Yun; Sandler, Irwin N.; Zhao, Zhongtang
This case control study examined the relationship between psychopathological profiles and self reported suicide attempts among rural adolescents of China. Cases consisted of 142 adolescents who reported a suicide attempt in the past 6 months in a questionnaire survey (n = 1,365). An equal number of adolescents without reporting a suicide attempt,…
Gilreath, Tamika D; Wrabel, Stephani L; Sullivan, Kathrine S; Capp, Gordon P; Roziner, Ilan; Benbenishty, Rami; Astor, Ron A
Previous research indicates that suicidal ideation is higher among military-connected youth than non military-connected youth. This study extends prior work by examining suicidal ideation, plans, and attempts in military-connected and non military-connected adolescents. Data were gathered from 390,028 9th and 11th grade students who completed the 2012-2013 California Healthy Kids Survey. Bivariate comparisons and multivariate logistic analyses were conducted to examine differences in suicidal ideation, plans, attempts, and attempts requiring medical attention between military and not military-connected youth. In multivariate logistic analyses, military-connected youth were at increased risk for suicidal ideation (OR = 1.43, 95 % CI = 1.37-1.49), making a plan to harm themselves (OR = 1.19, CI = 1.06-1.34), attempting suicide (OR = 1.67, CI = 1.43-1.95), and an attempted suicide which required medical treatment (OR = 1.71, CI = 1.34-2.16). These results indicate that military-connected youth statewide are at a higher risk for suicidal ideation, plans, attempts, and attempts requiring medical care because of suicidal behaviors. It is suggested that policies be implemented to increase awareness and screening among primary care providers, school personnel, and military organizations that serve military-connected youth.
Garfinkel, B. D.; Golombek, H.
Suicide and depression in children and adolescents are reviewed. The true incidence of suicide in the pediatric population is not known because of under-reporting; suicide is, however, considered as a leading cause of death in this age group. Suicide in young children often reflects an immature comprehension of the state of death, combined with a wish to alter an intolerable living situation or to punish individuals significant in his environment. At age 14 the incidence of suicide increases markedly. These acts of self-destruction reflect a developmental process that follows puberty. During this period the youth experiences an impoverishment of values and controls, as well as an intensification of emotions and needs, resulting in extreme disequilibrium. In the late adolescent, as in the adult, suicide occurs commonly in response to real or imagined loss. Specific guidelines are set out for the assessment and management of the depressed and suicidal youth. Community and medical measures of a prophylactic nature are recommended in the belief that the rising incidence of suicide can be halted through an intensification of efforts on the part of the medical profession. PMID:4599484
Kõlves, Kairi; de Leo, Diego
There are notable differences in suicide methods between countries. The aim of this paper is to analyse and describe suicide methods in children and adolescents aged 10-19 years in different countries/territories worldwide. Suicide data by ICD-10 X codes were obtained from the WHO Mortality Database and population data from the World Bank. In total, 101 countries or territories, have data at least for 5 years in 2000-2009. Cluster analysis by suicide methods was performed for countries/territories with at least 10 suicide cases separately by gender (74 for males and 71 for females) in 2000-2009. The most frequent suicide method was hanging, followed by poisoning by pesticides for females and firearms for males. Cluster analyses of similarities in the country/territory level suicide method patterns by gender identified four clusters for both gender. Hanging and poisoning by pesticides defined the clusters of countries/territories by their suicide patterns in youth for both genders. In addition, a mixed method and a jumping from height cluster were identified for females and two mixed method clusters for males. A number of geographical similarities were observed. Overall, the patterns of suicide methods in children and adolescents reflect lethality, availability and acceptability of suicide means similarly to country specific patterns of all ages. Means restriction has very good potential in preventing youth suicides in different countries. It is also crucial to consider cognitive availability influenced by sensationalised media reporting and/or provision of technical details about specific methods.
Parellada, Mara; Saiz, Pilar; Moreno, Dolores; Vidal, Jorge; Llorente, Cloe; Alvarez, Mar; García-Portilla, Paz; Ruiz-Sancho, Ana; Arango, Celso; Bobes, Julio
Attempted suicide may be a different phenomenon in adolescents than in adults. To our knowledge, direct comparisons between these two populations are very scarce. The aim of this study is to analyze the differences between adolescents and adults in methods of attempted suicide, accompanying certainty of death, and intentionality. All cases admitted to one adult (n=173) and one adolescent (n=104) inpatient unit who attempted suicide in the period from January 2003 through October 2005 were included in a prospective, common, national register, with data on methods, circumstances, and intentionality. The methodology followed that of the WHO/Euro Multicenter Study on Parasuicide. A stratified analysis was performed using the Mantel-Haenszel procedure in order to control for the effects of gender and diagnosis. Adolescents used significantly more over-the-counter medicines. Adults were significantly more certain of the possible fatal outcome of their attempt and had a significantly more severe intention when harming themselves. Individuals appear to use the methods that are available to them to attempt suicide. Adolescents may display more impulsive and less lethal directed behavior than adults or, alternatively, they are more frequently admitted for less severe attempts.
You, Jianing; Leung, Freedom
This study used zero-inflated poisson regression analysis to examine the role of depressive symptoms, family invalidation, and behavioral impulsivity in the occurrence and repetition of non-suicidal self-injury among Chinese community adolescents over a 2-year period. Participants, 4782 high school students, were assessed twice during the…
Lipschitz, Jessica M; Yen, Shirley; Weinstock, Lauren M; Spirito, Anthony
This study assessed the relationship between perceived family functioning and two indicators of suicidality in an adolescent sample. A total of 103 adolescents psychiatrically hospitalized for suicidal ideation and/or behavior completed a battery of self-report questionnaires assessing family functioning, negative affectivity, suicidal ideation in the past week assessed by Beck's Scale for Suicide Ideation (BSS; Beck et al., 1979), and past suicide attempts. Participants' primary caregivers also completed a questionnaire on family functioning. A paired samples t-test evaluated overall discrepancy between adolescent- and caregiver-reported family functioning. Linear and logistic regression models were used to evaluate the simple associations between perceived family functioning and suicidal indicators (BSS and previous attempt status), as well as the associations between perceived family functioning and suicidal indicators after controlling for negative affect. Results indicated that adolescents' ratings of family functioning were significantly worse than caregivers' ratings, and positively associated with BSS scores and a history of suicide attempt. When negative affect was controlled for, adolescent-reported family functioning was significantly associated with BSS, but only trended toward significance with attempt status. Findings suggest that adolescents' perceptions of family functioning may be a key contributing factor to suicidal ideation in adolescents with psychiatric disorders.
Yen, S.; Weinstock, L. M.; Andover, M. S.; Sheets, E. S.; Selby, E. A.; Spirito, A.
Background The aim of this study was to examine prospective predictors of suicide events, defined as suicide attempts or emergency interventions to reduce suicide risk, in 119 adolescents admitted to an in-patient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Method Structured diagnostic interviews and self-report instruments were administered to adolescent participants and their parent(s) to assess demographic variables, history of suicidal behavior, psychiatric disorders, family environment and personality/temperament. Results Baseline variables that significantly predicted time to a suicide event during follow-up were Black race, high suicidal ideation in the past month, post-traumatic stress disorder (PTSD), childhood sexual abuse (CSA), borderline personality disorder (BPD), low scores on positive affectivity, and high scores on aggression. In a multivariate Cox regression analysis, only Black race, CSA, positive affect intensity and high aggression scores remained significant. Conclusions Our findings suggest the following for adolescent populations: (1) in a very high-risk population, risk factors for future attempts may be more difficult to ascertain and some established risk factors (e.g. past suicide attempt) may not distinguish as well; and (2) cross-cutting constructs (e.g. affective and behavioral dysregulation) that underlie multiple psychiatric disorders may be stronger predictors of recurrent suicide events than psychiatric diagnoses. Our finding with respect to positive affect intensity is novel and may have practical implications for the assessment and treatment of adolescent suicide attempters. PMID:22932393
Kaplow, Julie B.; Gipson, Polly Y.; Horwitz, Adam G.; Burch, Bianca N.; King, Cheryl A.
Suicidal ideation substantially increases the odds of future suicide attempts, and suicide is the second leading cause of death among adolescents. A history of adverse life events has been linked with future suicidal ideation and attempts, although studies examining potential mediating variables have been scarce. One probable mediating mechanism is how the individual copes with adverse life events. For example, certain coping strategies appear to be more problematic than others in increasing future psychopathology, and emotional suppression in particular has been associated with poor mental health outcomes in adults and children. However, no studies to date have examined the potential mediating role of emotional suppression in the relation between adverse life events and suicidal thoughts/behavior in adolescence. The goal of the current study was to examine emotional suppression as a mediator in the relation between childhood adversity and future suicidal thoughts/behaviors in youth. A total of 625 participants, aged 14–19 years, seeking ER services were administered measures assessing adverse life events, coping strategies, suicidal ideation in the last 2 weeks, and suicide attempts in the last month. The results suggest that emotional suppression mediates the relation between adversity and both (1) suicidal thoughts and (2) suicide attempts above and beyond demographic variables and depressive symptoms. This study has important implications for interventions aimed at preventing suicidal thoughts and behavior in adolescents with histories of adversity. PMID:23412949
Horwitz, Adam G; Czyz, Ewa K; King, Cheryl A
The purpose of this study was to longitudinally examine specific characteristics of suicidal ideation in combination with histories of suicide attempts and non-suicidal self-injury (NSSI) to best evaluate risk for a future attempt among high-risk adolescents and emerging adults. Participants in this retrospective medical record review study were 473 (53% female; 69% Caucasian) consecutive patients, ages 15 to 24 years (M=19.4 years) who presented for psychiatric emergency services during a 9-month period. These patients' medical records, including a clinician-administered Columbia-Suicide Severity Rating Scale, were coded at the index visit and at future visits occurring within the next 18 months. Logistic regression models were used to predict suicide attempts during this period. Socioeconomic status, suicidal ideation severity (i.e., intent, method), suicidal ideation intensity (i.e., frequency, controllability), a lifetime history of suicide attempt, and a lifetime history of NSSI were significant independent predictors of a future suicide attempt. Suicidal ideation added incremental validity to the prediction of future suicide attempts above and beyond the influence of a past suicide attempt, whereas a lifetime history of NSSI did not. Sex moderated the relationship between the duration of suicidal thoughts and future attempts (predictive for male patients but not female). Results suggest value in incorporating both past behaviors and current thoughts into suicide risk formulation. Furthermore, suicidal ideation duration warrants additional examination as a potential critical factor for screening assessments evaluating suicide risk among high-risk samples, particularly for male patients.
King, Cheryl A; Hill, Ryan M; Wynne, Henry A; Cunningham, Rebecca M
This experimental study examined the effect of communication about type of screening follow-up (in-person follow-up vs. no in-person follow-up) on adolescents' responses to a self-report suicide risk screen. Participants were 245 adolescents (131 girls, 114 boys; ages 13-17; 80% White, 21.6% Black, 9.8% American Indian, 2.9% Asian) seeking medical emergency services. They were randomized to a screening follow-up condition. Screening measures assessed primary risk factors for suicidal behavior, including suicidal thoughts, depressive symptoms, alcohol use, and aggressive/delinquent behavior. There was no main effect of follow-up condition on adolescents' screening scores; however, significant interactions between follow-up condition and public assistance status were evident. Adolescents whose families received public assistance were less likely to report aggressive-delinquent behavior if assigned to in-person follow-up. Adolescents whose families did not receive public assistance reported significantly higher levels of suicidal ideation if assigned to in-person follow-up. Findings suggest that response biases impact some adolescents' responses to suicide risk screenings. Because national policy strongly recommends suicide risk screening in emergency settings, and because screening scores are used to make critical decisions regarding risk management and treatment recommendations, findings indicate the importance of improving the reliability and validity of suicide risk screening for adolescents.
Young, Rachel; Subramanian, Roma; Miles, Stephanie; Hinnant, Amanda; Andsager, Julie L
Cyberbullying has provoked public concern after well-publicized suicides of adolescents. This mixed-methods study investigates the social representation of these suicides. A content analysis of 184 U.S. newspaper articles on death by suicide associated with cyberbullying or aggression found that few articles adhered to guidelines suggested by the World Health Organization and the American Foundation for Suicide Prevention to protect against suicidal behavioral contagion. Few articles made reference to suicide or bullying prevention resources, and most suggested that the suicide had a single cause. Thematic analysis of a subset of articles found that individual deaths by suicide were used as cautionary tales to prompt attention to cyberbullying. This research suggests that newspaper coverage of these events veers from evidence-based guidelines and that more work is needed to determine how best to engage with journalists about the potential consequences of cyberbullying and suicide coverage.
Galaif, Elisha R; Sussman, Steve; Newcomb, Michael D; Locke, Thomas F
Suicide is a serious health problem as it is currently the third leading cause of death for teenagers between the ages of 15 and 24 years. Depression, which is also a serious problem for adolescents, is the most significant biological and psychological risk factor for teen suicide. Alcohol use remains extremely widespread among today’s teenagers and is related to both suicidality and depression. Suicidality refers to the occurrence of suicidal thoughts or suicidal behavior. The consensus in empirical research is that mental disorders and substance abuse are the most important risk factors in both attempted and completed adolescent suicide. Therefore, it is incumbent upon researchers to identify the factors that can lead to their prevention among today’s youth. This review compiles the existing literature on suicidality, depression, and alcohol use among adolescents spanning over the past 15 years. Both Problem Behavior Theory and Stress-coping Theory can explain the relationships among suicidality, depression and alcohol use. The prevention of suicidality is critical, especially during the early school years, when it is associated with depression and alcohol use. Suicidality, depression and alcohol use are three phenomenon that noticeably increase in adolescence marking this time period as an ideal opportunity for prevention efforts to commence. Future empirical work is needed that will further assess the impact of adolescent depression and alcohol use on suicidality. In sum, this review of empirical research highlights critical results and limitations, as well as indicates a need for continued efforts in preventing suicidality, depression, and alcohol use among adolescents. PMID:17458321
Berk, Michele; Adrian, Molly; McCauley, Elizabeth; Asarnow, Joan; Avina, Claudia; Linehan, Marsha
Research on effective treatments for adolescent suicide attempters is urgently needed. However, there has been a lack of research in this area. This is likely a result of the multiple challenges faced by investigators working with individuals at high risk of suicide. Based on our experiences conducting a large, randomized clinical trial with adolescent suicide attempters, in this article, we review ways to address these challenges in order to facilitate needed research on suicide prevention in adolescents. PMID:24954969
Bolognini, Monique; Plancherel, Bernard; Laget, Jacques; Halfon, Olivier
Adolescence corresponds to a transition period that requires adaptation and change capacities and skills. Most young people succeed with this challenge, whereas a minority fail. In order to identify with the teenage culture, become autonomous, and differentiate from their parents, some adolescents choose to use drugs, beginning with the use of cigarettes, alcohol, cannabis, followed by other illicit drugs such as opiates and stimulants. A high proportion of these adolescents attempt suicide, which is the primary cause of death during adolescence in many European countries. Who are the "vulnerable" adolescents? What are the mechanisms that can explain the varieties of drug-use initiation or suicide attempts? Can "protective factors" be identified? What kind of strategies might be developed at a social and political level in order to prevent or to minimize drug abuse and suicide attempts, among other harmful behaviors? These issues will be discussed on the basis of the recent literature and in the light of a recent study carried out in the French-speaking part of Switzerland on large cohorts of adolescent drug users. Unresolved critical issues are noted and future needed research is suggested.
Stone, Lindsey Beth; Liu, Richard; Yen, Shirley
Adolescents with a history of suicidal behavior are especially vulnerable for future suicide attempts, particularly following discharge from an inpatient psychiatric admission. This study is the first to test whether adolescents’ tendency to generate stress, or report more dependent events to which they contributed, was predictive of prospective suicide events. Ninety adolescent psychiatric inpatients who were admitted for recent suicide risk, completed diagnostic interviews, assessments of history of suicidal behavior, and a self-report questionnaire of major life events at baseline. Participants were followed over the subsequent 6 months after discharge to assess stability vs. onset of suicide events. Cox proportional hazard regressions were used to predict adolescents’ time to suicide events. Results supported hypothesis, such that only recent greater dependent events, not independent or overall events, predicted risk for prospective suicide events. This effect was specific to adolescent girls. Importantly, dependent events maintained statistical significance as a predictor of future suicide events after co-varying for the effects of several established risk factors and psychopathology. Results suggest that the tendency to generate dependent events may contribute unique additional prediction for adolescent girls’ prospective suicide risk, and highlight the need for future work in this area. PMID:24893759
Crepeau-Hobson, Franci; Leech, Nancy L.
This study examined the association between various types of peer-directed violence and suicidal thoughts and behaviors among adolescents. A nationally representative sample of 15,425 high school students completed the 2011 Youth Risk Behavior Survey. All types of peer victimization (bullying, physical violence, and dating violence) were found to…
Li, Dongping; Bao, Zhenzhou; Li, Xian; Wang, Yanhui
Background: School factors play important roles in adolescent suicide. However, little is known about how school climate is associated with adolescent suicide. This study examined the relationship between perceived school climate and adolescent suicidal ideation and suicide attempts, and whether these relations were explained by adolescent sleep…
Kim, Hun Soo; Kim, Hyun Sil
This study examined the rate of suicide attempts and relevant variables and identified risk factors for suicide attempts among Korean adolescents. A cross-sectional study was performed using an anonymous, self-report questionnaire. A total of 2,100 Korean adolescents, including 1,321 student adolescents and 779 delinquent adolescents, were…
Scott, Lori N; Pilkonis, Paul A; Hipwell, Alison E; Keenan, Kate; Stepp, Stephanie D
Although both suicide ideation (SI) and non-suicidal self-injury (NSSI) are known risk factors for suicidal behavior, few longitudinal studies have examined whether having a history of one or both of these factors prospectively predicts increased risk for suicide attempts. According to the theory of acquired capability for suicide, engagement in NSSI may reduce inhibitions around self-inflicted violence, imparting greater risk for suicide attempts among those with SI than would be observed in those with SI who do not have a history of NSSI. We used prospective data from the Pittsburgh Girls Study, a large community sample, to compare groups of girls reporting no SI or NSSI, SI only, or both NSSI and SI between early to late adolescence on any lifetime or recent suicide attempts in late adolescence and early adulthood. As compared to girls with no SI or NSSI history and those with only an SI history, girls with a history of both NSSI and SI were significantly more likely to subsequently report both lifetime and recent suicide attempts. Results are consistent with the acquired capability theory for suicide and suggest that adolescent girls who have engaged in NSSI and also report SI represent a particularly high-risk group in need of prevention and intervention efforts.
Scott, Lori N.; Pilkonis, Paul A.; Hipwell, Alison E.; Keenan, Kate; Stepp, Stephanie D.
Although both suicide ideation (SI) and non-suicidal self-injury (NSSI) are known risk factors for suicidal behavior, few longitudinal studies have examined whether having a history of one or both of these factors prospectively predicts increased risk for suicide attempts. According to Joiner’s1 theory of acquired capability for suicide, engagement in NSSI may reduce inhibitions around self-inflicted violence, imparting greater risk for suicide attempts among those with SI than would be observed in those with SI who do not have a history of NSSI. We used prospective data from the Pittsburgh Girls Study, a large community sample, to compare groups of girls reporting no SI or NSSI, SI only, or both NSSI and SI between early to late adolescence on any lifetime or recent suicide attempts in late adolescence and early adulthood. As compared to girls with no SI or NSSI history and those with only an SI history, girls with a history of both NSSI and SI were significantly more likely to subsequently report both lifetime and recent suicide attempts. Results are consistent with the acquired capability theory for suicide and suggest that adolescent girls who have engaged in NSSI and also report SI represent a particularly high-risk group in need of prevention and intervention efforts. PMID:25595520
Johnson, Lisa A; Parsons, Mary E
Suicide is a major public health problem. Nationally, suicide is the third leading cause of death for adolescents. The purpose of this quality improvement project was to initiate and evaluate a gatekeeper suicide-prevention program within a local school system targeting faculty and staff without a medical or psychology background who interact regularly with middle- and high-school students. Following the implementation of this program, evaluation of increased knowledge related to adolescent suicide prevention was completed. All participants completed a pretest and posttest, and results indicate that the staff members' knowledge about identification of risk factors, behavioral responses to suicidal students, and knowledge of community resources were increased. This project highlights the need for planned and sustainable education and training for faculty and school staff who regularly interact with adolescents. Additionally, the importance of continued monitoring, training, and advocating for suicide prevention programming is noted.
Eskin, Mehmet; Palova, Eva; Krokavcova, Martina
Suicidal behavior and its variation across social contexts are of importance for the science of suicidology. Due to its special character controlled experimental studies on suicide are ruled out for ethical reasons. Cross-cultural studies may throw light on the etiology of both suicidal behavior and its cross-cultural variation. The present study compared suicidal behavior and attitudes in 423 Slovak and 541 Turkish high school students by means of a self-report questionnaire. The two groups reported similar percentages (Slovak = 36.4%; Turkish = 33.8%) of lifetime, past 12-months or current suicidal ideation but significantly more Turkish (12.2%) than Slovak (4.8%) students reported lifetime or past 12-months suicide attempts. Slovak adolescents displayed more liberal and permissive attitudes toward suicide, while those of Turkish adolescents were more rejecting. Turkish students rated themselves to be more religious and hence they believed to a greater extent that suicidal persons would be punished in a life after death than their Slovak peers. However, attitudes of Turkish students toward an imagined suicidal close friend were more accepting than the attitudes of Slovak students. Comparison of suicidal and nonsuicidal students revealed that those reporting suicidal ideation or attempts were more accepting of suicide and viewed suicide as a solution to a greater extent than the nonsuicidal ones. The results from this study suggest that cultural factors play a role in suicidal behavior, attitudes and reactions in a predicted direction.
Zalsman, G; Frisch, A; Bromberg, M; Gelernter, J; Michaelovsky, E; Campino, A; Erlich, Z; Tyano, S; Apter, A; Weizman, A
The serotonin transporter-linked promoter region polymorphism (5-HTTLPR) is thought to be associated with some serotonin dysfunction-related psychopathologies such as depression and anxiety disorders. Suicide and suicide-related behaviors such as violence, aggression, and impulsivity have been reproducibly associated with serotonin dysfunction and are partially genetic. This study examined the association of 5-HTTLPR with suicidal behavior and related traits in Israeli suicidal adolescent inpatients using the haplotype relative risk (HRR) method that controls for artifacts caused by population stratification. Forty-eight inpatient adolescents who recently attempted suicide were assessed by structured interviews for detailed clinical history, diagnoses, suicide intent, suicide risk, impulsivity, violence, and depression. Blood samples were collected and DNA extracted from patients and their biological parents. The 5-HTTLPR allele frequencies were tested for association with suicidality by the HRR method. In addition, the relationship between genotypes and phenotypic severity of several clinical parameters was analyzed. No significant allelic association of the 5-HTTLPR polymorphism with suicidal behavior was found (chi square = 0.023; P = 0.88). Analysis of variance of the suicide-related trait measures for the three genotypes demonstrated a significant difference in violence measures between patients carrying the LL and LS genotypes (9.50+/-4.04 vs. 5.36+/-4.03; P = 0.029). This study suggests that the 5-HTTLPR polymorphism is unlikely to have major relevance to the pathogenesis of suicidal behavior in adolescence but may contribute to violent behavior in this population.
Boričević Maršanić, Vlatka; Margetić, Branka Aukst; Zečević, Iva; Herceg, Miroslav
Despite evidence that children of male war veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk for behavior problems, very little is currently known about suicidal behaviors in this population of youth. This study aimed to examine the prevalence and psychosocial correlates of suicide attempts among psychiatrically hospitalized adolescent offspring of Croatian male PTSD veterans. Participants were psychiatric inpatients, ages 12-18 years. Self-report questionnaires assessed demographics, suicide attempts, psychopathology, parenting style, and family functioning. The prevalence of suicide attempts was 61.5% (65.2% for girls and 58.0% for boys). Internalizing symptoms, family dysfunction, lower levels of maternal and paternal care, and paternal overcontrol were significantly associated with suicide attempts. Our findings suggest that suicide attempts are common among inpatient adolescent offspring of male PTSD veterans and that interventions targeting both adolescent psychopathology and family relationships are needed for adolescents who have attempted suicide.
Mauk, Gary W.
During 1988 there were 4,929 deaths by suicide among persons 15 to 24 years of age in the United States, making suicide the third leading cause of death in this age group, following accidents and homicide. Adolescent suicide is a particularly toxic form of death for the peers who are left behind. A "survivor of suicide" is defined as…
Hooven, Carole; Snedker, Karen A.; Thompson, Elaine Adams
Young adult suicide is an important social problem, yet little is known about how risk for young adult suicide develops from earlier life stages. In this study the authors report on 759 young adults who were potential high school dropouts as youth. At both adolescence and young adulthood, measures of suicide risk status and related suicide risk…
Lyon, Maureen E.; Benoit, Marilyn; O'Donnell, Regina M.; Getson, Pamela R.; Silber, Tomas; Walsh, Thomas
Evaluates risk factors in African American adolescent suicide attempters (n=51) and nonsuicidal (n=124) adolescents. Results show that threat of separation from a parental figure, insomnia, neglect, substance abuse, suicidal ideation, and failing grades were the strongest predictors of suicide attempt. Unexpected findings include high levels of…
Steinhausen, Hans-Christoph; Bosiger, Ruth; Metzke, Christa Winkler
Background: The goal of this study was to investigate the stability and correlates of adolescent suicidal risk across adolescence. Methods: Suicidal risk was studied longitudinally in N = 593 subjects in 1994, 1997, and 2001 at mean ages of 13, 16, and 20 years. Three partly overlapping suicidal risk groups were compared to three control groups…
Carvalho, Célia Barreto; Nunes, Carolina; Castilho, Paula; da Motta, Carolina; Caldeira, Suzana; Pinto-Gouveia, José
Non-suicidal self-injury (NSSI) is the deliberate, self-inflicted destruction of body tissue without suicidal intent and an important clinical phenomenon. Rates of NSSI appear to be disproportionately high in adolescents and young adults, and is a risk factor for suicidal ideation and behavior. The present study reports the psychometric properties of the Impulse, Self-harm and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A), a measure designed to comprehensively assess the impulsivity, NSSI behaviors and suicide ideation. An additional module of this questionnaire assesses the functions of NSSI. Results of Confirmatory Factor Analysis (CFA) of the scale on 1722 youths showed items' suitability and confirmed a model of four different dimensions (Impulse, Self-harm, Risk-behavior and Suicide ideation) with good fit and validity. Further analysis showed that youth׳s engagement in self-harm may exert two different functions: to create or alleviate emotional states, and to influence social relationships. Our findings contribute to research and assessment on non-suicidal self-injury, suggesting that the ISSIQ-A is a valid and reliable measure to assess impulse, self-harm and suicidal thoughts, in adolescence.
Goldston, David B.; Molock, Sherry Davis; Whitbeck, Leslie B.; Murakami, Jessica L.; Zayas, Luis H.; Hall, Gordon C. Nagayama
Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African…
Lee, Gyu-Young; Choi, Yun-Jung
In a cross-sectional research design, we investigated factors related to suicidal ideation in adolescents using data from the 2013 Online Survey of Youth Health Behavior in Korea. This self-report questionnaire was administered to 72,435 adolescents aged 13-18 years in middle and high school. School characteristics, family characteristics, and mental health variables were analyzed using descriptive statistics, χ(2) tests, and logistic regression. Both suicidal ideation and behavior were more common in girls. Suicidal ideation was most common in 11th grade for boys and 8th grade for girls. Across the sample, in logistic regression, suicidal ideation was predicted by low socioeconomic status, high stress, inadequate sleep, substance use, alcohol use, and smoking. Living apart from family predicted suicidal ideation in boys but not in girls. Gender- and school-grade-specific intervention programs may be useful for reducing suicidal ideation in students.
Wong, Joy P. S.; Stewart, Sunita M.; Ho, S. Y.; Lam, T. H.
This study examined 1,361 Chinese adolescents who reported self-injurious behaviors. Groups A and B both acknowledged deliberate self-injury, but only Group A had made a suicide attempt. Group C reported accidental self-injury. Deliberate self-injurers (Groups A and B) were more frequently girls, older, and with more suicidal ideation. Group A had…
Daniel, Stephanie S.; Goldston, David B.; Erkanli, Alaattin; Franklin, Joseph C.; Mayfield, Andrew M.
Previous studies of the relationship between anger, anger expression, and suicidal behavior have been largely cross-sectional and have yielded mixed findings. In a prospective, naturalistic study, we examined how trait anger and anger expression influenced the likelihood of suicide attempts among 180 adolescents followed for up to 13.3 years after…
Gérard, N; Delvenne, V; Nicolis, H
Suicide is the second leading cause of death among adolescents. The risk factors are many and varied. The contagion of suicide was raised as a potential cause of youth suicide. In support of this argument, we did a review of the literature on the possible contagion of adolescent suicide. Several types of situations can support this hypothesis : when a youth is faced with the suicide of a relative or close friend, when he lived in a community, through the media or via the Internet. The way suicide is reported in the press shows a correlation with increased incidence of suicide among adolescents. In summary, there is evidence increasingly obvious that the contagion is the source of some youth suicides. For this reason, it seems important that preventive measures are in place. However, although this mechanism has been instrumental in initiating the act, it is important to note that suicide is always the result of several factors including the personal history of the subject.
Roy, Alec; Sarchiopone, Marco; Carli, Vladimir
Studies have increasingly shown that gene-environment interactions are important in psychiatry. Suicidal behavior is a major public health problem. Suicide is generally considered to be a multi-determined act involving various areas of proximal and distal risk. Genetic risk factors are estimated to account for approximately 30% to 40% of the variance in suicidal behavior. In this article, the authors review relevant studies concerning the interaction between the serotonin transporter gene and environmental variables as a model of gene-environment interactions that may have an impact on suicidal behavior. The findings reviewed here suggest that there may be meaningful interactions between distal and proximal suicide risk factors that may amplify the risk of suicidal behavior. Future studies of suicidal behavior should examine both genetic and environmental variables and examine for gene-environment interactions.
Valente, Sharon M.; And Others
Examined existing literature on links between bereavement after suicide and the subsequent development of adolescents including increased suicide risks. Found inconsistent definitions of adolescence in literature, samples of adolescents were drawn from those in psychotherapy, and other methodological problems. (Author/ABL)
Connor, Jennifer; Rueter, Martha
Adolescent suicidality is a serious problem among American youth. Common risk factors for adolescent suicidality include depression and conduct problems but there is little agreement on the best means to assess these factors. We compared multiple informants (mothers, fathers, the adolescent and a sibling) and multiple assessment techniques using a…
Hawton, Keith; Saunders, Kate E A; O'Connor, Rory C
Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs.
Jamieson, Patrick Edwin; Romer, Dan
Trends in suicidal behavior portrayal in movies may reflect greater societal acceptance of suicide with potential adverse effects on adolescents. To assess the potential for such adverse effects, explicit portrayals of suicidal behavior and the ratings of films were coded in top-grossing U.S. movies from 1950-2006 (N = 855). Suicidal behavior portrayal in films increased linearly from 1950 to 2006. From 1968-1984, movies rated R by the Motion Picture Association of America had 5 times more highly explicit suicide behavior portrayals than did G/PG films. After the adoption of the PG-13 category in 1985, PG-13 and R films were indistinguishable on this measure. The results indicate the need for further study of the effects of suicidal behavior portrayals on adolescent movie audiences.
Yen, Shirley; Kuehn, Kevin; Melvin, Caitlin; Weinstock, Lauren M.; Andover, Margaret S.; Selby, Edward A.; Solomon, Joel B.; Spirito, Anthony
This study examined prospective predictors of persistent non-suicidal self-injury (NSSI) in adolescents admitted to an inpatient psychiatric unit for suicidal behaviors and followed naturalistically for six months. Seventy-one (77%) participants reported NSSI at baseline and 40 (56%) persisted at the six month follow-up. Those who endorsed automatic positive reinforcement (APR) as the predominant reason for NSSI, were more likely to persist in NSSI. Depression over follow-up, but not at baseline, also predicted persistence. These results suggest that helping high risk adolescents to identify alternative ways of generating emotion(s) to counter the effects of APR that may accompany NSSI, should be a high priority treatment target. PMID:25907682
Girard, Gustavo A; Silber, Tomas J
The aftermath of an adolescent's suicide can be devastating to family, friends, and treating professionals, yet not much has been written on this subject. In this article, we briefly develop a conceptualization of suicide and a typology of suicide and the physicians' attitudes toward suicide. This is followed with a more detailed review of the aftermath of suicide (focusing on the suicide grievers) and the impact of suicide on clinicians. The work ends with discussion of research data and the role of spirituality as well as an outline of therapeutic interventions.
McManama O'Brien, Kimberly H; Berzin, Stephanie C
Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of suicide attempts among adolescents presenting to an urban general hospital (N=375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without substance abuse. Regression results indicated having depression comorbid with any other diagnosis was not associated with medical lethality. However, having a substance abuse disorder was associated with higher suicide attempt lethality, highlighting the importance of substance abuse as a risk factor for lethal suicide attempts in adolescents. This finding stimulates critical thinking around the understanding of suicidal behavior in youth and the development and implementation of treatment strategies for suicidal adolescents with substance abuse disorders.
Andover, Margaret S; Morris, Blair W; Wren, Abigail; Bruzzese, Margaux E
Although attempted suicide and non-suicidal self-injury (NSSI) are distinct behaviors differing in intent, form, and function, the behaviors co-occur at a high rate in both adults and adolescents. Researchers have begun to investigate the association between attempted suicide and NSSI among adolescents. The purpose of this paper is to present current research on this association. First, we discuss definitional issues associated with self-injurious behaviors. Next, we present research on the co-occurrence of attempted suicide and NSSI, including prevalence and associations with self-injury characteristics. We then discuss psychosocial variables associated with engaging in both NSSI and attempted suicide or one type of self-injury alone. Finally, we present the research to date on risk factors uniquely associated with either attempted suicide or NSSI. Implications for mental health professionals and future avenues of research are discussed.
Although attempted suicide and non-suicidal self-injury (NSSI) are distinct behaviors differing in intent, form, and function, the behaviors co-occur at a high rate in both adults and adolescents. Researchers have begun to investigate the association between attempted suicide and NSSI among adolescents. The purpose of this paper is to present current research on this association. First, we discuss definitional issues associated with self-injurious behaviors. Next, we present research on the co-occurrence of attempted suicide and NSSI, including prevalence and associations with self-injury characteristics. We then discuss psychosocial variables associated with engaging in both NSSI and attempted suicide or one type of self-injury alone. Finally, we present the research to date on risk factors uniquely associated with either attempted suicide or NSSI. Implications for mental health professionals and future avenues of research are discussed. PMID:22463065
Amitai, Maya; Apter, Alan
Purpose: The present review summarizes the updated literature on the social aspects of suicidal behavior and prevention in adolescents. Recent findings: The predictive role of psychiatric disorders and past history are well recognized in adolescent suicide, but the role of social and cultural factors is less clear. Studies have focused on the importance of ethnicity, gender, family characteristics, and socioeconomic status. More recently, attention has been addressed to broader social risk factors, such as bullying in adolescents, suicide contagion, sexual orientation, and the popular media. Further empirical evidence is needed to advance our understanding of suicidal youth, develop better assessment tools, and formulate effective prevention and treatment programs. Summary: Suicidal behavior remains an important clinical problem and major cause of death in youth. Social factors may be at least as important as genetics. Advancing our understanding of underlying cultural and sociological issues in youth suicide will help clinicians achieve more efficient prediction, prevention and treatment. PMID:22690178
Horváth, Olga Lili; Mészáros, Gergely; Balázs, Judit
Although non-suicidal self-injury (NNSI), a behavior with a typical onset during adolescence, is a well-researched topic in the international literature and affects numerous adolescents both in clinical and non-clinical populations, it is rarely studied in Hungary. The aim of our paper is to review the historical and cultural background, terms and definitions used in the international and Hungarian literature, the epidemiology, the psychosocial correlates and the theories for possible predictors and functions of NSSI. Terms and definitions for NSSI evolved in international but not in Hungarian literature. Most frequently found functions for NSSI were affect regulation, self-punishment, anti-suicide, anti-dissociation. NSSI is also used to affirm interpersonal boundaries, for sensation seeking and to influence others. Prevalence of NSSI is 15-46% in community and 40-80% in clinical sample in adolescents. Hungarian results on prevalence of NSSI are relatively low in comparison with international data (7-17% in adolescent community sample). NSSI is often associated with psychiatric disorders: DSM-IV Axis I disorders are present in 88% and Axis II disorders are present in 67% of adolescent self-injurer samples. NSSI and suicidal behavior are two different but not independent phenomena: correlation is approximately 50% in community and 70% in clinical population. In conclusion we would like to highlight that NSSI affects numerous adolescents and it is often comorbid with other psychiatric disorders, thus developing adequate Hungarian terminology, increasing the amount of Hungarian studies and the up-to-date knowledge of the clinicians are necessary.
Sampasa-Kanyinga, Hugues; Dupuis, Lorette C; Ray, Robin
Suicide is a potentially preventable public health issue. It is therefore important to examine its immediate precursors, including suicidal ideation and attempts, to help in the development of future public health interventions. The present study reports the prevalence of suicidal ideation and attempts in the past 12 months in children and adolescents and identifies correlates of such behaviors in a large and diverse sample of middle and high school students. Data were drawn from a representative sample of Ottawa students (n=1922) aged 11-20 years (14.4±1.9 years) from three cycles (2009, 2011 and 2013) of the Ontario Student Drug Use and Health Survey (OSDUHS), a cross-sectional school-based appraisal of students in grades 7-12 across Ontario, Canada. Overall, 10.8% of students exhibited suicidal ideation and 3.0% reported suicide attempts in the past 12 months. The conditional probability of making an attempt was 25.5% among suicide ideators. Multivariable analyses indicated that being a girl and using alcohol and cannabis were positively associated with suicidal ideation, while tobacco was positively associated with suicide attempts. Being a victim of school bullying was significantly associated with reports of suicidal ideation and attempts, whereas school connectedness had protective effects against both suicidal ideation and attempts. These results indicate that suicidal ideation and attempts are related to other risky behaviors. Suicide-prevention efforts should be integrated within broader health-promoting initiatives.
Orri, Massimiliano; Paduanello, Matteo; Lachal, Jonathan; Falissard, Bruno; Sibeoni, Jordan; Revah-Levy, Anne
Background Suicide by adolescents and young adults is a major public health concern, and repetition of self-harm is an important risk factor for future suicide attempts. Objective Our purpose is to explore the perspective of adolescents directly involved in suicidal acts. Methods Qualitative study involving 16 purposively selected adolescents (sex ratio1∶1) from 3 different centers. Half had been involved in repeated suicidal acts, and the other half only one. Data were gathered through semistructured interviews and analyzed according to Interpretative Phenomenological Analysis. Results We found five main themes, organized in two superordinate themes. The first theme (individual dimensions of the suicide attempt) describes the issues and explanations that the adolescents saw as related to themselves; it includes the subthemes: (1) negative emotions toward the self and individual impasse, and (2) the need for some control over their lives. The second main theme (relational dimensions of attempted suicide) describes issues that adolescents mentioned that were related to others and includes three subthemes: (3) perceived impasse in interpersonal relationships, (4) communication, and (5) revenge. Conclusions Adolescents involved in suicidal behavior are stuck in both an individual and a relational impasse from which there is no exit and no apparent way to reach the other. Revenge can bridge this gap and thus transforms personal distress into a relational matter. This powerful emotion has been neglected by both clinicians and researchers. PMID:24802777
Fiedorowicz, Jess G.; Mills, James A.; Ruggle, Adam; Langbehn, Douglas; Paulsen, Jane S.
Background Several studies have suggested a greater risk of suicide in Huntington disease (HD); however, unique risk factors for suicide in HD are not established. Objective We sought to determine risk factors for suicidal behavior, defined as suicide or attempted suicide, in prodromal HD. Methods From the prospective PREDICT-HD cohort, we identified 735 cases with HD gene expansion but no manifest symptoms of HD and 194 non-gene-expanded controls. In survival analysis, a number of potential risk factors for suicidal behavior were assessed, including symptoms of depression, hopelessness, substance abuse, marital status, gender, and psychiatric history. Results During a mean of 3.7 years of prospective follow-up, 12 cases (1.6%) attempted suicide and 1 completed suicide (0.1%). No suicides were observed among controls. In univariate Cox proportional hazards regression models, a history of suicide attempts (HR 8.5, 95% CI 2.8–26.1, p < 0.0002) and a Beck Depression Inventory II score >13 (HR 7.2, 95% CI 2.3–22.0, p < 0.0006) were associated with suicidal behavior. These risk factors had independent effects in multivariate models. A history of incarceration in the past 2 years was also associated (HR 12.5, 95% CI 2.7–56.6, p < 0.002), though uncommon. No further risk factors were identified. Conclusion A history of suicide attempts and the presence of depression are strongly predictive of suicidal behavior in prodromal HD. As these risk factors are among the most robust risk factors for suicide, established suicide risk factors appear applicable to those with prodromal HD. Copyright © 2011 S. Karger AG, Basel PMID:21659725
Greening, Leilani; Stoppelbein, Laura; Fite, Paula; Dhossche, Dirk; Erath, Stephen; Brown, Jacqueline; Cramer, Robert; Young, Laura
Path analyses were applied to test a model that includes internalizing and externalizing behavior problems as predictors of suicidal behaviors in children. Parents of an inpatient sample of boys (N = 87; M age = 9.81 years) rated the frequency of suicidal ideation and completed standardized measures of behavior problems. Blind raters rated the…
Suicidal behaviors are among the leading causes of death worldwide. The large spread of suicide suggests that educational programs and literature to parents or guardians should include information about the potential risks and potential consequences of the onset of the idea of suicide in children. We identified 55 cases of suicide among children and young adults <18-year-old occurring in Italy between 1st January, 2011 and 31st December, 2013. The results point to the need to increase our understanding of the dramatic rise in suicidal behaviors during childhood/adolescence and of the causal pathways linking these behaviors to child-adolescent mental disorders. During routine care visits, pediatricians should be skilled to recognize risk factors for adolescent suicide in order to intervene appropriately. PMID:25022200
Duldulao, Aileen Alfonso; Takeuchi, David T; Hong, Seunghye
This study examines the correlates of suicidal ideation, suicide plan and suicide attempt among Asian Americans focusing on nativity and gender. Analyses are performed on data from the National Latino and Asian American Study (N = 2095), the first ever study conducted on the mental health of a national sample of Asian Americans. The sample is comprised of adults with 998 men (47%) and 1,097 (53%) women. Analysis of weighted lifetime prevalence of suicidal behaviors revealed that U.S.-born Asian American women had higher prevalence of suicidal ideation and suicide plan than U.S.-born Asian American men and immigrant Asian American men and women. In multivariate analyses controlling for socio-demographic differences such as ethnicity, marital status and income, differences in suicidal behaviors are found only between U.S.-born women and U.S.-born men. The findings demonstrate the need to disaggregate data by immigrant status as well as socio-demographic correlates.
Radeloff, D; Lempp, T; Herrmann, E; Kettner, M; Bennefeld-Kersten, K; Freitag, C M
Incarcerated adolescents are a high-risk group for suicidal behaviour, but data on completed suicide are scarce in this population. The present study aimed at calculating relative risks (RR) of suicide in detention and identifying age-related risk factors. We compared data of a German national total survey of completed suicide of young detainees (14 to <21 years, N = 79) during the years 2000-2010 with age- and gender-adjusted suicide deaths in non-incarcerated adolescents (N = 3,484) and incarcerated adults (N = 781). Prison suicide accounted for 2.3% of all suicide deaths in adolescents, but only 0.1% of this age group was detained. The RR = 23.0 for adolescent suicide in detention exceeded the RR = 7.7 of adults by far. In adults, suicide rates in pre-trial detention was fivefold higher than in criminal detention; suicide rates were more balanced in adolescent detainees. Our results underline the need for age-specific suicide prevention strategies in detention.
Wilburn, Victor R.; Smith, Delores E.
The relationships among stress, self-esteem, and suicidal ideation in late adolescents were examined in a group of college students. Multiple regression analysis indicated that both stress and self-esteem were significantly related to suicidal ideation; low self-esteem and stressful life events significantly predicted suicidal ideation. The…
Esposito-Smythers, Christianne; Spirito, Anthony; Kahler, Christopher W.; Hunt, Jeffrey; Monti, Peter
Objective: This study tested a cognitive-behavioral treatment protocol for adolescents with a co-occurring alcohol or other drug use disorder (AOD) and suicidality in a randomized clinical trial. Method: Forty adolescents (M[subscript age] = 15 years; 68% female, 89% White) and their families recruited from an inpatient psychiatric hospital were…
Muehlenkamp, Jennifer J.; Walsh, Barent W.; McDade, Moira
Non-suicidal self-injury (NSSI) continues to be a problem among youth and there is a great need for programming aimed at reducing NSSI in adolescents. The signs of self-injury program is the first known NSSI school-based prevention program for adolescents that attempts to increase knowledge, improve help-seeking attitudes and behaviors, and…
Jones, Angela C.; Schinka, Katherine C.; van Dulmen, Manfred H. M.; Bossarte, Robert M.; Swahn, Monica H.
We investigated whether changes in loneliness during middle childhood as well as from middle childhood into adolescence were associated with adolescent self-harm behaviors and suicidal thoughts using a community sample of 889 participants. Multivariate logistic regressions indicate that the relationship between changes in loneliness and…
Andriessen, Karl; Draper, Brian; Dudley, Michael; Mitchell, Philip B
Despite increasing clinical and research interest in suicide bereavement the impact of suicide on adolescents is still poorly understood. This systematic review aims to disentangle pre- and postloss features that affect response to grief in this age group. The literature was analyzed after a systematic search and hand-check of retrieved articles. The impact of suicide is affected by (a) preloss features related to personal/family history of mental health, family life, suicidal behavior, and type and emotional closeness of relationship; and (b) postloss issues such as quality of remaining relationships. Future research and bereavement support should consider these broader contexts.
Greene-Palmer, Farrah N; Wagner, Barry M; Neely, Laura L; Cox, Daniel W; Kochanski, Kristen M; Perera, Kanchana U; Ghahramanlou-Holloway, Marjan
This study examined parental reactions to adolescents' suicide attempts and the association of reactions with future suicidal self-directed violence. Participants were 81 mothers and 49 fathers of 85 psychiatric inpatient adolescents. Maternal hostility and paternal anger and arguing predicted future suicide attempts. From pre- to post-attempt, mothers reported feeling increased sadness, caring, anxiety, guilt, fear, and being overwhelmed; fathers reported increased sadness, anxiety, and fear. Findings have clinical implications; improving parent-child relationships post-suicide attempt may serve as a protective factor for suicide.
Medina, Catherine; Luna, Gaye
Suicide is the second leading cause of death among school-aged students between the ages of 15 and 19. There is an increasing frequency of suicide and other self-destructive behaviors among Mexican American youth and students in special education classrooms for emotional and behavioral disabilities. Recognizing Mexican American youth in special education classes as a separate risk group, this study (a) identifies factors that contribute to suicide, (b) reviews the signs and characteristics associated with these factors, (c) interviews Mexican American students in special education who have either exhibited various characteristics of suicidal thoughts and/or have attempted suicide, (d) explores effective prevention programs, and (e) provides suggestions for school personnel. Interviews with five adolescent Mexican American special education students support previous research findings that depression, substance abuse, social and interpersonal conflict, family distress, and school stress are primary characteristics related to suicidal minority youth.
Joe, Sean; Romer, Daniel; Jamieson, Patrick E.
The association between adolescents' and young adults' attitudes toward suicide and their own suicidality across five racial-ethnic classifications was studied in a nationally representative sample of 3,301 youth ages 14 to 22 years from the National Annenberg Risk Survey of Youth. Results indicate that adolescents and young adults who most…
Gulbas, Lauren E; Zayas, Luis H
In this article, we explore the relationships among culture, family, and attempted suicide by U.S. Latinas. We analyzed qualitative interviews conducted with Latina teen suicide attempters (n = 10) and their parents. We also incorporated data collected from adolescents with no reported history of self-harm (n = 10) and their parents to examine why some individuals turned to suicide under similar experiences of cultural conflict. Our results reveal that Latina teens who attempted suicide lacked the resources to forge meaningful social ties. Without the tools to bridge experiences of cultural contradiction, the girls in our study described feeling isolated and alone. Under such conditions, adolescents turned to behaviors aimed at self-destruction. Unlike their peers who attempted suicide, adolescent Latinas with no lifetime history of attempted suicide were able to mobilize resources in ways that balanced experiences of acculturative tension by creating supportive relationships with other individuals.
Park, Young-Joo; Ryu, Hosihn; Han, Kuem Sun; Kwon, Jung Hye; Kim, Han Kyeom; Kang, Hyun Cheol; Yoon, Ji-Won; Cheon, Suk-Hee; Shin, Hyunjeong
This study described the levels of anger, anger expression, and suicidal ideation in Korean adolescents. Data from 18,752 adolescents were collected using a self-report questionnaire. Anger, anger expression, and suicidal ideation exhibited significant differences according to school level and gender. The group with higher anger and anger expression showed a higher average suicidal ideation score than that of the group with lower anger and anger expression, suggesting that school-based programs which alleviate anger may be needed to decrease suicidal ideation among Korean adolescents.
Winterrowd, Erin; Canetto, Silvia Sara; Chavez, Ernest L.
Friendship factors have been implicated in adolescent suicidality, but this relationship has not been verified across ethnicities. This study examined suicidality and friendship problems (i.e., social isolation, poor friendship quality, friends' school disconnection, and friends' delinquency) among Mexican American adolescents, an understudied,…
Kumar, Geetha; Steer, Robert A.
Beck Scale for Suicide Ideation (BSI) was administered to 121 adolescent inpatients. Twelve characteristics found to be associated with adolescent suicide ideation were entered into multiple regression to estimate BSI scores, along with Beck inventories for anxiety, depression (BDI), and hopelessness (BHS), and Youth Self Report. BHS and BDI were…
Rotheram-Borus, Mary J.; And Others
Compared cognitive style and pleasant activities of 77 suicide-attempting female minority adolescents with those of 39 psychiatrically disturbed and 23 nondisturbed female adolescents. Suicide attempters reported significantly fewer alternatives for solving interpersonal problems, were significantly more focused on problems, and were more likely…
Cooper, Gregory D.; Clements, Paul Thomas; Holt, Karyn E.
Adolescent suicide is a preventable tragedy yet is still the third leading cause of death in young people of age 10-24. Contrary to the idea that childhood bullying is a normal part of growing up or a rite of passage, it is now correlated with adolescent suicidality. An integrative review of the contemporary, extant literature was conducted to…
Dougherty, Donald M.; Mathias, Charles W.; Marsh-Richard, Dawn M.; Prevette, Kristen N.; Dawes, Michael A.; Hatzis, Erin S.; Palmes, Guy; Nouvion, Sylvain O.
This study examined clinical characteristics and laboratory-measured impulsive behavior of adolescents engaging in either non-suicidal self-injury with (NSSI+SA; n = 25) or without (NSSI-Only; n = 31) suicide attempts. We hypothesized that adolescent with NSSI+SI would exhibit more severe clinical symptoms and higher levels of behavioral impulsivity compared to adolescents with NSSI-Only. Adolescents were recruited from an inpatient psychiatric hospital unit and the two groups were compared on demographic characteristics, psychopathology, self-reported clinical ratings, methods of non-suicidal self-injury, and two laboratory impulsivity measures. Primary evaluations were conducted during psychiatric hospitalization, and a subset of those tested during hospitalization was retested 4-6 weeks after discharge. During hospitalization, NSSI+SA patients reported worse depression, hopelessness, and impulsivity on standard clinical measures, and demonstrated elevated impulsivity on a reward-directed laboratory measure compared to NSSI-Only patients. In the preliminary follow-up analyses, depression, hopelessness, suicidal ideation, and laboratory impulsivity were improved for both groups, but the NSSI+SA group still exhibited significantly more depressive symptoms, hopelessness, and impulsivity than the NSSI-Only group. Risk assessments for adolescents with NSSI+SA should include consideration not only of the severity of clinical symptoms but of the current level impulsivity as well. PMID:19631392
Abdollahi, Abbas; Abu Talib, Mansor
To examine the moderating role of spirituality between hopelessness, spirituality, and suicidal ideation, 202 Iranian depressed adolescent inpatients completed measures of patient health, suicidal ideation, hopelessness, and core spiritual experience. Structural equation modelling indicated that depressed inpatients high in hopelessness, but also high in spirituality, had less suicidal ideation than others. These findings reinforce the importance of spirituality as a protective factor against hopelessness and suicidal ideation.
Lopez-Castroman, J; Guillaume, S; Olié, E; Jaussent, I; Baca-García, E; Courtet, P
Family history of suicidal behavior and personal history of childhood abuse are reported risk factors for suicide attempts and suicide completion. We aim to quantify the additive effect of family history of suicidal behavior and different subtypes of childhood abuse on suicidal behavior. We examined a sample of 496 suicide attempters, comparing individuals with family history of suicidal behavior and personal history of childhood (physical or sexual) abuse, individuals with family history of suicidal behavior only, individuals with history of early traumatic experiences only, and individuals with none of these two risk factors with regards to suicidal features. An additive effect was found for the age at the first attempt in suicide attempters with both family history of suicidal behavior and either physical or sexual abuse. No significant interactions were found between family history of suicidal behavior and childhood trauma in relation to any characteristics of suicidal behavior. Subjects presenting family history of suicidal behavior and childhood abuse attempt suicide earlier in life than subjects with just one or none of them, particularly if they were sexually abused. Other suicidality indexes were only partially or not associated with this combination of risk factors. A careful assessment of patients with both family history of suicidal behavior and childhood abuse could help to prevent future suicide attempts, particularly in young people.
LeCloux, Mary; Maramaldi, Peter; Thomas, Kristie; Wharff, Elizabeth
Developing policies and interventions that increase rates of mental health service use for suicidal adolescents is crucial for suicide prevention. Data from a sample of suicidal youth (n = 1356) from the National Longitudinal Study of Adolescent Health (Add Health) were analyzed to examine whether type of insurance, receipt of routine medical care, and access to school-based mental health treatment predicted mental health service use cross-sectionally and longitudinally. Rates of mental health service use were low in cross-sectional analyses at all three waves (∼11%-30%), despite the fact that respondents were at high risk for suicide attempts and depression. With demographic factors and symptom severity controlled, only receipt of a routine physical predicted an increased likelihood of mental health service use at wave I and in longitudinal analyses. Implications discussed include the utility of universal suicide screenings and integrated behavioral health care as potential intervention strategies for this population.
Homan, Kendra J; Sim, Leslie A; Fargo, Jamison D; Twohig, Michael P
Although borderline personality disorder (BPD) is frequently characterized by nonsuicidal self-injurious behavior (NSSI), suicide attempts (SA), suicidal ideation (SI), and/or suicide threats (ST), it is unclear whether these behaviors are precursors of BPD in adolescence. This study examined self-harm/suicide-related behaviors in the development of BPD from adolescence to adulthood in psychiatrically hospitalized adolescents. Participants were 116 adolescents consecutively admitted for a psychiatric hospitalization for self-harm/suicide-related behaviors. Adolescents completed self-report questionnaires assessing self-harm/suicide-related behaviors, maladaptive familial behavior, and peer victimization upon admission. Admission diagnoses and history of sexual/physical abuse were abstracted from medical/psychiatric records. Five years after index hospitalization, medical/psychiatric records were systematically reviewed and information on diagnoses was collected. Using multivariable logistic regression analyses, ST predicted BPD above and beyond NSSI, SA, and SI 5 years later (odds ratio = 1.31, 95% confidence interval [1.06, 1.62], p > .01). Traditional risk factors of BPD were not predictive of BPD at 5-year follow-up. Suicidal threats are an important risk factor in adolescents who engage in self-harm/suicide-related behaviors that may differentiate those adolescents who go on to develop BPD as adults. Implications for research and treatment are discussed. (PsycINFO Database Record
Auerbach, Randy P.; Millner, Alexander J.; Stewart, Jeremy G.; Esposito, Erika
Background Adolescent depression and suicide are pressing public health concerns, and identifying key differences among suicide ideators and attempters is critical. The goal of the current study is to test whether depressed adolescent suicide attempters report greater anhedonia severity and exhibit aberrant effort-cost computations in the face of uncertainty. Methods Depressed adolescents (n = 101) ages 13–19 years were administered structured clinical interviews to assess current mental health disorders and a history of suicidality (suicide ideators = 55, suicide attempters = 46). Then, participants completed self-report instruments assessing symptoms of suicidal ideation, depression, anhedonia, and anxiety as well as a computerized effort-cost computation task. Results Compared with depressed adolescent suicide ideators, attempters report greater anhedonia severity, even after concurrently controlling for symptoms of suicidal ideation, depression, and anxiety. Additionally, when completing the effort-cost computation task, suicide attempters are less likely to pursue the difficult, high value option when outcomes are uncertain. Follow-up, trial-level analyses of effort-cost computations suggest that receipt of reward does not influence future decision-making among suicide attempters, however, suicide ideators exhibit a win-stay approach when receiving rewards on previous trials. Limitations Findings should be considered in light of limitations including a modest sample size, which limits generalizability, and the cross-sectional design. Conclusions Depressed adolescent suicide attempters are characterized by greater anhedonia severity, which may impair the ability to integrate previous rewarding experiences to inform future decisions. Taken together, this may generate a feeling of powerlessness that contributes to increased suicidality and a needless loss of life. PMID:26233323
Björkenstam, C; Björkenstam, E; Ljung, R; Vinnerljung, B; Tuvblad, C
Child welfare clients represent a high-risk group for delinquency and adult criminality, but also for future suicidal behavior. We examine associations between delinquency and suicidal behavior in a national child welfare population. This register-based cohort study is based on data for all Swedish former child welfare clients born between 1972 and 1981 that experienced interventions before their adolescent years. We followed 27,228 individuals from age 20 years until 31 December 2006. Juvenile delinquency was defined as being convicted of at least one crime between age 15 and 19. The risk of suicidal behavior was calculated as incidence rate ratios (IRRs). Fifteen percent of the women and 40% of the men had at least one conviction between the age 15 and 19. The adjusted risk of suicidal behavior among women with five or more convictions was 3.5 (95% CI 2.0-6.2); corresponding IRR for men was 3.9 (95% CI 3.1-4.9). Child welfare experience-specifically of out-of-home care-in combination with delinquency is a potent risk factor for suicidal behavior among young adults. However, we cannot exclude that some of this association is an epiphenomenon of uncontrolled confounders, such as impulsivity or severity of psychiatric disease. Despite this caveat, results should be disseminated to practitioners in the health and correction services.
Kim, Young Shin; Leventhal, Bennett L; Koh, Yun-Joo; Boyce, W Thomas
This study examines the independent impact of bullying on suicide risk. Bullying was assessed by peer nomination in a prospective study of 1,655 7th and 8th grade Korean students, and suicide by youth self-report. Odds Ratios (ORs) of bullying for suicidal risks were computed, controlling for other suicide risk factors. Victim-Perpetrators and female Victims at baseline showed increased risk for persistent suicidality (OR: 2.4-9.8). Male Incident Victims exhibited increased risk for suicidal behaviors and ideations (OR = 4.4, 3.6). Female Persistent Perpetrators exhibited increased risks for suicidal behaviors; male Incident Perpetrators had increased risk for suicidal ideations (OR = 2.7, 2.3). Baseline-only male Victim-Perpetrators showed increased risk for suicidal ideations. (OR = 6.4). Bullying independently increased suicide risks.
Kim, Sun Mi; Baek, Ji Hyun; Han, Doug Hyun; Lee, Young Sik; Yurgelun-Todd, Deborah A
We determined risk factors that discriminate between suicide attempt (SA) adolescents and suicidal ideation only (SI only) adolescents using data from the 2010 Korea Youth Risk Behavior Web-based Survey (12-19 years; N = 73,238). In males, heavy alcohol use, drug use, and high perceived sadness/hopelessness showed significant effects on the presence of SA versus the presence of SI only. In females, along with these variables, low academic achievement, poor perceived health status, high perceived stress, and unhealthy coping strategy were also significantly related to the presence of SA versus SI only. Therefore, clinical interventions targeting adolescents' psychological distress are warranted to prevent suicide.
Bazrafshan, Mohammad-Rafi; Sharif, Farkhondeh; Molazem, Zahra; Mani, Arash
Background: Since suicide attempt among adolescents is a major challenge and the reasons why this age group attempt suicide are complex, the aim of this study was to investigate the risk factors that contribute to suicide attempt among adolescents. Materials and Methods: In this qualitative content analysis, 14 adolescents (12–19 years old) who were admitted in two hospitals in Shiraz, Iran, were interviewed. Participants who tried attempt suicide with medication were selected by purposive sampling and the data were gathered by semi-structured interviews. Data analysis was guided by the conventional approach of qualitative content analysis. Results: Three major themes and 13 subthemes emerged from data analysis. The main themes were: (a) Individual factors and experiences (psycho-emotional problems, puberty, religious beliefs, stress management strategies, marriage and love, field and level of education); (b) family factors (family structure, family relationship, family economic features, family health conditions); and (c) social factors (suicidal behavior in others, media influence, professional support). Conclusions: This study identified three major themes related to suicide attempt among adolescents in the context. As a result, suicide prevention and care provision should formulate a comprehensive method, considering the interaction of medical besides individual, familiar, and social factors in their assessment and care provision. PMID:26985229
Vieira, Luiza Jane Eyre de Souza; Freitas, Mary Landy Vasconcelos; Pordeus, Augediva Maria Jucá; Lira, Samira Valentim Gama; Silva, Juliana Guimarães E
This report describes the reasons of the suicidal behavior in adolescents, taking in this anthropologic analysis, the impact in the familiar and social context. The study was conducted during the period of March to August, 2005 using a qualitative approach and ethnography as methods. The participants of this study were 12 teenagers, assisted in an emergency hospital in Fortaleza, Ceará State, Brazil, for suicide attempt using any kind of mechanisms. As shown in the experiment's result, the main reason of the attempts was a broken heart, this as a reason of dating someone and others love relationship established between two persons. Not only broken heart was mentioned, there were also cases of problems with family bonds, the affection and the lack of attention to the individual adolescent. In this context, the inability of the health professional was very clear. Under the presented circumstances, the professional must come up with a new praxis approach. The suicide is a real fact present at the teenagers' life and it is necessary to redirect the Brazilian Unified Health System s philosophy and operational principles of the way health professionals cope with this demanding the society to embrace the politics that cares for the human being life and wellness.
Prasad, Ashoka Jahnavi; Kumar, Nirmal
Compared 131 hospitalized schizophrenics who had attempted suicide within past year to 70 hospitalized schizophrenics who had not attempted suicide, using the Present State Examination depressive symptoms. Found that schizophrenics who had attempted suicide had significantly higher number of symptoms indicative of a depressive disorder. (Author/NB)
Bedrosian, Richard C.; Beck, Aaron T.
Hopelessness seems to account for the bulk of the relationship between depression and suicidal intent. The Scale for Suicide Ideation seems to show promise as a predictive instrument, as a dependent variable in research on treatment efficacy, and as a tool for clinical assessment of suicide potential. (Author)
Hicinbothem, Julie; Gonsalves, Sonia; Lester, David
In a large sample of individuals who belong to a website for body modification, having body modifications (e.g., piercings, tattoos, scarification and surgical procedures) was associated with a higher incidence of prior suicidality (i.e., suicidal ideation and attempted suicide). However, controls for self-reported depression weakened the strength…
Esposito-Smythers, Christianne; Spirito, Anthony; Kahler, Christopher W.; Hunt, Jeffrey; Monti, Peter
Objective The purpose of this study was to test a cognitive behavioral treatment protocol for adolescents with a co-occurring alcohol or other drug use disorder (AOD) and suicidality in a randomized clinical trial. Method Forty adolescents (Mage = 15; 68% females, 89% Caucasian) and their families recruited from an inpatient psychiatric hospital were randomly assigned to an integrated outpatient cognitive behavioral intervention for co-occurring AOD and suicidality (I-CBT) or enhanced treatment-as-usual (E-TAU). Primary measures include the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Suicide Ideation Questionnaire, Columbia Impairment Scale, Timeline Followback, Rutgers Alcohol Problem Index, and the Rutgers Marijuana Problem Index. Assessments were completed at pre-treatment as well as 3, 6, 12, and 18 months post-enrollment. Results Using intent-to-treat analyses, I-CBT was associated with significantly fewer heavy drinking days and days of marijuana use relative to E-TAU, but not drinking days. Those randomized to I-CBT in comparison to E-TAU also reported significantly less global impairment as well as fewer suicide attempts, inpatient psychiatric hospitalizations, emergency department visits, and arrests. Adolescents across groups showed equivalent reductions in suicidal ideation. Conclusions I-CBT for adolescents with co-occurring AOD and suicidality is associated with significant improvement in both substance use and suicidal behavior, as well as markedly decreased use of additional health services including inpatient psychiatric hospitalizations and emergency department visits. Further testing of integrated protocols for adolescent AOD and suicidality with larger and more diverse samples is warranted. PMID:22004303
Linker, Julie; Gillespie, Nathan A; Maes, Hermine; Eaves, Lindon; Silberg, Judy L
The co-occurrence of suicidal ideation, depression, and conduct disturbance is likely explained in part by correlated genetic and environmental risk factors. Little is known about the specific nature of these associations. Structured interviews on 2,814 twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and Young Adult Follow-Up (YAFU) yielded data on symptoms of depression, conduct disorder, and adolescent and young adult suicidal ideation. Univariate analyses revealed that the familial aggregation for each trait was explained by a combination of additive genetic and shared environmental effects. Suicidal ideation in adolescence was explained in part by genetic influences, but predominantly accounted for by environmental factors. A mixture of genetic and shared environmental influences explained ideation occurring in young adulthood. Multivariate analyses revealed that there are genetic and shared environmental effects common to suicidal ideation, depression, and conduct disorder. The association between adolescent suicidal ideation and CD was attributable to the same genetic and environmental risk factors for depression. These findings underscore that prevention and intervention strategies should reflect the different underlying mechanisms involving depression and conduct disorder to assist in identifying adolescents at suicidal risk.
Turecki, Gustavo; Ernst, Carl; Jollant, Fabrice; Labonté, Benoit; Mechawar, Naguib
Suicide and related behaviors are complex phenomena associated with different risk factors. Although most individuals who display suicidal behavior do not have a history of early-life adversity, a significant minority does. Recent animal and human data have suggested that early-life adversity leads to epigenetic regulation of genes involved in stress-response systems. Here, we review this evidence and suggest that early-life adversity increases risk of suicide in susceptible individuals by influencing the development of stable emotional, behavioral and cognitive phenotypes that are likely to result from the epigenetic regulation of the hypothalamic-pituitary-adrenal axis and other systems involved in responses to stress.
You, Jianing; Leung, Freedom
This study used zero-inflated poisson regression analysis to examine the role of depressive symptoms, family invalidation, and behavioral impulsivity in the occurrence and repetition of non-suicidal self-injury among Chinese community adolescents over a 2-year period. Participants, 4782 high school students, were assessed twice during the follow-up period. Results indicate that while Year 1 depressive symptoms and family invalidation were significantly associated with the occurrence of Year 2 NSSI, Year 1 behavioral impulsivity contributed to both the occurrence and repetition of Year 2 NSSI. Findings of this study suggest that adolescents who display multiple impulsive behaviors may be at particular risk for engaging in repetitive NSSI. Clinical implications of these findings and future research directions were discussed.
Tong, Yongsheng; Phillips, Michael R; Duberstein, Paul; Zhan, Weihai
The prevalence and odds ratios of different suicide risk factors were compared in three pairs of decedents: 80 suicides and 25 injury decedents with blood relatives with suicidal behavior history (biologically exposed); 259 suicides and 126 injury decedents with unrelated acquaintances with suicidal behavior history (socially exposed); and 471 suicides and 523 injury decedents with neither relatives nor acquaintances with suicidal behavior history (unexposed). Negative life events and high psychological stress were more common in socially exposed suicides than in other suicides. The adjusted odds ratios of most established suicide risk factors were higher in unexposed decedents than in biologically or socially exposed decedents, suggesting that the predictive value of established risk factors wanes in individuals who have been exposed to suicidal behavior in family or friends.
Quarshie, Emmanuel Nii-Boye; Osafo, Joseph; Akotia, Charity S.; Peprah, Jennifer
Adolescent suicide is now a major health concern for many countries. However, there is paucity of systematic studies and lack of official statistics on adolescent suicide in Ghana. Mass media coverage of adolescent suicide (even though crude), at least, may reflect the reality of the phenomenon. With an ecological orientation, this study used qualitative content analysis to analyse the pattern of 44 media reports of adolescent suicide in Ghana from January 2001 through September 2014. Results showed that hanging was the dominant method used. The behaviour usually takes place within or near the adolescent's home environment. The act was often attributed to precursors within the microsystem (family and school) of the deceased. This study serves a seminal function for future empirical studies aimed at deeper examination of the phenomenon in order to inform prevention programmes. PMID:26015405
Quarshie, Emmanuel Nii-Boye; Osafo, Joseph; Akotia, Charity S; Peprah, Jennifer
Adolescent suicide is now a major health concern for many countries. However, there is paucity of systematic studies and lack of official statistics on adolescent suicide in Ghana. Mass media coverage of adolescent suicide (even though crude), at least, may reflect the reality of the phenomenon. With an ecological orientation, this study used qualitative content analysis to analyse the pattern of 44 media reports of adolescent suicide in Ghana from January 2001 through September 2014. Results showed that hanging was the dominant method used. The behaviour usually takes place within or near the adolescent's home environment. The act was often attributed to precursors within the microsystem (family and school) of the deceased. This study serves a seminal function for future empirical studies aimed at deeper examination of the phenomenon in order to inform prevention programmes.
Kwok, Sylvia Y C L; Chai, Wenyu; He, Xuesong
The present study examined the relationship among physical abuse, psychological abuse, perceived family functioning and adolescent suicidal ideation in Shanghai, China. Perceived family functioning was investigated as a possible moderator between physical abuse, psychological abuse and suicidal ideation. A cross sectional survey using convenience sampling was conducted. A total of 560 valid self-administered questionnaires were completed by the students aged from 12 to 17 in Shanghai. Descriptive statistical analyses, Pearson correlations analyses, and hierarchical regression analyses were adopted as methods of data analyses. Results indicated that physical abuse was significantly associated with greater adolescent suicidal ideation, while a higher level of perceived family functioning was significantly associated with lower suicidal ideation. However, psychological abuse was not associated with suicidal ideation. Perceived family functioning was shown to be a moderator between physical abuse and suicidal ideation. Specifically, mutuality and family communication moderated the relationship between physical abuse and suicidal ideation. To decrease adolescent suicidal ideation, measures are suggested to prevent physical abuse and enhance family functioning. First, it is important to increase the parents' awareness of the meaning and boundaries of physical abuse, as well as the role it plays in contributing to adolescent suicidal ideation. Second, parents should be taught appropriate parenting skills and knowledge and be guided to treat the children as individuals with their unique personality, rights and privileges. Third, it is important to promote family harmony, effective communication as well as mutual trust, concern and understanding among family members.
The suicide of Sylvia Plath is examined from the perspective of 15 theories of suicidal behavior and is found to fit best with psychoanalytic and cognitive theories of suicide, in particular those of Aaron Beck, Henry Murray, and Edwin Shneidman.
Else, Iwalani; Andrade, Naleen; Nahulu, Linda
The authors present a comprehensive review on U.S. Pacific Islander suicide and suicide-related behaviors to extend the knowledge and understanding of suicide and suicide-related behaviors among the indigenous peoples of the state of Hawai'i, the territories of American Samoa, Guam, Commonwealth of the Northern Mariana Islands, and the Pacific…
Gromatsky, Molly A; Waszczuk, Monika A; Perlman, Greg; Salis, Katie Lee; Klein, Daniel N; Kotov, Roman
Adolescent non-suicidal self-injury (NSSI), a significant risk factor for suicidal behavior, is strongly associated with adolescent psychopathology and personality traits, particularly those characterized by poor self-regulation. Some parental psychopathology and personality traits have also been identified as risk factors for adolescent NSSI, but specific parental characteristics and mechanisms involved in this association have not been systematically examined. The current study comprehensively investigated the contribution of parental psychopathology and personality to adolescent NSSI using data from the baseline wave of the Adolescent Development of Emotion and Personality Traits (ADEPT) study of 550 adolescent girls (mean age = 14.39 years, SD = 0.63) and their biological parents. We first investigated whether parental lifetime psychiatric diagnoses, and personality and clinical (rumination, self-criticism, emotional reliance) traits were associated with adolescent NSSI. We also tested whether adolescent history of psychiatric illness, personality, and clinical traits mediated the associations between parental characteristics and adolescent NSSI. Parental substance use disorder, adult-ADHD symptoms, self-criticism, and lower agreeableness and conscientiousness were associated with offspring's NSSI. These associations were mediated through adolescent characteristics. In contrast, parental mood and anxiety disorders and neuroticism were unrelated to adolescent NSSI. The results suggest that parental traits and disorders characterized by self-regulatory difficulties and lack of support constitute risk factors for self-injury in adolescent girls, acting via adolescent traits. This demonstrates that parental influences play a significant role in the etiology of adolescent NSSI.
Greening, Leilani; Stoppelbein, Laura; Luebbe, Aaron
Given that parenting practices have been linked to suicidal behavior in adolescence, examining the moderating effect of parenting styles on suicidal behavior early in development could offer potential insight into possible buffers as well as directions for suicide prevention and intervention later in adolescence. Hence, the moderating effects of parenting styles, including authoritarian, permissive, and features of authoritative parenting, on depressed and aggressive children's suicidal behavior, including ideation and attempts, were evaluated with young children (N = 172; 72% male, 28% female) ranging from 6 to 12 years of age. African American (69%) and Caucasian (31%) children admitted for acute psychiatric inpatient care completed standardized measures of suicidal behavior, depressive symptoms, and proactive and reaction aggression. Their parents also completed standardized measures of parental distress and parenting style. Hierarchical regression analyses revealed that, while statistically controlling for age and gender, children who endorsed more depressive symptoms or reactive aggression reported more current and past suicidal behavior than children who endorsed fewer depressive or aggressive symptoms. The significant positive relationship observed between depressive symptoms and childhood suicidal behavior, however, was attenuated by parental use of authoritarian parenting practices for African-American and older children but not for younger and Caucasian children. The ethnic/racial difference observed for the buffering effect of authoritarian parenting practices offers potential theoretical and clinical implications for conceptualizing the moderating effects of parenting styles on African-American and Caucasian children's suicidal behavior.
Nihira, Kazuo; And Others
Parents' behavior as perceived by an adolescent population admitted to the adolescent crisis Ward at USC Medical Center is analyzed. The sample consisted of 86 patients who were admitted to the adolescent crisis ward during 1969 and 1970. The population could be divided according to four distinct crisis groups: (1) the suicidal group; (2) the…
Dearden, Kirk A.; De La Cruz, Natalie G.; Crookston, Benjamin T.; Novilla, M. Lelinneth B.; Clark, Matthew
This paper describes the prevalence of depression and suicidal tendencies as well as risk factors for attempted suicide among students in Bolivia. Adolescents 13-18 years old (182 females, 394 males) from randomly selected schools in La Paz completed the Youth Risk Behavior Survey. Frequencies and logistic regression were used to identify…
Park, Subin; Song, Hokwang
Drug abuse has been widely linked to suicide risk. We examined the factors that affect adolescent drug users' suicide attempts in South Korea. This study analyzed the data of 311 adolescents who had used drugs such as inhalants, psychotropic drugs, and marijuana (195 males and 116 females). Among 311 subjects, 109 (35.0%) had attempted suicide during the last 12 months. After adjusting for other variables, depressive mood (OR=19.79) and poly-drug use (OR=2.79), and low/middle levels of academic achievement compared with a high level (OR=3.72 and 4.38) were independently associated with increased odds of a suicide attempt, while better perceived health (OR=0.32) was independently associated with reduced odds of a suicide attempt. For adolescent drug users, preventive work should be directed toward the active treatment of drug use, depression, and physical health and reinforcing proper coping strategies for academic and other stress.
Goldston, David B.; Daniel, Stephanie S.; Erkanli, Alaattin; Heilbron, Nicole; Doyle, Otima; Weller, Bridget; Sapyta, Jeffrey
Objectives This study was designed to examine escalation in repeat suicide attempts from adolescence through adulthood, as predicted by sensitization models (and reflected in increasing intent and lethality with repeat attempts, decreasing amount of time between attempts, and decreasing stress to trigger attempts) Method In a prospective study of 180 adolescents followed through adulthood after a psychiatric hospitalization, suicide attempts and antecedent life events were repeatedly assessed (M = 12.6 assessments, SD = 5.1) over an average of 13 years, 6 months (SD = 4 years, 5 months). Multivariate logistic, multiple linear, and negative binomial regression models were used to examine patterns over time. Results After age 17-18, the majority of suicide attempts were repeat attempts (i.e., made by individuals with prior suicidal behavior). Intent increased both with increasing age, and with number of prior attempts. Medical lethality increased as a function of age but not recurrent attempts. The time between successive suicide attempts decreased as a function of number of attempts. The amount of precipitating life stress was not related to attempts. Conclusions Adolescents and young adults show evidence of escalation of recurrent suicidal behavior, with increasing suicidal intent and decreasing time between successive attempts. However, evidence that sensitization processes account for this escalation was inconclusive. Effective prevention programs that reduce the likelihood of individuals attempting suicide for the first time (and entering this cycle of escalation), and relapse prevention interventions that interrupt the cycle of escalating suicidal behavior among individuals who already have made attempts are critically needed. PMID:25622200
Lahti, Anniina; Harju, Aleksi; Hakko, Helinä; Riala, Kaisa; Räsänen, Pirkko
Despite the large amount of research on adolescent suicidality, there are few detailed studies illustrating the characteristics of child and adolescent completed suicide. Our study presents the characteristics of child and adolescent suicides occurring over a period of 25 years within a large geographical area in Northern Finland, with a special focus on gender differences. The study sample included all 58 suicides among children and adolescents (<18 years) occurring in the province of Oulu in Finland between 1988 and 2012. The data is based on documents pertaining to establish the cause of death from forensic autopsy investigations. A register linkage to the data from the Finnish Hospital Discharge Register (FHDR) was also made. 79% of the suicide victims were male. Violent suicide methods predominated in both genders (males 98%, females 83%). While symptoms of mental illness were common, only a minority (15% of males and 17% of females) had a previous history of psychiatric hospitalization. 17% of females but none of the males had been hospitalized previously due to self-poisoning. A greater proportion of females than males had a history of self-cutting (33% vs. 7%) and previous suicide attempts (25% vs. 4%). 48% of males and 58% of females were under the influence of alcohol at the time of their suicide, and alcohol intoxication was related to suicides during the night. One fifth of the adolescents screened positive for substances other than alcohol. The results of this study indicate that there are similarities but also some differences in the characteristics of male and female suicides in adolescents.
Larsson, Bo; Sund, Anne Mari
In this survey of early Norwegian school adolescents, the prevalence, course, and incidence of self-harm behavior with or without suicide intent were examined, in addition to predictors of self-harm for a 1-year follow-up period. Lifetime prevalence rates of self-harm without suicide intent and suicide attempts were 2.9% and 3.0%, respectively,…
Sedillo, P. J.
Little empirical research has been conducted regarding suicide and suicidal ideation about gay gifted adolescents, so most of what is presented in the literature is based on theories and assumptions. One key assumption was that the psychological challenges of gay gifted youth stemming from sexual identity and giftedness contribute to suicidal…
Gillis, H. Lee, Ed.; Sirmans, Amanda, Ed.
Critical annotations of articles written in 1988 or 1989 and selected from "PSYCHSCAN: Clinical Psychology" are presented in this document. The annotations were written by college students in an undergraduate adolescent psychology class. The annotations are clustered under the following topics: (1) academics, including learning disabilities, sleep…
Scheel, Karen R.; Westefeld, John S.
Investigates the relationship between preference for heavy metal music and vulnerability to suicide among high school students. Results indicate that preference for heavy metal music among adolescents may be sign of increased suicidal vulnerability, but also suggests that the source of the problem may lie more in personal and familial…
Cross, Tracy L.; Cassady, Jerrell C.; Miller, Kimberly A.
This study describes psychological characteristics of gifted adolescents. It also identifies the relationships between psychological personality types and suicide ideation. Participants in the study were 152 juniors enrolled in a public residential high school for academically gifted students. The Suicide Ideation Questionnaire, a 30-item…
Kuramoto, S. Janet; Brent, David A.; Wilcox, Holly C.
Child and adolescent survivors of parental suicide experience two stressful events simultaneously: (1) the loss of a primary caregiver, and (2) suicidal death of a significant person. These youths are thought to be at increased risk for mental health problems, but a systematic review of studies on these survivors has not yet been conducted. A…
Johnson, Renee M.; Barber, Catherine; Azrael, Deborah; Clark, David E.; Hemenway, David
In this brief report, the source of firearms used in adolescent suicides was examined using data from the National Violent Injury Statistics System, the pilot to the CDC's National Violent Death Reporting System, a uniform reporting system for violent and firearm-related deaths. Data represent the 63 firearm suicides among youth (less than 18 yrs)…
Brent, David A.; Greenhill, Laurence L.; Compton, Scott; Emslie, Graham; Wells, Karen; Walkup, John T.; Vitiello, Benedetto; Bukstein, Oscar; Stanley, Barbara; Posner, Kelly; Kennard, Betsy D.; Cwik, Mary F.; Wagner, Ann; Coffey, Barbara; March, John S.; Riddle, Mark; Goldstein, Tina; Curry, John; Barnett, Shannon; Capasso, Lisa; Zelazny, Jamie; Hughes, Jennifer; Shen, Sa; Gugga, S. Sonia; Turner, J. Blake
Objective: To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial. Method: Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two…
Harter, Susan; Marold, Donna B.
Presents evidence for a model of risk factors, including depression, hopelessness, lack of social support, and negative self-evaluations, that contribute to suicidal ideation among normative and clinically depressed adolescents. (HTH)
Cooper, Gregory D; Clements, Paul Thomas; Holt, Karyn E
Adolescent suicide is a preventable tragedy yet is still the third leading cause of death in young people of age 10-24. Contrary to the idea that childhood bullying is a normal part of growing up or a rite of passage, it is now correlated with adolescent suicidality. An integrative review of the contemporary, extant literature was conducted to examine the following question: Are adolescents who have been involved in childhood bullying or cyberbullying as victim, offender, or victim/offender at greater risk for suicidality than those who have not. It is important to empower school nurses with current and evidence-based information regarding childhood bullying and examine empirical science and tools to effectively address the current serious problem of adolescent suicide risk assessment and intervention.
Fordwood, Samantha R; Asarnow, Joan R; Huizar, Diana P; Reise, Steven P
Although depression is strongly associated with suicide attempts and suicide deaths, most depressed youth do not make an attempt, indicating the need to identify additional risk factors. We examined suicide attempts among 451 depressed primary care patients, 13 to 21 years of age. In bivariate analyses, youth classified as suicide attempters showed elevated levels of psychopathology, specifically depressive symptoms, externalizing behaviors, anxiety, substance use, mania, and posttraumatic stress disorder symptoms. Externalizing behaviors and depression severity uniquely contributed to the prediction of suicide attempts in multivariate analyses. High levels of environmental stress as well as a few key stressful events were associated with suicide attempts; a recent romantic breakup or being assaulted added to suicide attempt risk, beyond the effects of psychopathology. Implications of results for primary care preventive services and suicide attempt prevention are discussed.
Wilson, Scott T; Chesin, Megan; Fertuck, Eric; Keilp, John; Brodsky, Beth; Mann, J John; Sönmez, Cemile Ceren; Benjamin-Phillips, Christopher; Stanley, Barbara
Identification of biological indicators of suicide risk is important given advantages of biomarker-based models. Decreased high frequency heart rate variability (HF HRV) may be a biomarker of suicide risk. The aim of this research was to determine whether HF HRV differs between suicide attempters and non-attempters. Using the Trier Social Stress Test (TSST), we compared HF HRV between females with and without a history of suicide attempt, all with a lifetime diagnosis of a mood disorder. To investigate a potential mechanism explaining association between HF HRV and suicide, we examined the association between self-reported anger and HF HRV. Results of an Area under the Curve (AUC) analysis showed attempters had a lower cumulative HF HRV during the TSST than non-attempters. In addition, while there was no difference in self-reported anger at baseline, the increase in anger was greater in attempters, and negatively associated with HF HRV. Results suggest that suicide attempters have a reduced capacity to regulate their response to stress, and that reduced capacity to regulate anger may be a mechanism through which decreased HF HRV can lead to an increase in suicide risk. Our results have implications for the prevention of suicidal behavior in at-risk populations.
Rabinovitch, Sara M; Kerr, David C R; Leve, Leslie D; Chamberlain, Patricia
Childhood sexual abuse (CSA) histories are prevalent among adolescent girls in the juvenile justice system (JJS) and may contribute to their high rates of suicidal behavior. Among 166 JJS girls who participated in an intervention trial, baseline CSA and covariates were examined as predictors of suicide attempt and nonsuicidal self-injury (NSSI) reported at long-term follow-up (7-12 years later). Early forced CSA was related to lifetime suicide attempt and NSSI history and (marginally) to postbaseline attempt; effects were not mediated by anxiety or depressive symptoms. Findings suggest that earlier victimization and younger entry into JJS are linked with suicide attempt and NSSI.
Garland, A; Shaffer, D; Whittle, B
A national survey of suicide prevention programs was conducted to determine the number, distribution and content of school-based, curriculum programs for adolescents. One hundred fifteen programs were identified. The total number of students and schools targeted for prevention efforts more than doubled during the academic years 1984/1985 to 1986/1987. Content of the programs was similar, with nearly all including information on suicide warning signs and other facts, as well as on accessing community mental health resources. Most included a separate component for school staff and parents. Ninety-five percent subscribed to the view that suicide is most commonly a response to extreme stress or pressure and could happen to anyone. Possible negative implications of this "stress model" of suicide were discussed. While this survey plays an important first step in providing a description of these programs, more evaluative research is needed to determine what effect, if any, these programs have on suicidal behavior.
Daniel, Stephanie S; Goldston, David B; Erkanli, Alaattin; Franklin, Joseph C; Mayfield, Andrew M
Previous studies of the relationship between anger, anger expression, and suicidal behavior have been largely cross-sectional and have yielded mixed findings. In a prospective, naturalistic study, we examined how trait anger and anger expression influenced the likelihood of suicide attempts among 180 adolescents followed for up to 13.3 years after discharge from an inpatient psychiatry unit. Results showed that higher trait anger and anger expressed outwardly over the follow-up was related to increased likelihood of suicide attempts among boys. For girls, trait anger and both the inward and outward expression of anger moderated the risk for suicide attempts associated with major depression. These results are interpreted in light of theory regarding behavioral activation and behavioral inhibition systems.
Kim, Jae-Hyun; Park, Eun-Cheol; Lee, Sang Gyu; Yoo, Ki-Bong
Objectives To examine the hypothesis that respondents with any of three specific sleep patterns would have a higher likelihood of suicidality than those without reports of these patterns in Korean adolescents. Setting Data from the 2011–2013 Korea Youth Risk Behavior Web-based Survey were used. Participants 191 642 subjects were included. The survey's target population was students in grades 7 through 12 in South Korea. Independent variable Sleep time. Primary and secondary outcome measures Suicidal thoughts, plans and attempts. Results The odds of suicidal thoughts in subjects with very short or long time in bed were 1.487-fold higher (95% CI 1.219 to 1.815) or 0.611-fold lower (95% CI 0.460 to 0.811), respectively, than for subjects with 7 h/day in bed; the odds were similar for suicidal plans. The odds of suicidal thoughts in subjects with early or late awakening times were 1.231-fold higher (95% CI 1.050 to 1.442) or 1.528-fold lower (95% CI 1.000 to 2.334), respectively, than for subjects with 7 h/day in bed; these odds were lower for suicidal plans and attempts. The odds of suicidal thoughts in subjects with early bedtime were 1.748-fold higher (95% CI 1.302 to 2.346), the odds of suicidal plans in people with an early bedtime were 2.494-fold higher (95% CI 1.671 to 3.722) and the odds of suicide attempts in subjects with late bedtime were 1.313-fold higher (95% CI 1.005 to 1.716) than for subjects with a bedtime of 23:00. Conclusions The sleep-related time is associated with suicide-related behaviours in Korean adolescents. Multilateral approaches are needed to identify the greatest risk factors for suicidal behaviours. PMID:26341585
Rice, Timothy R
Suicide and homicide are much more commonly committed by adolescent males than females. Herein, a proposal in favor of gender-specific understanding and approach to these violent behaviors is presented. Social and healthcare service system factors, including issues of male adolescents' access to care and help-seeking behaviors, are reviewed alongside the epidemiology of adolescent suicide and homicide as a transition into a detailed discussion of the putative biological factors at play. An emphasis upon the male androgen testosterone organizes the discussion. Behavioral manifestations of this brain-based organizational model are presented with a focus on impulsivity, aggression, and externalizing dysregulated emotionality. Treatment considerations and implications are developed.
Sex differences in suicide rates and suicide methods was compared among adolescents in South Korea, Japan, Finland, and the United States. This study analyzed suicide rates and suicide methods of adolescents aged 15-19 years in four countries, using the World Health Organization mortality database. Among both male and female adolescents, the most common method of suicide was jumping from heights in South Korea and hanging in Japan. In Finland, jumping in front of moving objects and firearms were frequently used by males, but not by females. In the United States, males were more likely to use firearms, and females were more likely to use poison. The male to female ratio of suicide rates was higher in the United States (3.8) and Finland (3.6) than in Korea (1.3) and Japan (1.9). Sex differences in suicide methods may contribute to differences in the suicide rates among males and female adolescents in different countries.
Coryell, William; Yolken, Robert; Butcher, Brandon; Burns, Trudy; Dindo, Lilian; Schlechte, Janet; Calarge, Chadi
Latent infection with toxoplasmosis is a prevalent condition that has been linked in animal studies to high-risk behaviors, and in humans, to suicide and suicide attempts. This analysis investigated a relationship between suicide attempt history and toxoplasmosis titers in a group of older adolescents who had recently begun treatment with an SSRI. Of 108 participants, 17 (15.7 %) had a lifetime history of at least one suicide attempt. All were given structured and unstructured diagnostic interviews and provided blood samples. Two individuals (11.9%) with a past suicide attempt, and two (2.1%) without this history, had toxoplasmosis titers ≥ 10 IU/ml (p = 0.166). Those with a past suicide attempt had mean toxoplasmosis titers that were significantly different (p = 0.018) from those of patients who lacked this history. An ROC analysis suggested a lower optimal threshold for distinguishing patients with and without suicide attempts (3.6 IU/ml) than that customarily used to identify seropositivity. Toxoplasmosis titers may quantify a proneness to suicidal behavior in younger individuals being treated with antidepressants.
Tingey, Lauren; Cwik, Mary F; Goklish, Novalene; Larzelere-Hinton, Francene; Lee, Angelita; Suttle, Rosemarie; Walkup, John T; Barlow, Allison
Native American (Native) adolescents have the highest suicide rates in the United States, yet no conceptual models describing risk factors specific to this population exist. We sought to further hone a Native-specific conceptual model developed from quantitative data with qualitative data collected from a longitudinal series of interviews with (N = 22) Native adolescents who had attempted suicide. Four levels of suicide risk emerged, detailing individual, family, community, and societal factors that affect youths' pathways to suicide, along with a variety of subthemes and constructs. Some themes parallel established models of suicide risk; however, others are unique to the experience of this sample, including the impact of overtaxed households and family composition, significant grief burden, contagion, and stigma surrounding treatment seeking. We suggest adaptations of existing themes and constructs in the model. We discuss practical implications for research and intervention development, along with strengths and limitations of the study.
The Yellow Ribbon Suicide Prevention Program has gained national and international recognition for its school- and community-based activities. After the introduction of Yellow Ribbon to a Denver-area high school, staff and adolescents were surveyed to determine if help-seeking behavior had increased. Using a prepost intervention design, staff at…
Everall, Robin D.; Bostik, Katherine E.; Paulson, Barbara L.
Adolescence is a developmental transition period during which there are profound transformations in emotional, cognitive, and behavioral systems. Despite being a time of rapid development and increasing rates of suicidality, limited research has examined possible interrelationships. Through the use of a case study, this paper illustrates the role…
Linker, Julie; Gillespie, Nathan A.; Maes, Hermine; Eaves, Lindon; Silberg, Judy L.
The co-occurrence of suicidal ideation, depression, and conduct disturbance is likely explained in part by correlated genetic and environmental risk factors. Little is known about the specific nature of these associations. Structured interviews on 2,814 twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and Young…
Yoder, Kevin A.; Hoyt, Dan R.
This study used a sample of 501 families from the Mississippi Delta region to examine the feasibility of the Family Stress Model for understanding adolescent suicidal ideation. The results indicated that family economic pressure was related to parental depressive symptoms, which, in turn, was related to parental hostile behavior and physical…
Wild, Lauren G.; Flisher, Alan J.; Bhana, Arvin; Lombard, Carl
Associations among six different domains of self-esteem (peers, school, family, sports/athletics, body image, and global self-worth) and risk behaviors related to substance use and suicidality were investigated in a sample of South African adolescents. Students enrolled in Grades 8 and 11 at independent secondary schools in Cape Town (N = 116)…
Muehlenkamp, Jennifer J.; Brausch, Amy M.
Attitudes towards the body have been largely overlooked as a potential risk factor for adolescent non-suicidal self-injury (NSSI) despite theorizing that a negative body image may play a critical role in the development of this behavior. The current study used structural equation modeling to evaluate the fit of a theoretical model specifying body…
Communities across the country are having to deal with teenage suicide--a tragedy because it is preventable in many situations. Characteristics of a suicidal person are discussed. Recommendations for intervening with students after the suicide death of a peer in order to help prevent subsequent suicide deaths are made. (RM)
Czyz, Ewa K.; Liu, Zhuqing; King, Cheryl A.
This study examined the extent to which posthospitalization "change" in connectedness with family, peers, and nonfamily adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Participants were 338 inpatient suicidal adolescents, ages 13 to…
Burns, Craig D.; Cortell, Ranon; Wagner, Barry M.
The study investigates compliance with mental health treatments among suicidal adolescents. Results show that child psychopathology and parental attitudes toward treatment plays an important part in increasing compliance with mental health treatment for adolescent suicide attempters.
Mallick, Faryal; McCullumsmith, Cheryl B
Ketamine, an NMDA receptor antagonist with efficacy as a rapid anti-depressant, has early evidence for action to reduce suicidal ideation. This review will explore several important questions that arise from these studies. First, how do we measure reductions in suicidal ideation that occur over minutes to hours? Second, are the reductions in suicidal ideation after ketamine treatment solely a result of its rapid anti-depressant effect? Third, is ketamine only effective in reducing suicidal ideation in patients with mood disorders? Fourth, could ketamine's action lead us to a greater understanding of the neurobiology of suicidal processes? Last, do the reductions in depression and suicidal ideation after ketamine treatment translate into decreased risk for suicidal behavior? Our review concludes that ketamine treatment can be seen as a double-edged sword, clinically to help provide treatment for acutely suicidal patients and experimentally to explore the neurobiological nature of suicidal ideation and suicidal behavior.
Wilburn, Victor R; Smith, Delores E
The relationships among stress, self-esteem, and suicidal ideation in late adolescents were examined in a group of college students. Multiple regression analysis indicated that both stress and self-esteem were significantly related to suicidal ideation; low self-esteem and stressful life events significantly predicted suicidal ideation. The hypothesis that self-esteem would moderate the effects of life stressors on suicidal ideation was supported at the .06 level. A significant minority of the sample indicated having thoughts severe enough to be classified as clinical suicidal ideation. In general, participants who had experienced negative life events in the 6 to 12 months prior to participating in the study had lower self-esteem than those who had similar stresses within the prior six months. However, the opposite was true for clinical suicidal ideators; those who experienced negative life stressors recently had lower self-esteem than those who experienced negative life events six months to a year in the past.
Adolescents (N=53) and both parents completed Parent-Adolescent Communication Inventory (PACI) and Suicide-Depression Inventory (SDI). Found significant relationships between mother's and adolescent's scores, not between father's and adolescent's scores. When other independent variables were controlled, neither parents' scores were significantly…
van Geel, Mitch; Goemans, Anouk; Vedder, Paul
Several studies suggest that there are relations between children's or adolescents' self-injurious behaviors and peer victimization. In the current study, a meta-analysis was performed to study the relations between non-suicidal self-injury and peer victimization. Non-suicidal self-injury focuses on self-injurious behaviors without suicidal intent, that result in immediate tissue damage and are not socially sanctioned within one's culture or for display. Using a meta-analysis, effect sizes of existing studies can be statistically summarized, and publication bias and moderators can be analyzed. The databases PsycINFO, MEDLINE, ERIC and ProQuest were searched for relevant articles. Articles were only included if they focused on children or adolescents, if they focused on non-clinical samples, and if they focused on self-injuring behaviors as opposed to thoughts or ideation. We found nine studies with fourteen independent samples and a total of 20,898 adolescents and children reporting on the relation between peer victimization and non-suicidal self-injury. Our analysis showed positive and significant relations between non-suicidal self-injury and peer victimization. Further analyses showed an absence of publication bias. Younger children that were victimized reported significantly more non-suicidal self-injury than older children. By preventing peer victimization we may potentially prevent non-suicidal self-injury in children and adolescents.
Kenny, Thomas J.; And Others
Using the Canter Background Interference Procedure with the Bender Gestalt Test, a group of 18 adolescent suicide attempters earned test scores indicating they had significantly more problems with visual motor coordination than did a control group of 21 adolescents. (Author/SBH)
Rotheram-Borus, Mary Jane; Piacentini, John; Van Rossem, Ronan; Graae, Flemming; Cantwell, Coleen; Castro-Blanco, David; Feldman, Julie
Disenfranchised Latina adolescents (N=140) and their mothers presenting at a large urban emergency room after a suicide attempt by the adolescent were assessed to examine treatment adherence. Predictor variables for treatment adherence were established. Results are discussed in relation to treatment session attendance. Implications for the…
Maimon, David; Browning, Christopher R.; Brooks-Gunn, Jeanne
The suicide rate among American adolescents between the ages of 14-25 has dramatically increased during the last 50 years, and this fact has been the focus of extensive social-scientific investigation. To date, however, research focusing on the joint effects of mental health, family, and contextual-level predictors on adolescents' suicidal…
Kirkcaldy, Bruce D.; Eysenck, Michael W.; Siefen, Georg R.
Although there is an enormous amount of literature demonstrating socio-psychological determinants of suicide and self-injurious behaviour among adults or clinical samples of children and adolescents, there is a scarcity of studies focussing on non-clinical adolescent samples. The current study examined associations between self-reported data on…
Pierson, Eric E.
The past two decades have seen a rapid increase in the number and types of psychopharmacological medications that are available for the treatment of depression in children and adolescents. Parents and adolescents often raise questions as to the potential increase in suicidal ideation associated with the use of primarily selective serotonin…
Chinawa, J. M.; Manyike, P. C.; Obu, H. A.; Odetunde, O. I.; Aniwada, E. C.; Ndu, I. K.; Chinawa, A. T.
Background. Adolescents are prone to various forms of behavioral problems. These behavioral issues in adolescents can have serious consequences for the adolescents. Objectives. The objectives of the study are to determine the causative factors of adolescent problems and specific manifestations. Methods. Behavioral problems were investigated using a random sampling of adolescents from secondary schools in southeast Nigeria from February to April, 2014. A self-administered questionnaire was developed from Health Kids Colorado Questionnaire. Results. A total of 763 subjects completed the questionnaire. Adolescents who reported to have used tobacco 3 to 5 and 6 to 9 times during the last 30 days are just 3.14% and 3.4%, respectively. Nineteen (2.49%) adolescents claimed that they have had sex before but not in the last 3 months. Adolescents who attempted suicide are from 15 years and peaked at 18. Eighty-three (11%) adolescents who are 15 years old attempted suicide in a year; this peaks at 17 years where 235 (30.8%) committed suicide. Majority of adolescents with behavioral disorder are from the upper class family. Conclusion. This study revealed that adolescents exhibit several forms of behavioral problems. PMID:25276048
Akcan, Ramazan; Arslan, M Mustafa; Çekin, Necmi; Karanfil, Ramazan
This report aims to draw attention to the fragility of adolescents' mind and irrational thinking in adolescence that might lead to suicide due to unusual experiences, by presenting a case of completed suicide with its unusual etiology. The victim, a 13 years old boy, had a quarrel with his mother as she sacrificed his pet, a cock, to prepare for dinner. Because of this, the victim had denied to join the family for dinner and wanted to be alone. While the family having dinner, a passing by neighbor realized that the victim was suspended with a ligature around his neck, in the backyard of the house. Meaningfully, there were feathers of cock in pants pockets of the deceased, in the corpse examination. Adolescents are experiencing dramatic physical and emotional changes, and being oversensitive and fragile in that period of life. Thus, a life experience that is tolerable to adults might badly affect adolescents and lead to suicide which is incomprehensible to them.
McNamara, Patricia M
Adolescent suicide rates in Australia have fallen significantly during recent years. The incidence, however, clearly remains a serious concern for young people, parents, professionals and policy makers. Some groups of Australian youth appear to be at heightened risk. Adolescents within the welfare system, indigenous, rural and refugee youth, along with same sex attracted young people often need very careful monitoring and support. Young men continue to take their lives more frequently than young women. Prevention programmes in Australia aim to develop resilience in young people, families and communities that can serve as protection against self harm and suicide. The improvement of mental health literacy, a fostering of adolescent self-efficacy and better access to early intervention strategies are currently privileged in national and state policies related to young people in Australia. More work is needed, however, to achieve a well integrated mental health framework capable of effectively addressing adolescent suicide prevention into the twenty-first century.
Groholt, Berit; Ekeberg, Oivind; Wichstrom, Lars; Haldorsen, Tor
Some risk and protective factors differ in their importance to suicidal and nonsuicidal people. In this research we explore the cross-sectional differences between risk factors among suicidal adolescents and nonsuicidal adolescents by focusing on self-esteem. Sixty-five suicidal and 390 nonsuicidal adolescents were compared on Harter's…
Baetens, Imke; Claes, Laurence; Muehlenkamp, Jennifer; Grietens, Hans; Onghena, Patrick
The aim of the present study was to examine differences in psychological symptoms and sense of self-competence between adolescents with and without non-suicidal self-injurious behavior. We collected data in a sample of 281 Flemish adolescents. Psychological symptoms and self-competencies were assessed by means of the Youth Self-Report (YSR) and…
Foto-Özdemir, Dilşad; Akdemir, Devrim; Çuhadaroğlu-Çetin, Füsun
The main aim of this study was to investigate the gender differences in defense mechanisms, ways of coping with stress and identity formation in relation to adolescent suicidal behavior. This study involved 64 adolescents between 12-17 years of age, who were admitted to the emergency service with a suicide attempt. They were evaluated with a semi-structured clinical interview (K-SADS), Ways of Coping Inventory (WCI), Defense Mechanisms Inventory (DMI) and Sense of Identity Assessment Form (SIAF). 60.9% (n = 39) of the adolescents were female, and 39.1% (n=25) were male. There were no statistically significant differences between the girls and the boys with respect to the clinical characteristics of the suicide attempt and the rate of psychiatric disorders. Of the 64 adolescents with suicide attempt, 47 (73.4%) had at least one, and 26 (40.6%) had more than one psychiatric disorder according to K-SADS. Disruptive behavior disorders were more frequent in males, whereas depression was more frequent in girls. The data indicated the importance of identity confusion, major depression and ADHD in adolescents with suicide attempt in both genders. 43.6% (n=17) of the girls and 36% (n=9) of the boys obtained scores higher than the cut-off point of SIAF indicating identity confusion. Professional help seeking and NSSI behaviors before the suicide attempt were more common in adolescents with identity confusion. While there were differences between genders with respect to the defense mechanisms used, no significant difference was found in terms of ways of coping. Evaluation of DMI scores revealed that the turning against object subscale score was significantly higher in boys compared to girls. While evaluating the adolescents at risk, their defense mechanisms, way of coping and sense of identity, as well as their psychiatric diagnosis should be assessed in detail in order to identify the suicidal thoughts and prevent possible suicide attempts.
Taliaferro, Lindsay A; Borowsky, Iris Wagman
Many young people who present to primary care providers (PCPs) have high levels of emotional distress and/or suicidal ideation. Therefore, PCPs are in an ideal position to recognize and respond to early symptoms and distress signals that accompany suicide warning signs, yet they underrecognize mood disorders and suicidality among youth. Medical school and residency programs typically provide inadequate training on pediatric mental health and adolescent suicide prevention. Thus, PCPs lack complete knowledge of risk factors and feel unprepared to handle mental health problems among youth. In this article, the authors provide an overview of the epidemiology of adolescent suicide and describe risk factors, protective factors, and warning signs. They propose that physician education represents a promising strategy to prevent adolescent suicide, and they establish the need for improved educational opportunities that would provide PCPs with the necessary skills and supports to identify and respond to psychosocial concerns that may increase suicide risk among youth. They recommend strategies, methods, and content areas for addressing educational gaps, as well as organizational approaches to support enhanced physician education. They also suggest areas for future research.
Background Suicidal ideation and suicide attempts are serious but not rare conditions in adolescents. However, there are several research and practical suicide-prevention initiatives that discuss the possibility of preventing serious self-harm. Profound knowledge about risk and protective factors is therefore necessary. The aim of this study is a) to clarify the role of parenting behavior and parenting styles in adolescents’ suicide attempts and b) to identify other statistically significant and clinically relevant risk and protective factors for suicide attempts in a representative sample of German adolescents. Methods In the years 2007/2008, a representative written survey of N = 44,610 students in the 9th grade of different school types in Germany was conducted. In this survey, the lifetime prevalence of suicide attempts was investigated as well as potential predictors including parenting behavior. A three-step statistical analysis was carried out: I) As basic model, the association between parenting and suicide attempts was explored via binary logistic regression controlled for age and sex. II) The predictive values of 13 additional potential risk/protective factors were analyzed with single binary logistic regression analyses for each predictor alone. Non-significant predictors were excluded in Step III. III) In a multivariate binary logistic regression analysis, all significant predictor variables from Step II and the parenting styles were included after testing for multicollinearity. Results Three parental variables showed a relevant association with suicide attempts in adolescents – (all protective): mother’s warmth and father’s warmth in childhood and mother’s control in adolescence (Step I). In the full model (Step III), Authoritative parenting (protective: OR: .79) and Rejecting-Neglecting parenting (risk: OR: 1.63) were identified as significant predictors (p < .001) for suicidal attempts. Seven further variables were interpreted to be
Rice, Timothy R
Suicide is the second leading cause of death among adolescents aged 14-19 years. Pediatricians report strong interest in receiving additional training to reduce suicide mortality, and physician education is one of the most robust means of suicide prevention. However, many studies suggest that existing educational methods and means leave much room for improvement. In light of the emerging evidence that emotion regulation (ER) deficits are significantly associated with adolescent suicide, this paper proposes the untested hypothesis that a module on the brain-based ER system may strengthen existing methods of provider education. The ER system and the evidence supporting its association with adolescent suicide are reviewed. The ability to ground an approach to suicide prevention within this brain-based medical model may be appealing to pediatricians; its transdiagnostic breadth and dimensional makeup may also be appealing to pediatricians. Most importantly, its emphasis on the negative effects of impoverished self-regulation broaden non-specialist concern from a restriction upon withdrawn, depressed adolescents to those with a wide range of psychopathology. Implications and further considerations are discussed.
Joiner, Thomas E., Jr.
The author has proposed a new theory of suicidal behavior--the interpersonal-psychological theory of suicidal behavior (Joiner, 2005)--which attempts to answer the question "Why do people die by suicide?" In this commentary, he briefly describes the theory, and then argues that the theory's constructs may allow a new level of focus and specificity…
Street, S; Kromrey, J D
This study examined the hypotheses that introversion in general and the introverted-intuitive-feeling-perceiving (INFP) type as measured by the Meyers-Briggs Type Indicator are related to suicidal ideation and behaviors. Analyses of data from 330 university students found four interactive suicidal behavior risk models: introverted-perceiving (IP) (females); introverted-sensing-feeling (ISF) (males); introverted-intuitive-perceiving (INP) (males); extraverted-intuitive-judging (ENJ) (males). Study findings were interpreted in terms of implications for risk assessment and intervention.
Valois, Robert F.; Zullig, Keith J.; Huebner, E. Scott; Drane, J. Wanzer
Relationships between perceived life satisfaction, poor mental health, suicide ideation and suicide behaviors were examined in a statewide sample of 13 to 18 year old public high school students (n = 4,758) using the self-report CDC Youth Risk Behavior Survey (YRBS). Adjusted logistic regression analyses and multivariate models constructed…
Stanley, Barbara; Brown, Gregory; Brent, David; Wells, Karen; Poling, Kim; Curry, John; Kennard, Betsy D.; Wagner, Ann; Cwik, Mary; Klomek, Anat Brunstein; Goldstein, Tina; Vitiello, Benedetto; Barnett, Shannon; Daniel, Stephanie; Hughes, Jennifer
Objective To describe the elements of a manualized cognitive behavior psychotherapy for suicide prevention (CBT-SP) and to report its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide. Method CBT-SP was developed using a risk reduction, relapse prevention approach and theoretically grounded in principles of cognitive behavior therapy, dialectical behavioral therapy and targeted therapies for suicidal, depressed youth. CBT-SP consists of acute and continuation phases, each lasting about 12 sessions, and includes a chain analysis of the suicidal event, safety plan development, skill building, psychoeducation, family intervention, and relapse prevention. Results CBT-SP was administered to 110 depressed, recent suicide attempters aged 13–19 years (mean 15.8±1.6) across five academic sites. Twelve or more sessions were completed by 72.4% of the sample. Conclusions A specific intervention for adolescents at high risk for repeated suicide attempts has been developed and manualized, and further testing of its efficacy appears feasible. PMID:19730273
Wolff, Jennifer C.; Seaboyer, Lourah M.; Hunt, Jeffrey; Esposito-Smythers, Christianne; Nugent, Nicole; Zlotnick, Caron; Miller, Ivan
Abstract Objective: The purpose of this study was to conduct a treatment development study to examine the feasibility, acceptability, and preliminary efficacy of treating depressed, suicidal adolescents and their depressed parent concurrently in a cognitive behavioral therapy (CBT) protocol (Parent-Adolescent-CBT [PA-CBT]). Methods: A randomized, controlled, repeated measures design was used to test the hypothesis that PA-CBT would lead to greater reductions in suicidality and depression compared with Adolescent Only CBT (AO-CBT). Participants included 24 adolescent and parent dyads in which the adolescent met American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for current major depressive episode (MDE) and the parent met DSM-IV criteria for current or past MDE. Results: The concurrent protocol was found to be feasible to implement with most depressed adolescents and parents. Adolescent ratings of program satisfaction were somewhat lower in PA-CBT, suggesting that some teens view treatment negatively when they are required to participate with a parent. The concurrent treatment protocol was more effective in reducing depressed mood in the parent–adolescent dyad at the end of maintenance treatment (24 weeks) than treating an adolescent alone for depression; the largest effect was on parental depressed mood. This difference between dyads was no longer significant, however, at the 48 week follow-up. Adolescent and parent suicidal ideation improved equally in both groups during active and maintenance treatment, and remained low at follow-up in both groups. Conclusions: The PA-CBT protocol is feasible to conduct and acceptable to most but not all adolescents. The strongest effect was on parental depressed mood. A larger study that has sufficient power to test efficacy and moderators of treatment outcome is necessary to better understand which adolescents would benefit most from concurrent treatment with a
Van Orden, Kimberly A.; Witte, Tracy K.; Gordon, Kathryn H.; Bender, Theodore W.; Joiner, Thomas E., Jr.
The interpersonal-psychological theory of suicidal behavior (T. E. Joiner, 2005) proposes that an individual will not die by suicide unless he or she has both the desire to die by suicide and the ability to do so. Three studies test the theory's hypotheses. In Study 1, the interaction of thwarted belongingness and perceived burdensomeness…
Leong, Choi Hong; Wu, Anise M S; Poon, Mary Man-Yee
Due to the lack of validated assessment tools for motives of non-suicidal self-injury behaviors in the Chinese contexts, this study aims to evaluate the psychometric properties of the Chinese version of the Functional Assessment of Self-Mutilation (C-FASM). A total of 345 secondary school students (mean age = 11.41 years), who reported non-suicidal self-injury in the past year, voluntarily participated in the questionnaire survey. Confirmatory factor analysis results supported a second-order model of 4 motivational factors. The overall scale scores had significant correlations with depression, anxiety, impulsiveness, self-esteem, social support, and suicidal ideation. The internal consistency of the scale was also satisfactory. The C-FASM is a valid and reliable instrument for assessing non-suicidal self-injury among nonclinical Chinese adolescents.
Hunt, Claire Y.
This document presents guidelines for school staff to use in responding to an adolescent suicide. It gives statistics on teenage suicides and suicide attempts and examines characteristics of high-risk adolescents. Behavior patterns associated with adolescent suicide are described, paying close attention to the patterns of depression, substance…
Muehlenkamp, Jennifer J.; Ertelt, Troy W.; Miller, Alec L.; Claes, Laurence
Background: There is little research on how specific borderline personality disorder (BPD) symptoms relate to suicide attempts or suicide and non-suicidal self-injury (NSSI) within adolescent populations, which is important to know given the recent proposal of an NSSI disorder. Even less well known is whether specific BPD symptoms distinguish NSSI…
Helsper, Werner; Breyvogel, Wilfried
Contrasts motives for adolescent suicide around the turn of the century with motivations for suicide in the 1980s. Concludes that suicide motivations changed from fear of punishment to those involving identity crises. Uses case studies to discuss relationship of causative factors and to illustrate appropriate pedagogical action. (KO)
Scheel, K R; Westefeld, J S
This study investigated the relationship between preference for heavy metal music and vulnerability to suicide among 121 high school students. Heavy metal fans had less strong reasons for living (especially male fans) and had more thoughts of suicide (especially female fans). For a large majority, listening to music (all types) had a positive effect on mood. Overall, the results indicate that preference for heavy metal music among adolescents may be a "red flag" for increased suicidal vulnerability, but also suggest that the source of the problem may lie more in personal and familial characteristics than in any direct effects of the music. Implications for intervention and for future research are discussed.
Miller, Matthew; Barber, Catherine; White, Richard A; Azrael, Deborah
On an average day in the United States, more than 100 Americans die by suicide; half of these suicides involve the use of firearms. In this ecological study, we used linear regression techniques and recently available state-level measures of suicide attempt rates to assess whether, and if so, to what extent, the well-established relationship between household firearm ownership rates and suicide mortality persists after accounting for rates of underlying suicidal behavior. After controlling for state-level suicide attempt rates (2008-2009), higher rates of firearm ownership (assessed in 2004) were strongly associated with higher rates of overall suicide and firearm suicide, but not with nonfirearm suicide (2008-2009). Furthermore, suicide attempt rates were not significantly related to gun ownership levels. These findings suggest that firearm ownership rates, independent of underlying rates of suicidal behavior, largely determine variations in suicide mortality across the 50 states. Our results support the hypothesis that firearms in the home impose suicide risk above and beyond the baseline risk and help explain why, year after year, several thousand more Americans die by suicide in states with higher than average household firearm ownership compared with states with lower than average firearm ownership.
Bradley, Kailyn A. L.; Case, Julia A. C.; Khan, Omar; Ricart, Thomas; Hanna, Amira; Alonso, Carmen M.; Gabbay, Vilma
The neuroimmunological kynurenine pathway (KP) has been implicated in major depressive disorder (MDD) in adults and adolescents, most recently in suicidality in adults. The KP is initiated by the enzyme indoleamine 2,3-dioxygenase (IDO), which degrades tryptophan (TRP) into kynurenine (KYN) en route to neurotoxins. Here, we examined the KP in 20 suicidal depressed adolescents—composed of past attempters and those who expressed active suicidal intent—30 non-suicidal depressed youth, and 22 healthy controls (HC). Plasma levels of TRP, KYN, 3-hydroxyanthranilic acid, and KYN/TRP (index of IDO) were assessed. Suicidal adolescents showed decreased TRP and elevated KYN/TRP compared to both non-suicidal depressed adolescents and HC. Findings became more significantly pronounced when excluding medicated participants, wherein there was also a significant positive correlation between KYN/TRP and suicidality. Finally, although depressed adolescents with a history of suicide attempt differed from acutely suicidal adolescents with respect to disease severity, anhedonia, and suicidality, the groups did not differ in KP measures. Our findings suggest a possible specific role of the KP in suicidality in depressed adolescents, while illustrating the clinical phenomenon that depressed adolescents with a history of suicide attempt are similar to acutely suicidal youth and are at increased risk for completion of suicide. PMID:25865484
Anestis, Michael D; Soberay, Kelly A; Gutierrez, Peter M; Hernández, Theresa D; Joiner, Thomas E
It is widely accepted that suicidal behavior often occurs with little planning. We propose, however, that suicidal behavior is rarely if ever impulsive-that it is too frightening and physically distressing to engage in without forethought-and that suicidal behavior in impulsive individuals is accounted for by painful and fearsome behaviors capable of enhancing their capacity for suicide. We conducted a meta-analysis of the association between trait impulsivity and suicidal behavior and a critical review of research considering the impulsiveness of specific suicide attempts. Meta-analytic results suggest the relationship between trait impulsivity and suicidal behavior is small. Furthermore, studies examining a mediating role of painful and provocative behaviors have uniformly supported our model. Results from our review suggest that researchers have been unable to adequately measure impulsivity of attempts and that measures sensitive to episodic planning must be developed to further our understanding of this phenomenon.
Dobry, Yuriy; Sher, Leo
Posttraumatic stress disorder (PTSD) is concerning not only because of the severity and chronicity of its symptoms - including distressing nightmares, flashbacks, anxiety attacks and maladaptive patterns of avoidant and nearly paranoid behavior - but also because of the wide spectrum of clinical and social impairments it is tightly associated with. The most striking example of clinical morbidity associated with PTSD is the well-known increase in the risk of suicidal behavior. Given that PTSD and medical illnesses increase the likelihood of suicide separately and independently, it is reasonable to suggest that the risk of suicidal behavior differs between patients suffering from PTSD comorbid with medical illnesses and patients having either condition alone. The available data point toward a novel clinical notion, an altered risk of suicidal behavior in patients suffering from comorbid PTSD and medical illnesses. This area of overlap between medicine and psychiatry is still in its infancy, with many unanswered questions about the rate, patterns and psychobiological mechanisms of suicidal behavior in this patient population. The positive association between PTSD, medical illness and suicidal behavior that appears to exist in the adult population, most likely affects the pediatric population as well. Closer investigation into the significance of the association between chronic medical illnesses, PTSD and suicidality in children, adolescents and adults is necessary.
Black, Donald W; Monahan, Patrick O; Winokur, George
The authors assessed the relationship between dexamethasone suppression test (DST) results and suicidal ideations and behavior. Four-hundred-twenty-three mood disorder patients admitted to a tertiary care medical center were administered the DST from 1978 to 1981. The patients were subsequently followed up to determine death status using a record-linkage method. More than 44% had abnormal cortisol suppression (nonsuppressors) at the index admission. Suppressors and nonsuppressors did not differ significantly with respect to frequency of suicidal ideations or completed suicides. Suppressors were significantly more likely than nonsuppressors to have a history of suicide attempts or to have a suicide attempt following hospital discharge. Using logistic regression, and controlling for several important variables including diagnosis, maximum postdexamethasone cortisol was not significantly associated with suicide, suicidal ideation, or suicide attempts. We conclude that an abnormal DST is not useful as a predictor of suicidal behavior.
Grossman, Arnold H; Park, Jung Yeon; Russell, Stephen T
The interpersonal psychological theory of suicide (IPTS) was used to examine suicidal thoughts and behaviors among 129 transgender and gender nonconforming (TGNC) youth. Youth were categorized according to their gender identities: female-to-male (FTM), male-to-female (MTF), female-to-different-gender (FTDG), and male-to-different gender (MTDG). Higher percentages of suicidal ideation were reported by FTDG and FTM youth; and higher percentages of suicide attempts by FTDG and MTDG youth. Perceived burdensomeness and thwarted belongingness were significantly related to suicidal ideation and/or suicide attempts. Experiences of painful, provocative and harmful events and acquired capability significantly predicted suicide attempts. The findings support IPTS in explaining suicidal behaviors among TGNC youth. Implications for prevention and intervention efforts are discussed.
Approximately 2-3% of all fatal air accidents may be attributed to suicide, and in many other accidents in aviation there are grounds for inferring that self-destructive or suicidal behavior was involved. Narcissistic personality traits are of paramount importance for the choice of this suicide method. Precursors include undetected depressions, alcoholism, and family problems of pilots.
Kwok, Sylvia Y. C. Lai; Shek, Daniel T. L.
Based on the responses of 5,557 Chinese secondary students in Hong Kong, the relationships among perceived hopelessness, family functioning, and suicidal ideation were examined. Results showed that suicidal ideation was positively related to hopelessness, but negatively related to parent-adolescent communication. Compared with father-adolescent…
Fitzpatrick, Scott J
Moral constructions of suicide are deliberately avoided in contemporary suicidology, yet morality persists, little or imperfectly acknowledged, in its practices and in the policies, discourses, and instruments that it underpins. This study used narrative methodologies to examine the normative force of suicidology and its implications for persons who had engaged in an act of nonfatal suicidal behavior. I interviewed a convenience sample of twelve persons from two inner-urban community mental health centers who were receiving crisis and case management services after a recent act of nonfatal suicidal behavior. Interviews focused on events leading up to and after participants' suicidal behavior; the responses their suicidal behavior generated in others, including family, friends, and the health professionals caring for them; and cultural views of suicide more broadly. Analysis of these interviews revealed that, although participants' narratives were broadly consistent with a number of recognizable, canonical story formats common to our cultural repertoire of stories of suicide, they also revealed important tensions, divisions, conflicts, and challenges to contemporary suicidological discourse and practice. Despite evidence to suggest that biomedical understandings of suicide provided some therapeutic benefit to participants, they did not address important social and moral dimensions of human life or explore their connection to suicidal behavior-aspects of the suicidal event that were critical to its causation and to its retelling and "resolution." The results of this study provide important insights into the moral features of suicidal behavior, the moral and ethical implications of suicide research, and the limitations of moral and ethical discourse in suicidology.
Rabinovitch, Sara M.; Kerr, David C. R.; Leve, Leslie D.; Chamberlain, Patricia
Childhood sexual abuse (CSA) histories are prevalent among adolescent girls in the juvenile justice system (JJS) and may contribute to their high rates of suicidal behavior. Among 166 JJS girls who participated in an intervention trial, baseline CSA and covariates were examined as predictors of suicide attempt and non-suicidal self-injury (NSSI) reported at long-term follow-up (7–12 years later). Early forced CSA was related to lifetime suicide attempt and NSSI history, and (marginally) to post-baseline attempt; effects were not mediated by anxiety or depressive symptoms. Findings suggest that earlier victimization and younger entry into JJS are linked with girls’ suicide attempt and NSSI. PMID:25370436
Army Public Health Center (Provisional) Public Health Report Surveillance of Suicidal Behavior January through December 2014 PHR No. S...Surveillance Portfolio Behavioral and Social Health Outcomes Program Surveillance of Suicidal Behavior is published by the Behavioral and Social...9 5.5 Behavioral Health Indicators
Yoder, Kevin A.; Longley, Susan L.; Whitbeck, Les B.; Hoyt, Dan R.
The present study examined associations among dimensions of suicidality and psychopathology in a sample of 428 homeless adolescents (56.3% female). Confirmatory factor analysis results provided support for a three-factor model in which suicidality (measured with lifetime suicidal ideation and suicide attempts), internalizing disorders (assessed…
Kelly, Thomas M.; Lynch, Kevin G.; Donovan, John E.; Clark, Duncan B.
Adolescents diagnosed with at least one mental disorder were studied to determine predictors of suicidal ideation and suicide attempts. Major depression was predictive of suicidal ideation and attempts for both genders. Chronic stress was found predictive of male suicidal ideations, while low self esteem and family dysfunction were predictive in…
Shilubane, Hilda N.; Ruiter, Robert A. C.; Bos, Arjan E. R..; van den Borne, Bart; James, Shamagonam; Reddy, Priscilla S.
In South Africa, one in five adolescents attempt suicide. Suicide attempts continue to rise. We aimed to identify psychosocial target points for future educational interventions. One-to-one semi-structured interviews were conducted to explore psychosocial factors associated with past suicide attempts among suicide survivors in Limpopo province,…
de Anda, Diane; Smith, Melanie A.
Examined data on 165 adolescents, 65 young adults, and 175 adults who called 2 suicide help lines. Adults and young adults reported depression as primary reason for contemplating suicide; adolescents reported interpersonal problems. Although callers reported suicide ideation, very small percentage fell into high-risk categories with regard to…
Melhem, Nadine M.; Day, Nancy; Shear, M. Katherine; Day, Richard; Reynolds, Charles F.; Brent, David
The purpose of this article is to examine the predictors of complicated grief, depression, and post traumatic stress disorder (PTSD) among adolescents exposed to the suicide of a peer. One hundred and forty six peers of adolescent suicide victims were interviewed at 6, 12-18, and 36 months following the suicide. The roles of previous psychiatric…
Spirito, Anthony; And Others
Although suicide is the second leading cause of death for adolescents in the United States, there are little empirical data available on psychological factors which may lead an adolescent to consider or attempt suicide. To address this issue, the relationships among depression, social skills, and severity of suicidal attempt were investigated in…
Borges, Guilherme; Benjet, Corina; Medina-Mora, Maria Elena; Orozco, Ricardo; Molnar, Beth E.; Nock, Matthew K.
Background: We report the prevalence and associations between traumatic events and suicidal ideation, suicide plans and suicide attempts among Mexican adolescents. Methods: The data are from a representative multistage probability household survey of 3,005 adolescents aged 12 to 17 years residing in the Mexico City Metropolitan Area that was…
Mahfoud, Ziyad R.; Afifi, Rema A.; Haddad, Pascale H.; DeJong, Jocelyn
The current study examined prevalence and risk factors for suicide ideation in 5038 Lebanese adolescents using Global School Health Survey data. Around 16% of Lebanese adolescents thought of suicide. Multivariate logistic regression models showed that risk factors for suicide ideation included poor mental health (felt lonely, felt worried, felt…
Zhao, Sibo; Zhang, Jie
Background: In China, suicide is one of the major causes of death among adolescents and young adults aged 15 to 34 years. Aim: The current study examines how risk factors vary by age groups in rural China, referring to those aged 15 to 24 years and those aged 25 to 34 years. Method: A case-control psychological autopsy (PA) study is conducted in sixteen counties from three Chinese provinces, including 392 suicide cases and 416 community living controls in the sample. Results: In China, young adults aged 25 to 34 years have a higher risk for suicide than adolescents aged 15 to 24 years, and it holds true even controlling for relevant social factors. In addition, age-related factors such as education, marital status, whether having children, status in the family, physical health, and personal income all have varying degrees of impact on suicide risks for rural youth. Conclusions: This study shows that there are some age-related risk factors for suicide at certain life stages and emphasizes that young adults in rural China aged 25 to 34 years have an increased risk of suicide as a result of experiencing more psychological strains with age. PMID:25546276
Anestis, Michael D; Selby, Edward A
Data indicate persistence facilitates suicidal behavior. Non-suicidal self-injury (NSSI) is characterized by difficulty persisting while upset. The relationship between NSSI and suicidal behavior thus may hinge upon persistence. Participants were 604 undergraduates (79.5% women; 42.4% African American; 6.1% with 1 + prior suicide attempt). Data were collected online via self-report and analyzed using hierarchical multiple regression. As expected, higher levels of grit and perseverance predicted more frequent suicide attempts. Furthermore, grit and perseverance moderated the relationship between NSSI and suicide attempts, which increased in magnitude as individuals reported greater persistence. Findings depict suicidal behavior as a deliberate pursuit of death.
Lacourse, Eric; Claes, Michel; Villeneuve, Martine
Studied differentiating characteristics of youth who prefer heavy metal music, worship music, and use music for vicarious release. Data for 275 secondary school students suggest that heavy metal music preference and worshipping is not related to suicidal risk when controlling for other suicide factors. Discusses findings in the context of…
Burke, Ainsley K.; Galfalvy, Hanga; Everett, Benjamin; Currier, Dianne; Zelazny, Jamie; Oquendo, Maria A.; Melhem, Nadine M.; Kolko, David; Harkavy-Friedman, Jill M.; Birmaher, Boris; Stanley, Barbara; Mann, J. John; Brent, David A.
Objective: Exposure to suicidal behavior in peers and relatives is thought to increase risk for suicidal behavior in vulnerable individuals, possibly as a result of imitation or modeling. This study examines exposure to suicidal behavior and likelihood of suicide attempt in a high-risk cohort of offspring of a depressed parent. Method: A total of…
Background Bullying in schools has been associated with suicidal ideation but the confounding effect of psychiatric morbidity has not always been taken into account. Our main aim was to test the association between bullying behavior and early stages of suicidal ideation in a sample of Greek adolescents and to examine whether this is independent of the presence of psychiatric morbidity, including sub-threshold symptoms. Methods 5614 pupils 16-18 years old and attending 25 senior high schools were screened in the first phase and a stratified random sample of 2431 were selected for a detailed interview at the second phase. Psychiatric morbidity and suicidal ideation were assessed with the revised Clinical Interview Schedule (CIS-R) while bullying was assessed with the revised Olweus bully/victim questionnaire. Results Victims of bullying behavior were more likely to express suicidal ideation. This association was particularly strong for those who were bullied on a weekly basis and it was independent of the presence of psychiatric morbidity (Odds Ratio: 7.78; 95% Confidence Interval: 3.05 - 19.90). In contrast, being a perpetrator ("bullying others") was not associated with this type of ideation after adjustment. These findings were similar in both boys and girls, although the population impact of victimization in the prevalence of suicidal ideation was potentially higher for boys. Conclusions The strong cross-sectional association between frequent victimization and suicidal ideation in late adolescence offers an opportunity for identifying pupils in the school setting that are in a higher risk for exhibiting suicidal ideation. PMID:21303551
Haring, C; Biebl, W; Barnas, C; Miller, C H; Fleischhacker, W W
This study deals with suicides of children and adolescents in the region of Tyrol, Austria from 1976-1984. The upper age limit was set at 19 years. During the time period stated above, 54 suicides were registered for the relevant age group, using police records as a source of information. Special attention was paid to the distribution of age, sex and occupation, as well as to the suicide methods. As far as age distribution is concerned, a significant increase of suicides was registered at the age of 15 and again at the age of 19. According to the authors, the reason for this increase is pronounced psychosocial changes which occur especially in these age groups and weaken social integration. The various implications ensuing from the available data are discussed.
Borges, Guilherme; Benjet, Corina; Medina-Mora, Maria Elena; Orozco, Ricardo; Familiar, Itziar; Nock, Matthew K.; Wang, Philip S.
Background We report the lifetime and 12-month prevalence and associations of mental health treatment among Mexican adolescents with suicide-related outcomes (SROs; including ideation, plans, gestures and attempts). Methods A representative multistage probability household survey of 3005 adolescents aged 12 to 17 years residing in the Mexico City Metropolitan Area was carried out in 2005. Discrete time survival analyses were used to assess the relationships between SROs and receiving treatment for emotional, alcohol, or drug problems. Results The prevalence of lifetime service use among respondents with SROs was 35% for those with ideation only, 44% for those with ideation and plan, 49% for those with gesture and 50% for those with attempt; the prevalence of 12-month service use was 10%, 24%, 6% and 21%, respectively. Timing between onset of SRO and receiving treatment for emotional, alcohol, or drug problems showed that about 50% of adolescents will have contact with a service provider before developing any SRO. Healthcare professionals were the most likely to be consulted, followed by school-based programs. Limitations This survey was limited to adolescents living in one of the largest metropolitan areas in the world and the analyses used data on retrospectively reported ages of onset that are subject to recall errors. Conclusions Most suicidal adolescents do not receive treatment, and many adolescents develop their suicidality in spite of prior contacts with service providers. Interventions to increase treatment, prevention, and monitoring are sorely needed for this vulnerable population. PMID:19411113
Arslan, Mustafa; Akcan, Ramazan; Hilal, Ahmet; Batuk, Hulya; Cekin, Necmi
The purpose of this study was to investigate the general properties of suicide among children and adolescents in our region, and to evaluate the results in the light of the literature. The autopsy records of the morgue of the Adana branch of the Turkish Forensic Medicine Council were investigated retrospectively. Focus of the study was shaped by…
Pena, Juan B.; Caine, Eric D.
Among the provisions of the recently signed Garrett Lee Smith Memorial Act, Congress called for the use of screening to detect adolescents who are at risk for suicide. After a review of the literature, 17 studies involving screening instruments and programs were identified. We addressed the question: What do we know about the demonstrated…
Gutierrez, Peter M.
This article briefly reviews key issues in adolescent suicide risk assessment and proposes that assessing risk and protective factors in combination has the best probability of informing the field's understanding of this complex problem. Several newer measures are described along with summaries of their psychometric properties. A recommended…
Berg, Rachelle; Hendricks, Bret; Bradley, Loretta
Major ethical considerations must be taken into account when providing counseling services to suicidal adolescents and their families. This article explores these ethical issues and the American Counseling Association and International Association of Marriage and Family Counselors ethical codes relevant to these issues. Related liability and…
Zeng, Kangmin; Le Tendre, Gerald
Uses recent data and new theoretical perspectives to reexamine hypothesized links between academic competition and adolescent suicide in East Asia, particularly Japan. Finds no direct connection, discusses possible indirect effects on individual motives, and suggests a more complicated model. Analyzes how cultural and historical factors may…
Vander Stoep, Ann; McCauley, Elizabeth; Flynn, Cynthia; Stone, Andrea
The prevalence and persistence of thoughts of death and suicide during early adolescence were estimated in a community-based cohort. A latent class approach was used to identify distinct subgroups based on endorsements to depression items administered repeatedly over 24 months. Two classes emerged, with 75% in a low ideation class across four…
Rafi Bazrafshan, Mohammad; Sharif, Farkhondeh; Molazem, Zahra; Mani, Arash
Background Research shows that parents have an immense influence over their children’s behavior during adolescence. Adolescents who grow up with parents who are addicted to drugs and alcohol are more likely to turn to self-destructive behaviors such as suicide attempts. Because addiction in Iran is a primarily masculine phenomenon and in traditional Iranian culture, the father is responsible for family affairs and is recognized as the family provider, paternal addiction affects adolescent children. However, the impact of this type of parental addiction on adolescent suicide attempts has received little attention. Objectives This study was conducted to assess the impact of paternal addiction on adolescent suicide attempts. Patients and Methods This was a qualitative study that used a grounded theory approach. Thirteen participants, from two hospitals in Shiraz (southern Iran), were interviewed. We used purposeful sampling, followed by theoretical sampling. Data were collected from in-depth semi-structured interviews. Data analysis was done using Strauss and Corbin’s (1998) approach, followed by the constant comparative method. Results The mean age of the adolescents was 15.75 ± 1.83, and all of them were single. Five main themes were extracted from the data: mental health problems, relationship problems, financial problems, family problems, and imitation of risky behaviors. Conclusions The findings suggest that in addition to the need to consider paternal addiction in health care plans, it is also necessary to pay attention to other family members, including the adolescents themselves. Health care providers, including nurses, can use the findings from this study for the purposes of prevention and education. PMID:27818961
Suicide is the second leading cause of death in the 10- to 19-year-old population in Oregon. The suicide rate has increased more than five-fold in the last three and one-half decades. This trend can be reversed by developing an understanding of the characteristics, behaviors, and events associated with suicide in at-risk youth. The Youth Risk…
Thompson, Martie P.; Kaslow, Nadine J.; Lane, Danielle Bradshaw; Kingree, J. B.
Investigates how childhood maltreatment and current post-traumatic stress disorder (PTSD) predict nonfatal suicide attempts among 335 African American women. PTSD in combination with any of the maltreatments of childhood increased the risk of suicide attempts. Suggests that interventions designed to reduce suicidal behavior should focus on women…
Dougherty, Donald M.; Mathias, Charles W.; Marsh, Dawn M.; Papageorgiou, T. Dorina; Swann, Alan C.; Moeller, F. Gerard
The purpose of this study was to examine the relationship between laboratory behavioral measured impulsivity (using the Immediate and Delayed Memory Tasks) and suicidal attempt histories. Three groups of adults were recruited, those with either: no previous suicide attempts (Control, n = 20), only a single suicide attempt (Single, n = 20), or…
SOYLU, Nusret; TANELİ, Yeşim; TANELİ, Suna
Introduction Our study aimed at investigating social, emotional, and cognitive factors playing a role in the development of suicidal ideation in depressed adolescents and its turning into a suicide attempt. Method Sixty-three adolescents (48 female, 15 male) aged 12 to 18 years were included in the study. In face-to-face interviews, suicide ideation, suicide plans, and previous suicide attempts were evaluated, sociodemographic data were collected. Additionally, the Children’s Depression Inventory, State-Trait Anxiety Inventory (STAI-I, II), Beck Hopelessness Scale, Coopersmith Self-Esteem Inventory, Multidimensional Scale of Perceived Social Support, Strengths and the Difficulties Questionnaire (SDQ) parent forms were applied. SPSS version 13.0 for Windows was used for statistical analysis. Results It has been established that in the last six months, 71.4% of cases (n=45) had suicidal ideation and 27% (n=17) attempted suicide. Factors associated with suicidal ideation in depressed adolescents were: high depression and anxiety levels, hopelessness and low self-esteem (p<0.05). Factors associated with suicide attempts were: separated family background, lower perceived family support and high rates of conduct difficulties (p<0.05). Patients with suicide attempt differed from patients with suicidal ideation but without suicide attempt in lower perceived family support only (p<0.05). Discussion It is thought that keeping in mind the factors associated with the development of suicidal ideation and its turning into a suicide attempt, will help clinicians in preventing suicide attempts in depressed adolescents.
Park, Subin; Lee, Yeeun
We examined the factors that affect suicide attempts adolescents multicultural families in South Korea. The participants were 727 adolescents whose mothers and/or fathers were born outside of South Korea (376 males and 351 females). Among them, 41 (weighted prevalence 6.2%) had attempted suicide during the last 12 months. Female gender, residence in large cities (compared with in rural areas), living with relatives/alone/with friends/in a dormitory or living in a facility (compared with living with family), high and low socio-economic status (compared with a middle level), high and low academic performance (compared with a middle level), severe perceived stress (compared with non-severe stress), conflicts with a teacher (compared with conflicts with parent), and foreign-father/-parent families (compared with foreign-mother family) were associated with increased odds of suicide attempt. The results indicate that greater awareness of the possibility of suicidal behavior is prudent for adolescents in multicultural families with certain risk factors, such as being from a foreign-parents family, living separately from the family, and having conflicts with a teacher. PMID:27916813
Park, Subin; Lee, Yeeun
We examined the factors that affect suicide attempts adolescents multicultural families in South Korea. The participants were 727 adolescents whose mothers and/or fathers were born outside of South Korea (376 males and 351 females). Among them, 41 (weighted prevalence 6.2%) had attempted suicide during the last 12 months. Female gender, residence in large cities (compared with in rural areas), living with relatives/alone/with friends/in a dormitory or living in a facility (compared with living with family), high and low socio-economic status (compared with a middle level), high and low academic performance (compared with a middle level), severe perceived stress (compared with non-severe stress), conflicts with a teacher (compared with conflicts with parent), and foreign-father/-parent families (compared with foreign-mother family) were associated with increased odds of suicide attempt. The results indicate that greater awareness of the possibility of suicidal behavior is prudent for adolescents in multicultural families with certain risk factors, such as being from a foreign-parents family, living separately from the family, and having conflicts with a teacher.
Tanner, Alicia; Hasking, Penelope; Martin, Graham
Co-occurring internalizing and externalizing problem behaviors in adolescence typically marks more severe psychopathology and poorer psychosocial functioning than engagement in a single problem behavior. We examined the negative life events, emotional and behavioral problems, substance use, and suicidality of school-based adolescents reporting both non-suicidal self-injury (NSSI) and repetitive firesetting, compared to those engaging in either behavior alone. Differences in NSSI characteristics among self-injurers who set fires, compared to those who did not, were also assessed. A total of 384 at-risk adolescents aged 12-18 years (58.8% female) completed self-report questionnaires measuring NSSI, firesetting, and key variables of interest. Results suggest that adolescents who both self-injure and deliberately set fires represent a low-prevalence but distinct high-risk subgroup, characterized by increased rates of interpersonal difficulties, mental health problems and substance use, more severe self-injury, and suicidal behavior. Implications for prevention and early intervention initiatives are discussed.
Ballard, Elizabeth; Bosk, Abigail; Pao, Maryland
Whereas non-suicidal self injury (NSSI) is reported in 13-23% of adolescents and is an increasingly studied topic, there has been little investigation into the pathophysiology behind self-injury. This commentary examines recent research into pain and emotional distress to discuss implications for the manner we should understand, research, and treat NSSI in the future. Research indicates that adolescents may be particularly vulnerable to NSSI behaviors due to neurodevelopmental changes in the processing of distress and pain. Additionally, emotional distress and physical pain neural pathways may have been altered in these individuals, leading to the development of NSSI behaviors during adolescence when changes in ongoing brain development may lead to further emotional dysregulation and poor impulse control. Further studies that directly characterize the relationship between emotional distress and physical pain in adolescence, as well as the neural differences between self-injurers and non-self-injurers, are needed.
Siegel, Darren; McCabe, Paul C.
The "Morbidity and Mortality Weekly Report" published by the Centers for Disease Control (CDC) reported that in 2004, suicide was the third leading cause of death among 10- to 24-year olds and accounted for 4,599 deaths. From 2003 to 2004, suicide rates of females age 10-14 years and 15-19 years and males age 15-19 years increased significantly.…
Borges, Guilherme; Benjet, Corina; Medina-Mora, Maria Elena; Orozco, Ricardo; Nock, Matthew
The study examines data from the Mexican Adolescent Mental Health Survey to study the prevalence and risk factors for suicide ideation, plan, and attempt among Mexican adolescents. The results reveal patterns of the risk factors and suggest that intervention should focus on adolescents with mental disorders to effectively prevent suicides.
Panagioti, Maria; Gooding, Patricia A; Dunn, Graham; Tarrier, Nicholas
This study investigated paths to suicidal behavior in 94 civilian participants with chronic posttraumatic stress disorder (PTSD). Two statistical modeling programs, TETRAD II version 2.1 and Mplus 5.21 were used to construct a working model of suicide in PTSD. Two paths to suicidal behavior were identified. In the first path, suicidal behavior was directly associated with greater life impairment, which in turn was associated with poorer occupational and social functioning. In the second path, suicidal behavior was directly associated with depressive symptoms, which in turn were associated with more severe PTSD symptoms. Psychotropic medication, employment status, and threat to life further contributed to the model. The findings suggest that negative perceptions of functional impairment and depression are strongly associated with suicidal behavior in PTSD.
Kirkcaldy, Bruce; Richardson-Vejlgaard, Randall; Siefen, Georg
A sample of 2553 children and adolescents in a psychiatry clinic in Germany were assessed using a structured interview inventory that included history of self-injurious behaviour, suicidal intent and socially disruptive and threatening behaviour, and diverse socio-demographic variables (the basis documentation or 'Ba-Do'). Birth order was associated with both suicidal and self-injurious behaviour, middle children being most likely to exhibit such behaviour. Females were more than twice as likely to have self-injured than males. Comparisons of birth order groups within gender found no significant differences in suicidal behaviour between birth positions for males, however among females, middle children were much more likely to have attempted suicide. Conversely, there was no difference in self-injurious behaviour among birth positions in females, but among males, middle children were significantly more likely to have self-injured than firstborns, only children or lastborns. The number of siblings in the family was significantly correlated with both suicidal history (r = 0.12, p < 0.001) and self-injurious behaviour (r = 0.10, p < 0.001). The risk of suicidal behaviour was highest for those with four or more siblings.
Rosewater, K M; Burr, B H
Increasing rates of adolescent suicide are a significant health concern and the third leading cause of death for this age group. Recent research into psychiatric, gender-related, family, cultural and neurobiologic risk factors is reviewed. The effects of suicide exposure and media influences are also examined. Although many risk factors have been identified, the application of this knowledge to clinical practice requires further study. The limited number of studies on prevention and intervention strategies are discussed. High rates of nonadherence to follow-up remain problematic. More research is needed to develop appropriate treatments, prevention programs and outcome measures.
Parfilova, Gulfiya G.; Karimova, Lilia Sh.
The problem of demonstrative behavior is very topical among teenagers and this issue has become the subject of systematic scientific research. Demonstrative manifestations in adolescents disrupt the favorable socialization; therefore, understanding, prevention and correction of demonstrative behavior at this age is relevant and requires special…
Confined to discussion of heterosexual activities, this article examines adolescent sexual behavior in terms of promiscuity; the search for a sexual behavior code; the impact of the media; and the influence of peer groups, religious identification, and the adult double standard. (JC)
Wolitzky-Taylor, Kate B.; Ruggiero, Kenneth J.; McCart, Michael R.; Smith, Daniel W.; Hanson, Rochelle F.; Resnick, Heidi S.; de Arellano, Michael A.; Saunders, Benjamin E.; Kilpatrick, Dean G.
We compared the prevalence and correlates of adolescent suicidal ideation and attempts in two nationally representative probability samples of adolescents interviewed in 1995 (National Survey of Adolescents; N =4,023) and 2005 (National Survey of Adolescents-Replication; N =3,614). Participants in both samples completed a telephone survey that assessed major depressive episode (MDE), post-traumatic stress disorder, suicidal ideation and attempts, violence exposure, and substance use. Results demonstrated that the lifetime prevalence of suicidal ideation among adolescents was lower in 2005 than 1995, whereas the prevalence of suicide attempts remained stable. MDE was the strongest predictor of suicidality in both samples. In addition, several demographic, substance use, and violence exposure variables were significantly associated with increased risk of suicidal ideation and attempts in both samples, with female gender, nonexperimental drug use, and direct violence exposure being consistent risk factors in both samples. PMID:20390799
Liu, Richard T; Frazier, Elisabeth A; Cataldo, Andrea M; Simon, Valerie A; Spirito, Anthony; Prinstein, Mitchell J
Although life stressors have been implicated in the aetiology of various forms of psychopathology related to non-suicidal self-injury (NSSI), particularly depression and suicidal behavior, they have rarely been examined in relation with NSSI. The objective of the current study was to assess the association between life stressors and NSSI in adolescent inpatients. Adolescent inpatients (n = 110) completed measures of life events, NSSI, and depressive symptoms at 3 time-points over a 9-month period. Higher rates of life stressors were significantly associated with greater NSSI. This finding held even after covarying concurrent depressive symptoms and gender. Life stressors may have a unique role in the pathogenesis of NSSI. Directions for future research and clinical implications are discussed.
Liu, Richard T.; Frazier, Elisabeth A.; Cataldo, Andrea M.; Simon, Valerie A.; Spirito, Anthony; Prinstein, Mitchell J.
Objective Although life stressors have been implicated in the aetiology of various forms of psychopathology related to non-suicidal self-injury (NSSI), particularly depression and suicidal behavior, they have rarely been examined in relation with NSSI. The objective of the current study was to assess the association between life stressors and NSSI in adolescent inpatients. Methods Adolescent inpatients (n = 110) completed measures of life events, NSSI, and depressive symptoms at three time-points over a nine-month period. Results Higher rates of life stressors were significantly associated with greater NSSI. This finding held even after covarying concurrent depressive symptoms and gender. Conclusion Life stressors may have a unique role in the pathogenesis of NSSI. Directions for future research and clinical implications are discussed. PMID:24712970
Santana, Geilson Lima; Coelho, Bruno Mendonca; Borges, Guilherme; Viana, Maria Carmen; Wang, Yuan Pang; Andrade, Laura Helena
Suicide tends to occur in families, and parental psychopathology has been linked to offspring suicidal behaviors. This study explores the influence of parental mental disorders across the lifespan. Data are from the Sao Paulo Megacity Mental Health Survey, a cross-sectional household study with a representative sample of the adult population living in the Sao Paulo Metropolitan Area, Brazil (N=2,942). Survival models examined bivariate and multivariate associations between a range of parental disorders and offspring suicidality. After controlling for comorbidity, number of mental disorders and offspring psychopathology, we found that parental psychopathology influences suicidal behaviors throughout most part of the life cycle, from childhood until young adult years. Generalized anxiety disorder (GAD) and antisocial personality were associated with offspring suicidal ideation (OR 1.8 and 1.9, respectively), panic and GAD predicted suicidal attempts (OR 2.3 and 2.7, respectively), and panic was related to the transition from ideation to attempts (OR 2.7). Although noticed in many different stages of the lifespan, this influence is most evident during adolescence. In this period, depression and antisocial personality increased the odds of suicidal ideation (OR 5.1 and 3.2, respectively), and depression, panic disorder, GAD and substance abuse predicted suicidal attempts (OR varying from 1.7 to 3.8). In short, parental disorders characterized by impulsive-aggression and anxiety-agitation were the main predictors of offspring suicidality across the lifespan. This clinically relevant intergenerational transmission of suicide risk was independent of offspring mental disorders, and this underscores the need for a family approach to psychopathology.
Heilbron, Nicole; Prinstein, Mitchell J.
This study examined concurrent and longitudinal associations among peer victimization, peer status, and self-injurious thoughts and behaviors (i.e., suicidal ideation and nonsuicidal self-injury [NSSI]) over a 2-year period. A community sample of 493 adolescents (51% girls) in Grades 6-8 participated in the study. Participants completed measures…
Breton, Jean-Jacques; Labelle, Réal; Berthiaume, Claude; Royer, Chantal; St-Georges, Marie; Ricard, Dominique; Abadie, Pascale; Gérardin, Priscille; Cohen, David; Guilé, Jean-Marc
Objectives: To examine whether protective factors in the Protection for Adolescent Depression Study (PADS) moderate the impact of stressful events on depression and suicidal behaviour in the community and a clinical setting; and to study the influence of sex. Method: Participants were 283 adolescents from the community and 119 from a mood disorder clinic in Montreal. The participants were evaluated on 6 instruments measuring individual risk and protective factors. Descriptive analyses and univariate and multiple logistic regression models were carried out. Results: Risk factors predicted higher levels of depression and presence of suicidal behaviour, and protective factors predicted lower levels of depression and absence of suicidal behaviour, as expected under the vulnerability-resilience stress model. Several sex differences were observed in terms of the predictive power of risk factors (for example, hopelessness among girls and keep to themselves among boys) and protective factors (for example, focusing on the positive among girls and self-discovery among boys). Conclusions: Findings from the PADS suggest that protective factors moderate the impact of stress on depression and suicidal behaviour. Developing protection appears important in the presence of chronic conditions, such as depressive disorders, to reduce the likelihood of further episodes. The influence of sex makes it all the more relevant to target different factors for boys and girls to increase protection and decrease risk in prevention and intervention programs. PMID:25886672
Lin, Danhua; Li, Xiaoming; Fan, Xinghua; Fang, Xiaoyi
Objective: The current study was designed to explore the prevalence of child sexual abuse (CSA) and its association with health risk behaviors (i.e., smoking, alcohol use, binge drinking, suicidal ideation, and suicide attempt) among rural children and adolescents in China. Methods: A sample of 683 rural children and adolescents (8 to 18 years of…
Brownson, Chris; Becker, Martin Swanbrow; Shadick, Richard; Jaggars, Shanna S.; Nitkin-Kaner, Yael
Suicidal and help-seeking behaviors of students of color remain a significant problem on college campuses. Self-reported suicidal experiences and help-seeking behavior of diverse students are examined on the basis of results from a national survey of college student mental health. The results suggest significant differences in the expression of…
Osgood, Nancy J.; Brant, Barbara A.
Surveyed administrators of 463 long-term care facilities concerning overt suicides and intentional life-threatening behaviors. Data revealed that White males were highest risk group. Refusal to eat, drink, or take medications were most common suicidal behaviors. Depression, loneliness, feelings of family rejection, and loss were significant…
Brown, David R.; Blanton, Curtis J.
Used data from the 1995 National College Health Risk Behavior Survey to evaluate the relationship between physical activity, sports participation, and suicide among college students. Overall, selected physical activity patterns were associated in a non-systematic manner with decreased or increased odds of suicidal behavior among male and female…
LeMaster, Pamela L.; Beals, Janette; Novins, Douglas K.; Manson, Spero M.
This study examined the prevalence of suicidal behaviors among 1,638 Northern Plains American Indians ages 15?57. Age and gender patterns were investigated as was comorbidity with psychiatric and substance use disorders. Data from a population-based survey indicated that suicidal behaviors were more frequently reported among females than males and…
Engin, Esra; Cuhadar, Dondu; Ozturk, Emel
This study aims to determine the sociodemographic factors and healthy life behaviors affecting suicide and suicide probability of university students. The research was designed as a complementary study and conducted with 334 students from several faculties and colleges at Ege University, Turkey. The study findings indicated that suicide probability could be affected by the students' age, their problems at school, their troubled relations with friends, and a psychiatric disorder history within the last year. Moreover, it was concluded that the students with healthy life behaviors had significantly lower scores on the Suicide Probability Scale and its subscales.
Lee, Margaret T. Y.; Wong, Betty P.; Chow, Bonnie W.-Y.; McBride-Chang, Catherine
The unique dimensions of perceptions of school and family contributing to depression and suicide ideation in Hong Kong adolescents were examined in two studies. In Study 1, among 327 Hong Kong Chinese female students ages 13-18, 47% reported some suicide ideation. Suicide ideation was significantly associated with depression, test anxiety,…
Xavier, Ana; Pinto Gouveia, José; Cunha, Marina
Background: Non-suicidal self-injury (NSSI) is a serious and relatively prevalent problem in adolescence. Although several studies have identified risk factors for the aetiology and maintenance of NSSI, little is known about the impact of individual and contextual variables in such pervasive behaviors among adolescents. Objective: This paper aims…
Wolitzky-Taylor, Kate B.; Ruggiero, Kenneth J.; McCart, Michael R.; Smith, Daniel W.; Hanson, Rochelle F.; Resnick, Heidi S.; de Arellano, Michael A.; Saunders, Benjamin E.; Kilpatrick, Dean G.
We compared the prevalence and correlates of adolescent suicidal ideation and attempts in two nationally representative probability samples of adolescents interviewed in 1995 (National Survey of Adolescents; N = 4,023) and 2005 (National Survey of Adolescents-Replication; N = 3,614). Participants in both samples completed a telephone survey that…
Knafo, Alexandra; Guilé, Jean-Marc; Breton, Jean-Jacques; Labelle, Réal; Belloncle, Vincent; Bodeau, Nicolas; Boudailliez, Bernard; de la Rivière, Sébastien Garny; Kharij, Brahim; Mille, Christian; Mirkovic, Bojan; Pripis, Cornelia; Renaud, Johanne; Vervel, Christine; Cohen, David; Gérardin, Priscille
Objectives: To compare the coping strategies of adolescents with borderline personality disorder (BPD) to the coping strategies of adolescents without BPD, and to explore the association of coping with suicidal ideation and attempts among adolescents with BPD. Method: Adolescent inpatients (n = 167) aged 13 to 17 years were admitted after suicide attempts and evaluated within 10 days, using the abbreviated version of the Diagnostic Interview for Borderlines–Revised, the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version supported by a team consensus best estimate method for the primary diagnosis, the Adolescent Coping Scale, and the Columbia-Suicide Severity Rating Scale. Results: Firstly, compared with adolescents without BPD, adolescents with BPD relied more on nonproductive coping strategies, mostly avoidant strategies, and less on productive coping strategies. Secondly, coping appeared as a factor associated with suicidal ideation in adolescents with BPD. While while controlling for age, sex, and depression, multivariate analyses showed a significant positive association between the coping strategy to focusing on solving the problem and suicidal ideation. Conclusion: The use of avoidant strategies by adolescents with BPD could be viewed as attempts to increase emotional regulation. Problem-solving strategies in the immediate aftermath of a suicide attempt may prevent adolescents with BPD from overcoming a crisis and may increase suicidal ideation. PMID:25886671
Lai Kwok, Sylvia Y. C.; Shek, Daniel T. L.
Based on the family ecological model, personal (hopelessness, social problem solving, emotional competence) and family (parent-adolescent communication, family functioning) quality of life measures related to adolescent suicidal ideation were examined in 5,557 Secondary 1 to Secondary 4 students in Hong Kong. Results showed that suicidal ideation…
Donaldson, Deidre; Spirito, Anthony; Esposito-Smythers, Christianne
Objective: To compare the efficacy of a skills-based treatment protocol to a supportive relationship therapy for adolescents after a suicide attempt. Method: Thirty-nine adolescents (12-17 years old) and parents who presented to a general pediatric emergency department or inpatient unit of a child psychiatric hospital after a suicide attempt were…
Liu, Ruth X.
This paper examines whether severity of depression reduces or intensifies the relationship between friends' suicide attempt and adolescent's own attempt to commit suicide, and whether there are gender differences in this interrelationship. Using logistic regression and data from a nationally representative sample of adolescents studied at 2 points…
Lucey, Christopher F.; Lam, Sarah K. Y.
This study was designed to identify characteristics of family functioning that relate to suicide potential in an outpatient adolescent population. Participants included 51 adolescents between the ages of 14 and 18 who were involved in outpatient counselling. The Family Environment Scale and the Suicide Probability Scale were used to assess…
Vitiello, Benedetto; Brent, David A.; Greenhill, Laurence L.; Emslie, Graham; Wells, Karen; Walkup, John T.; Stanley, Barbara; Bukstein, Oscar; Kennard, Betsy D.; Compton, Scott; Coffey, Barbara; Cwik, Mary F.; Posner, Kelly; Wagner, Ann; March, John S.; Riddle, Mark; Goldstein, Tina; Curry, John; Capasso, Lisa; Mayes, Taryn; Shen, Sa; Gugga, S. Sonia; Turner, J. Blake; Barnett, Shannon; Zelazny, Jamie
Objective: To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. Method: Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Children's Depression Rating…
Wolff, Jennifer; Frazier, Elisabeth A.; Esposito-Smythers, Christianne; Burke, Taylor; Sloan, Emma; Spirito, Anthony
Although non-suicidal self-injury (NSSI) and suicide attempts (SA) frequently co-occur among youth, there is increasing evidence that both the risk factors and the phenomenology of the behaviors are distinct. This study examined how individuals who engage in NSSI only, individuals who attempt suicide only, and those who have histories of both NSSI and at least one suicide attempt may differ in terms of cognitions and perceived social support. Participants were 185 adolescents (78.1% female) between the ages of 13 and 18 recruited from a psychiatric inpatient facility in the northeastern United States. One hundred forty-eight teens were identified with a history of self-injurious behavior and divided into three groups: NSSI only (n=45), SA only (n=24) or both NSSI and SA (NSSI+SA; n=79). Analyses showed that the NSSI+SA group exhibited more cognitive errors, negative self-statements, and negative views of self, world, and future, as well as less perceived familial support than either the NSSI or SA only groups. There were no differences between groups on perceived support from teachers or peers. No significant demographic or diagnostic differences were found between the NSSI and SA groups. Limitations and clinical implications of the current research are discussed. PMID:23588400
Wolff, Jennifer; Frazier, Elisabeth A; Esposito-Smythers, Christianne; Burke, Taylor; Sloan, Emma; Spirito, Anthony
Although non-suicidal self-injury (NSSI) and suicide attempts (SA) frequently co-occur among youth, there is increasing evidence that both the risk factors and the phenomenology of the behaviors are distinct. This study examined how individuals who engage in NSSI only, individuals who attempt suicide only, and those who have histories of both NSSI and at least one suicide attempt may differ in terms of cognitions and perceived social support. Participants were 185 adolescents (78.1 % female) between the ages of 13 and 18 recruited from a psychiatric inpatient facility in the northeastern United States. One hundred forty-eight teens were identified with a history of self-injurious behavior and divided into three groups: NSSI only (n = 45), SA only (n = 24) or both NSSI and SA (NSSI+SA; n = 79). Analyses showed that the NSSI+SA group exhibited more cognitive errors, negative self-statements, and negative views of self, world, and future, as well as less perceived familial support than either the NSSI or SA only groups. There were no differences between groups on perceived support from teachers or peers. No significant demographic or diagnostic differences were found between the NSSI and SA groups. Limitations and clinical implications of the current research are discussed.
Chang, B P; Franklin, J C; Ribeiro, J D; Fox, K R; Bentley, K H; Kleiman, E M; Nock, M K
Prior studies have proposed a wide range of potential biological risk factors for future suicidal behaviors. Although strong evidence exists for biological correlates of suicidal behaviors, it remains unclear if these correlates are also risk factors for suicidal behaviors. We performed a meta-analysis to integrate the existing literature on biological risk factors for suicidal behaviors and to determine their statistical significance. We conducted a systematic search of PubMed, PsycInfo and Google Scholar for studies that used a biological factor to predict either suicide attempt or death by suicide. Inclusion criteria included studies with at least one longitudinal analysis using a biological factor to predict either of these outcomes in any population through 2015. From an initial screen of 2541 studies we identified 94 cases. Random effects models were used for both meta-analyses and meta-regression. The combined effect of biological factors produced statistically significant but relatively weak prediction of suicide attempts (weighted mean odds ratio (wOR)=1.41; CI: 1.09–1.81) and suicide death (wOR=1.28; CI: 1.13–1.45). After accounting for publication bias, prediction was nonsignificant for both suicide attempts and suicide death. Only two factors remained significant after accounting for publication bias—cytokines (wOR=2.87; CI: 1.40–5.93) and low levels of fish oil nutrients (wOR=1.09; CI: 1.01–1.19). Our meta-analysis revealed that currently known biological factors are weak predictors of future suicidal behaviors. This conclusion should be interpreted within the context of the limitations of the existing literature, including long follow-up intervals and a lack of tests of interactions with other risk factors. Future studies addressing these limitations may more effectively test for potential biological risk factors. PMID:27622931
Holt, Melissa K.; Vivolo-Kantor, Alana M.; Polanin, Joshua R.; Holland, Kristin M.; DeGue, Sarah; Matjasko, Jennifer L.; Wolfe, Misty; Reid, Gerald
BACKGROUND AND OBJECTIVES Over the last decade there has been increased attention to the association between bullying involvement (as a victim, perpetrator, or bully-victim) and suicidal ideation/behaviors. We conducted a meta-analysis to estimate the association between bullying involvement and suicidal ideation and behaviors. METHODS We searched multiple online databases and reviewed reference sections of articles derived from searches to identify cross-sectional studies published through July 2013. Using search terms associated with bullying, suicide, and youth, 47 studies (38.3% from the United States, 61.7% in non-US samples) met inclusion criteria. Seven observers independently coded studies and met in pairs to reach consensus. RESULTS Six different meta-analyses were conducted by using 3 predictors (bullying victimization, bullying perpetration, and bully/victim status) and 2 outcomes (suicidal ideation and suicidal behaviors). A total of 280 effect sizes were extracted and multilevel, random effects meta-analyses were performed. Results indicated that each of the predictors were associated with risk for suicidal ideation and behavior (range, 2.12 [95% confidence interval (CI), 1.67–2.69] to 4.02 [95% CI, 2.39–6.76]). Significant heterogeneity remained across each analysis. The bullying perpetration and suicidal behavior effect sizes were moderated by the study’s country of origin; the bully/victim status and suicidal ideation results were moderated by bullying assessment method. CONCLUSIONS Findings demonstrated that involvement in bullying in any capacity is associated with suicidal ideation and behavior. Future research should address mental health implications of bullying involvement to prevent suicidal ideation/behavior. PMID:25560447
Brent, David; Emslie, Graham; Clarke, Greg; Asarnow, Joan Rosenbaum; Spirito, Anthony; Ritz, Louise; Vitiello, Benedetto; Iyengar, Satish; Birmaher, Boris; Ryan, Neal; Zelazny, Jamie; Onorato, Matthew; Kennard, Betsy; Mayes, Taryn; DeBar, Lynn; McCracken, James; Strober, Michael; Suddath, Robert; Leonard, Henrietta; Porta, Giovanna; Keller, Marty
Objective The authors sought to identify predictors of self-harm adverse events in treatment-resistant, depressed adolescents during the first 12 weeks of treatment. Method Depressed adolescents (N=334) who had not responded to a previous trial with an SSRI antidepressant were randomized to a switch to either another SSRI or venlafaxine, with or without cognitive behavior therapy. Self-harm events, i.e., suicidal and non-suicidal self-injury adverse events were assessed by spontaneous report for the first 181 participants, and by systematic weekly assessment for the last 153 participants. Results Higher rates of suicidal (20.8% vs. 8.8%) and nonsuicidal self-injury (17.6% vs. 2.2%), but not serious adverse events (8.4% vs. 7.3%) were detected with systematic monitoring. Median time to a suicidal event was 3 weeks, predicted by high baseline suicidal ideation, family conflict, and drug and alcohol use. Median time to nonsuicidal self-injury was 2 weeks, predicted by previous history of nonsuicidal self-injury. While there were no main effects of treatment, venlafaxine treatment was associated with a higher rate of self-harm adverse events in those with higher suicidal ideation. Adjunctive use of benzodiazepines, while in a small number of participants (N=10) was associated with higher rate of both suicidal and nonsuicidal self-injury adverse events. Conclusions Since predictors of suicidal adverse events also predict poor response to treatment, and many of these events occurred early in treatment, improving the speed of response to depression, by targeting of family conflict, suicidal ideation, and drug use may help to reduce their incidence. The relationship of venlafaxine and of benzodiazepines to selfharm events requires further study and clinical caution. PMID:19223438
Currier, Dianne; Mann, J. John
Suicidal behavior is in part heritable. Studies seeking the responsible candidate genes have examined genes involved in neurotransmitter systems demonstrated to have altered function in suicide and attempted suicide. These neurotransmitter systems include the serotonergic, noradrenergic and dopaminergic systems and the HPA axis. With some exceptions, most notably the serotonin transporter promotor HTTLPR polymorphism, replication of candidate gene association studies findings has proven difficult. This chapter reviews what is known of specific gene effects and gene-environment interactions that influence risk for suicidal behavior. Effects of childhood stress on development and how that influences adult responses to current stress will be shown to be relevant for mood disorders, aggressive/impulsive traits and suicidal behavior. PMID:18439448
Pompili, Maurizio; Dwivedi, Yogesh; Girardi, Paolo
There is a growing evidence that neuropeptides may be involved in the pathophysiology of suicidal behavior. A critical review of the literature was conducted to investigate the association between neuropeptides and suicidal behavior. Only articles from peer-reviewed journals were selected for the inclusion in the present review. Twenty-six articles were assessed for eligibility but only 22 studies were included. Most studies have documented an association between suicidality and some neuropeptides such as corticotropin-releasing factor (CRF), VGF, cholecystokinin, substance P, and neuropeptide Y (NPY), which have been demonstrated to act as key neuromodulators of emotional processing. Significant differences in neuropeptides levels have been found in those who have attempted or completed suicide compared with healthy controls or those dying from other causes. Despite cross-sectional associations between neuropeptides levels and suicidal behavior, causality may not be inferred. The implications of the mentioned studies were discussed in this review paper. PMID:23986909
Background Non-suicidal self-injury (NSSI) is a common concern among hospitalized adolescents, and can have significant implications for short and long-term prognosis. Little research has been devoted on how personality features in severely ill adolescents interact with NSSI and "attitude toward life and death" as a dimension of suicidality. Developing more specific assessment methodologies for adolescents who engage in self-harm without suicidal intent is relevant given the recent proposal of a non-suicidal self-injury (NSSI) disorder and may be useful in predicting risk in psychiatrically impaired subjects. Methods Consecutively hospitalized adolescents in a psychiatric unit (N = 52; 71% females; age 12-19 years), reporting at least one recent episode of self-harm according to the Deliberate Self-harm Inventory, were administered the Structured Clinical Interview for DSM Mental Disorders and Personality Disorders (SCID I and II), the Children's Depression Inventory and the Multi-Attitude Suicide Tendency Scale (MAST). Results Mean age onset of NSSI in the sample was 12.3 years. All patients showed "repetitive" NSSI (high frequency of self-harm), covering different modalities. Results revealed that 63.5% of adolescents met criteria for Borderline Personality Disorder (BPD) and that the rest of the sample also met criteria for personality disorders with dysregulated traits. History of suicide attempts was present in 46.1% of cases. Elevated depressive traits were found in 53.8%. Results show a statistically significant negative correlation between the score on the "Attraction to Life" subscale of the MAST and the frequency and diversification of self-harming behaviors. Conclusions Most adolescent inpatients with NSSI met criteria for emotionally dysregulated personality disorders, and showed a reduced "attraction to life" disposition and significant depressive symptoms. This peculiar psychopathological configuration must be addressed in the treatment of adolescent
Struve, Frederick A.
Shows that EEGs (electroencephalography) can be used to help screen for the presence of covert disease that may produce psychiatric depressive symptomatology, as well as to denote cerebral dysrhythmias that may directly influence suicidal behavior. The clinical EEG cannot effectively predict suicide attempt risk, nor can it reasonably guide…
Cha, Christine B.; Nock, Matthew K.
Emotional intelligence is found to be a protective factor for suicidal behavior after examining the relations between childhood sexual abuse and suicidal ideation and attempts to emotional intelligence. Childhood sexual abuse is found to be a strong predictive of the results.
Lau, Anna S.; Jernewall, Nadine M.; Zane, Nolan; Myers, Hector F.
Medical record abstraction was conducted to identify correlates of suicidal behaviors in a sample of 285 Asian American youths. Acculturation interacted with risk factor of parent-child conflict to predict suicidality. Finding underscores the importance of culture as a context for determining the relevance of stressors for potentiating…
De Leo, Diego; Milner, Allison; Xiangdong, Wang
Current knowledge of suicidal behavior in the Western Pacific region is relatively limited when compared to other areas of the world. This area is characterized by a wide diversity of social, economic, and cultural aspects that do not permit any homogenous reading of suicide phenomena. Data from countries of the region included in this article…
Lloyd-Richardson, Elizabeth E.
While awareness of non-suicidal self-injury (NSSI) appears to be increasing among school counselors, social workers, nurses, and others who work with youth, it remains one of the most difficult behaviors to encounter, with few professionals feeling well equipped to handle these situations. This introductory article aims to define NSSI, describe…
Award Number: W81XWH-09-1-0722 TITLE: High Risk Suicidal Behavior in Veterans- Assessment of Predictors and Efficacy of Dialectical Behavioral ...first project is a randomized clinical trial of 120 veterans identified with high-risk suicidal behavior comparing the efficacy of Dialectical... Behavioral Therapy (DBT) vs. treatment as usual (TAU) on suicidal behavior as a primary outcome measure. A second aim of the project is to examine group
Muehlenkamp, Jennifer J; Brausch, Amy M
Attitudes towards the body have been largely overlooked as a potential risk factor for adolescent non-suicidal self-injury (NSSI) despite theorizing that a negative body image may play a critical role in the development of this behavior. The current study used structural equation modeling to evaluate the fit of a theoretical model specifying body image as a mediator between negative affect and NSSI in a combined clinical and non-clinical sample of 284 adolescents. The data supported the model, accounted for 21.6% of the variance in NSSI, and body image significantly mediated the relationship between negative affect and NSSI. These findings provide essential preliminary evidence that body image may represent a necessary but not sufficient risk factor for NSSI in adolescents and that treatment for NSSI should consider targeting body-related pathology in addition to emotion regulation. The findings also support including body image within developing etiological models of NSSI.
Wilson, Michael L.; Dunlavy, Andrea C.; Viswanathan, Bharathi; Bovet, Pascal
We investigated correlates for suicidal expression among adolescents in the Seychelles. Data on 1,432 students (52% females) were derived from the Global School-based Health Survey. Participants were divided into three groups: those with no suicidal behavior (N = 1,199); those with suicide ideation/SI (N = 89); and those reporting SI with a plan to carry out a suicide attempt/SISP (N = 139), each within a 12-month recall period. Using multinomial logistic regression, we examined the strength of associations with social, behavioral and economic indicators while adjusting for covariates. Sixteen percent of school-attending adolescents reported a suicidal expression (10% with a plan/6.2% without). Those reporting SI were younger (relative risk ratio RRR = 0.81; CI = 0.68–0.96), indicated signs of depression (RRR = 1.69; CI = 1.05–2.72) and loneliness (RRR=3.36; CI =1.93–5.84). Tobacco use (RRR = 2.34; CI = 1.32–4.12) and not having close friends (RRR = 3.32; CI = 1.54–7.15) were significantly associated with SI. Those with SISP were more likely to be female (RRR = 0.47; 0.30–0.74), anxious (RRR = 3.04; CI = 1.89–4.88) and lonely (RRR = 1.74; CI = 1.07–2.84). Having no close friends (RRR = 2.98; 1.56–5.69) and using tobacco (RRR = 2.41; 1.48–3.91) were also strongly associated. Having parents who were understanding was protective (RRR = 0.50; CI = 0.31–0.82). Our results suggest that school health promotion programs may benefit from targeting multiple factors associated with suicidal expression. More research, particularly multilevel designs are needed to identify peer and family influences which may modify associations with suicidality. PMID:23202835
Chou, Wen-Jiun; Liu, Tai-Ling; Hu, Huei-Fan; Yen, Cheng-Fang
The aim of this study was to examine the prevalence rates of suicidal intent and its correlates among adolescents diagnosed with ADHD in Taiwan. A total of 287 adolescents aged 11-18 years and diagnosed with ADHD participated in this study. Their suicidal ideation and suicide attempts were assessed. Logistic regression analysis was used to examine the associations of suicide with individual, family, peer, ADHD, and psychopathology factors. A total of 12.2% of the participants reported suicidal ideation or a suicide attempt. A logistic regression analysis model showed that adolescents who were older, were bullying perpetrators, and reported high depression level were more likely to have suicidal intent. These three factors were also significantly correlated with suicidal ideation; however, only having high depression level was significantly correlated with suicidal attempts. The results of this study showed that a high proportion of adolescents with ADHD reported suicidal ideation or a suicide attempt. Multiple factors were significantly associated with suicidal intent among adolescents with ADHD. Clinicians, educational professionals, and parents of adolescents with ADHD should monitor the possibility of suicide in adolescents with ADHD who exhibit the correlates of suicidal intent identified in this study.
Plener, Paul L; Kapusta, Nestor D; Brunner, Romuald; Kaess, Michael
Non-Suicidal Self-Injury (NSSI) and Suicidal Behavior Disorder (SBD) were included as diagnostic categories in Section 3 of the 5th edition of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association (APA). Thus, these diagnostic entities were not recognized as formal clinical diagnoses, but rather for the first time clearly defined in a classificatory system to standardize further research in this field. This paper introduces both concepts and addresses the discussion about NSSI and suicidal behavior disorder based on a selective review of the literature. First studies using the new definitions are introduced. In Germany the prevalence of NSSI is estimated to lie at about 4 %, of SBD at about 9 %. It can be expected that in the future the new definitions will lead to a better comparability of study outcomes with regards to NSSI and suicidal behavior disorder.
Koyawala, Neel; Stevens, Jack; McBee-Strayer, Sandra M; Cannon, Elizabeth A; Bridge, Jeffrey A
This study used a case-control design to compare sleep disturbances in 40 adolescents who attempted suicide with 40 never-suicidal adolescents. Using hierarchical logistic regression analyses, we found that self-reported nighttime awakenings were significantly associated with attempted suicide, after controlling for antidepressant use, antipsychotic use, affective problems, and being bullied. In a separate regression analysis, the parent-reported total sleep problems score also predicted suicide attempt status, controlling for key covariates. No associations were found between suicide attempts and other distinct sleep problems, including falling asleep at bedtime, sleeping a lot during the day, trouble waking up in the morning, sleep duration, and parent-reported nightmares. Clinicians should be aware of sleep problems as potential risk factors for suicide attempts for adolescents.
Neuner, Tanja; Hubner-Liebermann, Bettina; Hausner, Helmut; Hajak, Goran; Wolfersdorf, Manfred; Spiessl, Hermann
Our study investigated the association of aggression and suicidal behavior in schizophrenic inpatients. Eight thousand nine hundred one admissions for schizophrenia (1998-2007) to a psychiatric university hospital were included. Schizophrenic suicides (n = 7)/suicide attempters (n = 40) were compared to suicides (n = 30)/suicide attempters (n =…
Dobry, Yuriy; Braquehais, María Dolores; Sher, Leo
Bullying is a highly prevalent behavior which carries a significant social, medical and financial cost for its victims and perpetrators, with powerful and long-lasting psychological and social impact. Bullying has been defined as a specific form of intentional, repeated aggression, that involves a disparity of power between the victim(s) and perpetrator(s). The aggression can take physical, verbal or gestural forms. The behavior of bullying crosses sociodemographic categories of age, gender, ethnicity, level of academic achievement and professional environment. It has been abundantly observed by teachers and parents in elementary schools, but has also shown its negative presence in corporate boardrooms. The direct outcome of bullying, for both victims and perpetrators, is an increased risk of psychiatric disorders including depression, post-traumatic stress disorder, anxiety disorders, substance abuse and suicidal behavior. Cruelty (and bullying, as one of its manifestations) breaks the basis of morality. Mental health professionals usually treat the victims of those actions unfortunately long after they have been exposed to the harm. The evidence does not support the idea that the majority of cruel actions are intrinsically "pathological", in the sense of being motivated by "mental disorders". Therefore, only moral rules and legal actions - but not psychiatric or psychological interventions - may dissuade humans from this form of cruelty.
de Assis, Simone Gonçalves; Gomes, Romeu; Pires, Thiago de Oliveira
OBJECTIVE To analyze the relationships between sexual behavior and risk factors to physical and mental health in adolescents. METHODS Study of 3,195 pupils aged 15 to 19 in secondary education, in public and private schools in 10 state capitals in Brazil between 2007 and 2008. Multi-stage (schools and pupils) cluster sampling was used in each city and public and private educational network. All of the students selected completed a questionnaire on the following items: socioeconomic and demographic data; sexual behavior; having sex with those of the same sex, the opposite sex, or both; alcohol and cannabis use; using condoms; traumatic sexual experiences as a child or adolescent; suicidal thoughts. The analysis included describing frequencies, Chi-square test, analysis of multiple and cluster correspondence. Responses to an open ended question in which the adolescent expressed general comments about themselves and their lives were qualitatively analyzed using content analysis. RESULTS Around 3.0% of adolescents reported homosexual or bisexual behavior, with no difference according to sex, age, skin color, social status family structure or educational network. Adolescents with homosexual/bisexual sexual behavior, compared to their heterosexual peers, reported: (p < 0.05): getting drunk (18.7% and 10.5%, respectively), frequent cannabis use (6.1% and 2.1%, respectively), suicidal thoughts (42.5% and 18.7%, respectively), and having been the victim of sexual violence (11.7% and 1.5%; respectively). Adolescents with homosexual/bisexual sexual behavior reported that they used condoms less frequently (74.2%) than their heterosexual peers (48.6%, p < 0.001). In the correspondence analysis, three groups were found, one composed of adolescents with homosexual/bisexual behavior and experiencing risk factors; suffering sexual violence, never using a condom, suicidal thoughts, frequent cannabis use; another composed of occasional cannabis and condom users, who got drunk
Coleman, Casey; Wileyto, E. Paul; Lenhart, Clare M.; Patterson, Freda
Background: Chronic disease risk factors tend to cooccur. Purpose: This study examined the cooccurrence of 8 negative health behaviors in a representative sample of urban adolescents to inform educational interventions. Methods: The prevalence, cooccurrence, and clustering of suicide attempt, lifetime history of sexual activity, tobacco use, cell…
O'Connor, Daryl B; Ferguson, Eamonn; Green, Jessica A; O'Carroll, Ronan E; O'Connor, Rory C
Suicide is a major cause of death worldwide, responsible for 1.5% of all mortality. The causes of suicidal behavior are not fully understood. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, is one potential risk factor. This meta-analytic review aimed (i) to estimate the strength and variability of the association between naturally fluctuating cortisol levels and suicidal behavior and (ii) to identify moderators of this relationship. A systematic literature search identified 27 studies (N=2226; 779 suicide attempters and 1447 non-attempters) that met the study eligibility criteria from a total of 417 unique records initially examined. Estimates of effect sizes (r) obtained from these studies were analysed using Comprehensive Meta-Analysis. In these analyses, we compared participants identified as having a past history of suicide attempt(s) to those with no such history. Study quality, mean age of sample and percentage of male participants were examined as potential moderators. Overall, there was no significant effect of suicide group on cortisol. However, significant associations between cortisol and suicide attempts were observed as a function of age. In studies where the mean age of the sample was below 40 years the association was positive (i.e., higher cortisol was associated with suicide attempts; r=.234, p<.001), and where the mean age was 40 or above the association was negative (i.e., lower cortisol was associated with suicide attempts; r=-.129, p<.001). These findings confirm that HPA axis activity, as indicated by age-dependent variations in cortisol levels, is associated with suicidal behavior. The challenge for theory and clinical practice is to explain the complete reversal of the association with age and to identify its clinical implications.
Lubin, Gad; Werbeloff, Nomi; Halperin, Demian; Shmushkevitch, Mordechai; Weiser, Mark; Knobler, Haim Y.
The use of firearms is a common means of suicide. We examined the effect of a policy change in the Israeli Defense Forces reducing adolescents' access to firearms on rates of suicide. Following the policy change, suicide rates decreased significantly by 40%. Most of this decrease was due to decrease in suicide using firearms over the weekend.…
King, Jessica D; Horton, Sarah E; Hughes, Jennifer L; Eaddy, Michael; Kennard, Betsy D; Emslie, Graham J; Stewart, Sunita M
This study investigated change in suicide risk in the framework of the interpersonal theory of suicide. Fifty-four adolescents completed measures of interpersonal needs, acquired capability, depressive symptoms, and suicide risk at entry and exit from treatment. There was a significant drop following treatment in unmet interpersonal needs but not in acquired capability, consistent with the theory. Both change in the interaction between interpersonal needs and in depressive symptoms contributed unique prediction to change in suicide risk. These findings extend the research in understanding changes in suicide risk and inform treatment by suggesting cognitive targets for intervention.
Greydanus, Donald; Patel, Dilip; Pratt, Helen
Suicide in adolescents is a global tragedy. Research-identified correlates of suicide in youth include depression, academic failure, loss of friends, social isolation, and substance abuse, among others. This review focuses on the potential link between chronic illness in adolescents and increased suicide risk. Research suggests that chronic…
Jones, Heather A; Bilge-Johnson, Sumru; Rabinovitch, Annie E; Fishel, Hazel
The current study investigated relationships among self-reported peer victimization, suicidality, and depression in adolescent psychiatric inpatients. Sixty-seven adolescent psychiatric inpatients at a Midwestern children's hospital completed measures of bullying and peer victimization, suicidal ideation, and depression during their inpatient stay. Analyses indicated significant moderate correlations among victimization, suicidal ideation, and depression in adolescents. Results from mediational analyses found that negative self-esteem mediated the relationship between peer victimization and suicidal ideation. To date, this study is the first to directly examine the mechanisms underlying the relationship between peer victimization and suicidal ideation in adolescent psychiatric inpatients.
Klomek, Anat Brunstein; Kleinman, Marjorie; Altschuler, Elizabeth; Marrocco, Frank; Amakawa, Lia; Gould, Madelyn S
This is the first study to examine the extent to which frequent involvement in high-school bullying (as a bullying perpetrator, victim of bullying, or bully-victim) increases the risk for later depression and suicidality beyond other well-established risk factors of suicide. The study included 96 students who reported being a bully, a victim, or a bully-victim, and also reported depression, suicidality, or substance problems during an initial suicide screen. These students were interviewed 2 years later and were compared with 142 youth identified during the initial screen as "suicide-at-risk" by virtue of their depression, suicidal ideation, attempts, and substance problems, but who did not report any involvement in bullying behavior. Students who reported both bullying others and other suicide-related behaviors at baseline had higher suicide ideation and were more functionally impaired at follow-up than students who reported suicide-related behaviors but were not involved in bullying. Preventive efforts in high school should target those children who are characterized by both psychological disturbance and bullying, especially the frequent bullies.
Mirkovic, Bojan; Labelle, Réal; Guilé, Jean-Marc; Belloncle, Vincent; Bodeau, Nicolas; Knafo, Alexandra; Condat, Agnès; Bapt-Cazalets, Nathalie; Marguet, Christophe; Breton, Jean-Jacques; Cohen, David; Gérardin, Priscille
Objectives: A multisite study was undertaken to advance our understanding of how coping skills, depression, and suicidal ideation are related among adolescents who attempt suicide. Two hypotheses were postulated: productive coping and nonproductive coping would be associated, respectively, with lower and higher depression scores when age, sex, and stressful life events (SLEs) were controlled; and productive coping and nonproductive coping would be associated, respectively, with the presence and absence of suicidal ideation when age, sex, and SLEs were controlled. Methods: Participants were 167 adolescents (13 to 17 years of age) hospitalized for attempting suicide in 5 pediatric departments across France. Four instruments were administered: the Kiddie Schedule for Affective Disorders and Schizophrenia—Present and Lifetime Version, the Adolescent Coping Scale, the Life Events Questionnaire, and the Columbia-Suicide Severity Rating Scale. Descriptive analyses and univariate and multiple regression models were completed. Results: Both hypotheses were confirmed. Focus on the positive emerged as a significant variable in both models; depression emerged as a significant variable in the suicidal ideation model. The only sex difference observed was that girls made greater use of wishful thinking and seek social support. Conclusions: These findings suggest that coping skills are important mechanisms through which depression and suicidal ideation are maintained after attempting suicide. In intervening with adolescents who have attempted suicide, it may be useful to emphasize cognitive work geared to looking on the bright side, positive thinking, and fighting depression. PMID:25886670
Kasckow, John; Montross, Lori; Prunty, Laurie; Fox, Lauren; Zisook, Sidney
Little is known about treating elderly suicidal patients with schizophrenia. The purpose of this article is to review the literature dealing with this population and to discuss what is required to advance this field. Most available studies from middle-aged and older individuals suggest that risk factors include hopelessness, lower quality of life, past traumatic events, depressive symptoms, lifetime suicidal ideation and past attempts; it is not clear whether these findings are generalizable to geriatric populations. Although little treatment research has been performed in older suicidal patients with schizophrenia, an integrated psychosocial and pharmacologic approach is recommended. In addition, one recent study augmented antipsychotic treatment with an SSRI (i.e., citalopram) in a sample of middle-aged and older individuals with schizophrenia with subsyndromal depression; in that study, serotonin selective reuptake inhibitor augmentation reduced depressive symptoms and suicidal ideation. More research is required to better understand suicidal behavior in older patients with schizophrenia. PMID:22028735
Objective: Although suicidal behavior is a major public health concern, understanding of individually sensitive suicide risk mechanisms is limited. In this study, the authors investigated, for the first time, the utility of defeat and entrapment in predicting repeat suicidal behavior in a sample of suicide attempters. Method: Seventy patients hospitalized after a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, defeat, and entrapment) while in hospital. Four years later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. Results: Over 4 years, 24.6% of linked participants were readmitted to hospital after a suicidal attempt. In univariate logistic regression analyses, defeat and entrapment as well as depression, hopelessness, past suicide attempts, and suicidal ideation all predicted suicidal behavior over this interval. However, in the multivariate analysis, entrapment and past frequency of suicide attempts were the only significant predictors of suicidal behavior. Conclusions: This longitudinal study supports the utility of a new theoretical model in the prediction of suicidal behavior. Individually sensitive suicide risk processes like entrapment could usefully be targeted in treatment interventions to reduce the risk of repeat suicidal behavior in those who have been previously hospitalized after a suicide attempt. PMID:23855989
Ran, Mao-Sheng; Wu, Qiu-Hua; Conwell, Yeates; Chen, Eric Yu-Hai; Chan, Cecilia Lai-Wan
This study evaluated the characteristics of suicidal behavior (suicide attempt or suicidal ideation) among 230 consecutively admitted inpatients with schizophrenia and mood disorders in a university hospital in China. The rate of lifetime suicidal behavior was found to be significantly higher in patients with mood disorders (62.4%) than in…
He, Amy S; Fulginiti, Anthony; Finno-Velasquez, Megan
Using data from the National Survey of Child and Adolescent Well-Being, this study examined the relationship between connectedness in major social domains (i.e., caregiver, peers, deviant peers, and school) and suicidal ideation among adolescents (11-17 years old) investigated by child welfare agencies (N=995). Weighted logistic regression models were used to evaluate the relationships between connectedness variables and suicidal ideation, after adjusting for covariates. Youths with a stronger connection to caregivers were much less likely to report suicidal ideation, whereas youths with stronger deviant peer relationships were significantly more likely to report suicidal ideation. Significant associations found between primary caregiver and deviant peer connectedness and suicidal ideation highlight the need for attentive consideration of these relationships when working with this highly vulnerable population. Identifying domain-specific connectedness factors related to suicidal ideation presents an opportunity for the development of targeted early intervention for child welfare-involved youths.
Current suicide prevention strategies often include suicide education based on the premise that education can lead to recognition of those at risk of suicide and others who are prepared can respond and potentially save lives. As suicide is a leading cause of death for young people, it is relevant to explore how suicide education is made available…
Tarrier, Nicholas; Taylor, Katherine; Gooding, Patricia
Suicide behavior is a serious clinical problem worldwide, and understanding ways of reducing it is a priority. A systematic review and meta-analysis were carried out to investigate whether Cognitive-behavioral therapies (CBTs) would reduce suicide behavior. From 123 potential articles, 28 studies met the entry criteria. Overall, there was a highly…
Family Rejection, Social Isolation, and Loneliness as Predictors of Negative Health Outcomes (Depression, Suicidal Ideation, and Sexual Risk Behavior) among Thai Male-to-Female Transgender Adolescents
Yadegarfard, Mohammadrasool; Meinhold-Bergmann, Mallika E.; Ho, Robert
This study examined the influence of family rejection, social isolation, and loneliness on negative health outcomes among Thai male-to-female transgender adolescents. The sample consisted of 260 male respondents, of whom 129 (49.6%) were self-identified as transgender and 131 (50.4%) were self-identified as cisgender (nontransgender). Initial…
Groholt, Berit; Ekeberg, Oivind; Wichstrom, Lars; Haldorsen, Tor
Analyzes all residents in Norway, ages 19 and younger, who committed suicide from 1990 to 1992 so as to describe characteristics of young suicide victims. Results indicate that depression, disruption disorders, and previous suicidal behavior were main risk factors for suicide. Of the group, 74% had mental disorders, but few had received treatment.…
Reflects the author's experiences as a suicide prevention counselor at a Japanese university. Discusses the rising rate of adolescent suicide and its relationship to social change and family structure. Concludes that adolescent suicide is a silent indictment of current society in Japan. (JAC)
Lyons-Ruth, Karlen; Bureau, Jean-Francois; Holmes, Bjarne; Easterbrooks, Ann; Brooks, Nancy Hall
The primary objective was to assess whether prospectively observed quality of parent-child interaction in infancy and middle childhood contributed to the prediction of borderline symptoms and recurrent suicidality/self-injury in late adolescence. Adolescents (mean 19.9 years) from 56 families participating in a longitudinal study since infancy (retention rate 74%) were assessed on the SCID-II for symptoms of borderline personality disorder, including suicidality/self-injury. Early clinical risk was indexed by clinical referral to parent-infant services. Attachment security and parent-child interaction were assessed from videotape at 18 months and 8 years. Severity of childhood abuse was rated from interview and self-report measures. Maternal withdrawal in infancy was a significant predictor of both borderline symptoms and suicidality/self-injury in late adolescence. Disorganizedcontrolling child behavior at age 8 contributed independently to the prediction of borderline symptoms. The effect of maternal withdrawal was independent of, and additive to, variability explained by severity of childhood abuse. Borderline symptoms and suicidality/self-injury may be preceded developmentally by disturbed interactions as early as 18 months of age. A parent-child transactional model is proposed to account for the findings. PMID:23123044
Stewart, Jeremy G.; Kim, Judy C.; Esposito, Erika C.; Gold, Joseph; Nock, Matthew K.; Auerbach, Randy P.
Background Suicide is the second leading cause of death among adolescents, and depressed youth are six times more likely to make suicide attempts as compared to non-depressed adolescents. The present study examined the unique and interactive effects of two well-established correlates of suicidality – childhood sexual abuse (CSA) and disinhibition – in predicting suicide attempts among depressed adolescents. Method Participants were 163 adolescents (125 females) aged 13 to 18 (M = 15.60, SD = 1.27) diagnosed with Major Depressive Disorder (n = 95, 58.3%) and/or Dysthymia (n = 69, 42.3%) recruited from an acute residential treatment service. Participants completed interviews assessing psychopathology and suicidality, self-report measures of depressive symptoms and CSA, and a computerized disinhibition task. Results Consistent with hypotheses, CSA moderated the association between disinhibition and adolescents' report of their past year and lifetime suicide attempts. Specifically, higher disinhibition was associated with a greater likelihood of having made a suicide attempt among adolescents with a history of CSA, but not among those without. The same pattern of results held in analyses of suicide attempt frequency. Limitations Primary findings were based on observational, cross-sectional data, and therefore, causal relationships cannot be inferred. The gender imbalance in the sample precluded stratifying our analyses by gender. CSA was ascertained by self-report; replication of the results with more objective measures is warranted. Conclusions Our findings indicate that CSA and disinhibition may work together to predict elevated suicide risk, and these results have implications for early identification efforts in youth at high risk for suicide. PMID:26318268
One of the most persistent findings in the literature on suicidal behavior in adolescence is its association with the characteristics of the adolescent's family. Although empirical work clearly indicates that the family is a critical variable to consider in the study of teenage suicidal behavior, it is less clear how particular family features…
Martin, Graham; Bergen, Helen A.; Richardson, Angela S.; Roeger, Leigh; Allison, Stephen
Objective: A cross-sectional study of gender specific relationships between self-reported child sexual abuse and suicidality in a community sample of adolescents. Method: Students aged 14 years on average (N=2,485) from 27 schools in South Australia completed a questionnaire including items on sexual abuse and suicidality, and measures of…
Pace, Ugo; Zappulla, Carla
We examined the relations between depression, emotional autonomy quality-related constructs of separation and detachment, and suicidal ideation, focusing on the unique and common contribution that depression, separation and detachment made to suicidal ideation. We also examined gender differences. 403 adolescents, 196 boys and 207 girls, completed…
Babow, Irving; Rowe, Robin
In study of hospitalized suicidal youth, account of 16-year-old girl, diagnosed as schizophrenic, is analyzed to gain insight into family's role in suicidal career of adolescent preoccupied with death and dying, sleep, and drugs; the interplay of her construction of reality with her risk-taking, self-injurious way of life; and her perceived…
The present study explores the life history of a South Korean adolescent girl who attempted suicide. The study focuses on how sociocultural values affected her suicide attempt and how she made meaning out of the experience. The results revealed that her life history was a process of seeking independence and autonomy, and freeing herself from…
Wild, Lauren G.; Flisher, Alan J.; Lombard, Carl
This study aimed to disentangle the influence of depression and self-esteem on suicidal behaviour in adolescence. Grades 8 and 11 students in Cape Town, South Africa (n=939) completed questionnaires assessing suicidal ideation and behaviour, depression, and self-esteem with respect to family, peers, school, sports/athletics, body image and global…
Portzky, Gwendolyn; Audenaert, Kurt; van Heeringen, Kees
This study aimed at the investigation of psychosocial and psychiatric risk factors of adolescent suicide by means of a case-control psychological autopsy study. Relatives and other informants of 19 suicide victims and 19 matched psychiatric controls were interviewed by means of a semi-structured interview schedule. Psychiatric controls included…
This qualitative inquiry, phenomenology, purported to provide insight into the role of parental suicide on the adolescent survivors' adult lives between 18 and 40. This study described the survivors' coping strategies, self-esteem, and effects of their grief and bereavement as a result of parental suicide on their emotional wellness or…
Portes, Pedro R.; Sandhu, Daya S.; Longwell-Grice, Robert
Using Erikson's theories on identity development as a framework, this paper examines the motives for and contexts of suicide among preadolescents, adolescents, and young adults, identifies specific school-age populations that are vulnerable to suicide, and discusses implications. (Contains 45 references.) (GCP)
Hill, Ryan M.; Pettit, Jeremy W.; Green, Kelly L.; Morgan, Sharon T.; Schatte, Dawnelle J.
Factors distinguishing adolescents who experienced a precipitating event in the week preceding a suicidal crisis from those who did not were examined. Among 130 suicidal inpatients (mean age = 15.01 years), those who experienced a precipitating event reported significantly lower depressive symptom scores, better perceived problem solving, less…
Cho, Yong-Beom; Haslam, Nick
Acculturative stress and social support play important roles in suicide-related phenomena among adolescent immigrants. To examine their contributions, measures of acculturative and general life stress and a measure of multiple sources of social support were used to predict psychological distress and suicidal ideation among Korean-born high school…
Huff, Cynthia O.
Seeks to identify the factors related to stress that predict suicide ideation among adolescents. Results reveal that recency and degree of stress were significant in the prediction of degree and recency of suicide ideation. Implications of findings for prevention and intervention are discussed. (Author/GCP)
Apsche, Jack A.; Siv, Alexander M.
This case study presents a case study of the effectiveness of Mode deactivation therapy (MDT) (Apsche, Bass, Jennings, Murphy, Hunter, and Siv, 2005) with an adolescent male, with reactive conduct disorder, PTSD and 8 lethal suicide attempts. The youngster was hospitalized four times for suicide attempts, three previous placements in residential…
Bhatta, Madhav P.; Shakya, Sunita; Jefferis, Eric
Background: This study examined the association of ever being bullied in school with suicide ideation (ever thinking about killing oneself) and ever seriously making a plan to kill oneself (suicide planning) among rural middle school adolescents. Methods: Using the US Centers for Disease Control and Prevention's Middle School Youth Risk Behavior…
White, George L.; And Others
Developed pilot instrument to examine differences between adolescents who have attempted suicide and others. An 86-item questionnaire was administered to 25 suicide attempters and 57 nonsuicide attempters. Found significant differences for each of 3 domains (family environment, social environment, self-perceptions) and for 55 questions. Used…
Vermont State Dept. of Education, Montpelier.
This report was written as part of an attempt by the state of Vermont to significantly decrease the number of adolescents involved in self-destructive and suicidal behaviors. It focuses on schools as a starting point to preventing youth suicide in Vermont. The introduction outlines the extent of the problem of adolescent suicide. The remainder of…
Selby, Edward A; Smith, April R; Bulik, Cynthia M; Olmsted, Marion P; Thornton, Laura; McFarlane, Traci L; Berrettini, Wade H; Brandt, Harry A; Crawford, Steve; Fichter, Manfred M; Halmi, Katherine A; Jacoby, Georg E; Johnson, Craig L; Jones, Ian; Kaplan, Allan S; Mitchell, James E; Nutzinger, Detlev O; Strober, Michael; Treasure, Janet; Woodside, D Blake; Kaye, Walter H; Joiner, Thomas E
Anorexia nervosa (AN) is perhaps the most lethal mental disorder, in part due to starvation-related health problems, but especially because of high suicide rates. One potential reason for high suicide rates in AN may be that those affected face pain and provocation on many fronts, which may in turn reduce their fear of pain and thereby increase risk for death by suicide. The purpose of the following studies was to explore whether repetitive exposure to painful and destructive behaviors such as vomiting, laxative use, and non-suicidal self-injury (NSSI) was a mechanism that linked AN-binge-purging (ANBP) subtype, as opposed to AN-restricting subtype (ANR), to extreme suicidal behavior. Study 1 utilized a sample of 787 individuals diagnosed with one or the other subtype of AN, and structural equation modeling results supported provocative behaviors as a mechanism linking ANBP to suicidal behavior. A second, unexpected mechanism emerged linking ANR to suicidal behavior via restricting. Study 2, which used a sample of 249 AN patients, replicated these findings, including the second mechanism linking ANR to suicide attempts. Two potential routes to suicidal behavior in AN appear to have been identified: one route through repetitive experience with provocative behaviors for ANBP, and a second for exposure to pain through the starvation of restricting in ANR.
Selby, Edward A.; Smith, April R.; Bulik, Cynthia M.; Olmsted, Marion P.; Thornton, Laura; McFarlane, Traci L.; Berrettini, Wade H.; Brandt, Harry A.; Crawford, Steve; Fichter, Manfred M.; Halmi, Katherine A.; Jacoby, Georg E.; Johnson, Craig L.; Jones, Ian; Kaplan, Allan S.; Mitchell, James E.; Nutzinger, Detlev O.; Strober, Michael; Treasure, Janet; Woodside, D. Blake; Kaye, Walter H.; Joiner, Thomas E.
Anorexia nervosa (AN) is perhaps the most lethal mental disorder, in part due to starvation-related health problems, but especially because of high suicide rates. One potential reason for high suicide rates in AN may be that those affected face pain and provocation on many fronts, which may in turn reduce their fear of pain and thereby increase risk for death by suicide. The purpose of the following studies was to explore whether repetitive exposure to painful and destructive behaviors such as vomiting, laxative use, and non-suicidal self-injury (NSSI) was a mechanism that linked AN-binge-purging (ANBP) subtype, as opposed to AN-restricting subtype (ANR), to extreme suicidal behavior. Study 1 utilized a sample of 787 individuals diagnosed with one or the other subtype of AN, and structural equation modeling results supported provocative behaviors as a mechanism linking ANBP to suicidal behavior. A second, unexpected mechanism emerged linking ANR to suicidal behavior via restricting. Study 2, which used a sample of 249 AN patients, replicated these findings, including the second mechanism linking ANR to suicide attempts. Two potential routes to suicidal behavior in AN appear to have been identified: one route through repetitive experience with provocative behaviors for ANBP, and a second for exposure to pain through the starvation of restricting in ANR. PMID:20398895
Choi, Kyung-Hwa; Kim, Dong-Hyun
This study aims to quantifiably evaluate the trend of the suicide rate among Korean adolescents from 1997 to 2012 according to urbanity. We used national death certificates and registration population data by administrative district for 15–19 years-old adolescents. The annual percent change (APC) and average annual percent change (AAPC) were estimated by the Joinpoint Regression Program. The suicide rate in the rural areas was higher than that in the urban areas in both genders (males (/100,000), 12.2 vs. 8.5; females (/100,000), 10.2 vs. 7.4 in 2012). However, the trend significantly increased only in the urban area (AAPC [95% CI]: males 2.6 [0.7, 4.6], females 3.3 [1.4, 5.2]). In urban areas, the suicide rate by jumping significantly increased in both genders (AAPC [95% CI]: males, 6.7 [4.3, 9.1]; females, 4.5 [3.0, 6.1]). In rural areas, the rate by self-poisoning significantly decreased by 7.9% per year for males (95% CI: −12.5, −3.0) and the rate by hanging significantly increased by 10.1% per year for females (95% CI: 2.6, 18.2). The trend and methods of suicide differ according to urbanity; therefore, a suicide prevention policy based on urbanity needs to be established for adolescents in Korea. PMID:25985313
Background Suicidal behavior is a leading cause of injury and death worldwide. Several studies have provided a possible relationship between genetic factors and suicidal behavior. Also, these studies have shown evidence for altered serotonergic neural transmission in the pathogenesis of suicidal behavior. In addition, genes pertaining to the serotonergic system have been proposed as candidates to establish biological correlates between suicidal behavior and the serotonergic system. The most studied genes are SCL6A4, HTR2A, HTR2C, HTR1A, HTR1B, TPH-1, and TPH-2. To get a comprehensive understanding of the association with suicidal behavior we will conduct genotype assays studies in a Mexican population. Methods/Design We will conduct a case–control study. The population sample will comprise adolescent and adult patients admitted for attempted of suicide and diagnosed by a psychiatrist. A peripheral blood sample will be taken from all the subjects (cases and controls). Genomic DNA from the leukocytes blood sample will be extracted. The genotypes of interest are distributed in the following genes: SCL6A4, HTR2A, HTR1A, HTR1B, HTR2C, TPH-2 and TPH-1. All the samples will be analyzed using a polymerase chain reaction (PCR) end-point method. We will evaluate the Hardy-Weinberg Equilibrium. The chi-squared test or Fisher’s exact test will be used to compare genotype and allele frequencies between control and case groups. The Quanto 1.2 software will measure the sample size of the association. For all the association analyses the level of significance will be set at p = 0.05 and the confidence interval at 95%. Discussion Suicidal behavior has been increase in Mexico, principally in young population. Our study will demonstrate the association between serotoninergic genes and suicide behavior in Mexican population. PMID:24495559
Daniel, Stephanie S.; Goldston, David B.
Suicidal behavior is developmentally mediated, but the degree to which interventions for suicidal behaviors have been developmentally tailored has varied widely. Published controlled studies of psychosocial treatment interventions for reducing adolescent suicidal behavior are reviewed, with a particular emphasis on the developmental nuances of these interventions. In addition, developmental considerations important in the treatment of suicidal adolescents are discussed. There are insufficient data available from controlled trials to recommend one intervention over another for the treatment of suicidal youth, but interventions that are sensitive to the multiple developmental contexts have potential for greater effectiveness in reducing adolescent suicidal behavior. PMID:19606918
Lee, Seo Yoon; Park, Eun-Cheol; Han, Kyu-Tae; Kim, Seung Ju; Chun, Sung-Youn
Objective: To examine the association between the level of Internet addiction and suicidal ideation and suicide attempts in South Korean adolescents, focusing on the roles of family structure and household economic status. Methods: Data from 221 265 middle and high school students taken from the 2008–2010 Korea Youth Risk Behavior Web-based Survey were used in this study. To identify factors associated with suicidal ideation/attempts, multiple logistic regression analysis was performed. The level of Internet use was measured using the simplified Korean Internet Addiction Self-assessment Tool. Results: Compared with mild users of the Internet, high-risk users and potential-risk users were more likely to report suicidal ideation (nonuser, odds ratio [OR] 1.10, 95% confidence interval [CI] 1.05 to 1.15; potential risk, OR 1.49, 95% CI: 1.36 to 1.63; high risk OR 1.94, 95% CI 1.79 to 2.10) or attempts (nonuser, OR 1.33, 95% CI 1.25 to 1.42; potential risk, OR 1.20, 95% CI 1.04 to 1.38; high risk, OR 1.91, 95% CI 1.71 to 2.14). The nonuser group also had a slightly higher risk of suicidal ideation/attempts compared with mild users. This association appeared to vary by perceived economic status and family structure. Conclusions: Our study suggests that it is important to attend to adolescents who are at high risk for Internet addiction, especially when they do not have parents, have stepparents, or perceive their economic status as either very low or very high. PMID:27254417
Abstract. Background: Worldwide, prisoners are at high risk of suicide. Research on near-lethal suicide attempts can provide important insights into risk and protective factors, and inform suicide prevention initiatives in prison. Aims: To synthesize findings of research on near-lethal attempts in prisons, and consider their implications for suicide prevention policies and practice, in the context of other research in custody and other settings. Method: We searched two bibliographic indexes for studies in any language on near-lethal and severe self-harm in prisoners, supplemented by targeted searches over the period 2000–2014. We extracted information on risk factors descriptively. Data were not meta-analyzed owing to heterogeneity of samples and methods. Results: We identified eight studies reporting associations between prisoner near-lethal attempts and specific factors. The latter included historical, prison-related, and clinical factors, including psychiatric morbidity and comorbidity, trauma, social isolation, and bullying. These factors were also identified as important in prisoners' own accounts of what may have contributed to their attempts (presented in four studies). Conclusion: Factors associated with prisoners' severe suicide attempts include a range of potentially modifiable clinical, psychosocial, and environmental factors. We make recommendations to address these factors in order to improve detection, management, and prevention of suicide risk in prisoners. PMID:27278569
Conejero, Ismael; Lopez-Castroman, Jorge; Giner, Lucas; Baca-Garcia, Enrique
Suicidal behavior and its prevention constitute a major public health issue. Etiology of suicidal behavior is multifactorial. Whereas current research is mostly focused on clinical and biological risk factors, the sociodemographic risk factors for suicidal behavior, first highlighted by Durkheim, have received less attention. Besides the well-known impact of age and gender, sociodemographic variables such as marital and parental status, education, occupation, income, employment status, religion, migration or minority status, and sexual orientation are repeatedly reported to play an important role in suicidal behavior. This narrative review aimed to summarize recent research on sociodemographic risk factors for suicidal behavior and to elicit possible implications for suicide prevention.
Horton, Sarah E; Hughes, Jennifer L; King, Jessica D; Kennard, Betsy D; Westers, Nicholas J; Mayes, Taryn L; Stewart, Sunita M
This study offers a preliminary examination of the Interpersonal-Psychological Theory of Suicide (IPTS; Joiner 2005) in an adolescent clinical sample. The IPTS offers a nuanced framework that has many conceptual and practical merits. Although this theory has a growing base of evidence among adults, it has yet to be tested in adolescents using direct measures of its central constructs. Participants were 147 adolescents (76.2 % girls) on an inpatient psychiatric unit, who completed measures of key IPTS constructs of thwarted belongingness, perceived burdensomeness, acquired capability for suicide, as well as depression severity, hopelessness, and severity of suicidal symptoms. Our findings were largely consistent with hypotheses derived from the IPTS: perceived burdensomeness, and at a marginal level, thwarted belongingness, were independently associated with current suicidal ideation. The thwarted belongingness by perceived burdensomeness interaction marginally distinguished between adolescents with passive and active suicidal ideation. Acquired capability for suicide was associated with recent suicidal intent. Examination of all three IPTS constructs simultaneously revealed main effects of each construct (with a marginal effect of thwarted belongingness), and interaction effects for thwarted belongingness by perceived burdensomeness, and thwarted belongingness by perceived burdensomeness by acquired capability for suicide in association with suicidal symptom severity. Sex, age, depression severity, and hopelessness were controlled in all analyses. This study offers strong, albeit preliminary, support of the IPTS in a clinical adolescent sample. Assessment of IPTS constructs may be useful in determining persistent risk for suicide attempt. Prospective tests of the theory, and extensions to intervention and prevention should be considered in future IPTS research.
Bannink, Rienke; Broeren, Suzanne; van de Looij – Jansen, Petra M.; de Waart, Frouwkje G.; Raat, Hein
Purpose To examine whether traditional and cyber bullying victimization were associated with adolescent's mental health problems and suicidal ideation at two-year follow-up. Gender differences were explored to determine whether bullying affects boys and girls differently. Methods A two-year longitudinal study was conducted among first-year secondary school students (N = 3181). Traditional and cyber bullying victimization were assessed at baseline, whereas mental health status and suicidal ideation were assessed at baseline and follow-up by means of self-report questionnaires. Logistic regression analyses were conducted to assess associations between these variables while controlling for baseline problems. Additionally, we tested whether gender differences in mental health and suicidal ideation were present for the two types of bullying. Results There was a significant interaction between gender and traditional bullying victimization and between gender and cyber bullying victimization on mental health problems. Among boys, traditional and cyber bullying victimization were not related to mental health problems after controlling for baseline mental health. Among girls, both traditional and cyber bullying victimization were associated with mental health problems after controlling for baseline mental health. No significant interaction between gender and traditional or cyber bullying victimization on suicidal ideation was found. Traditional bullying victimization was associated with suicidal ideation, whereas cyber bullying victimization was not associated with suicidal ideation after controlling for baseline suicidal ideation. Conclusions Traditional bullying victimization is associated with an increased risk of suicidal ideation, whereas traditional, as well as cyber bullying victimization is associated with an increased risk of mental health problems among girls. These findings stress the importance of programs aimed at reducing bullying behavior, especially
Batterham, Philip J; Calear, Alison L; van Spijker, Bregje A J
The interpersonal-psychological theory of suicidal behavior suggests that the combination of perceived burdensomeness and thwarted belongingness predicts suicidal ideation. However, the specificity of this prediction to suicidal ideation has not been tested. This study examined whether these constructs were consistently associated with different characteristics of suicidal ideation, and whether they were associated with mental health problems more broadly, in an online sample of 1,352 Australian adults. Findings indicated that the interaction between perceived burdensomeness and thwarted belongingness was associated only with suicidal ideation and consistent across multiple characteristics of ideation. The study broadly supported the specificity of the IPTS.
Fang, Beverly J; Tonelli, Leonardo H; Soriano, Joseph J; Postolache, Teodor T
Allergic inflammation is associated with mood disorders, exacerbation of depression, and suicidal behavior. Mediators of inflammation modulate sleep , with Th1 cytokines promoting NREM sleep and increasing sleepiness and Th2 cytokines (produced during allergic inflammation) impairing sleep. As sleep impairment is a rapidly modifiable suicide risk factor strongly associated with mood disorders, we review the literature leading to the hypothesis that allergic rhinitis leads to mood and anxiety disorders and an increased risk of suicide via sleep impairment. Specifically, allergic rhinitis can impair sleep through mechanical (obstructive) and molecular (cytokine production) processes. The high prevalence of mood and anxiety disorders and allergy, the nonabating suicide incidence, the currently available treatment modalities to treat sleep impairment and the need for novel therapeutic targets for mood and anxiety disorders, justify multilevel efforts to explore disturbance of sleep as a pathophysiological link.
Gatta, Michela; Miscioscia, Marina; Sisti, Marta; Comis, Ilaria; Battistella, Pier Antonio
Non-Suicidal Self-Injury (NSSI) is a common, multifaceted phenomenon among adolescents. Recent researchers have shown that a number of psychological and psychiatric correlates are implicated in the onset/repetition of NSSI, but those previous studies did not directly observe the family interaction patterns of this clinical population. In this paper, the quality of family interactions was observed using the Lausanne Trilogue Play procedure to deepen the specific interactive dimensions associated with NSSI in adolescents. The results of a single case study showed a lack of positive emotional exchanges, a parenting style expressing hostility, a high level of control and difficulties in triangulation. Through this method, the authors show that a better understanding of the role of family interactions is crucial and could improve the assessment and treatment of Non-Suicidal Self-Injurious behaviors. Research and clinical implications are discussed. PMID:28220084
Gatta, Michela; Miscioscia, Marina; Sisti, Marta; Comis, Ilaria; Battistella, Pier Antonio
Non-Suicidal Self-Injury (NSSI) is a common, multifaceted phenomenon among adolescents. Recent researchers have shown that a number of psychological and psychiatric correlates are implicated in the onset/repetition of NSSI, but those previous studies did not directly observe the family interaction patterns of this clinical population. In this paper, the quality of family interactions was observed using the Lausanne Trilogue Play procedure to deepen the specific interactive dimensions associated with NSSI in adolescents. The results of a single case study showed a lack of positive emotional exchanges, a parenting style expressing hostility, a high level of control and difficulties in triangulation. Through this method, the authors show that a better understanding of the role of family interactions is crucial and could improve the assessment and treatment of Non-Suicidal Self-Injurious behaviors. Research and clinical implications are discussed.
Tresno, Fiona; Ito, Yoshimi; Mearns, Jack
This study reports the prevalence of self-injurious behavior and suicide attempts among college students in Indonesia and examines risk factors distinguishing between 3 groups: self-injury with suicide attempt, non-suicidal self-injury, and non-self-injury. Self-report questionnaires measuring self-injury and suicide attempts, negative mood…
Reeves, Gloria M; Tonelli, Leonardo H; Anthony, Bruno J; Postolache, Teodor T
Suicide is a leading cause of mortality among adolescents. There is a pressing public health need to investigate triggers and novel vulnerabilities for suicide in order to improve risk assessment and develop innovative prevention strategies. Alcohol is a well established risk factor for adolescent suicide. In this paper, we outline a novel mechanism linking allergy, alcohol, and suicide, reviewing (a) the association between allergic inflammation, depression, and suicide; and (b) the role of alcohol in inducing phosphorylation and rearrangement of tight junction proteins of the blood-brain barrier (BBB) resulting in increased "leakiness", i.e. passage of cells and molecules. Seasonal peaks of suicide in spring have been consistently reported, but their causality is poorly understood. A preliminary epidemiologic study found increased nonviolent suicide rates in females in spring during intervals of high tree pollen, in comparison to similar intervals of low tree pollen. This initial report added to the emerging literature proposing a relationship between allergy and depression, and is being further pursued at clinical, epidemiological, animal and postmortem tissue levels. We propose that allergic inflammation influences depression-related brain function via molecular and cellular mediators, but those mediators have a very limited access to the brain when the BBB is intact. Alcohol intake disrupts BBB, allowing increased brain exposure to cellular mediators of allergy. Considering the greater prevalence of allergy in adolescence when alcohol use starts, studies investigating the connection between allergy, alcohol, and suicide should be expanded to also include a focus on youth.
Redmore, James; Kipping, Ruth; Trickey, Adam; May, Margaret T.; Gunnell, David
Background Previous analyses of adolescent suicides in England and Wales have focused on short time periods. Aims To investigate trends in suicide and accidental deaths in adolescents between 1972 and 2011. Method Time trend analysis of rates of suicides and deaths from accidental poisoning and hanging in 10- to 19-year-olds by age, gender and deprivation. Rate ratios were estimated for 1982–1991, 1992–2001 and 2002–2011 with 1972–1981 as comparator. Results Suicide rates have remained stable in 10- to 14-year-olds, with strong evidence for a reduction in accidental deaths. In males aged 15–19, suicide rates peaked in 2001 before declining. Suicide by hanging is the most common method of suicide. Rates were higher in males and in 15- to 19-year-olds living in more deprived areas. Conclusions Suicide rates in adolescents are at their lowest since the early 1970s with no clear evidence that changes in coroners' practices underlie this trend. PMID:27284083
New York State Education Dept., Albany. Educational Programs and Studies Information Service.
This focus paper contains reprints of 11 articles intended to provide an overview of the key issues in the area of adolescent behavior change as it relates to Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) education. Included are: (1) "Preventing HIV Infection and AIDS in Children and Adolescents" (J.…
Cho, Yong-Beom; Haslam, Nick
Acculturative stress and social support play important roles in suicide-related phenomena among adolescent immigrants. To examine their contributions, measures of acculturative and general life stress and a measure of multiple sources of social support were used to predict psychological distress and suicidal ideation among Korean-born high school students residing in the US. Korean students who were sojourning without both parents were compared to Korean students who immigrated with both parents, Korean students who remained in Korea, and American high school students in the US (total N = 227; 56.8% female). The sojourning group reported higher levels of life stress, distress, psychological symptoms, and suicidal ideation than the other groups. Within the two acculturating groups, levels of distress, symptoms, and suicidal ideation were associated with life stress, lack of parental support, and not living with both parents. The findings have important implications for suicide prevention among immigrant adolescents, and imply that parental support is particularly protective.
Alavi, Nazanin; Roberts, Nasreen; Sutton, Chloe; Axas, Nicholas; Repetti, Leanne
Objective: To examine the prevalence of bullying victimization among adolescents referred for urgent psychiatric consultation, to study the association between bullying victimization and suicidality, and to examine the relation between different types of bullying and suicidality. Method: A retrospective chart review was conducted for all adolescents referred to a hospital-based urgent consultation clinic. Our study sample consisted of adolescents with a history of bullying victimization. The Research Ethics Board of Queen’s University provided approval. Data analysis was conducted using SPSS (IBM SPSS Inc, Armonk, NY). Chi-square tests were used for sex, suicidal ideation, history of physical and sexual abuse, and time and type of bullying, and an independent sample t test was used for age. Results: The prevalence of bullying victimization was 48.5% (182 of 375). There was a significant association between being bullied and suicidal ideation (P = 0.01), and between sex and suicidal ideation (P ≤ 0.001). Victims of cyberbullying reported more suicidal ideation than those who experienced physical or verbal bullying (P = 0.04). Conclusions: Bullying victimization, especially cyberbullying, is associated with increased risk of suicidal ideation among adolescents referred for psychiatric risk assessment. The detailed history of the type and duration of bullying experienced by the victims should be considered when conducting a psychiatric risk assessment. PMID:26720189
Lewinsohn, Peter M.; And Others
Examined psychosocial risk factors for attempting suicide in 1,508 high school students, 26 of whom attempted suicide during year following entry into study. Strongest predictors of future suicide attempt were history of past attempt, current suicidal ideation and depression, recent attempt by friend, low self-esteem, and having been born to…
Fordwood, Samantha R.; Asarnow, Joan R.; Huizar, Diana P.; Reise, Steven P.
Although depression is strongly associated with suicide attempts and suicide deaths, most depressed youth do not make an attempt, indicating the need to identify additional risk factors. We examined suicide attempts among 451 depressed primary care patients, 13 to 21 years of age. In bivariate analyses, youth classified as suicide attempters…
Dick, Danielle M; Adkins, Amy E; Kuo, Sally I-Chun
Adolescence is a transitional, developmental phase with marked shifts in behavior, particularly as related to risk-taking and experimentation. Genetic influences on adolescent behavior also show marked changes across this developmental period; in fact, adolescence showcases the dynamic nature of genetic influences on human behavior. Using the twin studies literature on alcohol use and misuse, we highlight several principles of genetic influence on adolescent behavior. We illustrate how genetic influences change (increase) across adolescence, as individuals have more freedom to express their predispositions and to shape their social worlds. We show how there are multiple genetic pathways to risk, and how the environment can moderate the importance of genetic predispositions. Finally, we review the literature aimed at identifying specific genes involved in adolescent behavior and understanding how identified genes impact adolescent outcomes. Ultimately, understanding how genetic predispositions combine with environmental influences to impact pathways of risk and resilience should be translated into improved prevention and intervention efforts; this remains a rich area for future research.
Capron, Daniel W; Allan, Nicholas P; Ialongo, Nicholas S; Leen-Feldner, Ellen; Schmidt, Norman B
Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality.
Muehlenkamp, Jennifer J; Walsh, Barent W; McDade, Moira
Non-suicidal self-injury (NSSI) continues to be a problem among youth and there is a great need for programming aimed at reducing NSSI in adolescents. The signs of self-injury program is the first known NSSI school-based prevention program for adolescents that attempts to increase knowledge, improve help-seeking attitudes and behaviors, and decrease acts of NSSI. A total of five schools implemented the program in selected classrooms (n = 274 adolescents; 51.5% female, mean age = 16.07 years) that consisted of predominantly Caucasian (73%) adolescents. Researchers collected pre-post evaluation surveys of the program and feasibility interviews were conducted with the school guidance personnel who ran the program. Results indicated the prevention program did not produce iatrogenic effects, increased accurate knowledge and improved help-seeking attitudes and intentions among students. No significant changes were found in regards to self-reported formal help-seeking actions. Feasibility responses indicate the program is user-friendly and well received by school personnel. The data offer preliminary evidence that the program may be an effective prevention program for schools.
Ellis, B Heidi; Lankau, Emily W; Ao, Trong; Benson, Molly A; Miller, Alisa B; Shetty, Sharmila; Lopes Cardozo, Barbara; Geltman, Paul L; Cochran, Jennifer
Attention has been drawn to high rates of suicide among refugees after resettlement and in particular among the Bhutanese refugees. This study sought to understand the apparent high rates of suicide among resettled Bhutanese refugees in the context of the Interpersonal-Psychological Theory of Suicidal Behavior (IPTS). Expanding on a larger investigation of suicide in a randomly selected sample of Bhutanese men and women resettled in Arizona, Georgia, New York, and Texas (Ao et al., 2012), the current study focused on 2 factors, thwarted belongingness and perceived burdensomeness, examined individual and postmigration variables associated with these factors, and explored how they differed by gender. Overall, factors such as poor health were associated with perceived burdensomeness and thwarted belongingness. For men, stressors related to employment and providing for their families were related to feeling burdensome and/or alienated from family and friends, whereas for women, stressors such as illiteracy, family conflict, and being separated from family members were more associated. IPTS holds promise in understanding suicide in the resettled Bhutanese community.
Ellis, B. Heidi; Lankau, Emily W.; Ao, Trong; Benson, Molly A.; Miller, Alisa B.; Shetty, Sharmila; Cardozo, Barbara Lopes; Geltman, Paul L.; Cochran, Jennifer
Attention has been drawn to high rates of suicide among refugees after resettlement and in particular among the Bhutanese refugees. This study sought to understand the apparent high rates of suicide among resettled Bhutanese refugees in the context of the Interpersonal-Psychological Theory of Suicidal Behavior (IPTS). Expanding on a larger investigation of suicide in a randomly selected sample of Bhutanese men and women resettled in Arizona, Georgia, New York, and Texas (Ao et al., 2012), the current study focused on 2 factors, thwarted belongingness and perceived burdensomeness, examined individual and postmigration variables associated with these factors, and explored how they differed by gender. Overall, factors such as poor health were associated with perceived burdensomeness and thwarted belongingness. For men, stressors related to employment and providing for their families were related to feeling burdensome and/or alienated from family and friends, whereas for women, stressors such as illiteracy, family conflict, and being separated from family members were more associated. IPTS holds promise in understanding suicide in the resettled Bhutanese community. PMID:25642653
Coleman, Daniel; Lawrence, Ryan; Parekh, Amrita; Galfalvy, Hanga; Blasco-Fontecilla, Hilario; Brent, David A; Mann, J John; Baca-Garcia, Enrique; Oquendo, Maria A
The relationship of Narcissistic Personality Disorder (NPD) to suicidal behavior is understudied. The modest body of existing research suggests that NPD is protective against low-lethality suicide attempts, but is associated with high lethality attempts. Mood-disordered patients (N = 657) received structured interviews including Axis I and II diagnosis and standardized clinical measures. Following chi-square and t-tests, a logistical regression model was constructed to identify predictors of suicide attempt. While there was no bivariate relationship of NPD on suicide attempt, in the logistic regression patients with NPD were 2.4 times less likely to make a suicide attempt (OR = 0.41; 95% CI = 0.19 - 0.88; p < 0.05), compared with non-NPD patients and controlling for possible confounding variables. NPD was not associated with attempt lethality. NPD patients were more likely to be male, to have a substance use disorder, and to have high aggression and hostility scores. Limitations include that the sample consists of only mood-disordered patients, a modest sample size of NPD, and the data are cross-sectional. The multivariate protective effect of NPD on suicide attempt is consistent with most previous research. The lower impulsivity of NPD patients and less severe personality pathology relative to other personality disorders may contribute to this effect. No relationship of NPD to attempt lethality was found, contradicting other research, but perhaps reflecting differences between study samples. Future studies should oversample NPD patients and include suicide death as an outcome. Clinical implications include discussion of individualized suicide risk assessment with NPD patients.
García-Nieto, Rebeca; Carballo, Juan J; Díaz de Neira Hernando, Mónica; de León-Martinez, Victoria; Baca-García, Enrique
Non-suicidal self-injury (NSSI) in adolescents is a major public health concern. The first goal of our study was to describe the characteristics and functions of NSSI and NSSI thoughts in an adolescent outpatient sample. The second goal was to examine which clinical factors discriminate between these two groups of patients. A group of 267 subjects was recruited from the Adolescent Outpatient Psychiatric Services, Jiménez Díaz Foundation (Madrid, Spain) from November 2011 to October 2012. All participants were administered the Spanish version of the Self-Injurious Thoughts and Behaviors Interview (SITBI). A total of 21.7% of patients reported having engaged in NSSI at least once in their lifetime. The most strongly endorsed function for NSSI was automatic negative reinforcement. In comparison with patients in the NSSI Thoughts group and the control group, patients in the NSSI group scored higher in Internalization of Anger and in all the scales comprising the Children's Depression Inventory. Our findings on the prevalence and functions of NSSI are consistent with the literature. NSSI was mainly performed for emotion regulation purposes; specifically, NSSI seems to be used to cope with anger and depression. In addition, internalization of anger might play a significant role in the maintenance of this behavior.
Goldston, David B.; Daniel, Stephanie Sergent; Erkanli, Alaattin; Reboussin, Beth A.; Mayfield, Andrew; Frazier, Patricia H.; Treadway, Sarah L.
The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to…
Wong, Y. Joel; Maffini, Cara S.
Although suicide-related outcomes among Asian American adolescents are a serious public health problem in the United States, research in this area has been relatively sparse. To address this gap in the empirical literature, this study examined subgroups of Asian American adolescents for whom family, school, and peer relationships exerted…
King, Cheryl A.; Kramer, Anne; Preuss, Lesli; Kerr, David C. R.; Weisse, Lois; Venkataraman, Sanjeev
In this study, the authors investigated the efficacy of the Youth-Nominated Support Team-Version 1 (YST-1), a psychoeducational social network intervention, with 289 suicidal, psychiatrically hospitalized adolescents (197 girls, 92 boys). Adolescents were randomly assigned to treatment-as-usual plus YST-1 or treatment-as-usual only. Assessments…
Berger, Emily; Hasking, Penelope; Martin, Graham
Non-suicidal self-injury (NSSI) is of increasing concern, yet many adolescents who self-injure are reluctant to seek professional help. Instead, they turn to friends for support, although it is unclear what these friends can offer. This study aimed to identify adolescents' views of how peers and online friends can help young people who…
van Bergen, D D; Smit, J H; van Balkom, A J L M; van Ameijden, E; Saharso, S
We investigated the prevalence and explored the vulnerability to suicidal ideation across several ethnic minority versus ethnic majority adolescents in the city of Utrecht in The Netherlands. Exploratory analyses were conducted on a dataset obtained from the Municipal Health Services in Utrecht. We examined whether ethnic minority adolescents are at risk for suicidal ideation because of a family background of migration, social-economic position and certain family factors, which influence psychological constellations. We found that levels of suicidal ideation among adolescents of Turkish background were significantly higher than in both majority and other minority adolescents, The Turkish adolescents at risk for suicidal ideation reported that they do not enjoy being at home with their families. Psychological factors, in particular lack of self-pride and the idea of not becoming successful in life, appeared to be important, as well as feelings of loneliness. Suicidal ideation was not found equally across all ethnic minority groups. A history of migration, ethnic minority status, or low socioeconomic status were not sufficient to explain the variation across ethnicities. Our results suggest that specific social-cultural factors, contextualized in the individual and located in the family environment, are relevant in explaining the disproportionate rates for Turkish adolescents in Utrecht.
Fujikawa, Shinya; Ando, Shuntaro; Shimodera, Shinji; Koike, Shinsuke; Usami, Satoshi; Toriyama, Rie; Kanata, Sho; Sasaki, Tsukasa; Kasai, Kiyoto; Okazaki, Yuji; Nishida, Atsushi
Although several studies have reported that child physical abuse increased the risk for bullying involvement, the effect of current violence from adult family members (CVA) on bullying involvement and suicidal feelings among adolescents has not been sufficiently examined. This study investigated the association of CVA with adolescent bullying involvement and the interaction effect of CVA and bullying involvement on suicidal feelings. This cross-sectional study used data from a school-based survey with a general population of adolescents (grades 7 to 12). Data were collected using a self-report questionnaire completed by 17,530 students. Logistic regression analyses were performed to explore the association of CVA with adolescent bullying involvement and suicidal feelings. The overall response rate was 90.2%. The odds of students being characterized as bullies, victims, and bully-victims were higher among adolescents with CVA than without CVA (odds ratios (OR) = 2.9, 95% confidence interval (CI), [2.3-3.7], 4.6 [3.6-5.8], and 5.8 [4.4-7.6], respectively). Both CVA (OR = 3.4 [95% CI 2.7-4.3]) and bullying (bullies, victims, and bully-victims; OR = 2.0 [95% CI 1.6-2.6], 4.0 [3.1-5.1], 4.1 [3.0-5.6], respectively), were associated with increased odds of current suicidal feelings after adjusting for confounding factors. Furthermore, positive additive effects of CVA and all three types of bullying involvement on suicidal feelings were found. For example, bully-victims with CVA had about 19-fold higher odds of suicidal feelings compared with uninvolved adolescents without CVA. This study, although correlational, suggested that CVA avoidance might prevent bullying involvement and suicidal feelings in adolescents.
Shimodera, Shinji; Koike, Shinsuke; Usami, Satoshi; Toriyama, Rie; Kanata, Sho; Sasaki, Tsukasa; Kasai, Kiyoto; Okazaki, Yuji; Nishida, Atsushi
Although several studies have reported that child physical abuse increased the risk for bullying involvement, the effect of current violence from adult family members (CVA) on bullying involvement and suicidal feelings among adolescents has not been sufficiently examined. This study investigated the association of CVA with adolescent bullying involvement and the interaction effect of CVA and bullying involvement on suicidal feelings. This cross-sectional study used data from a school-based survey with a general population of adolescents (grades 7 to 12). Data were collected using a self-report questionnaire completed by 17,530 students. Logistic regression analyses were performed to explore the association of CVA with adolescent bullying involvement and suicidal feelings. The overall response rate was 90.2%. The odds of students being characterized as bullies, victims, and bully-victims were higher among adolescents with CVA than without CVA (odds ratios (OR) = 2.9, 95% confidence interval (CI), [2.3–3.7], 4.6 [3.6–5.8], and 5.8 [4.4–7.6], respectively). Both CVA (OR = 3.4 [95% CI 2.7–4.3]) and bullying (bullies, victims, and bully-victims; OR = 2.0 [95% CI 1.6–2.6], 4.0 [3.1–5.1], 4.1 [3.0–5.6], respectively), were associated with increased odds of current suicidal feelings after adjusting for confounding factors. Furthermore, positive additive effects of CVA and all three types of bullying involvement on suicidal feelings were found. For example, bully-victims with CVA had about 19-fold higher odds of suicidal feelings compared with uninvolved adolescents without CVA. This study, although correlational, suggested that CVA avoidance might prevent bullying involvement and suicidal feelings in adolescents. PMID:27711150
Watkins, Adam M.; Lizotte, Alan J.
The aim of this research is to assess if home firearm access increases the risk of nonfatal suicidal attempts among adolescents. Such a gun focus has largely been limited to case-control studies on completed suicides. This line of research has found that household gun access increases the risk of suicide due to features of available firearms…