101
|
Nesi J, Burke TA, Bettis AH, Kudinova AY, Thompson EC, MacPherson HA, Fox KA, Lawrence HR, Thomas SA, Wolff JC, Altemus MK, Soriano S, Liu RT. Social media use and self-injurious thoughts and behaviors: A systematic review and meta-analysis. Clin Psychol Rev 2021; 87:102038. [PMID: 34034038 PMCID: PMC8243901 DOI: 10.1016/j.cpr.2021.102038] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
Despite considerable public and scholarly debate about the role of social media in self-injurious thoughts and behaviors (SITBs), no comprehensive, quantitative synthesis of this literature has previously been undertaken. The current systematic review and meta-analysis examines associations between social media use and SITBs, including suicidal ideation, suicide plans, suicide attempts, and nonsuicidal self-injury (NSSI). A range of social media behaviors and experiences were identified, including cybervictimization and perpetration, exposure to and generation of SITB-related content, problematic use, sexting, social media importance, and frequency of use. A systematic search of PsycINFO, Medline, CINAHL, and the references of prior reviews yielded 61 eligible studies. Results largely suggested medium effect sizes for associations between specific social media constructs (cybervictimization, SITB-related social media use, problematic social media use) and SITBs. There was no association between frequency of social media use and SITBs; however, studies on this topic were limited. The majority of studies identified focused on cybervictimization, and results suggested positive associations with all SITBs, with the association between cybervictimization and suicidal ideation stronger for adolescents than adults. Overall, findings highlight the utility of examining specific social media behaviors and experiences, and point to the need for more research in this area.
Collapse
Affiliation(s)
- Jacqueline Nesi
- Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States.
| | - Taylor A Burke
- Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States
| | | | - Anastacia Y Kudinova
- Alpert Medical School of Brown University, United States; Emma Pendleton Bradley Hospital, United States
| | - Elizabeth C Thompson
- Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States
| | - Heather A MacPherson
- Alpert Medical School of Brown University, United States; Emma Pendleton Bradley Hospital, United States
| | - Kara A Fox
- University of North Carolina at Chapel Hill, United States
| | - Hannah R Lawrence
- McLean Hospital, United States; Havard Medical School, United States
| | - Sarah A Thomas
- Alpert Medical School of Brown University, United States; Emma Pendleton Bradley Hospital, United States
| | - Jennifer C Wolff
- Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States
| | | | - Sheiry Soriano
- Alpert Medical School of Brown University, United States
| | - Richard T Liu
- Havard Medical School, United States; Massachusetts General Hospital, United States
| |
Collapse
|
102
|
Grande E, Vichi M, Alicandro G, Simeoni S, Murianni L, Marchetti S, Zengarini N, Frova L, Pompili M. Suicide among adolescents in Italy: a nationwide cohort study of the role of family characteristics. Eur Child Adolesc Psychiatry 2021; 30:1037-1045. [PMID: 32617776 DOI: 10.1007/s00787-020-01591-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/26/2020] [Indexed: 01/16/2023]
Abstract
Suicide is a leading cause of death among adolescents and is recognized as a serious public health problem. This study aimed to investigate the relationship between family characteristics and the risk of suicide among adolescents in Italy using nationwide official data. We carried out a cohort study based on the record linkage between the 15th Italian Population Census, the Italian Population Register, and the National Register of Causes of Death. Suicides in adolescents aged 10-19 years from 2012 to 2016 were analyzed. Hazard ratios of mortality from suicide were estimated through a multivariable Cox regression model using time-on-study as the time scale. We included 8,284,359 children and adolescents (51% males, 49% females). Over the 5-year follow-up, we registered 330 deaths from suicides (74% males), mostly occurred in the age class 15-19 years (86%). The suicide rate was 1.71 per 100,000 person-years among males and 0.65 among females. We found some familial characteristics associated with a higher risk of dying by suicide, including: living in single-parent or reconstructed families (among boys), a 40-year or more age gap between mother and child (among girls), having highly educated parents, an age difference between parents greater than 5 years. Furthermore, the study showed a lower risk for boys living in urban areas and for both boys and girls living in South Italy. Our results could help in identifying adolescents at high risk of suicide who could benefit from the planning of targeted intervention strategies.
Collapse
Affiliation(s)
- Enrico Grande
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics, Viale Liegi 13, 00198, Rome, Italy.
| | - Monica Vichi
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy
| | - Gianfranco Alicandro
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics, Viale Liegi 13, 00198, Rome, Italy
| | - Silvia Simeoni
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics, Viale Liegi 13, 00198, Rome, Italy
| | - Laura Murianni
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics, Viale Liegi 13, 00198, Rome, Italy
| | - Stefano Marchetti
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics, Viale Liegi 13, 00198, Rome, Italy
| | - Nicolas Zengarini
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, TO, Italy
| | - Luisa Frova
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics, Viale Liegi 13, 00198, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
103
|
Ruch DA, Heck KM, Sheftall AH, Fontanella CA, Stevens J, Zhu M, Horowitz LM, Campo JV, Bridge JA. Characteristics and Precipitating Circumstances of Suicide Among Children Aged 5 to 11 Years in the United States, 2013-2017. JAMA Netw Open 2021; 4:e2115683. [PMID: 34313741 PMCID: PMC8317003 DOI: 10.1001/jamanetworkopen.2021.15683] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
IMPORTANCE Suicide is the eighth leading cause of death among children aged 5 to 11 years, with rates increasing during the past decade. A better understanding of factors associated with childhood suicide can inform developmentally appropriate prevention strategies. OBJECTIVE To examine characteristics and precipitating circumstances of childhood suicide. DESIGN, SETTING, AND PARTICIPANTS This qualitative study examined restricted-use data from the National Violent Death Reporting System (NVDRS) regarding child suicide decedents aged 5 to 11 years in the US from 2013 to 2017. The NVDRS is a state-based surveillance system that collects data on suicide and violent deaths in 50 states, with restricted-use data available from 37 states. Details and context related to suicide deaths were identified through a content analysis of case narratives from coroner or medical examiner and law enforcement reports associated with each incident. EXPOSURES Characteristics and precipitating circumstances associated with suicide cited in the coroner, medical examiner, and law enforcement case narratives. MAIN OUTCOMES AND MEASURES Suicide incidence and risk factors for suicide including mental health, prior suicidal behavior, trauma, and peer, school, or family-related problems. RESULTS Analyses included 134 child decedents (101 [75.4%] males; 79 [59.0%] White individuals; 109 [81.3%] non-Hispanic individuals; mean [SD] age, 10.6 [0.8] years). Most suicides occurred in the child's home (95.5% [n = 128]), and more specifically in the child's bedroom. Suicide by hanging or suffocation (78.4% [n = 105]) was the most frequent method, followed by firearms (18.7% [n = 25]). Details on gun access were noted in 88.0% (n = 22) of suicides by firearm, and in every case, the child obtained a firearm stored unsafely in the home. Findings revealed childhood suicide was associated with numerous risk factors accumulated over time, and suggest a progression toward suicidal behavior, especially for youth with a history of psychopathology and suicidal behavior. An argument between the child and a family member and/or disciplinary action was often a precipitating circumstance of the suicide. CONCLUSIONS AND RELEVANCE This qualitative study found that childhood suicide was associated with multiple risk factors and commonly preceded by a negative precipitating event. Potential prevention strategies include improvements in suicide risk assessment, family relations, and lethal means restriction, particularly safe firearm storage. Future research examining the myriad aspects of childhood suicide, including racial/ethnic and sex differences, is needed.
Collapse
Affiliation(s)
- Donna A. Ruch
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus
| | - Kendra M. Heck
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus
| | - Arielle H. Sheftall
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
| | - Cynthia A. Fontanella
- The Ohio State University Wexner Medical Center Department of Psychiatry and Behavioral Health, Columbus
| | - Jack Stevens
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
| | - Motao Zhu
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
| | - Lisa M. Horowitz
- National Institute of Mental Health, National Institutes of Health, Office of the Clinical Director, Bethesda, Maryland
| | - John V. Campo
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland
| | - Jeffrey A. Bridge
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
| |
Collapse
|
104
|
Salem T, Walters KA, Verducci JS, Fristad MA. Psychoeducational and Skill-building Interventions for Emotion Dysregulation. Child Adolesc Psychiatr Clin N Am 2021; 30:611-622. [PMID: 34053689 DOI: 10.1016/j.chc.2021.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Family psychoeducation plus skill building is a class of interventions considered to be well-established for youth with mood disorders or emotion dysregulation. Psychoeducational psychotherapy (PEP) is an example of this class of interventions. PEP provides psychoeducation for parents and children, skill building to help children better regulate emotions and behaviors, and strategies for parents to better facilitate school-based interventions, develop specific symptom management techniques, and generate coping strategies for the entire family. Evidence is summarized supporting the efficacy of PEP for reducing rage, overall mood symptom severity, disruptive behavior, and executive functioning deficits in youth. Long-term benefits of PEP are discussed.
Collapse
Affiliation(s)
- Taban Salem
- Department of Psychology and Neuroscience, Millsaps College, 1701 North State Street, Jackson, MS 39210, USA
| | - Kimberly A Walters
- Statistics Collaborative, Inc., 1625 Massachusetts Avenue NQ, Suite 600, Washington, DC 20036, USA
| | - Joseph S Verducci
- Department of Statistics, The Ohio State University, 404 Cockins Hall, 1458 Neil Avenue, Columbus, OH 43210, USA
| | - Mary A Fristad
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Harding Hospital, Suite 460H, 1670 Upham Drive, Columbus, OH 43210, USA; Nationwide Children's Hospital Behavioral Health Pavilion, 444 Butterfly Gardens Drive #3207, Columbus, OH 43215, USA.
| |
Collapse
|
105
|
Sheftall AH, Vakil F, Armstrong SE, Rausch JR, Feng X, Kerns KA, Brent DA, Bridge JA. Clinical risk factors, emotional reactivity/regulation and suicidal ideation in elementary school-aged children. J Psychiatr Res 2021; 138:360-365. [PMID: 33930615 PMCID: PMC8192478 DOI: 10.1016/j.jpsychires.2021.04.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Suicidal behavior (SB) in young children is rare yet in 2019, suicide was the fifth leading cause of death in 5-12-year-old youth. Understanding the risks associated with childhood suicidal ideation (SI) and SB will determine which factors should be targeted for prevention programming. This study examined clinical characteristics and emotional reactivity/regulation (ERR) in children with (SI+) and without (SI-) SI. METHOD One hundred seventeen children, 6-9 years, and one biological parent were enrolled. Children completed interviews concerning SI/SB and parents completed interviews/self-reports about SI/SB, psychiatric distress, and history of abuse/neglect and their child's SI/SB, mental health, and ERR. Independent t-tests and Chi-square analyses using Bonferroni correction were conducted to examine SI group differences. Variables were then screened using forward stepwise logistic regression to determine association with SI + status. The final logistic regression included variables that survived screening procedures only. RESULTS Univariate analyses revealed SI + children were more likely to have a parental history of suicide attempt (PH+), higher rates of current psychotropic medication use, higher scores on the CBCL-DSM oriented scales (e.g., ADHD problems), and higher negative affect compared to SI- children. After analytic screening procedures, PH+, anxiety problems, ADHD problems, and anger survived. The final logistic regression revealed PH + status and anxiety problems were associated with SI + status. CONCLUSION Long-term follow-up is needed to determine if these factors are predictive of a first-time suicide attempt in this at-risk group.
Collapse
Affiliation(s)
- Arielle H Sheftall
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA; Department of Pediatrics, The Ohio State University, College of Medicine, USA.
| | - Fatima Vakil
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA
| | - Sarah E Armstrong
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA
| | - Joseph R Rausch
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA
| | - Xin Feng
- Department of Human Sciences, College of Education and Human Ecology, Ohio State University, USA
| | - Kathryn A Kerns
- Department of Psychological Sciences, Kent State University, USA
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, USA
| | - Jeffrey A Bridge
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA; Departments of Pediatrics and Psychiatry & Behavioral Health, Ohio State University College of Medicine, USA
| |
Collapse
|
106
|
Kerr KL, Ralph-Nearman C, Colaizzi JM, DeVille DC, Breslin FJ, Aupperle RL, Paulus MP, Morris AS. Gastric symptoms and low perceived maternal warmth are associated with eating disorder symptoms in young adolescent girls. Int J Eat Disord 2021; 54:1009-1018. [PMID: 33836108 PMCID: PMC9945938 DOI: 10.1002/eat.23516] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/03/2021] [Accepted: 03/23/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study sought to determine whether gastric symptoms are associated with later eating disorder (ED) symptoms during early adolescence, and whether this relationship is moderated by parental warmth/acceptance and/or the child's sex. METHOD Longitudinal data from the Adolescent Brain Cognitive DevelopmentSM Study were utilized. Participants ages 9-10 years old (N = 4,950; 2,370 female) completed measures at baseline and 1 year later (Y1). At baseline, gastric symptoms were measured by parent-reported items from the Child Behavior Checklist (CBCL), and perceived parental acceptance was measured by youth report on the Children's Report of Parent Behavior Inventory (CRPBI) Acceptance subscale separately for mothers and fathers. ED symptoms at Y1 were assessed by parent report on a computerized version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Linear mixed-effects models were conducted separately for maternal and paternal acceptance to test relationships among variables. RESULTS A three-way interaction between baseline gastric symptoms, sex, and maternal acceptance predicted Y1 ED symptoms (𝛽 = 0.08; p < .01). Post-hoc analyses revealed that the interaction between gastric symptoms and maternal acceptance was significant for girls only (𝛽 = -0.06, p < .01), such that low maternal acceptance was associated with a stronger relationship between baseline gastric symptoms and Y1 ED symptoms. No statistically significant main effects or interactions were found in the model for paternal acceptance. DISCUSSION Gastric symptoms and low perceived maternal acceptance may interact to result in heightened risk for EDs in young adolescent girls.
Collapse
Affiliation(s)
- Kara L. Kerr
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - Christina Ralph-Nearman
- Department of Psychological and Brain Sciences, The University of Louisville, Louisville, Kentucky,Laureate Institute for Brain Research, Tulsa, Oklahoma
| | | | - Danielle C. DeVille
- Laureate Institute for Brain Research, Tulsa, Oklahoma,Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | | | - Robin L. Aupperle
- Laureate Institute for Brain Research, Tulsa, Oklahoma,Department of Community Medicine, The University of Tulsa, Tulsa, Oklahoma
| | - Martin P. Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma,Department of Community Medicine, The University of Tulsa, Tulsa, Oklahoma,Department of Psychiatry, University of California, San Diego, California
| | - Amanda Sheffield Morris
- Laureate Institute for Brain Research, Tulsa, Oklahoma,Department of Human Development and Family Science, Oklahoma State University, Stillwater, Oklahoma
| |
Collapse
|
107
|
Shoval G, Visoki E, Moore TM, DiDomenico GE, Argabright ST, Huffnagle NJ, Alexander-Bloch AF, Waller R, Keele L, Benton TD, Gur RE, Barzilay R. Evaluation of Attention-Deficit/Hyperactivity Disorder Medications, Externalizing Symptoms, and Suicidality in Children. JAMA Netw Open 2021; 4:e2111342. [PMID: 34086035 PMCID: PMC8178707 DOI: 10.1001/jamanetworkopen.2021.11342] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Childhood suicidality (ie, suicidal ideation or attempts) rates are increasing, and attention-deficit/hyperactivity disorder (ADHD) and externalizing symptoms are common risk factors associated with suicidality. More data are needed to describe associations of ADHD pharmacotherapy with childhood suicidality. OBJECTIVE To investigate the associations of ADHD pharmacotherapy with externalizing symptoms and childhood suicidality. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, cross-sectional and 1-year-longitudinal associations were examined using data (collected during 2016-2019) from the Adolescent Brain Cognitive Development (ABCD) Study, a large, diverse US sample of children aged 9 to 11 years. Data analysis was performed from November to December 2020. EXPOSURES Main and interaction associations of externalizing symptoms (hyperactivity ADHD symptoms, oppositional defiant, and conduct disorder symptoms) and ADHD medication treatment (methylphenidate and amphetamine derivatives, α-2-agonists, and atomoxetine) at baseline assessment. MAIN OUTCOMES AND MEASURES Child-reported suicidality (past and present at baseline; current at longitudinal assessment). Covariates were age, sex, race/ethnicity, parents' education, marital status, and concomitant child psychiatric pharmacotherapy (antidepressants and antipsychotics). RESULTS Among 11 878 children at baseline assessment (mean [SD] age, 9.9 [0.6] years; 6196 boys [52.2%]; 8805 White [74.1%]), 1006 (8.5%) were treated with ADHD medication and 1040 (8.8%) reported past or current suicidality. Externalizing symptoms (median [range], 1 [0-29] symptom count) were associated with suicidality (for a change of 1 SD in symptoms, odds ratio [OR], 1.34; 95% CI, 1.26-1.42; P < .001), as was ADHD medication treatment (OR, 1.32; 95% CI, 1.06-1.64; P = .01). ADHD medication use was associated with less suicidality in children with more externalizing symptoms (significant symptom-by-medication interaction, B = -0.250; SE = 0.086; P = .004), such that for children who were not receiving ADHD medications, there was an association between more externalizing symptoms and suicidality (for a change of 1 SD in symptoms, OR, 1.42; 95% CI, 1.33-1.52; P < .001); however, for children who were receiving ADHD medication, there was no such association (OR, 1.15; 95% CI, 0.97-1.35; P = .10). The association with medication remained even when covarying for multiple confounders, including risk and protective factors for suicidality in ABCD, and was replicated in 1-year longitudinal follow-up. Sensitivity analyses matching participants with high numbers of externalizing symptoms taking and not taking ADHD medication treatment confirmed its association with less suicidality. CONCLUSIONS AND RELEVANCE These findings suggest that ADHD medication treatment is associated with less suicidality in children with substantial externalizing symptoms and may be used to inform childhood suicide prevention strategies.
Collapse
Affiliation(s)
- Gal Shoval
- Geha Mental Health Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey
| | - Elina Visoki
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
| | - Tyler M. Moore
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Grace E. DiDomenico
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
| | - Stirling T. Argabright
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
| | - Nicholas J. Huffnagle
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
| | - Aaron F. Alexander-Bloch
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Rebecca Waller
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
- Department of Psychology, University of Pennsylvania, Philadelphia
| | - Luke Keele
- Division of Epidemiology and Biostatistics, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Tami D. Benton
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Raquel E. Gur
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| |
Collapse
|
108
|
Prediction of suicidal ideation and attempt in 9 and 10 year-old children using transdiagnostic risk features. PLoS One 2021; 16:e0252114. [PMID: 34033672 PMCID: PMC8148349 DOI: 10.1371/journal.pone.0252114] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 05/10/2021] [Indexed: 11/19/2022] Open
Abstract
The objective of the current study was to build predictive models for suicidal ideation in a sample of children aged 9–10 using features previously implicated in risk among older adolescent and adult populations. This case-control analysis utilized baseline data from the Adolescent Brain and Cognitive Development (ABCD) Study, collected from 21 research sites across the United States (N = 11,369). Several regression and ensemble learning models were compared on their ability to classify individuals with suicidal ideation and/or attempt from healthy controls, as assessed by the Kiddie Schedule for Affective Disorders and Schizophrenia–Present and Lifetime Version. When comparing control participants (mean age: 9.92±0.62 years; 4944 girls [49%]) to participants with suicidal ideation (mean age: 9.89±0.63 years; 451 girls [40%]), both logistic regression with feature selection and elastic net without feature selection predicted suicidal ideation with an AUC of 0.70 (CI 95%: 0.70–0.71). The random forest with feature selection trained to predict suicidal ideation predicted a holdout set of children with a history of suicidal ideation and attempt (mean age: 9.96±0.62 years; 79 girls [41%]) from controls with an AUC of 0.77 (CI 95%: 0.76–0.77). Important features from these models included feelings of loneliness and worthlessness, impulsivity, prodromal psychosis symptoms, and behavioral problems. This investigation provided an unprecedented opportunity to identify suicide risk in youth. The use of machine learning to examine a large number of predictors spanning a variety of domains provides novel insight into transdiagnostic factors important for risk classification.
Collapse
|
109
|
Assari S, Boyce S, Bazargan M. Feasibility of Race by Sex Intersectionality Research on Suicidality in the Adolescent Brain Cognitive Development (ABCD) Study. CHILDREN-BASEL 2021; 8:children8060437. [PMID: 34071105 PMCID: PMC8224640 DOI: 10.3390/children8060437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 01/09/2023]
Abstract
Intersectional research on childhood suicidality requires studies with a reliable and valid measure of suicidality, as well as a large sample size that shows some variability of suicidality across sex by race intersectional groups. Objectives: We aimed to investigate the feasibility of intersectionality research on childhood suicidality in the Adolescent Brain Cognitive Development (ABCD) study. We specifically explored the reliability and validity of the measure, sample size, and variability of suicidality across sex by race intersectional groups. Methods: We used cross-sectional data (wave 1) from the ABCD study, which sampled 9013 non-Hispanic white (NHW) or non-Hispanic black (NHB) children between the ages of 9 and 10 between years 2016 and 2018. Four intersectional groups were built based on race and sex: NHW males (n = 3554), NHW females (n = 3158), NHB males (n = 1164), and NHB females (n = 1137). Outcome measure was the count of suicidality symptoms, reflecting all positive history and symptoms of suicidal ideas, plans, and attempts. To validate our measure, we tested the correlation between our suicidality measure and depression and Child Behavior Checklist (CBCL) sub-scores. Cronbach alpha was calculated for reliability across each intersectional group. We also compared groups for suicidality. Results: We observed some suicidality history in observed 3.2% (n = 101) of NHW females, 4.9% (n = 175) of NHW males, 5.4% (n = 61) of NHB females, and 5.8% (n = 68) of NHB males. Our measure’s reliability was acceptable in all race by sex groups (Cronbach alpha higher than 0.70+ in all intersectional groups). Our measure was valid in all intersectional groups, documented by a positive correlation with depression and CBCL sub-scores. We could successfully model suicidality across sex by race groups, using multivariable models. Conclusion: Given the high sample size, reliability, and validity of the suicidality measure, variability of suicidality, it is feasible to investigate correlates of suicidality across race by sex intersections in the ABCD study. We also found evidence of higher suicidality in NHB than NHW children in the ABCD study. The ABCD rich data in domains of social context, self-report, schools, parenting, psychopathology, personality, and brain imaging provides a unique opportunity to study intersectional differences in neural circuits associated with youth suicidality.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA;
- Department of Urban Public Health, Charles Drew University, Los Angeles, CA 90059, USA
- Correspondence: ; Tel.: +1-734-858-8333
| | - Shanika Boyce
- Department of Pediatrics, Charles Drew University, Los Angeles, CA 90059, USA;
| | - Mohsen Bazargan
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA;
- Department of Urban Public Health, Charles Drew University, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| |
Collapse
|
110
|
Race, Family Conflict and Suicidal Thoughts and Behaviors among 9-10-Year-Old American Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105399. [PMID: 34070158 PMCID: PMC8158501 DOI: 10.3390/ijerph18105399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 01/09/2023]
Abstract
Family conflict is known to operate as a major risk factor for children’s suicidal thoughts and behaviors (STBs). However, it is unknown whether this effect is similar or different in Black and White children. Objectives: We compared Black and White children for the association between family conflict and STBs in a national sample of 9–10-year-old American children. Methods: This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) study. This study included 9918 White or Black children between the ages of 9 and 10 living in married households. The predictor variable was family conflict. Race was the moderator. The outcome variable was STBs, treated as a count variable, reflecting positive STB items that were endorsed. Covariates included ethnicity, sex, age, immigration status, family structure, parental education, and parental employment, and household income. Poisson regression was used for data analysis. Results: Of all participants, 7751 were Whites, and 2167 were Blacks. In the pooled sample and in the absence of interaction terms, high family conflict was associated with higher STBs. A statistically significant association was found between Black race and family conflict, suggesting that the association between family conflict and STBs is stronger in Black than White children. Conclusion: The association between family conflict and STBs is stronger in Black than White children. Black children with family conflict may be at a higher risk of STBs than White children with the same family conflict level. These findings align with the literature on the more significant salience of social relations as determinants of mental health of Black than White people. Reducing family conflict should be regarded a significant element of suicide prevention for Black children in the US.
Collapse
|
111
|
Aguinaldo LD, Goldstone A, Hasler BP, Brent DA, Coronado C, Jacobus J. Preliminary analysis of low-level alcohol use and suicidality with children in the adolescent brain and cognitive development (ABCD) baseline cohort. Psychiatry Res 2021; 299:113825. [PMID: 33713937 PMCID: PMC8224175 DOI: 10.1016/j.psychres.2021.113825] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 02/21/2021] [Indexed: 12/21/2022]
Abstract
Cross-sectional analyses were conducted in the baseline cohort of the Adolescent Brain and Cognitive Development (ABCD) Study to determine if lifetime low-level alcohol use was associated with an increased likelihood of lifetime suicidality (N=10,773, ages 9-10). Among the lifetime suicide ideation and attempt groups, 37.7% and 36.2% reported lifetime low-level alcohol use, respectively; versus 22.2% in the non-suicidality group. Children reporting lifetime alcohol use (i.e., ≥ a sip) showed a nearly two-fold increase in their odds of lifetime suicidality compared to those with no previous alcohol use. Future prospective research with this cohort will continue to probe alcohol-suicidality associations.
Collapse
Affiliation(s)
- Laika D. Aguinaldo
- University of California San Diego, Department of Psychiatry, La Jolla, California, USA
| | - Aimee Goldstone
- SRI International, Human Sleep Research Program, Menlo Park, California, USA
| | - Brant P. Hasler
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, USA
| | - David A. Brent
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, USA
| | - Clarisa Coronado
- University of California San Diego, Department of Psychiatry, La Jolla, California, USA
| | - Joanna Jacobus
- University of California San Diego, Department of Psychiatry, La Jolla, California, USA.
| |
Collapse
|
112
|
Hansen-Moore JA, Kapa HM, Litteral JL, Nahata L, Indyk JA, Jayanthi VR, Chan YM, Tishelman AC, Crerand CE. Psychosocial Functioning Among Children With and Without Differences of Sex Development. J Pediatr Psychol 2021; 46:69-79. [PMID: 33313877 DOI: 10.1093/jpepsy/jsaa089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess health-related quality of life (HRQoL), psychosocial adjustment, and family functioning of children with differences of sex development (DSD) or cleft lip and/or palate (CL/P). METHODS In this cross-sectional study, parents of children with DSD (n = 67), CL/P (n = 121), and a comparison group of unaffected youth (n = 126) completed standardized measures assessing family functioning and their children's HRQoL and psychosocial adjustment. Medical charts were abstracted for youth with either congenital condition. RESULTS Children with DSD were rated as having significantly lower HRQoL and greater internalizing problems compared to youth with CL/P and unaffected youth. Children in the DSD group were also significantly more likely to fall into the clinical risk categories for total and internalizing problems relative to the CL/P and unaffected groups. Caregivers of children with DSD were significantly more likely to endorse items about child suicidality compared with caregivers in the CL/P and unaffected groups. No significant differences were found between groups for externalizing problems or the expressiveness domain of family functioning; parents of children with DSD reported significantly less family conflict relative to the other groups and greater cohesion relative to the unaffected group. Conclusions Youth with DSD appear to be at greater risk for psychosocial problems relative to children with CL/P and unaffected peers. Results underscore the need for integrated interdisciplinary care and ongoing psychosocial risk monitoring in youth with DSD.
Collapse
Affiliation(s)
- Jennifer A Hansen-Moore
- Nationwide Children's Hospital.,Department of Pediatrics, The Ohio State University College of Medicine
| | - Hillary M Kapa
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital
| | - Jennifer L Litteral
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital
| | - Leena Nahata
- Nationwide Children's Hospital.,Department of Pediatrics, The Ohio State University College of Medicine.,Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital
| | - Justin A Indyk
- Nationwide Children's Hospital.,Department of Pediatrics, The Ohio State University College of Medicine
| | - Venkata R Jayanthi
- Nationwide Children's Hospital.,Department of Urology, The Ohio State University College of Medicine
| | - Yee-Ming Chan
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital.,Department of Pediatrics, Harvard Medical School
| | - Amy C Tishelman
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital.,Department of Psychiatry, Harvard Medical School
| | - Canice E Crerand
- Nationwide Children's Hospital.,Department of Pediatrics, The Ohio State University College of Medicine.,Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital.,Department of Plastic Surgery, The Ohio State University College of Medicine
| |
Collapse
|
113
|
Gratch I, Fernandes SN, Bell KA, Pollak OH, Fox KR, Tezanos K, Ebo T, Cha CB. Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R): Reliability, Validity, and Inter-Informant Agreement in an Adolescent Sample. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021; 51:484-494. [PMID: 33847199 DOI: 10.1080/15374416.2021.1901229] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: The present study sought to evaluate the psychometric properties and inter-informant agreement of the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R) in adolescents and their parents.Method: Suicidal and nonsuicidal adolescents from the community (N = 206), ages 12-19 years, were administered the SITBI-R during a lab visit. Approximately half of the adolescents' parents opted to complete a parent assessment, including the SITBI-R, on behalf of their child. Inter-rater reliability, convergent validity, and inter-informant agreement were assessed.Results: The SITBI-R exhibited overall excellent inter-rater reliability and good convergent validity in adolescents. Parent-adolescent agreement ranged from fair to poor across most outcomes, with parents tending not to report past self-injurious thoughts and behaviors endorsed by their children.Conclusions: The present study suggests that the SITBI-R can be extended for use with adolescents. Future research should evaluate moderators and implications of parent-adolescent disagreement, particularly with regard to suicide risk.
Collapse
Affiliation(s)
- Ilana Gratch
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Sara N Fernandes
- New York State Psychiatric Institute, Columbia University Irving Medical Center
| | - Kerri-Anne Bell
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Olivia H Pollak
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | - Katherine Tezanos
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Theresa Ebo
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| |
Collapse
|
114
|
Barzilay R, Moore TM, Calkins ME, Maliackel L, Jones JD, Boyd RC, Warrier V, Benton TD, Oquendo MA, Gur RC, Gur RE. Deconstructing the role of the exposome in youth suicidal ideation: Trauma, neighborhood environment, developmental and gender effects. Neurobiol Stress 2021; 14:100314. [PMID: 33869680 PMCID: PMC8040329 DOI: 10.1016/j.ynstr.2021.100314] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/28/2020] [Accepted: 03/04/2021] [Indexed: 02/06/2023] Open
Abstract
Environment (E) is pivotal in explaining variability in brain and behavior development, including suicidal ideation (SI) and behavior. It is therefore critical to systematically study relationships among environmental exposures (i.e., exposome) and suicidal phenotypes. Here, we evaluated the role of individual-level adversity and neighborhood environment and their interaction (E x E) in association with youth SI. Sample included youth (N = 7,054, ages 11–21) from the Philadelphia Neurodevelopmental Cohort, which investigated clinical phenotypes in a diverse US community population. We examined cross-sectional associations of environmental exposures with lifetime history of SI (n = 671), focusing on interactions between individual-level exposures to assaultive trauma (n = 917) and neighborhood-level socioeconomic status (SES) quantified using geocoded Census data. Models included potential confounds and overall psychopathology. Results showed that assaultive trauma was strongly associated with SI (OR = 3.3, 95%CI 2.7–4, p < .001), while low SES was not (p = .395). Both assault and low SES showed stronger association with SI in females, and in early adolescence (all E X gender/age interactions, p < .05). In traumatized youths, lower SES was associated with less SI, with no SES effects on SI in non-traumatized youths (Assault X SES interaction, Wald = 8.19, p = .004). Associations remained significant controlling for overall psychopathology. No single SES variable emerged above others to explain the moderating effect of SES. These findings may suggest a stress inoculation effect in low SES, where youths from higher SES are more impacted by the deleterious trauma-SI association. Determining which environmental factors contribute to resilience may inform population specific suicide prevention interventions. The cross-sectional study design limits causal inferences. Environment (E) is key in shaping development of suicidal ideation (SI). We integrated individual-level trauma exposure and neighborhood-level data on socioeconomic status (SES) in N=7,054 youths. Trauma was robustly associated with youth SI in our cohort, while SES had no association with SI. Only in youth with history of assaultive trauma, low SES was associated with lower SI rates (trauma by SES interaction). Results suggest a stress inoculation effect that was shown in animal models, but has not been shown in human suicide research.
Collapse
Affiliation(s)
- Ran Barzilay
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; The Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA, USA
| | - Tyler M Moore
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; The Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA, USA
| | - Monica E Calkins
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; The Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA, USA
| | - Lydia Maliackel
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; The Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA, USA
| | - Jason D Jones
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; The Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA
| | - Rhonda C Boyd
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; The Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA, USA
| | - Varun Warrier
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridgeshire, UK
| | - Tami D Benton
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; The Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA, USA
| | - Ruben C Gur
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; The Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA, USA
| | - Raquel E Gur
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; The Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA, USA
| |
Collapse
|
115
|
Karcher NR, Barch DM. The ABCD study: understanding the development of risk for mental and physical health outcomes. Neuropsychopharmacology 2021; 46:131-142. [PMID: 32541809 PMCID: PMC7304245 DOI: 10.1038/s41386-020-0736-6] [Citation(s) in RCA: 133] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 12/19/2022]
Abstract
Following in the footsteps of other large "population neuroscience" studies, the Adolescent Brain Cognitive Development℠ (ABCD) study is the largest in the U.S. assessing brain development. The study is examining approximately 11,875 youth from 21 sites from age 9 to 10 for approximately ten years into young adulthood. The ABCD Study® has completed recruitment for the baseline sample generally using a multi-stage probability sample including a stratified random sample of schools. The dataset has a wealth of measured attributes of youths and their environment, including neuroimaging, cognitive, biospecimen, behavioral, youth self-report and parent self-report metrics, and environmental measures. The initial goal of the ABCD Study was to examine risk and resiliency factors associated with the development of substance use, but the project has expanded far beyond this initial set of questions and will also greatly inform our understanding of the contributions of biospecimens (e.g., pubertal hormones), neural alterations, and environmental factors to the development of both healthy behavior and brain function as well as risk for poor mental and physical outcomes. This review outlines how the ABCD Study was designed to elucidate factors associated with the development of negative mental and physical health outcomes and will provide a selective overview of results emerging from the ABCD Study. Such emerging data includes initial validation of new instruments, important new information about the prevalence and correlates of mental health challenges in middle childhood, and promising data regarding neural correlates of both healthy and disordered behavior. In addition, we will discuss the challenges and opportunities to understanding both healthy development and the emergence of risk from ABCD Study data. Finally, we will overview the future directions of this large undertaking and the ways in which it will shape our understanding of the development of risk for poor mental and physical health outcomes.
Collapse
Affiliation(s)
- Nicole R Karcher
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| |
Collapse
|
116
|
Kushal SA, Amin YM, Reza S, Shawon MSR. Parent-adolescent relationships and their associations with adolescent suicidal behaviours: Secondary analysis of data from 52 countries using the Global School-based Health Survey. EClinicalMedicine 2021; 31:100691. [PMID: 33554083 PMCID: PMC7846673 DOI: 10.1016/j.eclinm.2020.100691] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite the potential benefits of parents-adolescent relationships on suicidal behaviours among adolescents, research on these topics are importantly limited by lack of comprehensiveness, difficulties in cross-country comparisons, and limited generalisability, among others. We aimed to estimate the prevalence of various aspects of parents-adolescent relationships and suicidal behaviours by sex and region, and to investigate their associations. METHODS We used data from the Global School-based Health Survey (GSHS) from 52 countries in 2009-2015 for 120 858 adolescents (53.9% girls) aged 12-15 years. Using meta-analysis with random effects, we estimated the prevalence of parents-adolescent relationships (i.e. understanding problems, monitoring academic and leisure time activities, and respecting privacy) and suicidal behaviours (i.e. suicidal ideation, suicide planning, and suicide attempt). Multi-level mixed-effect logistic regressions were used to investigate their associations. FINDINGS Overall, boys and girls reported similar levels of parental understanding of problems (35.8% vs. 36.8%), monitoring academic activities (41.8% vs. 41.1%), and respecting privacy (69.6% vs. 69.7%), whereas girls reported higher level of parental monitoring of leisure time activities than boys (44.9% vs. 40.0%). Adolescents in the Western Pacific region reported the lowest level of parental understanding of problems and monitoring activities, while those in South-East Asia region least reported that their parents respected their privacy. The overall prevalence of any suicidal behaviour was higher in girls than boys (26.2% vs. 23.0%). Suicidal behaviour was less likely in adolescents if their parents understood their problems (odds ratio, 95% confidence intervals: 0.70, 0.68-0.73), monitored their academic (0.81, 0.78-0.84) and leisure time activities (0.73, 0.71-0.75), and respected their privacy (0.83, 0.80-0.86). There was evidence of heterogeneity in those associations by sex and regions. INTERPRETATIONS Although the prevalence of parents-adolescent relationships and adolescent suicidal behaviours varied particularly by sex and region, there were strong and independent associations among them.
Collapse
Affiliation(s)
| | - Yahia Md Amin
- Lifespring, 14th floor, Union heights, 55/2, Panthapath, Dhaka 1205, Bangladesh
| | - Shusama Reza
- Lifespring, 14th floor, Union heights, 55/2, Panthapath, Dhaka 1205, Bangladesh
| | - Md Shajedur Rahman Shawon
- Centre for Big Data Research in Health, UNSW Medicine, Level 2, AGSM Building (G27), UNSW Sydney, NSW 2052, Australia
- Corresponding author.
| |
Collapse
|
117
|
Walsh RFL, Sheehan AE, Liu RT. Suicidal thoughts and behaviors in preadolescents: Findings and replication in two population-based samples. Depress Anxiety 2021; 38:48-56. [PMID: 32789968 PMCID: PMC7785704 DOI: 10.1002/da.23087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/16/2020] [Accepted: 07/29/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Given increasing concern in suicide in preadolescent children, this study aimed to characterize and identify potential indicators of risk for suicidal ideation (SI) and suicide attempts (SAs) in this population. METHODS Data were drawn from two population-based samples of preadolescents: the 2007 and 2010 Minnesota Student Survey and analyses were restricted to 11- and 12-year-olds. Sociodemographic characteristics, childhood maltreatment, parental relations, peer relations, and school climate were examined in relation to past-year SI and SA. To examine correlates of SI, unconfounded by risk for SA, individuals with a history of SA were excluded from SI analyses. Correlates of SA were examined among individuals with past-year SI. Logistic regression analyses were conducted with past-year SI and SA as criterion variables. RESULTS Results from the 2007 and 2010 data sets were highly consistent. The prevalence of past-year SI was 9.28% and 9.25% in 2007 and 2010, respectively. Of the total sample, 1.90% and 1.87% reported a past-year SA (17.00% and 16.78% of those with past-year SI). Overall, effect sizes were generally modest to medium. The strongest effects were observed for sexual and physical abuse, parental support, and perceived safety at school (ps < .001). In multivariate analyses of SI and SA, sexual and physical abuse had the largest effect sizes (ORSI = 2.18 [95% CI = 1.90-2.51] to 2.96 [95% CI = 2.69-3.26]; ORSA = 1.55 [95% CI = 1.29-1.86] to 2.26 [95% CI = 1.82-2.80]). CONCLUSIONS SI and SA occur at a concerning rate among preadolescent children. Screening for childhood sexual and physical abuse may be important for identifying those at risk for these clinical outcomes.
Collapse
Affiliation(s)
- Rachel F L Walsh
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Ana E Sheehan
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware
| | - Richard T Liu
- Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
118
|
Simone AC, Hamza CA. Examining the disclosure of nonsuicidal self-injury to informal and formal sources: A review of the literature. Clin Psychol Rev 2020; 82:101907. [DOI: 10.1016/j.cpr.2020.101907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/07/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022]
|
119
|
Isumi A, Doi S, Yamaoka Y, Takahashi K, Fujiwara T. Do suicide rates in children and adolescents change during school closure in Japan? The acute effect of the first wave of COVID-19 pandemic on child and adolescent mental health. CHILD ABUSE & NEGLECT 2020; 110:104680. [PMID: 32847679 PMCID: PMC7443207 DOI: 10.1016/j.chiabu.2020.104680] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has severely impacted the lives of children and adolescents. School closure, one of the critical changes during the first COVID-19 wave, caused decreases in social contacts and increases in family time for children and adolescents. This can have both positive and negative influences on suicide, which is one of the robust mental health outcomes. However, the impact of the COVID-19 crisis on children and adolescents in terms of suicide is unknown. OBJECTIVE This study investigates the acute effect of the first wave of the COVID-19 pandemic on suicide among children and adolescents during school closure in Japan. DATA Total number of suicides per month among children and adolescents under 20 years old between January 2018 and May 2020. METHODS Poisson regression was used to examine whether suicide increased or decreased during school closure, which spanned from March to May 2020, compared with the same period in 2018 and 2019. Robustness check was conducted using all data from January 2018 to May 2020. Negative binomial regression, a model with overdispersion, was also performed. RESULTS We found no significant change in suicide rates during the school closure (incidence rate ratio (IRR) = 1.15, 95% confidence interval (CI): 0.81 to 1.64). We found the main effect of month, that is, suicides significantly increased suicides in May (IRR: 1.34, 95% CI: 1.01 to 1.78) compared to March, but the interaction terms of month and school closure were not significant (p > 0.1). CONCLUSIONS As preliminary findings, this study suggests that the first wave of the COVID-19 pandemic has not significantly affected suicide rates among children and adolescents during the school closure in Japan.
Collapse
Affiliation(s)
- Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan; Japan Society of the Promotion of Science, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan; Japan Society of the Promotion of Science, Japan
| | - Yui Yamaoka
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
| | - Kunihiko Takahashi
- Medical and Dental Data Science Center, Tokyo Medical and Dental University, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
| |
Collapse
|
120
|
Effects of family-focused therapy on suicidal ideation and behavior in youth at high risk for bipolar disorder. J Affect Disord 2020; 275:14-22. [PMID: 32658817 PMCID: PMC7395856 DOI: 10.1016/j.jad.2020.06.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/30/2020] [Accepted: 06/17/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Youth who are at clinical and familial risk for bipolar disorder (BD) often have significant suicidal ideation (SI). In a randomized trial, we examined whether family-focused therapy (FFT) is associated with reductions in SI and suicidal behaviors in high-risk youth. METHODS Participants (ages 9-17 years) met diagnostic criteria for unspecified BD or major depressive disorder with active mood symptoms and had at least one relative with BD type I or II. Participants were randomly allocated to 12 sessions in 4 months of FFT or 6 sessions in 4 months of psychoeducation (enhanced care, EC), with pharmacotherapy as needed. Clinician- and child-rated assessments of mood, suicidal thoughts and behaviors, and family conflict were obtained at baseline and 4-6 month intervals over 1-4 years. RESULTS Participants (N=127; mean 13.2±2.6 yrs., 82 female) were followed over an average of 105.9±64.0 weeks. Youth with high baseline levels of SI who received FFT had lower levels of (and fewer weeks with) SI at follow-up compared to youth with high baseline SI who received EC. Participants in FFT had longer intervals without suicidal behaviors than participants in EC. Youths' ratings of family conflict significantly mediated the effects of treatment on SI at follow-up. LIMITATIONS Family conflict was based on questionnaires rather than observer ratings of family interactions. CONCLUSIONS Family psychoeducation with skill training can be an effective deterrent to suicidal thoughts and behaviors in youth at high risk for BD. Reducing parent/offspring conflict should be a central objective of psychosocial interventions for high-risk youth with SI.
Collapse
|
121
|
Abstract
PURPOSE OF REVIEW As a global pandemic, COVID-19 has profoundly disrupted the lives of individuals, families, communities, and nations. This report summarizes the expected impact of COVID-19 on behavioral health, as well as strategies to address mental health needs during the COVID-19 pandemic and its aftermath. The state of Michigan in the USA is used to illustrate the complexity of the mental health issues and the critical gaps in the behavioral health infrastructure as they pertain to COVID-19. Scoping review was conducted to identify potential mental health needs and issues during the COVID-19 pandemic and its aftermath. RECENT FINDINGS The ramifications of COVID-19 on mental health are extensive, with the potential to negatively impact diverse populations including healthcare providers, children and adolescents, older adults, the LGBTQ community, and individuals with pre-existing mental illness. Suicide rates, alone, are expected to rise for Michiganders due to the economic downturn, isolation and quarantine, increased substance use, insomnia, and increased access to guns associated with the COVID-19 pandemic. This report promotes awareness of a behavioral health crisis due to COVID-19. Increasing access to behavioral health care should minimize COVID-19's negative influence on mental health in Michigan. We propose a three-prong approach to access: awareness, affordability, and technology. Addressing workforce development and fixing gaps in critical behavioral health infrastructure will also be essential. These actions need to be implemented immediately to prepare for the expected "surge" of behavioral health needs in the ensuing months.
Collapse
|
122
|
Gabriel IM, Costa LCR, Campeiz AB, Salim NR, Silva MAI, Carlos DM. Autolesão não suicida entre adolescentes: significados para profissionais da educação e da Atenção Básica à Saúde. ESCOLA ANNA NERY 2020. [DOI: 10.1590/2177-9465-ean-2020-0050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo conhecer as percepções dos profissionais da educação e da saúde acerca da autolesão não suicida em adolescentes. Método pesquisa qualitativa, tendo como referencial teórico o Interacionismo Simbólico. Coleta de dados realizada junto a 20 profissionais de uma escola e de uma Unidade de Saúde da Família de São Carlos-SP, por meio de grupos focais e diário de campo. A análise de dados se deu pela modalidade temática indutiva. Resultados revelou-se que a adolescência ainda é vista como período de transição, e a autolesão emerge como passageira e pela busca por atenção. Reforça-se a banalização, principalmente, pela crença do efeito contágio, em que os adolescentes reproduzem o ato realizado por pares. As relações familiares e com a Internet são sinalizadas como propagadoras do fenômeno. Frente a esses significados, o cuidado é fragilizado, baseado em ações pontuais. Conclusão e implicações para a prática os profissionais agem frente à autolesão na adolescência de acordo com os significados que são construídos por eles. É urgente a necessidade de educação permanente sobre tais questões, o delineamento de ações promotoras de saúde mental no contexto escolar e construção de protocolos para cuidado intersetorial.
Collapse
|