101
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Cha CB, Franz PJ, Guzmán EM, Glenn CR, Kleiman EM, Nock MK. Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment. J Child Psychol Psychiatry 2018; 59:460-482. [PMID: 29090457 PMCID: PMC5867204 DOI: 10.1111/jcpp.12831] [Citation(s) in RCA: 276] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Suicide is a leading cause of death and a complex clinical outcome. Here, we summarize the current state of research pertaining to suicidal thoughts and behaviors in youth. We review their definitions/measurement and phenomenology, epidemiology, potential etiological mechanisms, and psychological treatment and prevention efforts. RESULTS We identify key patterns and gaps in knowledge that should guide future work. Regarding epidemiology, the prevalence of suicidal thoughts and behaviors among youth varies across countries and sociodemographic populations. Despite this, studies are rarely conducted cross-nationally and do not uniformly account for high-risk populations. Regarding etiology, the majority of risk factors have been identified within the realm of environmental and psychological factors (notably negative affect-related processes), and most frequently using self-report measures. Little research has spanned across additional units of analyses including behavior, physiology, molecules, cells, and genes. Finally, there has been growing evidence in support of select psychotherapeutic treatment and prevention strategies, and preliminary evidence for technology-based interventions. CONCLUSIONS There is much work to be done to better understand suicidal thoughts and behaviors among youth. We strongly encourage future research to: (1) continue improving the conceptualization and operationalization of suicidal thoughts and behaviors; (2) improve etiological understanding by focusing on individual (preferably malleable) mechanisms; (3) improve etiological understanding also by integrating findings across multiple units of analyses and developing short-term prediction models; (4) demonstrate greater developmental sensitivity overall; and (5) account for diverse high-risk populations via sampling and reporting of sample characteristics. These serve as initial steps to improve the scientific approach, knowledge base, and ultimately prevention of suicidal thoughts and behaviors among youth.
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Affiliation(s)
- Christine B. Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia
University
| | | | - Eleonora M. Guzmán
- Department of Counseling and Clinical Psychology, Teachers College, Columbia
University
| | - Catherine R. Glenn
- Department of Clinical and Social Sciences in Psychology, University of
Rochester
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102
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Niederkrotenthaler T, Helgesson M, Rahman S, Wang M, Mittendorfer-Rutz E. Period effects in the risk of subsequent labour market marginalisation in young suicide attempters. Eur J Public Health 2018; 28:253-258. [PMID: 29036335 DOI: 10.1093/eurpub/ckx140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Suicide attempt in young age is associated with subsequent labour market marginalisation, but little is known about how marginalisation is affected by changes in suicide attempt rates and social insurance legislation and by age differences. Methods Prospective cohort study based on register linkage of > 2.4 million Swedish residents per birth cohort, aged 19-40 years in 1999; 2004 and 2009, respectively, and followed up for 4 years. Suicide attempters treated in inpatient care in the three years preceding study entry (n > 7000 per cohort) were compared with the general population of the same age without attempt (1987 to end of follow-up). Hazard ratios (HR) and 95% confidence intervals for long-term unemployment (>180 days), sickness absence (>90 days) and disability pension were calculated with Cox regression, adjusted for several risk markers. Additional analyses were stratified by age (below/above 30 years). Results Across all cohorts, suicide attempt was associated with subsequent labour market marginalisation. Estimates were generally highest for disability pension [e.g. 2009 cohort: adjusted (a) HR = 2.7], followed by sickness absence (2009 cohort: aHR = 2.3) and unemployment (2009 cohort: aHR = 1.5). aHRs were higher in the 2004 and 2009 cohorts compared with the 1999 cohort. For disability pension, for example, aHRs were 2.39, 3.90 and 2.68 for the 1999, 2004 and 2009 cohorts, respectively. Stratification revealed marginal age differences. Conclusion It seems to have become more difficult for suicide attempters to establish themselves on the labour market in later cohorts, which might result from changes in social insurance regulations. There were no considerable age differences.
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Affiliation(s)
- T Niederkrotenthaler
- Suicide Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - M Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - S Rahman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - M Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - E Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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103
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Liu ZZ, Chen H, Bo QG, Chen RH, Li FW, Lv L, Jia CX, Liu X. Psychological and behavioral characteristics of suicide attempts and non-suicidal self-injury in Chinese adolescents. J Affect Disord 2018; 226:287-293. [PMID: 29024902 DOI: 10.1016/j.jad.2017.10.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 09/24/2017] [Accepted: 10/01/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Suicide attempts (SA) and non-suicidal self-injury (NSSI) are prevalent in adolescents and important risk factors of suicide death. Both SA and NSSI are associated with multiple psychosocial, behavioral, biological and genetic factors. This study examined similarities and differences in psychological vulnerability and internalizing and externalizing problems between adolescents with SA and NSSI. METHODS Participants consisted of 11,831 students and had a mean age of 14.97 (SD = 1.46) years. Students completed a structured questionnaire to report their demographic information, psychological characteristics, internalizing and externalizing problems, SA and NSSI. Based on the history of NSSI and SA in the last year, the sample was divided into four groups: non-self-harm (NSH), NSSI only, SA only, and NSSI+SA. Multivariate analyses of covariance and post-hoc pairwise comparisons were performed for multiple comparisons. RESULTS Compared with NSH group, adolescents with either NSSI or SA scored significantly higher on trait anger, impulsiveness, hopelessness, internalizing and externalizing problems. NSSI+SA group and SA only group scored significantly higher than NSSI only group but both did not score significantly different on most psychological and behavioral variables. LIMITATIONS Limitations include reliance on self-reported measures and cross-sectional survey. CONCLUSIONS Psychological and behavioral profiles between adolescents with SA and NSSI are similar but are more severe in suicide attempters. The findings highlight the necessity of assessing psychological and behavioral problems for prevention and early intervention of adolescent self-harm.
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Affiliation(s)
- Zhen-Zhen Liu
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China
| | - Hua Chen
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China
| | - Qi-Gui Bo
- Centers for Disease Control and Prevention of Lijin County, Lijin 257400, China
| | - Ren-Hong Chen
- Centers for Disease Control and Prevention of Yanggu County, Yanggu 252300, China
| | - Feng-Wen Li
- Centers for Disease Control and Prevention of Zoucheng City, Zoucheng 273500, China
| | - Lei Lv
- Education bureau of Yanggu County, Yanggu 252300, China
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China.
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China; School of Psychology, South China Normal University, Shipai, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, United States.
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104
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Ferro MA, Rhodes AE, Kimber M, Duncan L, Boyle MH, Georgiades K, Gonzalez A, MacMillan HL. Suicidal Behaviour Among Adolescents and Young Adults with Self-Reported Chronic Illness. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2017; 62:845-853. [PMID: 28814100 PMCID: PMC5714119 DOI: 10.1177/0706743717727242] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aims of this study were to estimate the: (1) 12-mo prevalence of suicidal thoughts, plans, and attempts in a population sample of adolescents and young adults with and without chronic illness; (2) associations among chronic illness and suicidal thoughts and behaviour (STB); and, (3) moderating roles of mood and substance use disorder on this association. METHOD Individuals were aged 15 to 30 y ( n = 5,248) from the Canadian Community Health Survey-Mental Health. Twelve-month STB and psychiatric disorder were measured using the World Health Organization Composite International Diagnostic Interview 3.0. Multinomial logistic regression examined associations between chronic illness and STB, adjusting for relevant sociodemographic and health characteristics. Product term interactions among chronic illness, mood, and substance use disorders were included in the regression models to examine potential moderating effects. RESULTS Prevalence of suicidal thoughts, plans, and attempts was higher in individuals with chronic illness ( P < 0.01 for all). After adjustment, chronic illness increased the odds for suicidal thoughts [OR = 1.28 (1.01 to 1.64)], plans [OR = 2.34 (1.22 to 4.39)], and attempts [OR = 4.63 (1.52 to 14.34)]. In the presence v. absence of a mood disorder, the odds for suicidal thoughts were higher among individuals with chronic illness [OR = 1.89 (1.06 to 5.28)]. CONCLUSIONS Suicidal thoughts and behaviours are common among adolescents and young adults with chronic illness, particularly among those with comorbid mood disorders. Health professionals should routinely ask about STB during assessments of their adolescent and young adult patients.
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Affiliation(s)
- Mark A Ferro
- 1 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario
| | - Anne E Rhodes
- 2 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario.,3 Department of Psychiatry, University of Toronto, Toronto, Ontario.,4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Melissa Kimber
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Laura Duncan
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Michael H Boyle
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Andrea Gonzalez
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Harriet L MacMillan
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,5 Department of Pediatrics, McMaster University, Hamilton, Ontario
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105
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Patchin JW, Hinduja S. Digital Self-Harm Among Adolescents. J Adolesc Health 2017; 61:761-766. [PMID: 28935385 DOI: 10.1016/j.jadohealth.2017.06.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/15/2017] [Accepted: 06/15/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Despite increased media and scholarly attention to digital forms of aggression directed toward adolescents by their peers (e.g., cyberbullying), very little research has explored digital aggression directed toward oneself. "Digital self-harm" is the anonymous online posting, sending, or otherwise sharing of hurtful content about oneself. The current study examined the extent of digital self-harm among adolescents. METHODS Survey data were obtained in 2016 from a nationally representative sample of 5,593 American middle and high school students (12-17 years old). Logistic regression analysis was used to identify correlates of participation in digital self-harm. Qualitative responses were also reviewed to better understand motivations for digital self-harm. RESULTS About 6% of students have anonymously posted something online about themselves that was mean. Males were significantly more likely to report participation (7.1% compared to 5.3%). Several statistically significant correlates of involvement in digital self-harm were identified, including sexual orientation, experience with school bullying and cyberbullying, drug use, participation in various forms of adolescent deviance, and depressive symptoms. CONCLUSIONS Digital self-harm is a new problem that demands additional scholarly attention. A deeper inquiry as to the motivations behind this behavior, and how it correlates to offline self-harm and suicidal ideation, can help direct mental health professionals toward informed prevention approaches.
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106
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Fonseca-Pedrero E, Inchausti F, Pérez-Gutiérrez L, Aritio Solana R, Ortuño-Sierra J, Sánchez-García MªÁ, Lucas-Molina B, Domínguez C, Foncea D, Espinosa V, Gorría A, Urbiola-Merina E, Fernández M, Merina Díaz C, Gutiérrez C, Aures M, Campos MS, Domínguez-Garrido E, Pérez de Albéniz Iturriaga A. Suicidal ideation in a community-derived sample of Spanish adolescents. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 11:76-85. [PMID: 29102308 DOI: 10.1016/j.rpsm.2017.07.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/24/2017] [Accepted: 07/26/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Suicide is a current public health problem and among the main causes of mortality in adolescents and young adults. The main goal of this study was to analyse suicidal ideation in a representative sample of Spanish adolescents. Specifically, the prevalence rates of suicide ideation, the psychometric properties of the Paykel Suicide Scale (PSS) scores, and the socio-emotional adjustment of adolescents at risk for suicide were analysed. MATERIAL AND METHODS The sample consisted of 1,664 participants (M=16.12 years, SD=1.36, range 14-19 years), selected by stratified sampling by clusters. The instruments used were the PSS, the Strengths and Difficulties Questionnaire, the Personal Wellbeing Index-School Children, and the Oviedo Infrequency Scale. RESULTS The results showed that 4.1% of the sample indicated that they had tried to commit suicide in the previous year. Statistically significant differences were found according to gender but not according to age in the PSS mean scores. The analysis of the internal structure of the PSS showed that the one-dimensional model presented excellent goodness of fit indexes. This model showed measurement invariance across gender. The reliability of the scores, estimated with ordinal alpha, was 0.93. Participants who reported suicide ideation showed poorer mental health status and lower life satisfaction compared to the non-suicide ideation group. CONCLUSIONS Suicidal ideation is present during adolescence and is associated with poor subjective well-being and increased emotional and behavioural problems. PSS seems to show adequate psychometric behaviour to assess suicidal ideation in adolescents. These findings have clear implications, both in health and education systems, to improve the promotion of emotional well-being and prevention of psychological and psychiatric problems in this sector of the population.
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Affiliation(s)
- Eduardo Fonseca-Pedrero
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España.
| | - Félix Inchausti
- Centro de Salud Mental Ermitagaña, Complejo Hospitalario de Navarra, Pamplona, España
| | | | - Rebeca Aritio Solana
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | - Javier Ortuño-Sierra
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | | | | | - César Domínguez
- Departamento de Matemáticas y Computación, Universidad de La Rioja, Logroño, España
| | - David Foncea
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | - Virginia Espinosa
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | - Ana Gorría
- Consejería de Salud, Gobierno de La Rioja, Logroño, España
| | | | | | | | | | - Marta Aures
- Consejería de Salud, Gobierno de La Rioja, Logroño, España
| | - María S Campos
- Consejería de Salud, Gobierno de La Rioja, Logroño, España
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107
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Becker K, Adam H, In-Albon T, Kaess M, Kapusta N, Plener PL, für die Leitliniengruppe. Diagnostik und Therapie von Suizidalität im Jugendalter: Das Wichtigste in Kürze aus den aktuellen Leitlinien. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2017; 45:485-497. [DOI: 10.1024/1422-4917/a000516] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Zusammenfassung. Aufgrund der klinischen Relevanz von suizidalen Krisen, Suizidversuchen und Suiziden im Jugendalter wurde eine konsensusbasierte Leitlinie als Handlungsempfehlung erstellt. Jede Andeutung in Richtung Suizidalität muss ernst genommen werden. Suizidalität ist ein zentraler Bestandteil des psychopathologischen Befunds und Patienten sollten gezielt auf kurz- und langfristige Suizidgefährdung exploriert werden. Eine klinische Einschätzung des akuten Suizidrisikos ergibt sich aus einem vertrauensvollen anamnestischen Gespräch, der Erhebung von Risikofaktoren und dem Erfassen von psychischen Störungen sowie von Suchtmittelkonsum. Bei akuter Selbstgefährdung besteht eine Indikation zur stationären Behandlung, die zum Schutz des Patienten notfalls auch gegen dessen Willen umgesetzt werden muss. Eine adäquate Dokumentation ist unumgänglich. Nach einem Suizidversuch ist neben der fachärztlichen medizinischen Erstversorgung darauf zu achten, dass der Patient sich nicht schaden kann und rasch ein Konsil in der akutversorgenden Klinik erfolgt. Erstes therapeutisches Ziel ist die Reduktion der Suizidalität und ggf. das Wiedererreichen der Absprachefähigkeit. Für wiederkehrende Suizidgedanken ist ein Notfallplan zu erstellen. Zur Entlastung kann zusätzlich zu Gesprächsangeboten vorübergehend eine sedierende Medikation notwendig werden. Im Falle eines Suizids in einer Klinik sollte ein Handlungsleitfaden vorliegen, der die Zuständigkeiten und Abläufe genau regelt und festhält. Wirksame präventive Maßnahmen sind Schulungen von Multiplikatoren, Aufklärungskampagnen, Einschränkung der Verfügbarkeit von Suizidmethoden und die Einhaltung der Richtlinien zur Suizidberichterstattung.
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Affiliation(s)
- Katja Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Hubertus Adam
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Martin Gropius Krankenhaus, Eberswalde
| | - Tina In-Albon
- Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Koblenz-Landau
| | - Michael Kaess
- Klinik für Kinder- und Jugendpsychiatrie, Zentrum für Psychosoziale Medizin, Universität Heidelberg
| | - Nestor Kapusta
- Klinik für Psychoanalyse und Psychotherapie, Medizinische Universität Wien
| | - Paul L. Plener
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universitätsklinik Ulm
| | - für die Leitliniengruppe
- Leitliniengruppe Suizidalität im Kindes- und Jugendalter (Koordination Prof. Dr. K. Becker & PD Dr. P. Plener) in alphabetischer Reihenfolge: Prof. Dr. H. Adam, Dr. M. Bahr, Prof. Dr. H. Braun-Scharm, Dipl.-Soz.päd. E. Brockmann, Prof. Dr. R. Brunner, Prof. Dr. E. Etzersdorfer, Prof. Dr. J. M. Fegert, Dr. M. Fischer, Prof. Dr. T. In-Albon, Dr. M. Jung, PD Dr. M. Kaess, Prof. Dr. N. Kapusta, Dr. J. Klein-Heßling, Dipl.-Psych. R. Merod, Dr. S. Schaller, Prof. Dr. A. Schmidtke, L. Werling
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108
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Sohn M, Oh H, Lee SK, Potenza MN. Suicidal Ideation and Related Factors Among Korean High School Students: A Focus on Cyber Addiction and School Bullying. J Sch Nurs 2017; 34:310-318. [PMID: 28992754 DOI: 10.1177/1059840517734290] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The purpose of the study was to explore the association among suicidal ideation, cyber addiction, and school bullying of Korean high school students. This descriptive cross-sectional study included 416 students. The data were collected using structured questionnaires on suicidal ideation, Internet and smartphone addiction, experiences of school bullying, impulsiveness, and depression. Students who were bullied (odds ratio [ OR] = 3.0, 95% CI [1.1, 8.4]) and more depressed ( OR = 10.8, 95% CI [2.4, 48.2]) were more likely to have higher scores for suicidal ideation; however, when a lower stringency was used, female gender ( OR = 2.3, 95% CI [1.3, 4.0]) and addiction to smartphones ( OR = 2.4, 95% CI [1.1, 5.4]) were also statistically significant contributors to the presence of suicidal ideation. Students with suicidal ideation that is higher than average, but lower than the classical thresholds for risk group designation, should also be carefully assessed for early detection and intervention. Cyber addiction may be a particularly significant contributor to suicidal ideation, in addition to bullying and depressive mood, among Korean adolescents.
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Affiliation(s)
- Min Sohn
- 1 Department of Nursing, Inha University, Incheon, South Korea
| | - Heymin Oh
- 1 Department of Nursing, Inha University, Incheon, South Korea
| | - Sang-Kyu Lee
- 2 Department of Psychiatry, Hallym University College of Medicine, Chuncheon, South Korea.,3 Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- 3 Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,4 Department of Neuroscience and Child Study Center, Yale University School of Medicine, New Haven, CT, USA.,5 National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, CT, USA.,6 The Connecticut Mental Health Center, New Haven, CT, USA
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109
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Simioni AR, Pan PM, Gadelha A, Manfro GG, Mari JJ, Miguel EC, Rohde LA, Salum GA. Prevalence, clinical correlates and maternal psychopathology of deliberate self-harm in children and early adolescents: results from a large community study. ACTA ACUST UNITED AC 2017; 40:48-55. [PMID: 28832748 PMCID: PMC6899416 DOI: 10.1590/1516-4446-2016-2124] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 04/02/2017] [Indexed: 11/22/2022]
Abstract
Objectives: Little is known about the prevalence and correlates of deliberate self-harm (DSH) in children from low- and middle-income countries. We investigated the prevalence of DSH and its clinical and maternal psychopathological associations in Brazilian children (n=2,508, ages 6-14y) in a community-based study. Methods: Participants of the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders (HRC) and their mothers were assessed in structured interviews. Current (last month) and lifetime DSH were estimated, including analysis stratified by age groups. Logistic regressions were performed to investigate the role of the children’s clinical diagnoses and maternal psychopathology on DSH prevalence estimates, adjusting for potential confounding factors. Results: The prevalence of current DSH was 0.8% (children 0.6%, adolescents 1%) and lifetime DSH was 1.6% (1.8% and 1.5%, respectively). Current and lifetime DSH were more frequent in children with depression, attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), even in multiple models accounting for demographic variables and co-occurring psychiatric disorders. Maternal anxiety disorder was strongly associated with current and lifetime DSH in offspring; whereas current DSH, specifically in young children, was associated with maternal mood disorder. Conclusion: Diagnoses of depression, ADHD and ODD were consistently associated with DSH, as was having a mother with anxiety disorder.
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Affiliation(s)
- André R Simioni
- Seção de Afeto Negativo e Processos Sociais, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São Paulo, SP, Brazil.,Departamento de Psiquiatria, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Pedro M Pan
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São Paulo, SP, Brazil.,Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ary Gadelha
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São Paulo, SP, Brazil.,Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Gisele G Manfro
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São Paulo, SP, Brazil.,Departamento de Psiquiatria, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Jair J Mari
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São Paulo, SP, Brazil.,Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Eurípedes C Miguel
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São Paulo, SP, Brazil.,Departamento e Instituto de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Luis A Rohde
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São Paulo, SP, Brazil.,Departamento de Psiquiatria, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil.,Departamento e Instituto de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Giovanni A Salum
- Seção de Afeto Negativo e Processos Sociais, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São Paulo, SP, Brazil.,Departamento de Psiquiatria, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
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110
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Brown RC. [Psychotherapeutic interventions for suicidal adolescents – a systematic review of the current literature]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2017; 45:499-508. [PMID: 28771078 DOI: 10.1024/1422-4917/a000538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although suicidal thoughts and behaviors are common in adolescents, the German guidelines for suicidality in children and adolescents state a lack of evidence for the effectiveness of specific psychotherapies for those patients. The aim of this systematic review was to summarize and critically discuss newest advances in the evaluation of specific therapeutic approaches for suicidality in youths. Building on other recent systematic reviews, 11 manuscripts published between 2013 and 2017 were included in this review. Included are studies on interventions in emergency departments, psychotherapeutic approaches specifically targeting suicidality despite other psychopathology, interventions for youth with specific disorders or risk-factors, and one study evaluating an online-intervention. First positive effects can be claimed for family interventions in emergency departments (regarding lower hospitalization rates) as well as cognitive-behavioral, dialectical-behavioral, and family-oriented interventions (regarding reducing suicidality). Promising results were also found in a pilot study on an online-intervention. However, further research is necessary, as replication of outcomes has not been attempted or published in most cases and studies including large sample sizes with long-term follow-up evaluation are very rare.
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Affiliation(s)
- Rebecca C Brown
- 1 Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Ulm
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111
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Reigstad B, Kvernmo S. Concurrent adversities and suicide attempts among Sami and non-Sami adolescents: the Norwegian Arctic Adolescent Study (NAAHS). Nord J Psychiatry 2017; 71:425-432. [PMID: 28486095 DOI: 10.1080/08039488.2017.1315175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Little is known about connections between adolescent suicide attempts (SA) and concurrent adversities. AIMS In a cross-sectional study, the authors wanted to investigate prevalences, additive effects of adversities, family and peer relations, gender, divorce and poverty, and ethnic differences between Sami and non-Sami youth. METHODS In an adolescent community population encompassing 4881 adolescents of 15-16 years of age, youth with and without self-reports of attempted suicide the last year were compared on 12 concurrent adversities, on scales assessing family and peer functioning, and on sociodemographic variables. RESULTS The prevalence of attempted suicide the last year was 5.3%, and more girls (8.8%) than boys (1.8%). All 12 concurrent adversities were strongly related to SA. The suicide attempters reported two and a half times as many adversities as non-attempters. A strong multiple additive relationship was found. Multivariately, among boys, the strongest risk factors were suicide among friends (OR = 9.4), and suicide in the family or in the neighbourhood (OR = 4.8). Among girls, sexual abuse (OR = 5.2) and parent mental problems (OR = 4.6) were strongest related to SA. Suicide attempters reported more divorce and poverty, more conflicts with parents, and less family support and involvement. Totally, Sami youth reported more SA and more concurrent adversities than non-Sami peers. CONCLUSION Adolescent suicide attempters are heavily burdened with concurrent adversities. Clinicians should be aware of gender differences in risk factors, and should ask about abuse and suicide or attempts among relatives and peers. A family perspective in clinical work is needed.
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Affiliation(s)
- Bjørn Reigstad
- a Department of Research, Division of Research and Patient Safety , Nordlandssykehuset , Bodø , Norway
| | - Siv Kvernmo
- b Department of Clinical Medicine, Faculty of Health Sciences , University of Tromsø, The Arctic University of Norway , Tromsø , Norway
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112
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Wong WHS, Lee JCY, Ho FKW, Li TMH, Ip P, Chow CB. Stock Market Fluctuations and Self-Harm among Children and Adolescents in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060623. [PMID: 28598378 PMCID: PMC5486309 DOI: 10.3390/ijerph14060623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/22/2017] [Accepted: 05/31/2017] [Indexed: 06/07/2023]
Abstract
Although a few studies investigated the impact of stock market fluctuations on population health, the question of whether stock market fluctuations have an impact on self-harm in children and adolescents remain unanswered. This study therefore investigated the association between stock market fluctuations and self-harm among children and adolescents in Hong Kong. Daily self-harm attendance records were retrieved from all 18 local Accident and Emergency Departments (AED) from 2001 to 2012. 4931 children and adolescents who committed self-harm were included. The results indicated positive correlation between daily change in stock market index, Hang Seng Index (∇HSI, per 300 points), and daily self-harm incident risk of children and adolescents, without time lag between the two. The incident risk ratio for ∇HSI was 1.09 (p = 0.0339) in children and 1.06 (p = 0.0246) in adolescents. Importantly, non-trading days were found to impose significant protective effect in both groups against self-harm risk. Our results showed that stock market fluctuations were related to self-harm behaviors in children and adolescents. Parents and professionals should be educated about the potential harm of stock market fluctuations and the importance of effective parenting in reducing self-harm among children and adolescents.
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Affiliation(s)
- Wilfred Hing-Sang Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - James Chun-Yin Lee
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Frederick Ka-Wing Ho
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Tim Man-Ho Li
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Chun-Bong Chow
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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Podlogar T, Žiberna J, Poštuvan V, C R Kerr D. Belongingness and Burdensomeness in Adolescents: Slovene Translation and Validation of the Interpersonal Needs Questionnaire. Suicide Life Threat Behav 2017; 47:336-352. [PMID: 27418450 DOI: 10.1111/sltb.12276] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 05/09/2016] [Indexed: 12/01/2022]
Abstract
The Interpersonal Needs Questionnaire (INQ) for assessing thwarted belongingness (TB) and perceived burdensomeness (PB) has not been validated with community adolescents. We translated and administered the INQ to 307 Slovenian adolescents twice over 2-3 months and found that the 15-item version (INQ-15) did not fit without modification. TB and PB scales correlated with concurrent and later suicide ideation and lifetime suicide attempt history. The latent PB factor was associated with concurrent and later ideation controlling for TB, age, gender, depressive symptoms, binge drinking, and peer victimization. Suicide ideation and binge drinking were independently related to attempt history. Assessing and intervening on PB and binge drinking may be promising approaches to suicide prevention with community adolescents.
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Affiliation(s)
- Tina Podlogar
- Andrej Marušič Institute, Slovene Centre for Suicide Research, University of Primorska, Koper, Slovenia
| | - Janina Žiberna
- Andrej Marušič Institute, Slovene Centre for Suicide Research, University of Primorska, Koper, Slovenia
| | - Vita Poštuvan
- Andrej Marušič Institute, Slovene Centre for Suicide Research, University of Primorska, Koper, Slovenia
| | - David C R Kerr
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
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Polydrug use by European adolescents in the context of other problem behaviours. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017. [DOI: 10.2478/nsad-2014-0026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim Previous studies of the association between polydrug use and other risk behaviours have generally been limited to specific substances and a small number of behaviours. The aim of this study is to obtain better insight into polydrug use (comprising legal and illegal substances: tobacco, alcohol, tranquillisers/sedatives, cannabis, and other illegal drugs) and its association with co-occurring problem behaviours drawn from various broad domains (sexual, aggressive, delinquent, school achievement, relationships) among European adolescents. Methods Data were obtained from 101,401 16-year-old students from 35 European countries participating in the 2011 ESPAD survey. Associations between polydrug use and other problem behaviours were examined by multinomial and binary logistic regression analyses. Results Tranquillisers/sedatives appeared among the commonest combinations in the polydrug use pattern, especially for females. A strong trend was found between levels of involvement with polydrug use and other problem behaviours for both genders. The highest associations with polydrug use were for problems with the police, risky sexual behaviour and skipping school. Gender differences showed higher prevalences among boys than girls of problem behaviours of aggressive, antisocial type, while girls prevailed over boys in relationship problems. Conclusion An incremental relationship exists between the level of involvement with polydrug use and the co-occurrence of problem behaviours. Preventative interventions should consider the misuse of tranquillisers/sedatives within the context of polydrug use by adolescents and expand their target groups towards multiple problem behaviours.
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115
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Quigley J, Rasmussen S, McAlaney J. The Social Norms of Suicidal and Self-Harming Behaviours in Scottish Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E307. [PMID: 28294999 PMCID: PMC5369143 DOI: 10.3390/ijerph14030307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/02/2017] [Accepted: 03/11/2017] [Indexed: 12/02/2022]
Abstract
Although the suicidal and self-harming behaviour of individuals is often associated with similar behaviours in people they know, little is known about the impact of perceived social norms on those behaviours. In a range of other behavioural domains (e.g., alcohol consumption, smoking, eating behaviours) perceived social norms have been found to strongly predict individuals' engagement in those behaviours, although discrepancies often exist between perceived and reported norms. Interventions which align perceived norms more closely with reported norms have been effective in reducing damaging behaviours. The current study aimed to explore whether the Social Norms Approach is applicable to suicidal and self-harming behaviours in adolescents. Participants were 456 pupils from five Scottish high-schools (53% female, mean age = 14.98 years), who completed anonymous, cross-sectional surveys examining reported and perceived norms around suicidal and self-harming behaviour. Friedman's ANOVA with post-hoc Wilcoxen signed-ranks tests indicated that proximal groups were perceived as less likely to engage in or be permissive of suicidal and self-harming behaviours than participants' reported themselves, whilst distal groups tended towards being perceived as more likely to do so. Binary logistic regression analyses identified a number of perceived norms associated with reported norms, with close friends' norms positively associated with all outcome variables. The Social Norms Approach may be applicable to suicidal and self-harming behaviour, but associations between perceived and reported norms and predictors of reported norms differ to those found in other behavioural domains. Theoretical and practical implications of the findings are considered.
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Affiliation(s)
- Jody Quigley
- Division of Psychology, University of Stirling, Stirling FK9 4LA, UK.
| | - Susan Rasmussen
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1QE, UK.
| | - John McAlaney
- Psychology Research Group, Bournemouth University, Fern Barrow, Poole BH12 5BB, UK.
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Davaasambuu S, Batbaatar S, Witte S, Hamid P, Oquendo MA, Kleinman M, Olivares M, Gould M. Suicidal Plans and Attempts Among Adolescents in Mongolia. CRISIS 2017; 38:330-343. [PMID: 28228061 DOI: 10.1027/0227-5910/a000447] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although 75% of suicides occur in low- and middle-income countries, few studies have examined suicidal behaviors among young people in these countries. AIMS This study aimed to examine what individual characteristics were associated with suicidal plans and attempts among Mongolian youth and whether suicidal risks and behaviors varied by urban and rural locations. METHOD Logistic regression analyses were utilized to investigate suicidal plans and attempts among 5,393 adolescents using the Global Student Health Survey - 2013. RESULTS Adolescents who lived in urban areas were at higher risk for suicidal plans and behaviors than those who lived in rural areas; however, the patterns of suicidal risks were similar. Specifically, individual characteristics, such as being female, feeling lonely and worried, smoking cigarettes, drinking alcohol, and having fights at school, were associated with suicidal plans and behaviors regardless of the residential places. LIMITATIONS A number of important variables have not been included in the questionnaire such as depression, family and parental support, household income, family constructs etc. CONCLUSION Given the comparable patterns of risk between urban and rural adolescents and the relatively high rates of suicidal plans and attempts, similar mental health services and interventions are necessitated for both urban and rural areas.
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Affiliation(s)
- Sarantsetseg Davaasambuu
- 1 Global Mental Health Fellowship Program, Department of Psychiatry Epidemiology, Columbia University, New York, NY, USA
| | - Suvd Batbaatar
- 2 Public Health Institute, Ministry of Health, Ulaanbaatar, Mongolia
| | - Susan Witte
- 3 School of Social Work, Columbia University, New York, NY, USA
| | - Phillip Hamid
- 1 Global Mental Health Fellowship Program, Department of Psychiatry Epidemiology, Columbia University, New York, NY, USA
| | - Maria A Oquendo
- 1 Global Mental Health Fellowship Program, Department of Psychiatry Epidemiology, Columbia University, New York, NY, USA.,4 Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA.,5 Departments of Psychiatry, Columbia University, New York, NY, USA
| | - Marjorie Kleinman
- 6 Epidemiology of Psychiatry, Columbia University, New York, NY, USA
| | - Michael Olivares
- 6 Epidemiology of Psychiatry, Columbia University, New York, NY, USA
| | - Madelyn Gould
- 6 Epidemiology of Psychiatry, Columbia University, New York, NY, USA
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Laido Z, Voracek M, Till B, Pietschnig J, Eisenwort B, Dervic K, Sonneck G, Niederkrotenthaler T. Epidemiology of suicide among children and adolescents in Austria, 2001-2014. Wien Klin Wochenschr 2017; 129:121-128. [PMID: 27743176 PMCID: PMC5318485 DOI: 10.1007/s00508-016-1092-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/01/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Previous epidemiological analyses indicated a decreasing trend of suicide rates for 10-19-year-olds in Austria for the period 1970-2001. However, data from the new millennium are missing. This epidemiological update reports on youth suicide in Austria, covering the period 2001-2014 in order to inform suicide preventive interventions targeting adolescents. METHODS The data on registered suicides among Austrian minors (10-19 years) and the population size were obtained from Statistics Austria. Chi-squared tests were used to analyze the associations between the suicide methods used and sex, as well as between suicide methods and Austrian federal states. Spearman correlations were calculated to assess time trends in the suicide rates. One-way ANOVA was used to investigate annual suicide rates of age groups 10-14, 15-19, and 10-19 years across the nine Austrian federal states. RESULTS The total average suicide rate for Austrian minors was 4.57 per 100,000. The male-female ratio was 3.5:1. The total youth suicide rate and male suicide rate significantly declined from 2001 to 2014, whereas there were no significant changes in female rates. More than one third of suicides among Austrian youth occurred through hanging, whereas jumping in front of a moving object was the second-most common suicide method. A spring peak was found, with most suicides occurring in April and May. CONCLUSION Suicide rates among minors in Austria continue to decrease. The present findings help to inform the ongoing implementation of the National Austrian Suicide Prevention Plan (SUPRA).
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Affiliation(s)
- Zrinka Laido
- Suicide Research Unit, Institute of Social Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Martin Voracek
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
| | - Benedikt Till
- Suicide Research Unit, Institute of Social Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Jakob Pietschnig
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Applied Psychology: Health, Development, Enhancement, and Intervention, School of Psychology, University of Vienna, Vienna, Austria
| | - Brigitte Eisenwort
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Child and Adolescent Medicine (day unit, pediatric psychosomatics), Medical University of Vienna, Vienna, Austria
| | - Kanita Dervic
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, Austria
| | - Gernot Sonneck
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Crisis Intervention Center Vienna, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Suicide Research Unit, Institute of Social Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
- Wiener Werkstaette for Suicide Research, Vienna, Austria.
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Beckman K, Mittendorfer-Rutz E, Lichtenstein P, Larsson H, Almqvist C, Runeson B, Dahlin M. Mental illness and suicide after self-harm among young adults: long-term follow-up of self-harm patients, admitted to hospital care, in a national cohort. Psychol Med 2016; 46:3397-3405. [PMID: 27644850 DOI: 10.1017/s0033291716002282] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Self-harm among young adults is a common and increasing phenomenon in many parts of the world. The long-term prognosis after self-harm at young age is inadequately known. We aimed to estimate the risk of mental illness and suicide in adult life after self-harm in young adulthood and to identify prognostic factors for adverse outcome. METHOD We conducted a national population-based matched case-cohort study. Patients aged 18-24 years (n = 13 731) hospitalized after self-harm between 1990 and 2003 and unexposed individuals of the same age (n = 137 310 ) were followed until December 2009. Outcomes were suicide, psychiatric hospitalization and psychotropic medication in short-term (1-5 years) and long-term (>5 years) follow-up. RESULTS Self-harm implied an increased relative risk of suicide during follow-up [hazard ratio (HR) 16.4, 95% confidence interval (CI) 12.9-20.9). At long-term follow-up, 20.3% had psychiatric hospitalizations and 51.1% psychotropic medications, most commonly antidepressants and anxiolytics. There was a six-fold risk of psychiatric hospitalization (HR 6.3, 95% CI 5.8-6.8) and almost three-fold risk of psychotropic medication (HR 2.8, 95% CI 2.7-3.0) in long-term follow-up. Mental disorder at baseline, especially a psychotic disorder, and a family history of suicide were associated with adverse outcome among self-harm patients. CONCLUSION We found highly increased risks of future mental illness and suicide among young adults after self-harm. A history of a mental disorder was an important indicator of long-term adverse outcome. Clinicians should consider the substantially increased risk of suicide among self-harm patients with psychotic disorders.
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Affiliation(s)
- K Beckman
- Centre for Psychiatry Research, Department of Clinical Neuroscience,Karolinska Institutet and Stockholm Health Care Services,Stockholm City Council, St Goran,Stockholm,Sweden
| | - E Mittendorfer-Rutz
- Department of Clinical Neuroscience,Insurance Medicine,Karolinska Institutet,Stockholm,Sweden
| | - P Lichtenstein
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - H Larsson
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - C Almqvist
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - B Runeson
- Centre for Psychiatry Research, Department of Clinical Neuroscience,Karolinska Institutet and Stockholm Health Care Services,Stockholm City Council, St Goran,Stockholm,Sweden
| | - M Dahlin
- Centre for Psychiatry Research, Department of Clinical Neuroscience,Karolinska Institutet and Stockholm Health Care Services,Stockholm City Council, St Goran,Stockholm,Sweden
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119
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Klemera E, Brooks FM, Chester KL, Magnusson J, Spencer N. Self-harm in adolescence: protective health assets in the family, school and community. Int J Public Health 2016; 62:631-638. [PMID: 27658811 PMCID: PMC5487889 DOI: 10.1007/s00038-016-0900-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 09/10/2016] [Accepted: 09/13/2016] [Indexed: 11/26/2022] Open
Abstract
Objectives The aim of this paper was to examine if the multiple environments of the adolescent including family, peers, school and neighbourhood might function as protective health assets against self-harming behaviour during adolescence. Methods The present study utilised data collected from 1608 respondents aged 15 years as part of the England WHO Health Behaviour in School-aged Children (HBSC) Study. Multilevel modelling was undertaken using the package MLwiN (version 2.33) to investigate the potential domains and dimensions of family life, school culture and environment, and neighbourhood factors that may operate as protective health assets. Results The results indicated that while peer support did not appear to operate as a protective health asset in the context of self-harm, key dimensions of adolescent/parent interaction and adolescent experience of the school culture and their neighbourhood were associated with reduced likelihood of self-harming behaviours during adolescence. Conclusions The Findings highlight the significance of belonging and connectedness as important constituent elements of protective health assets for young people. Interventions that address the multiple environments of the young person, may offer an effective means to reduce the levels of self-harm.
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Affiliation(s)
- Ellen Klemera
- The Centre for Research in Primary and Community Care (CRIPACC), University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AL Hertfordshire UK
| | - Fiona M. Brooks
- The Centre for Research in Primary and Community Care (CRIPACC), University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AL Hertfordshire UK
- Faculty of Health, University of Technology Sydney, PO Box 123 Broadway, Sydney NSW 2007, Australia
| | - Kayleigh L. Chester
- The Centre for Research in Primary and Community Care (CRIPACC), University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AL Hertfordshire UK
| | - Josefine Magnusson
- The Centre for Research in Primary and Community Care (CRIPACC), University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AL Hertfordshire UK
| | - Neil Spencer
- Statistical Services and Consultancy Unit, Hertfordshire Business School, University of Hertfordshire, de Havilland Campus, Hatfield, AL10 9EU Hertfordshire UK
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Tudrej BV, Heintz AL, Ingrand P, Gicquel L, Binder P. What do troubled adolescents expect from their GPs? Eur J Gen Pract 2016; 22:247-254. [PMID: 27594206 DOI: 10.1080/13814788.2016.1216541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Adolescents often have emotional and behavioural problems that general practitioners are likely to miss. While nearly 80% of them consult their GP every year, it is usually for physical, not psychological reasons. Trust in their GPs in necessary for screening. OBJECTIVES To identify the key quality desired by adolescents for them to feel free to confide in GPs. To determine whether this quality differed according to gender, level of at-risk behaviours or interlocutor: friend, parent or GP. METHODS A descriptive cross-sectional study was conducted in 182 French educational institutions chosen by lot. Fifteen-year-olds completed a self-administered questionnaire under examination conditions. While the questions on behaviour were drawn from the cross-national survey entitled 'Health behaviour in school-aged children (HBSC),' the questions on conditions conducive to trust were drawn from previous studies. RESULTS A total of 1817 (911 boys, 906 girls) questionnaires were analysed. Adolescents said they seldom confided. The main quality they expected from a GP to whom they could confide in was 'honesty', which meant ensuring secrecy, refraining from judgment, and putting forward the right questions. This priority was modified by neither gender nor experience with health-risk behaviour. The quality of 'reliability' was more closely associated with their parents or friends, while 'emotionality' was cited less often. CONCLUSION To gain the trust of adolescents, GPs have to be sincere and non-manipulative and have the ability to ensure confidentiality and to put forward the right questions without passing judgment. Can this be verified during consultations? Prospective studies could shed light on this point.[Box: see text].
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Affiliation(s)
- Benoit V Tudrej
- a Université de Poitiers UFR Medecine et Pharmacie , Department of General Practice , Poitiers , France.,b Université Paris Descartes , Medical Ethics and Legal Medicine Laboratory , Paris , Île-de-France , France
| | - Anne-Laure Heintz
- a Université de Poitiers UFR Medecine et Pharmacie , Department of General Practice , Poitiers , France
| | - Pierre Ingrand
- c Department of Epidemiology & Biostatistics, INSERM CIC-1402, Faculty of Medicine , Poitiers , France
| | - Ludovic Gicquel
- d Psychiatry and Neurosciences Center, INSERM U894, Child and Adolescent Psychiatry Department , University of Poitiers , France
| | - Philippe Binder
- a Université de Poitiers UFR Medecine et Pharmacie , Department of General Practice , Poitiers , France
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Eskin M, Kujan O, Voracek M, Shaheen A, Carta MG, Sun JM, Flood C, Poyrazli S, Janghorbani M, Yoshimasu K, Mechri A, Khader Y, Aidoudi K, Bakhshi S, Harlak H, Ahmead M, Moro MF, Nawafleh H, Phillips L, Abuderman A, Tran US, Tsuno K. Cross-national comparisons of attitudes towards suicide and suicidal persons in university students from 12 countries. Scand J Psychol 2016; 57:554-563. [DOI: 10.1111/sjop.12318] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/30/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Mehmet Eskin
- Faculty of Medicine; Department of Psychiatry; Adnan Menderes University, Aydin Turkey
| | - Omar Kujan
- Department of Oral and Maxillofacial Sciences; Al-Farabi College for Dentistry and Nursing; Riyadh Saudi Arabia
| | - Martin Voracek
- Department of Basic Psychological Research and Research Methods; School of Psychology; University of Vienna; Austria
| | - Amira Shaheen
- Faculty of Medicine and Health Sciences; An-Najah National University; Nablus West Bank Palestine
| | - Mauro Giovanni Carta
- Department of Public Health, Clinical and Molecular Medicine; University of Cagliari; Italy
| | - Jian-Min Sun
- Department of Psychology and School of Labor and Human Resources; Renmin University of China; Beijing China
| | - Chris Flood
- School of Health Sciences; City University of London; UK
| | - Senel Poyrazli
- School of Behavioral Sciences and Education; Pennsylvania State University-Harrisburg; Middletown Pennsylvania USA
| | - Mohsen Janghorbani
- School of Public Health; Isfahan University of Medical Sciences; Isfahan Iran
| | - Kouichi Yoshimasu
- Department of Hygiene; School of Medicine; Wakayama Medical University; Wakayama Japan
| | - Anwar Mechri
- Department of Psychiatry; University hospital of Monastir; Monastir Tunisia
| | - Yousef Khader
- Department of Community Medicine, Public Health and Family Medicine; Faculty of Medicine; Jordan University of Science & Technology; Irbid Jordan
| | - Khouala Aidoudi
- Department of Psychiatry; University hospital of Monastir; Monastir Tunisia
| | - Seifollah Bakhshi
- School of Public Health; Isfahan University of Medical Sciences; Isfahan Iran
| | - Hacer Harlak
- Faculty of Arts and Sciences; Department of Psychology; Adnan Menderes University, Aydin Turkey
| | - Muna Ahmead
- School of Public Health; Al-Quds University; Jerusalem Palestine
| | - Maria Francesca Moro
- Department of Public Health, Clinical and Molecular Medicine; University of Cagliari; Italy
| | - Hani Nawafleh
- Princess Aisha Faculty of Nursing and Health Sciences; Al-Hussein Bin Talal University; Ma'an Jordan
| | | | - Abdulwahab Abuderman
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al-Kharj Saudi Arabia
| | - Ulrich S. Tran
- Department of Basic Psychological Research and Research Methods; School of Psychology; University of Vienna; Austria
| | - Kanami Tsuno
- Department of Hygiene; School of Medicine; Wakayama Medical University; Wakayama Japan
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Xin X, Ming Q, Zhang J, Wang Y, Liu M, Yao S. Four Distinct Subgroups of Self-Injurious Behavior among Chinese Adolescents: Findings from a Latent Class Analysis. PLoS One 2016; 11:e0158609. [PMID: 27392132 PMCID: PMC4938421 DOI: 10.1371/journal.pone.0158609] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 06/17/2016] [Indexed: 12/27/2022] Open
Abstract
Self-injurious behavior (SIB) among adolescents is an important public health issue worldwide. It is still uncertain whether homogeneous subgroups of SIB can be identified and whether constellations of SIBs can co-occur due to the high heterogeneity of these behaviors. In this study, a cross-sectional study was conducted on a large school-based sample and latent class analysis was performed (n = 10,069, mean age = 15 years) to identify SIB classes based on 11 indicators falling under direct SIB (DSIB), indirect SIB (ISIB), and suicide attempts (SAs). Social and psychological characteristics of each subgroup were examined after controlling for age and gender. Results showed that a four-class model best fit the data and each class had a distinct pattern of co-occurrence of SIBs and external measures. Class 4 (the baseline/normative group, 65.3%) had a low probability of SIB. Class 3 (severe SIB group, 3.9%) had a high probability of SIB and the poorest social and psychological status. Class 1 (DSIB+SA group, 14.2%) had similar scores for external variables compared to class 3, and included a majority of girls [odds ratio (OR) = 1.94]. Class 2 (ISIB group, 16.6%) displayed moderate endorsement of ISIB items, and had a majority of boys and older adolescents (OR = 1.51). These findings suggest that SIB is a heterogeneous entity, but it may be best explained by four homogenous subgroups that display quantitative and qualitative differences. Findings in this study will improve our understanding on SIB and may facilitate the prevention and treatment of SIB.
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Affiliation(s)
- Xiuhong Xin
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
- Department of Medical Psychology, Clinical Medical College, Ningxia Medical University, Yinchuan, Ningxia, China
- Mental Health Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Qingsen Ming
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jibiao Zhang
- Psychology Department, School Education, Jianghan University, Wuhan, Hubei, China
| | - Yuping Wang
- School of Humanities & Social Sciences, Xi’an Jiaotong University, Xi’an, China
| | - Mingli Liu
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
- School of Education, Hunan University of Science and Technology, Xiangtan, Hunan, China
| | - Shuqiao Yao
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
- * E-mail:
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Evans R, Hurrell C. The role of schools in children and young people's self-harm and suicide: systematic review and meta-ethnography of qualitative research. BMC Public Health 2016; 16:401. [PMID: 27179765 PMCID: PMC4867904 DOI: 10.1186/s12889-016-3065-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 04/28/2016] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Evidence reports that schools influence children and young people's health behaviours across a range of outcomes. However there remains limited understanding of the mechanisms through which institutional features may structure self-harm and suicide. This paper reports on a systematic review and meta-ethnography of qualitative research exploring how schools influence self-harm and suicide in students. METHODS Systematic searches were conducted of nineteen databases from inception to June 2015. English language, primary research studies, utilising any qualitative research design to report on the influence of primary or secondary educational settings (or international equivalents) on children and young people's self-harm and suicide were included. Two reviewers independently appraised studies against the inclusion criteria, assessed quality, and abstracted data. Data synthesis was conducted in adherence with Noblit and Hare's meta-ethnographic approach. Of 6744 unique articles identified, six articles reporting on five studies were included in the meta-ethnography. RESULTS Five meta-themes emerged from the studies. First, self-harm is often rendered invisible within educational settings, meaning it is not prioritised within the curriculum despite students' expressed need. Second, where self-harm transgresses institutional rules it may be treated as 'bad behaviour', meaning adequate support is denied. Third, schools' informal management strategy of escalating incidents of self-harm to external 'experts' serves to contribute to non-help seeking behaviour amongst students who desire confidential support from teachers. Fourth, anxiety and stress associated with school performance may escalate self-harm and suicide. Fifth, bullying within the school context can contribute to self-harm, whilst some young people may engage in these practices as initiation into a social group. CONCLUSIONS Schools may influence children and young people's self-harm, although evidence of their impact on suicide remains limited. Prevention and intervention needs to acknowledge and accommodate these institutional-level factors. Studies included in this review are limited by their lack of conceptual richness, restricting the process of interpretative synthesis. Further qualitative research should focus on the continued development of theoretical and empirical insight into the relationship between institutional features and students' self-harm and suicide.
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Affiliation(s)
- Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK.
| | - Chloe Hurrell
- DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
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McKinnon B, Gariépy G, Sentenac M, Elgar FJ. Adolescent suicidal behaviours in 32 low- and middle-income countries. Bull World Health Organ 2016; 94:340-350F. [PMID: 27147764 PMCID: PMC4850530 DOI: 10.2471/blt.15.163295] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 02/12/2016] [Accepted: 02/13/2016] [Indexed: 11/27/2022] Open
Abstract
Objective To estimate prevalence of suicidal ideation and suicidal ideation with a plan in each surveyed country and to examine cross-national differences in associated risk factors. Methods We analysed data of students aged 13–17 years who participated in the 2003–2012 Global School-based Health Surveys in 32 countries, of which 29 are low- and middle-income. We used random effects meta-analysis to generate regional and overall pooled estimates. Multivariable logistic regression was used to estimate risk ratios for the associated risk factors. Population attributable fractions were estimated based on adjusted risk ratios and the prevalence of the determinants within each exposure level. Findings Across all countries, the pooled 12-month prevalence of suicide ideation were 16.2% (95% confidence interval, CI: 15.6 to 16.7) among females and 12.2% (95% CI: 11.7 to 12.7) among males and ideation with a plan were 8.3% (95% CI: 7.9 to 8.7) among females and 5.8% (95% CI: 5.5 to 6.1) among males. Suicide ideation in the WHO Region of the Americas was higher in females than males, with an estimated prevalence ratio of 1.70 (95% CI: 1.60 to 1.81), while this ratio was 1.04 (95% CI: 0.98 to 1.10) in the WHO African Region. Factors associated with suicidal ideation in most countries included experiences of bullying and physical violence, loneliness, limited parental support and alcohol and tobacco use. Conclusion The prevalence of adolescent suicidal behaviours varies across countries, yet a consistent set of risk factors of suicidal behaviours emerged across all regions and most countries.
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Affiliation(s)
- Britt McKinnon
- Institute for Health and Social Policy, McGill University, 1030 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada
| | - Geneviève Gariépy
- Institute for Health and Social Policy, McGill University, 1030 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada
| | - Mariane Sentenac
- Institute for Health and Social Policy, McGill University, 1030 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, 1030 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada
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Lee SY, Park EC, Han KT, Kim SJ, Chun SY, Park S. The Association of Level of Internet Use with Suicidal Ideation and Suicide Attempts in South Korean Adolescents: A Focus on Family Structure and Household Economic Status. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:243-51. [PMID: 27254417 PMCID: PMC4794961 DOI: 10.1177/0706743716635550] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Seo Yoon Lee
- Seoul National University Hospital, Seoul, Republic of Korea
| | | | | | | | | | - Sohee Park
- Yonsei University, Seoul, Republic of Korea
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126
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Leung CM, Yim CL, Yan CTY, Chan CC, Xiang YT, Mak ADP, Fok MLY, Ungvari GS. The Bipolar II Depression Questionnaire: A Self-Report Tool for Detecting Bipolar II Depression. PLoS One 2016; 11:e0149752. [PMID: 26963908 PMCID: PMC4786156 DOI: 10.1371/journal.pone.0149752] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 02/04/2016] [Indexed: 01/26/2023] Open
Abstract
Bipolar II (BP-II) depression is often misdiagnosed as unipolar (UP) depression, resulting in suboptimal treatment. Tools for differentiating between these two types of depression are lacking. This study aimed to develop a simple, self-report screening instrument to help distinguish BP-II depression from UP depressive disorder. A prototype BP-II depression questionnaire (BPIIDQ-P) was constructed following a literature review, panel discussions and a field trial. Consecutively assessed patients with a diagnosis of depressive disorder or BP with depressive episodes completed the BPIIDQ-P at a psychiatric outpatient clinic in Hong Kong between October and December 2013. Data were analyzed using discriminant analysis and logistic regression. Of the 298 subjects recruited, 65 (21.8%) were males and 233 (78.2%) females. There were 112 (37.6%) subjects with BP depression [BP-I = 42 (14.1%), BP-II = 70 (23.5%)] and 182 (62.4%) with UP depression. Based on family history, age at onset, postpartum depression, episodic course, attacks of anxiety, hypersomnia, social phobia and agoraphobia, the 8-item BPIIDQ-8 was constructed. The BPIIDQ-8 differentiated subjects with BP-II from those with UP depression with a sensitivity/specificity of 0.75/0.63 for the whole sample and 0.77/0.72 for a female subgroup with a history of childbirth. The BPIIDQ-8 can differentiate BP-II from UP depression at the secondary care level with satisfactory to good reliability and validity. It has good potential as a screening tool for BP-II depression in primary care settings. Recall bias, the relatively small sample size, and the high proportion of females in the BP-II sample limit the generalization of the results.
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Affiliation(s)
- Chi Ming Leung
- Department of Psychiatry, Shatin Hospital, Hong Kong SAR, China
- * E-mail: (CML); (YTX)
| | - Chi Lap Yim
- Department of Psychiatry, Shatin Hospital, Hong Kong SAR, China
| | | | - Cheuk Chi Chan
- Department of Psychiatry, Shatin Hospital, Hong Kong SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
- * E-mail: (CML); (YTX)
| | - Arthur D. P. Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Marcella Lei-Yee Fok
- King's College London, King's Health Partners, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Gabor S. Ungvari
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
- The University of Notre Dame Australia/Marian Centre, Perth, Australia
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127
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Nagarajan VD, Okoli CTC. A systematic review of tobacco use among adolescents with physical disabilities. Public Health 2016; 133:107-15. [PMID: 26877065 DOI: 10.1016/j.puhe.2016.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 12/22/2015] [Accepted: 01/08/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To provide a systematic review of tobacco use among adolescents with physical disabilities. STUDY DESIGN A systematic review. METHODS A search was performed of English articles published prior to December 2014 in the PubMed database for studies examining smoking rates among adolescents with and without physical disabilities. Ten studies were retrieved (all cross-sectional surveys) of which six compared adolescent populations from nationally representative samples and four examined those based on convenience sampling. Pooled analyses of smoking rates by disability status were performed. RESULTS In studies from nationally representative samples (n = 6 studies), adolescents with physical disabilities were significantly more likely to use tobacco as compared to adolescents without (pooled analyses = 29.7% vs 23.3%). However, in studies from non-representative samples, adolescents with physical disabilities were less likely to use tobacco as compared to adolescents without (pooled analyses = 22.7% vs 39.1%). CONCLUSIONS Adolescents with physical disabilities may have an increased risk of tobacco use relative to those without disabilities. Tailored tobacco use prevention and cessation strategies may be appropriate for this high-risk population. Future longitudinal studies which determine factors associated with tobacco use among adolescents with different disabilities should be considered to reduce the disproportionate tobacco use in this population.
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128
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Niederkrotenthaler T, Tinghög P, Goldman-Mellor S, Wilcox HC, Gould M, Mittendorfer-Rutz E. Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters. PLoS One 2016; 11:e0146130. [PMID: 26784886 PMCID: PMC4718648 DOI: 10.1371/journal.pone.0146130] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/14/2015] [Indexed: 11/18/2022] Open
Abstract
Background Individuals with a history of suicide attempt have a high risk for subsequent labour market marginalization. This study aimed at assessing the effect of individual and parental factors on different measures of marginalization. Methods Prospective cohort study based on register linkage of 5 649 individuals who in 1994 were 16–30 years old, lived in Sweden and were treated in inpatient care for suicide attempt during 1992–1994. Hazard ratios (HRs) for labour market marginalization defined as long-term unemployment (>180 days), sickness absence (>90 days), or disability pension in 1995–2010 were calculated with Cox regression. Results Medical risk factors, particularly any earlier diagnosed specific mental disorders (e.g., schizophrenia: HR 5.4 (95% CI: 4.2, 7.0), personality disorders: HR 3.9, 95% CI: 3.1, 4.9), repetitive suicide attempts (HR 1.6, 95% CI: 1.4, 1.9) were associated with a higher relative risk of disability pension. Individual medical factors were of smaller importance for long-term sickness absence, and of only marginal relevance to long-term unemployment. Country of birth outside Europe had an opposite effect on disability pension (HR 0.6, 95% CI: 0.4, 0.8) and long-term unemployment (HR 1.5, 95% CI: 1.3, 1.8). Female sex was positively correlated with long-term sickness absence (HR 1.6, 95% CI: 1.4, 1.7), and negatively associated with long-term unemployment (HR: 0.8, 95% CI: 0.7, 0.9). Conclusions As compared to disability pension, long-term sickness absence and unemployment was more strongly related to socio-economic variables. Marginalization pathways seemed to vary with migration status and sex. These findings may contribute to the development of intervention strategies which take the individual risk for marginalization into account.
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Affiliation(s)
- Thomas Niederkrotenthaler
- Medical University Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Vienna, A-1090 Vienna, Austria
- * E-mail:
| | - Petter Tinghög
- Karolinska Institutet, Department of Clinical Neuroscience, Division of Insurance Medicine, 17 177 Stockholm, Sweden
- The Swedish Red Cross University College, Stockholm, Sweden
| | | | - Holly C. Wilcox
- Johns Hopkins School of Medicine, Baltimore, MD 21205, United States of America
| | - Madelyn Gould
- Columbia University, NYS Psychiatric Institute, New York, NY 10032, United States of America
| | - Ellenor Mittendorfer-Rutz
- Karolinska Institutet, Department of Clinical Neuroscience, Division of Insurance Medicine, 17 177 Stockholm, Sweden
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129
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Moreira LCDO, Bastos PRHDO. Prevalência e fatores associados à ideação suicida na adolescência: revisão de literatura. PSICOLOGIA ESCOLAR E EDUCACIONAL 2015. [DOI: 10.1590/2175-3539/2015/0193857] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo: Para a elaboração deste artigo foi realizada uma revisão da literatura sobre a prevalência e os principais fatores associados à ideação suicida em adolescentes da população não clínica. A revisão foi baseada nos estudos de corte transversal encontrados em bases de dados eletrônicas (Medline, SciELO e Lilacs), referentes ao período de 2002 a 2013. As palavras-chave utilizadas foram: "ideação suicida", "ideação suicida e adolescentes", "ideação suicida e estudantes", "comportamento suicida e adolescentes". A prevalência de ideação suicida é alta e está significativamente relacionada a fatores como: depressão, uso de álcool e drogas, violência física, problemas de relacionamento com os pais, tristeza e solidão. A ideação suicida associada à depressão em adolescentes é prevenível desde que o adolescente seja devidamente tratado. Há necessidade de investimentos em pesquisas no Brasil, dado o crescimento das taxas de suicídio entre adolescentes, sobretudo do sexo masculino.
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130
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Miovský M, Vonkova H, Čablová L, Gabrhelík R. Cannabis use in children with individualized risk profiles: Predicting the effect of universal prevention intervention. Addict Behav 2015; 50:110-6. [PMID: 26126178 DOI: 10.1016/j.addbeh.2015.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 05/11/2015] [Accepted: 06/04/2015] [Indexed: 01/19/2023]
Abstract
AIM To study the effect of a universal prevention intervention targeting cannabis use in individual children with different risk profiles. METHODS A school-based randomized controlled prevention trial was conducted over a period of 33 months (n=1874 sixth-graders, baseline mean age 11.82). We used a two-level random intercept logistic model for panel data to predict the probabilities of cannabis use for each child. Specifically, we used eight risk/protective factors to characterize each child and then predicted two probabilities of cannabis use for each child if the child had the intervention or not. Using the two probabilities, we calculated the absolute and relative effect of the intervention for each child. According to the two probabilities, we also divided the sample into a low-risk group (the quarter of the children with the lowest probabilities), a moderate-risk group, and a high-risk group (the quarter of the children with the highest probabilities) and showed the average effect of the intervention on these groups. RESULTS The differences between the intervention group and the control group were statistically significant in each risk group. The average predicted probabilities of cannabis use for a child from the low-risk group were 4.3% if the child had the intervention and 6.53% if no intervention was provided. The corresponding probabilities for a child from the moderate-risk group were 10.91% and 15.34% and for a child from the high-risk group 25.51% and 32.61%. School grades, thoughts of hurting oneself, and breaking the rules were the three most important factors distinguishing high-risk and low-risk children. CONCLUSIONS We predicted the effect of the intervention on individual children, characterized by their risk/protective factors. The predicted absolute effect and relative effect of any intervention for any selected risk/protective profile of a given child may be utilized in both prevention practice and research.
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Abstract
The object of this article is to review the past decade of research on teenage suicide, with a particular emphasis on epidemiologic trends by age, gender and indigenous ethnicity. As such, a review of research literature from 2003 to 2014 was conducted via a comprehensive search of relevant psychological and medical databases. Wide gaps in our knowledge base exist concerning the true extent of teenage suicide due to lack of data, particularly in developing countries, resulting in a Western bias. The gender paradox of elevated suicidality in females with higher completed suicide rates in males is observed in teenage populations worldwide, with the notable exceptions of China and India. Native and indigenous ethnic minority teens are at significantly increased risk of suicide in comparison to general population peers. Often those with the highest need for mental health care (such as the suicidal adolescent) have least access to therapeutic support.Globally, suicide in teenagers remains a major public health concern. Further focused research concerning completed suicides of youth below the age of 18 is required across countries and cultures to understand more about risk as children progress through adolescence. Gender and ethnic variations in suicidality are embedded within cultural, historical, psychological, relational and socio-economic domains. Worldwide, the absence of child/adolescent-specific mental health policies may delay the development of care and suicide prevention. Overall, it is vital that clinicians adopt a holistic approach that incorporates an awareness of age and gender influences, and that cultural competency informs tailored and evaluated intervention programmes.
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Affiliation(s)
- A B McLoughlin
- From the Department of Psychiatry, Psychotherapy & Mental Health Research, St. Vincent's University Hospital and School of Medicine & Medical Science, University College Dublin, Elm Park, Dublin 4, Ireland and
| | - M S Gould
- Division of Child and Adolescent Psychiatry, Department of Epidemiology, College of Physicians and Surgeons, Columbia University/New York State Psychiatric Institute, Riverside Drive, New York, NY 10035, USA
| | - K M Malone
- From the Department of Psychiatry, Psychotherapy & Mental Health Research, St. Vincent's University Hospital and School of Medicine & Medical Science, University College Dublin, Elm Park, Dublin 4, Ireland and
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Plener PL, Munz LM, Allroggen M, Kapusta ND, Fegert JM, Groschwitz RC. Immigration as risk factor for non-suicidal self-injury and suicide attempts in adolescents in Germany. Child Adolesc Psychiatry Ment Health 2015; 9:34. [PMID: 26417389 PMCID: PMC4584432 DOI: 10.1186/s13034-015-0065-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/24/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Whereas non-suicidal self-injury (NSSI) and suicide attempts (SA) are rather common among adolescents, the description of risk factors has often failed to take migration into perspective. Our study aimed to describe immigration status in adolescents with regards to their lifetime history of NSSI and SA. METHODS We carried out a population based study in a school community of ninth-graders (N = 452, mean age 14.85, SD 0.58) in southern Germany. Data were collected via adolescent self report on sociodemographic variables and on NSSI and SA using the Self Harm Behavior Questionnaire. RESULTS Adolescents born outside Germany showed an elevated rate of a lifetime history of NSSI and SA. When compared to German adolescents without a (family) history of migration (NSSI 19.16%, SA 3.24%), adolescents who were born in another country had an elevated risk for NSSI (42.86%, OR 3.36) and SA (17.86%, OR 6.78), which was higher than the risk of adolescents who had at least one parent who had emigrated from another country (NSSI 30.08%, OR 2.46 and SA 8.94%, OR 4.45). CONCLUSION Our findings should inform intervention services and prevention programs for NSSI and suicidality in youth. Adopting such programs to include culturally sensible modules could improve the outcome in ethnically diverse adolescents.
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Affiliation(s)
- Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
| | - Lara M Munz
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
| | - Marc Allroggen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
| | - Nestor D Kapusta
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
| | - Rebecca C Groschwitz
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
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Kim SM, Baek JH, Han DH, Lee YS, Yurgelun-Todd DA. Psychosocial-Environmental Risk Factors for Suicide Attempts in Adolescents with Suicidal Ideation: Findings from a Sample of 73,238 Adolescents. Suicide Life Threat Behav 2015; 45:477-87. [PMID: 25443162 DOI: 10.1111/sltb.12143] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 09/12/2014] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Sun Mi Kim
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Ji Hyun Baek
- School of Medicine, Sungkyunkwan University, Seoul, Korea.,Bipolar Clinic and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Doug Hyun Han
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Young Sik Lee
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
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Developmentally adapted cognitive processing therapy for adolescents suffering from posttraumatic stress disorder after childhood sexual or physical abuse: a pilot study. Clin Child Fam Psychol Rev 2015; 17:173-90. [PMID: 24101403 DOI: 10.1007/s10567-013-0156-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although childhood sexual abuse and childhood physical abuse (CSA and CPA) have severe psychopathological consequences, there is little evidence supporting psychotherapeutic interventions for adolescents who have experienced CSA or CPA. To provide a treatment tailored to the specific needs of adolescents suffering from abuse-related posttraumatic stress disorder (PTSD), we modified Cognitive Processing Therapy (CPT) by adding new treatment modules and changing the therapy setting. To evaluate the feasibility and efficacy of Developmentally Adapted CPT (D-CPT), we treated 12 adolescents suffering from PTSD secondary to CSA or CPA. Patients were assessed prior to treatment (t0), post-treatment (t1), and 6 weeks after treatment (t2). Assessments included the Clinician-Administered PTSD Scale (CAPS), the UCLA PTSD Index (UCLA), the Children's Depression Inventory (CDI), the Adolescent Dissociative Experiences Scale (A-DES), and the Borderline Symptom List (BSL-23). MANOVAs revealed that posttraumatic stress measurements and associated symptom measurements significantly differed across time points. When comparing t0 with t2, Cohen's d was large with respect to the CAPS scores (d = 1.45, p < .001) and the UCLA scores (d = 1.91, p < .001). Cohen's d had a medium magnitude with respect to the CDI scores (d = .78, p < .001), the A-DES scores (d = 0.64, p < .05), and the BSL-23 scores (d = 0.74, p < .01). D-CPT has the potential to reduce PTSD symptoms and comorbid psychopathology in adolescents with histories of CSA or CPA.
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135
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Eskin M, Schild A, Öncü B, Stieger S, Voracek M. A Cross-Cultural Investigation of Suicidal Disclosures and Attitudes in Austrian and Turkish University Students. DEATH STUDIES 2015; 39:584-591. [PMID: 26079731 DOI: 10.1080/07481187.2015.1037971] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The prevalence of suicidal behavior and the nature of attitudes toward suicide differ in Austria and Turkey. To see if there were differences in disclosure, 351 Turkish and 310 Austrian students answered questions about disclosing suicidal thoughts. More Austrian than Turkish students reported suicidal ideation and believed that suicidal people disclose their plans, but suicidal disclosures were equally common in the two groups. Compared to Austria, suicidal disclosures in Turkey met with more positive social reactions that may facilitate a successful social support process. These findings imply that prevention efforts should reduce the stigma around suicidal disclosures.
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Affiliation(s)
- Mehmet Eskin
- a Department of Psychiatry, Faculty of Medicine , Adnan Menderes University , Aydin , Turkey
| | - Anne Schild
- b Department of Basic Psychological Research and Research Methods, School of Psychology , University of Vienna , Vienna , Austria
| | - Bedriye Öncü
- c Department of Psychiatry, Faculty of Medicine , Ankara University , Ankara , Turkey
| | - Stefan Stieger
- b Department of Basic Psychological Research and Research Methods, School of Psychology , University of Vienna , Vienna , Austria
| | - Martin Voracek
- b Department of Basic Psychological Research and Research Methods, School of Psychology , University of Vienna , Vienna , Austria
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136
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Cotter P, Kaess M, Corcoran P, Parzer P, Brunner R, Keeley H, Carli V, Wasserman C, Hoven C, Sarchiapone M, Apter A, Balazs J, Bobes J, Cosman D, Haring C, Kahn JP, Resch F, Postuvan V, Värnik A, Wasserman D. Help-seeking behaviour following school-based screening for current suicidality among European adolescents. Soc Psychiatry Psychiatr Epidemiol 2015; 50:973-82. [PMID: 25656270 DOI: 10.1007/s00127-015-1016-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE To screen and clinically interview European adolescents reporting current suicidality (suicidal ideation and suicide attempt) and investigate attendance at the clinical interview. METHODS The Saving and Empowering Young Lives in Europe (SEYLE) Project was carried out in 11 European countries. A baseline questionnaire was completed in school by 12,395 adolescents (mean age 14.9; SD 0.9). Those who screened positive for suicidality (attempting suicide and/or serious suicidal ideation or plans) in the past 2 weeks were invited to a clinical interview with a mental health professional. RESULTS Of the 12,395 adolescents, 4.2 % (n = 516) screened positive for current suicidality. The prevalence ranged from 1.1 % in Hungary to 7.7 % in Israel (p < 0.001). 37.6 % (n = 194) of those who screened positive subsequently attended the clinical interview. Female students were more likely to attend for interview (42.0 % versus 30.6 %, p = 0.010). The attendance rate varied considerably across countries, from 5.7 % in Italy to 96.7 % in France (p < 0.001). Improved attendance was associated with using school as the only interview setting (Mean attendance rate, MAR = 88 vs. 31 %, p = 0.006) and arranging the interview within 1 week of contacting the student (MAR = 64 vs. 23 %, p = 0.013). The greater the travel time to interview, the lower the attendance rate (Pearson's r = -0.64, p = 0.034). Independent of the variation by country, at the individual level, adolescents with more depressive symptoms and a recent suicide attempt more often attended for interview. CONCLUSION A high rate of current suicidality was found amongst European adolescents. However, the majority of these displayed limited help-seeking behaviour. Future studies should investigate ways of making screening programmes and other interventions more acceptable and accessible to young people, especially young males.
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Affiliation(s)
- Pádraig Cotter
- National Suicide Research Foundation, University College Cork, Western Gateway Building, Room 4.28, Cork, Ireland,
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137
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Rates of Reporting Suicidal Ideation and Symptoms of Depression on Children’s Depression Inventory in a Paediatric Neurology Sample. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2015. [DOI: 10.1007/s40817-015-0002-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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138
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Tseng FY, Yang HJ. Internet use and web communication networks, sources of social support, and forms of suicidal and nonsuicidal self-injury among adolescents: different patterns between genders. Suicide Life Threat Behav 2015; 45:178-91. [PMID: 25255896 DOI: 10.1111/sltb.12124] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 05/28/2014] [Indexed: 11/30/2022]
Abstract
The relationships of Internet use, web communication, and sources of social support with adolescent self-injurious thoughts and behaviors (SITBs) in Taiwan were investigated. The study sample of 391 12 to 18-year-olds was selected from nine public high schools. Findings show that girls are more likely to have SITBs, except for suicide gestures. Web communication is a risk factor for SITBs in boys but not in girls. Family support is protective in both genders. Support from friends is protective and support from significant others was a risk factor for suicide plans in girls. Support from virtual social communities can have both positive and negative effects on adolescent SITBs, with different effects by gender.
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Affiliation(s)
- Fang-Yi Tseng
- School of Public Health, Chung Shan Medical University, Taichung City, Taiwan
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139
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Internalizing antecedents and consequences of binge-eating behaviors in a community-based, urban sample of African American females. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 15:570-8. [PMID: 23873475 DOI: 10.1007/s11121-013-0411-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The etiology of problem-eating behaviors is often overlooked in research as it typically shares many symptoms with other more common psychiatric illnesses. Binge-eating problems are at the forefront of the popular media because of the connection to obesity; therefore, increased knowledge of binge eating problems, particularly the internalizing antecedents and consequences will have implications in a multitude of domains, including prevention programs aimed at physical and mental health. The current study examines the antecedents of binge-eating behaviors by exploring how the growth of internalizing symptoms influences the proximal outcome of a binge-eating inventory in a longitudinal sample of African American girls. Additional consequences of binge-eating problems are also explored. This study focuses on binge-eating problems in order to present valuable information for prevention scientists who wish to develop target individuals at high risk for internalizing problems such as suicide.
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140
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O'Connor M, Dooley B, Fitzgerald A. Constructing the Suicide Risk Index (SRI): does it work in predicting suicidal behavior in young adults mediated by proximal factors? Arch Suicide Res 2015; 19:1-16. [PMID: 25058873 DOI: 10.1080/13811118.2014.915775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Suicide is a key concern among young adults. The aim of the study was to (1) construct a suicide risk index (SRI) based on demographic, situational, and behavioral factors known to be linked to suicidal behavior and (2) investigate whether the association between the SRI and suicidal behavior was mediated by proximal processes (personal factors, coping strategies, and emotional states). Participants consisted of 7,558 individuals aged 17-25 years (M = 20.35, SD = 1.91). Nearly 22% (n = 1,542) reported self-harm and 7% (n = 499) had attempted suicide. Mediation analysis revealed both a direct effect (ß = .299, 95% CI = [.281, .317], p < .001), and a mediated effect (ß = .204, 95% CI = [.186, .222], p < .001), between the risk index and suicidal behavior. The strongest mediators were levels of self-esteem, depression, and avoidant coping. Interventions to increase self-esteem, reduce depression, and encourage adaptive coping strategies may prevent suicidal behavior in young people.
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Affiliation(s)
- Maebh O'Connor
- a School of Psychology, University College Dublin , Belfield , Dublin , Ireland
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141
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Straub J, Keller F, Sproeber N, Koelch MG, Plener PL. Suicidal behavior in german adolescents. Prevalence and association with depressive and manic symptoms. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2014; 43:39-45. [PMID: 25536895 DOI: 10.1024/1422-4917/a000331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. METHODS 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. RESULTS In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. CONCLUSIONS Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.
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Affiliation(s)
- Joana Straub
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Ferdinand Keller
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Nina Sproeber
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Michael G Koelch
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
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142
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Rhodes AE, Boyle MH, Bridge JA, Sinyor M, Links PS, Tonmyr L, Skinner R, Bethell JM, Carlisle C, Goodday S, Hottes TS, Newton A, Bennett K, Sundar P, Cheung AH, Szatmari P. Antecedents and sex/gender differences in youth suicidal behavior. World J Psychiatry 2014; 4:120-32. [PMID: 25540727 PMCID: PMC4274584 DOI: 10.5498/wjp.v4.i4.120] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 11/13/2014] [Accepted: 11/27/2014] [Indexed: 02/05/2023] Open
Abstract
Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suicide attempts. We review this "gender paradox" in youth, and in particular, the age-dependency of these sex/gender differences and the developmental mechanisms that may explain them. Epidemiologic, genetic, neurodevelopmental and psychopathological research have identified suicidal behaviour risks arising from genetic vulnerabilities and sex/gender differences in early adverse environments, neurodevelopment, mental disorder and their complex interconnections. Further, evolving sex-/gender-defined social expectations and norms have been thought to influence suicide risk. In particular, how youth perceive and cope with threats and losses (including conforming to others' or one's own expectations of sex/gender identity) and adapt to pain (through substance use and help-seeking behaviours). Taken together, considering brain plasticity over the lifespan, these proposed antecedents to youth suicide highlight the importance of interventions that alter early environment(s) (e.g., childhood maltreatment) and/or one's ability to adapt to them. Further, such interventions may have more enduring protective effects, for the individual and for future generations, if implemented in youth.
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143
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McDermott E. Asking for help online: Lesbian, gay, bisexual and trans youth, self-harm and articulating the ‘failed’ self. Health (London) 2014; 19:561-77. [DOI: 10.1177/1363459314557967] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
International evidence suggests that young people are less likely to seek help for mental health problems in comparison with adults. This study focused on lesbian, gay, bisexual and trans young people who are a population group with an elevated risk of suicide and self-harm, and little is known about their help-seeking behaviour. Utilising qualitative virtual methods, lesbian, gay, bisexual and trans youth web-based discussions about seeking help for suicidal feelings and self-harming were investigated. Findings from a thematic analysis indicate that these young people wanted assistance but found it difficult to (1) ask for help, (2) articulate emotional distress and (3) ‘tell’ their selves as ‘failed’. This analysis suggests that key to understanding these problems are emotions such as shame which arise from negotiating norms connected to heterosexuality, adolescence and rationality. I argue that these norms act to regulate what emotions it is possible to feel, what emotions it is possible to articulate and what type of young lives that can be told. The future development of health and social care interventions which aim to reduce lesbian, gay, bisexual and trans youth suicide and self-harm need to work with a nuanced understanding of the emotional life of young people if they are to be effective.
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144
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Ko MJ, Lee EY, Kim K. Objective and Subjective Socioeconomic Position and Current Smoking Among Korean Adolescents. Asian Pac J Cancer Prev 2014; 15:8877-81. [DOI: 10.7314/apjcp.2014.15.20.8877] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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145
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Mitchell KJ, Wells M, Priebe G, Ybarra ML. Exposure to websites that encourage self-harm and suicide: prevalence rates and association with actual thoughts of self-harm and thoughts of suicide in the United States. J Adolesc 2014; 37:1335-44. [PMID: 25313930 DOI: 10.1016/j.adolescence.2014.09.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 09/09/2014] [Accepted: 09/22/2014] [Indexed: 12/19/2022]
Abstract
This article provides 12-month prevalence rates of youth exposure to websites which encourage self-harm or suicide and examines whether such exposure is related to thoughts of self-harm and thoughts of suicide in the past 30 days. Data were collected via telephone from a nationally representative survey of 1560 Internet-using youth, ages 10-17 residing in the United States. One percent (95% CI: 0.5%, 1.5%) of youth reported visiting a website that encouraged self-harm or suicide. Youth who visited such websites were seven times more likely to say they had thought about killing themselves; and 11 times more likely to think about hurting themselves, even after adjusting for several known risk factors for thoughts of self-harm and thoughts of suicide. Given that youth thinking about self-harm and suicide are more likely to visit these sites, they may represent an opportunity for identification of youth in need of crisis intervention.
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146
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Ko MJ, Lee EY, Kim K. Relationship between socioeconomic position and suicide attempts among the Korean adolescents. J Korean Med Sci 2014; 29:1287-92. [PMID: 25246749 PMCID: PMC4168184 DOI: 10.3346/jkms.2014.29.9.1287] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 06/12/2014] [Indexed: 11/20/2022] Open
Abstract
This study explored the relationship of the subjective socioeconomic position (SEP) as well as the objective SEP with the rate of suicide attempts in 74,186 adolescents from the 2012 Korea Youth Risk Behavior Web-based Survey (KYRBS). The SEP was measured by the Family Affluence Scale (FAS) and the self-rated household economic status. The low perceived SEP for either the high or low FAS score was related to the elevated likelihood of suicide attempts in both genders. As compared with the adolescents in both the high level of perceived SEP and FAS score after adjusting for other confounding factors, the middle school students were more likely to attempt suicide in both low level of perceived SEP and FAS score (OR, 1.81; 95% CI, 1.18-2.78 for boys, OR, 1.46; 95% CI, 1.13-1.90 for girls). The high school students were more likely to attempt suicide in the low perceived SEP and high FAS score (OR, 1.44; 95% CI, 1.14-1.81 for boys, OR, 1.29; 95% CI, 1.07-1.56 for girls). In conclusion, the relationship of subjective SEP is important in suicide attempts as much as objective SEP and far more important in the high school students.
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Affiliation(s)
- Min Jung Ko
- Office of Health Services Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Eun Young Lee
- Institute for Health and Society, Hanyang University, Seoul, Korea
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Cheonan, Korea
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147
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Lee K, Namkoong K, Choi WJ, Park JY. The relationship between parental marital status and suicidal ideation and attempts by gender in adolescents: results from a nationally representative Korean sample. Compr Psychiatry 2014; 55:1093-9. [PMID: 24746529 DOI: 10.1016/j.comppsych.2014.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 03/21/2014] [Accepted: 03/21/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Suicide in adolescents is a major problem worldwide. The purpose of this study was to identify differences in suicidal behaviors with respect to parental marital status. METHODS The data used in this study were obtained from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) of middle and high school students in 2010. Using a national representative sample, this study analyzed data from 73,238 subjects. With respect to gender, the odds ratios of suicidal behavior were calculated based on the parental marital status, living situation, and family affluence scale (FAS). RESULTS After adjusting for age, achievement, sadness, and substance use, the prevalence of suicidal ideation in adolescents with a remarried parent significantly increased among boys to 1.364 [95% confidence interval (CI)=1.027-1.813] and among girls to 1.511 (95% CI=1.215-1.879). The odds ratio of suicide attempts increased to 1.808 (95% CI=1.119-2.923) for adolescent boys and to 1.947 (95% CI=1.609-2.356) for adolescent girls. However, having a single parent did not affect the prevalence of suicidal ideation in either gender. In girls, as family affluence decreased, the odds ratio of suicidal ideation notably increased. For girls whose families were in a low tier of the FAS, the odds ratio of both suicidal ideation and suicide attempts increased. CONCLUSIONS Both boys and girls were more likely to report suicidal ideation and attempts after a parent's remarriage, whereas family affluence was inversely related to suicidal ideation and attempts in girls.
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Affiliation(s)
- Kounseok Lee
- Department of Psychiatry, Samsung Medical Center, Sungkyungkwan University School of Medicine, Republic of Korea
| | - Kee Namkoong
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea
| | - Won-Jung Choi
- Institute of Behavioral Science in Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, National Health Insurance Service, Ilsan Hospital, Goyang, Republic of Korea
| | - Jin Young Park
- Institute of Behavioral Science in Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
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Adolescents’ Self-reported Running Away from Home and Suicide Attempts During a Period of Economic Recession in Greece. CHILD & YOUTH CARE FORUM 2014. [DOI: 10.1007/s10566-014-9260-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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149
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Donath C, Graessel E, Baier D, Bleich S, Hillemacher T. Is parenting style a predictor of suicide attempts in a representative sample of adolescents? BMC Pediatr 2014; 14:113. [PMID: 24766881 PMCID: PMC4011834 DOI: 10.1186/1471-2431-14-113] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 04/09/2014] [Indexed: 10/25/2022] Open
Abstract
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 statistically significant and clinically relevant: ADHD, female sex, smoking, Binge Drinking, absenteeism/truancy, migration background, and parental separation events. CONCLUSIONS Parenting style does matter. While children of Authoritative parents profit, children of Rejecting-Neglecting parents are put at risk - as we were able to show for suicide attempts in adolescence. Some of the identified risk factors contribute new knowledge and potential areas of intervention for special groups such as migrants or children diagnosed with ADHD.
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Affiliation(s)
- Carolin Donath
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
| | - Elmar Graessel
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
| | - Dirk Baier
- Criminological Research Institute of Lower Saxony, Lützerodestr 9, Hannover, 30161, Germany
| | - Stefan Bleich
- Center for Addiction Research, Clinic for Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Thomas Hillemacher
- Center for Addiction Research, Clinic for Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
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150
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Brunner R, Kaess M, Parzer P, Fischer G, Carli V, Hoven CW, Wasserman C, Sarchiapone M, Resch F, Apter A, Balazs J, Barzilay S, Bobes J, Corcoran P, Cosmanm D, Haring C, Iosuec M, Kahn JP, Keeley H, Meszaros G, Nemes B, Podlogar T, Postuvan V, Saiz PA, Sisask M, Tubiana A, Varnik A, Wasserman D. Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries. J Child Psychol Psychiatry 2014; 55:337-48. [PMID: 24215434 DOI: 10.1111/jcpp.12166] [Citation(s) in RCA: 241] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the prevalence and associated psychosocial factors of occasional and repetitive direct self-injurious behavior (D-SIB), such as self-cutting, -burning, -biting, -hitting, and skin damage by other methods, in representative adolescent samples from 11 European countries. METHODS Cross-sectional assessment of adolescents was performed within the European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), which was conducted in 11 European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9 ± 0.89) recruited from randomly selected schools. Frequency of D-SIB was assessed by a modified 6-item questionnaire based on previously used versions of the Deliberate Self-Harm Inventory (DSHI). In addition, a broad range of demographic, social, and psychological factors was assessed. RESULTS Overall lifetime prevalence of D-SIB was 27.6%; 19.7% reported occasional D-SIB and 7.8% repetitive D-SIB. Lifetime prevalence ranged from 17.1% to 38.6% across countries. Estonia, France, Germany, and Israel had the highest lifetime rates of D-SIB, while students from Hungary, Ireland, and Italy reported low rates. Suicidality as well as anxiety and depressive symptoms had the highest odds ratios for both occasional and repetitive D-SIB. There was a strong association of D-SIB with both psychopathology and risk-behaviors, including family related neglect and peer-related rejection/victimization. Associations between psychosocial variables and D-SIB were strongly influenced by both gender and country. Only a minor proportion of the adolescents who reported D-SIB ever received medical treatment. CONCLUSION These results suggest high lifetime prevalence of D-SIB in European adolescents. Prevalence as well as psychosocial correlates seems to be significantly influenced by both gender and country. These results support the need for a multidimensional approach to better understand the development of SIB and facilitate culturally adapted prevention/intervention.
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Affiliation(s)
- Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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