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Kusuma K, Larsen M, Quiroz JC, Torok M. Age-stratified predictions of suicide attempts using machine learning in middle and late adolescence. J Affect Disord 2024:S0165-0327(24)01261-8. [PMID: 39142588 DOI: 10.1016/j.jad.2024.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/29/2024] [Accepted: 08/11/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Prevalence of suicidal behaviour increases rapidly in middle to late adolescence. Predicting suicide attempts across different ages would enhance our understanding of how suicidal behaviour manifests in this period of rapid development. This study aimed to develop separate models to predict suicide attempts within a cohort at middle and late adolescence. It also sought to examine differences between the models derived across both developmental stages. METHODS This study used data from the nationally representative Longitudinal Study of Australian Children (N = 2266). We selected over 700 potential suicide attempt predictors measured via self-report questionnaires, and linked healthcare and education administrative datasets. Logistic regression, random forests, and gradient boosting algorithms were developed to predict suicide attempts across two stages (mid-adolescence: 14-15 years; late adolescence: 18-19 years) using predictors sampled two years prior (mid-adolescence: 12-13 years; late adolescence: 16-17 years). RESULTS The late adolescence models (AUROC = 0.77-0.88, F1-score = 0.22-0.28, Sensitivity = 0.54-0.64) performed better than the mid-adolescence models (AUROC = 0.70-0.76, F1-score = 0.12-0.19, Sensitivity = 0.40-0.64). The most important features for predicting suicide attempts in mid-adolescence were mostly school-related, while the most important features in late adolescence included measures of prior suicidality, psychosocial health, and future plans. CONCLUSIONS To date, this is the first study to use machine learning models to predict suicide attempts at different ages. Our findings suggest that the optimal suicide risk prediction model differs by stage of adolescence. Future research and interventions should consider that risk presentations can change rapidly during adolescence.
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Affiliation(s)
- Karen Kusuma
- University of New South Wales, Sydney, NSW 2052, Australia.
| | - Mark Larsen
- University of New South Wales, Sydney, NSW 2052, Australia
| | - Juan C Quiroz
- University of New South Wales, Sydney, NSW 2052, Australia
| | - Michelle Torok
- University of New South Wales, Sydney, NSW 2052, Australia
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Turner BJ, Porter AC, Robillard CL. Average ages of onset and time to transition between self-injurious thoughts and behaviors: Retrospective evidence from two developmentally distinct samples. J Affect Disord 2024:S0165-0327(24)01163-7. [PMID: 39033823 DOI: 10.1016/j.jad.2024.07.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/24/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Suicidal thoughts and behaviors often emerge in a predictable sequence, with suicidal ideation (SI) preceding planning, and planning preceding actions. Few studies, however, have considered the timing and duration of non-suicidal self-injury (NSSI) in these transitions. Accordingly, this study examined: 1) the developmental sequencing of NSSI, SI and suicide attempts, and 2) whether age of onset or duration predict transitions from NSSI to other SITB, and from SI to NSSI. METHODS 704 first-year students from a mid-sized Canadian university (Sample 1) and 2095 adults from an online research volunteer panel (Sample 2) completed the Self-Injurious Thoughts and Behaviors Interview self-report, which assessed the presence, age of onset, and recency of SITB. RESULTS NSSI and SI typically onset before age 15, while suicide planning and attempt usually began after age 15. Transition from NSSI to SI was likeliest in the first year after NSSI onset. Transition from NSSI to suicide attempt was likeliest in the second and third year after NSSI onset in Sample 1, and up to four years after NSSI onset in Sample 2. Early (before age 13) and late (after age 16) onsets of NSSI predicted higher odds of transitioning from NSSI to SI or attempt. Transition from SI to NSSI was likeliest in the first two years after SI onset and when SI began before age 13. CONCLUSIONS The first year after NSSI or SI onset are critical for transitions to other SITB. Targeted prevention and monitoring should be considered for people who recently initiated NSSI.
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Falcó R, Santana-Monagas E, Moreno-Amador B, Piqueras JA, Marzo JC. Suicidal Risk During Adolescence: Could Covitality Be Part of the Solution? Arch Suicide Res 2024; 28:948-963. [PMID: 37847011 DOI: 10.1080/13811118.2023.2262553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
OBJECTIVE The covitality model suggests that the co-disposition and synergy of core psychosocial assets (i.e., covitality) buffer the negative impact of stressful events and prevent the emergence of mental health problems during adolescence. At this stage of development, suicide already constitutes the leading cause of unnatural death in Europe. The present study aimed to examine how covitality relates to bidimensional mental health status (i.e., psychopathology and subjective well-being) and suicidal risk. METHOD Participants were 5,296 Spanish students ages 12 to 18 years (Mage ± SD = 14.19 ± 1.53), 50.2% male. RESULTS In a structural equation mediational model, covitality acted as a powerful shield of psychosocial strengths against suicidality, via an indirect effect entirely mediated by its impact on bidimensional mental health. The total variance in suicidal risk explained by the set of independent variables was 61.8%, while the total variance of psychopathology and subjective well-being explained by covitality was 54.1% and 75.6%, respectively. CONCLUSIONS These preliminary findings highlight the need for further study of covitality as a defense strategy against adolescent suicide. HIGHLIGHTSCovitality promote subjective well-being and prevent psychopathological symptoms.These self-perceived psychosocial strengths do not have direct effect on suicidality.Covitality is related to lower suicidal risk through indirect mechanisms: via bidimensional approach to mental health status (BMH).
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Planellas Kirchner I, Calderon Garrido C. Do Cybervictimizations Predict Suicide-Related Behaviors in Adolescents? Mediating Role of the "Escaping" Coping Strategy. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241256384. [PMID: 38855834 DOI: 10.1177/08862605241256384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
The high prevalence of suicide-related behaviors (SRB) among adolescents is a concerning issue that calls for the identification of explanatory and mediating factors involved. This study examines, by gender: (1) the percentage of adolescents reporting SRB, cyberbullying, and cybersexual harassment; (2) the association between cyberbullying and cybersexual harassment with SRB; (3) the predictive power of cybervictimization in SRB; and (4) the mediating role of Escaping coping strategy between cybervictimization and SRB. One thousand and twenty-seven adolescents (62.5% girls) aged 13 to 18 years (M = 15.59, SD = 1.28) participated in the study and completed the Youth Self Report (for SRB), Juvenile Victimization Questionnaire (for cybervictimization), and Adolescent Coping Orientation for Problem Experiences, Spanish (for coping). About 16% of respondents (19% of girls and 8.9% of boys) reported SRB, about 18% reported Cyberbullying (20.8% of girls and 13.0% of boys), and near 23% reported Cybersexual harassment (28.7% of girls and 12.5% of boys). There is a significant association between cybervictimization and SRB, with the presence of cybervictimization increasing the likelihood of SRB by three to four times (especially in boys), and significantly predicting SRB. Escaping coping strategy partially mediates the relationship between cybervictimization and SRB only in girls. The findings that cybervictimization predicts SRB and that Escaping coping mediates this relationship provide insights for the implementation of prevention and intervention policies.
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Zhou R, Foo JC, Nishida A, Ogawa S, Togo F, Sasaki T. Longitudinal relationships of psychotic-like experiences with suicidal ideation and self-harm in adolescents. Eur Child Adolesc Psychiatry 2024; 33:1977-1985. [PMID: 37740799 PMCID: PMC11211151 DOI: 10.1007/s00787-023-02299-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/08/2023] [Indexed: 09/25/2023]
Abstract
Research in adolescents suggests associations between psychotic-like experiences (PLEs) and self-injurious thoughts and behaviors (SITBs), but insights into their temporal relationship, which may inform prediction, have been limited. Psychological distress (PD; symptoms of depression and anxiety) has been related to both PLEs and SITBs, and may modulate this relationship. Given that PLEs have been linked to the development of several mental disorders, and the relationships between SITBs and suicide, it is important to better understand their relationship. The present study sought to investigate these factors using a longitudinal school-based design. Adolescents (n = 1685, ages 12-18) completed annual self-report assessments (6 time points) on PLEs, SITBs (suicidal ideation (SI) and self-harm (SH)), as well as PD. The longitudinal associations between PLEs and SITBs were analyzed, employing two cross-lagged panel models (CLPMs), with and without adjustment for PD. Unadjusted CLPMs revealed significant bidirectional temporal associations between PLEs and SITBs (both SI and SH), suggesting that PLEs both predicted and were predicted by SITBs. When adjusting for PD, the effect of SI on PLEs remained significant, but not PLEs on SI; bidirectional associations between PLEs and SH also remained significant. A bidirectional longitudinal relationship where both PLEs and SITBs can precede (and perhaps predict) each other was suggested in adolescents. PD may play a particular role in situations where PLEs are followed by SI. Heightened awareness about relationships between these phenotypes may be an important step toward facilitating timely interventions for both mental disorders and suicide.
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Affiliation(s)
- Rui Zhou
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Jerome Clifford Foo
- Institute for Psychopharmacology, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry, College of Health Sciences, University of Alberta, Edmonton, Canada
| | - Asuka Nishida
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Sayoko Ogawa
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Fumiharu Togo
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Tsukasa Sasaki
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
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Ndetei DM, Wasserman D, Mutiso V, Shanley JR, Musyimi C, Nyamai P, Munyua T, Swahn MH, Osborn TL, Johnson NE, Memiah P, Bhui K, Gilbert S, Weisz JR, Javed A, Sourander A. Methods and associations of suicidality in Kenyan high school students: clinical and public health implications. BJPsych Open 2024; 10:e112. [PMID: 38738349 PMCID: PMC11094434 DOI: 10.1192/bjo.2024.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Most evidence on suicidal thoughts, plans and attempts comes from Western countries; prevalence rates may differ in other parts of the world. AIMS This study determined the prevalence of suicidal thoughts, plans and attempts in high school students in three different regional settings in Kenya. METHOD This was a cross-sectional study of 2652 high school students. We asked structured questions to determine the prevalence of various types of suicidality, the methods planned or effected, and participants' gender, age and form (grade level). We provided descriptive statistics, testing significant differences by chi-squared and Fisher's exact tests, and used logistic regression to identify relationships among different variables and their associations with suicidality. RESULTS The prevalence rates of suicidal thoughts, plans and attempts were 26.8, 14.9 and 15.7%, respectively. These rates are higher than those reported for Western countries. Some 6.7% of suicide attempts were not associated with plans. The most common method used in suicide attempts was drinking chemicals/poison (18.8%). Rates of suicidal thoughts and plans were higher for older students and students in urban rather than rural locations, and attempts were associated with female gender and higher grade level - especially the final year of high school, when exam performance affects future education and career prospects. CONCLUSION Suicidal thoughts, plans and attempts are prevalent in Kenyan high school students. There is a need for future studies to determine the different starting points to suicidal attempts, particularly for the significant number whose attempts are not preceded by thoughts and plans.
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Affiliation(s)
- David M. Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | | | - Victoria Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | | | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Pascalyne Nyamai
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Timothy Munyua
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Monica H. Swahn
- Department of Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, USA
| | | | - Natalie E. Johnson
- Shamiri Institute, Nairobi, Kenya; Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland; and University of Basel, Basel, Switzerland
| | | | - Kamaldeep Bhui
- Department of Psychiatry, Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, UK; National Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre; Oxford, UK; and World Psychiatric Association Collaborating Centre, Oxford, UK
| | - Sonja Gilbert
- Research Centre for Child Psychiatry, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; and INVEST Child Psychiatry, INVEST Research Flagship Center, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - John R. Weisz
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Afzal Javed
- World Psychiatric Association, Geneva, Switzerland
| | - Andre Sourander
- Research Centre for Child Psychiatry, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; INVEST Child Psychiatry, INVEST Research Flagship Center, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; and Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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7
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López R, Turnamian MR, Liu RT. Prospective Relations between Life Stress, Emotional Clarity, and Suicidal Ideation in an Adolescent Clinical Sample. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-14. [PMID: 38690948 DOI: 10.1080/15374416.2024.2344735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Although life stress has been linked to adolescent suicidal ideation, most past research has been cross-sectional, and potential processes characterizing this relation remain unclear. One possibility may be a lack of emotional clarity. Informed by stress generation, the current study examined prospective relations between episodic life stress, lack of emotional clarity, and suicidal ideation in an adolescent clinical sample. METHODS The sample consisted of 180 youths (Mage = 14.89; SD = 1.35; 71.7% female; 78.9% White; 43.0% sexual minority) recruited from a psychiatric inpatient facility. Suicidal ideation severity was assessed at baseline and 18-month follow-up. Lack of emotional clarity and life stress were assessed at baseline, as well as 6-, and 12-month follow-ups. Two random-intercepts cross-lagged panel models were created to estimate within-person relations for variables of interest. RESULTS At the within-person level, lack of emotional clarity at baseline predicted greater 6-month impact of interpersonal dependent stressors (b = 0.29, p = .012, 95% CI [0.07, 0.52]), which subsequently predicted a greater 12-month lack of emotional clarity (b = 0.41, p = .005, 95% CI [0.12, 0.70]). Next, a 12-month lack of emotional clarity but not interpersonal dependent stress, predicted greater 18-month suicidal ideation (b = 0.81, p = .006, 95% CI [0.23, 1.30]; R2 = .24, p < .001). No significant relations were found for the lack of emotional clarity and independent stress. CONCLUSIONS Results support the stress generation hypothesis and suggest that future research should be conducted evaluating whether bolstering youth's understanding of their emotional experiences may reduce subsequent suicidal ideation.
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Affiliation(s)
- Roberto López
- Department of Psychiatry and Biobehavioral Sciences, University of California
| | - Margarid R Turnamian
- Division of Child and Adolescent Psychiatry, Massachusetts General Hospital
- Department of Psychiatry, Harvard Medical School
| | - Richard T Liu
- Division of Child and Adolescent Psychiatry, Massachusetts General Hospital
- Department of Psychiatry, Harvard Medical School
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard
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VanWormer JJ, Berg RL, Wieckhorst M, Burke RR, Weichelt BP. Medically Attended Suicidality in Youth Who Live on Farms. J Agromedicine 2024; 29:144-149. [PMID: 37772979 DOI: 10.1080/1059924x.2023.2264287] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Suicides are increasing in U.S. youth, particularly in rural areas. The influence of farming, however, is unclear, as suicide rates are higher in individual adult farm workers, but lower in farming-reliant counties. Early recognition of suicidality (suicidal ideation, intent, or attempt) is a key element of prevention, but there are no prior studies comparing suicidality in farm vs. non-farm youth. The purpose of this study was to examine associations between farm/rural residence and suicidality. Medical records were reused from an existing cohort of child and adolescent patients under surveillance for agricultural injuries in a Wisconsin healthcare system. The sample included 2,010 youth who lived on farms and 51,900 youth who did not live on farms (57% rural). The outcome was medically attended suicidality in 2017-2022 per a composite of diagnoses for suicidal ideation, attempt, or intentional self-harm that presented to ambulatory, emergency, or inpatient care settings. Suicidality was observed in 0.8% of farm, 1.8% of non-farm rural, and 1.6% of non-farm non-rural youth. After covariate adjustment, farm youth had significantly lower odds of suicidality (adjusted odds ratio [aOR] [95% confidence interval; CI] = 0.55 [0.33, 0.91], P = .019), while non-farm rural youth had significantly greater odds of suicidality (aOR [CI] = 1.21 [1.05, 1.40], P = .007), relative to non-farm non-rural youth. Children and adolescents who live on farms are about half as likely to (medically) present for suicidality as compared to their non-farm counterparts, both rural and non-rural. Future research should identify causal suicide protection factors in farm youth.
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Affiliation(s)
- Jeffrey J VanWormer
- Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Richard L Berg
- Office of Research Support Services, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Matthew Wieckhorst
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Richard R Burke
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Bryan P Weichelt
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, USA
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Mehanović E, Rosso G, Cuomo GL, Diecidue R, Maina G, Costa G, Vigna-Taglianti F. Risk Factors for Suicide Reattempt among Adolescents and Young Adults: The Role of Psychiatric Disorders. Psychiatr Q 2024; 95:69-84. [PMID: 38057631 DOI: 10.1007/s11126-023-10064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
Suicidal behaviour among young people is a serious public health concern. Each suicide attempt is related to further suicide attempts and completed suicide. This study aims to explore risk factors associated with repeated suicide attempt among adolescents and young adults. The cohort included 510 patients aged 12-29 years residing in Piedmont Region in North-Western Italy, who had been admitted to hospital or emergency department with a diagnosis of suicide attempt between 2010 and 2020. Cox regression models were used to evaluate potential risk factors for repeated suicide attempt. During the 11-years follow-up, 20.6% of adolescents and young adults repeated suicide attempt, 24.8% of females and 12.3% of males. Nearly 90% of youth who attempted suicide had a diagnosis of psychiatric disorder. After adjustment, younger age of onset of suicidal behaviour, and diagnosis of schizophrenia, bipolar disorder, depressive disorder, anorexia nervosa and personality disorder were significantly associated with repeated suicide attempt. The early identification of patients at higher risk of repetition of suicidal behaviour is of crucial importance. Better understanding of risk factors and effective treatment of mental disorders could help suicide prevention to reduce the burden of the problem among young people. Special attention should be paid during the initial months following discharge from hospital or emergency department, when suicide reattempt risk is very high.
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Affiliation(s)
- Emina Mehanović
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy.
- Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Grugliasco, Turin, Italy.
| | - Gianluca Rosso
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
- Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Gian Luca Cuomo
- Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Grugliasco, Turin, Italy
| | - Roberto Diecidue
- Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Grugliasco, Turin, Italy
| | - Giuseppe Maina
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
- Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Giuseppe Costa
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Turin, Italy
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Wang M, Zhong Y, Chen Y, Li Q, Su X, Wei Z, Sun L. Differentiating the association between age of alcohol use initiation and conditional suicidal behaviors among adolescents. Asia Pac Psychiatry 2024; 16:e12554. [PMID: 38509771 DOI: 10.1111/appy.12554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Suicide and early alcohol use initiation are public health concerns. Previous studies have explored the associations between age of alcohol use initiation and suicidal behaviors, which progresses from ideation to action. Distinguishing between the various associations can help gain a deeper understanding of suicidal behaviors and aid in developing social suicide prevention strategies. METHODS The study utilized the Youth Risk Behavior Survey to investigate this association. A total of 17 209 students were finally included in the study. Conditional suicidal behaviors included no suicidal behavior (NS), suicidal ideation without a plan or attempt (SINPA), suicide plan without an attempt (SPNA) and suicide attempt (SA). RESULTS Among 17 209 students, the prevalence of suicidal ideation, suicide plan, and suicide attempt were 21.4%, 17.3%, and 11.1%, respectively. Moreover, 15.2% of the students used alcohol before age 13, whereas 31.7% of students used alcohol at age 13 or older. Compared to NS, students using alcohol showed significant associations with SA (OR = 2.34, p < .001; OR = 1.29, p < .01), SPNA (OR = 1.68, p < .001; OR = 1.19, p < .05) and SINPA (OR = 1.55, p < .001; OR = 1.40, p < .001). Comparing with SINPA and SNPA, students using alcohol before age 13 were associated with SA (OR = 1.61, p < .001; OR = 1.46, p < .001), whereas those using alcohol at or after the age 13 were not associated with SA (OR = 0.98, p > .05; OR = 1.09, p > .05). DISCUSSION This study demonstrated that early alcohol use initiation was significantly associated with suicide attempts among students with suicidal ideations or plans.
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Affiliation(s)
- Meiqi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yunxi Zhong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yifan Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Qixiu Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaoying Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Zhen Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Hetrick SE, Hobbs M, Fortune S, Marek L, Wiki J, Boden JM, Theodore R, Ruhe T, Kokaua JJ, Thabrew H, Milne B, Bowden N. Proximity of alcohol outlets and presentation to hospital by young people after self-harm: A retrospective geospatial study using the integrated data infrastructure. Aust N Z J Psychiatry 2024; 58:152-161. [PMID: 37888830 PMCID: PMC10838485 DOI: 10.1177/00048674231203909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
OBJECTIVES There is a well-established association between alcohol use, misuse, intoxication and self-harm, the latter of which is associated with suicide. This study aimed to better understand the association between proximity to alcohol outlets and the likelihood of young people presenting to hospital following self-harm. METHODS This was a nationwide retrospective geospatial study using data from the New Zealand Integrated Data Infrastructure using population-level data for 10-29-year-olds for the 2018 and 2017 calendar years. Presentations to hospital following self-harm were identified using the national minimum data set. Proximity to alcohol outlets was defined in road network distance (in kilometres) and ascertained using Integrated Data Infrastructure geospatial data. Alternative measures of proximity were employed in sensitivity analyses. Complete-case two-level random intercept logistic regression models were used to estimate the relationship between alcohol outlet proximity and hospital presentation for self-harm. Adjusted models included sex, age, ethnicity, area-level deprivation, urbanicity and distance to nearest medical facility. Analyses were also stratified by urbanicity. RESULTS Of the 1,285,368 individuals (mean [standard deviation] age 20.0 [5.9] years), 7944 (0.6%) were admitted to hospital for self-harm. Overall, the odds of presenting to hospital for self-harm significantly decreased as the distance from the nearest alcohol outlet increased, including in adjusted models (adjusted odds ratio 0.980; 95% confidence interval = [0.969-0.992]); the association was robust to changes in the measure of alcohol proximity. The effect direction was consistent across all categorisations of urbanicity, but only statistically significant in large urban areas and rural areas. CONCLUSIONS The findings of this study show a clear association between young people's access to alcohol outlets and presentation to hospital for self-harm and may provide a mandate for government policies and universal interventions to reduce young people's access to alcohol outlets. Further research regarding causative mechanisms is needed.
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Affiliation(s)
- Sarah E Hetrick
- Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
- Suicide Prevention Office, Auckland, New Zealand
- A Better Start: E Tipu e Rea National Science Challenge, Auckland, New Zealand
| | - Matthew Hobbs
- Te Taiwhenua o te Hauora-GeoHealth Laboratory, University of Canterbury, Christchurch, Canterbury, New Zealand
- Te Kaupeka Oranga, Faculty of Health, University of Canterbury, Christchurch, Canterbury, New Zealand
- The Cluster for Community and Urban Resilience (CURe), University of Canterbury, Christchurch, Canterbury, New Zealand
| | - Sarah Fortune
- Department of Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Lukas Marek
- Te Taiwhenua o te Hauora-GeoHealth Laboratory, University of Canterbury, Christchurch, Canterbury, New Zealand
- Te Kaupeka Oranga, Faculty of Health, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - Jesse Wiki
- Epidemioloigy and Biostatistics, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Joseph M Boden
- Christchurch Health and Development Study, University of Otago, Christchurch, Canterbury, New Zealand
| | - Reremoana Theodore
- National Centre for Lifecourse Research, University of Otago, Dunedin, New Zealand
| | - Troy Ruhe
- Va'a O Tautai - Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Jesse J Kokaua
- National Centre for Lifecourse Research, University of Otago, Dunedin, New Zealand
- Va'a O Tautai - Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Hiran Thabrew
- Te Ara Hāro, Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Barry Milne
- A Better Start: E Tipu e Rea National Science Challenge, Auckland, New Zealand
- School of Social Sciences and Centre of Methods and Policy Application in the Social Sciences (COMPASS), The University of Auckland, Auckland, New Zealand
| | - Nicholas Bowden
- A Better Start: E Tipu e Rea National Science Challenge, Auckland, New Zealand
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
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Grosselli L, Knappe S, Baumgärtel J, Lewitzka U, Hoyer J. Addressing help-seeking, stigma and risk factors for suicidality in secondary schools: short-term and mid-term effects of the HEYLiFE suicide prevention program in a randomized controlled trial. BMC Public Health 2024; 24:113. [PMID: 38191336 PMCID: PMC10773084 DOI: 10.1186/s12889-023-17557-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Suicidal ideation and suicide attempts present a serious public health concern among adolescents and young adults. School-based suicide prevention programs are a key tool for addressing this problem. However, more research is necessary to assess their effectiveness, acceptability, and safety. In response, the HEYLiFE suicide prevention program was developed to enhance help-seeking, reduce stigma towards suicidal peers and diminish risk factors for suicidality. This article presents the evaluation findings of the HEYLiFE program in German secondary schools. METHODS We conducted a randomized-controlled trial measuring short-term pre-post within-group effects in the intervention group only and mid-term effects at 6-months-follow-up compared to a waitlist-control group. Schools were assigned randomly to the intervention or control group (no blinding). We recruited students ≥12 years of age. Primary outcomes were knowledge about suicidality, attitudes towards suicidality, stigma towards a suicidal peer, help-seeking intentions and behaviours, risk factors for suicidality. The data was analysed with linear mixed models and generalized linear mixed models. RESULTS A total of N = 745 students participated (n = 353 intervention group, n = 392 control group). We observed favourable short-term effects on knowledge, attitudes towards suicidality and fear towards a suicidal peer. Unexpectedly, the program also led to an increase in desire for social distance and a decrease in prosocial emotions towards a suicidal peer. The mid-term effects of the program were exclusively favourable, resulting in enhanced attitudes towards help-seeking while protecting from a sharper rise in risk-factors for suicidality and from an increase in social distance. The program had more favourable effects on females and on students aged >13 years. The program was well-received by the students, and no serious adverse events were reported. CONCLUSIONS These findings demonstrate the effectiveness of the HEYLiFE universal suicide prevention program in addressing variables associated with suicidal ideation and suicide attempts among adolescents on the mid-term. The short-term negative effects on stigma and more negative effects on males should be addressed in the future. Future evaluation studies should examine its effects on suicidality and its effectiveness within populations at high risk. TRIAL REGISTRATION The study was preregistered in the German Clinical Trials Register (registration number: DRKS00017045; registration date: 02/04/2019).
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Affiliation(s)
- Luna Grosselli
- Fakultät Psychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany.
- Werner-Felber-Institut e. V, Dresden, Germany.
| | - Susanne Knappe
- Fakultät Psychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany
- Werner-Felber-Institut e. V, Dresden, Germany
- Evangelische Hochschule Dresden (ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Julia Baumgärtel
- Fakultät Psychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany
| | - Ute Lewitzka
- Werner-Felber-Institut e. V, Dresden, Germany
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Hoyer
- Fakultät Psychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany
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Sekowski M, Wielogórska M, Lester D. Psychosocial Identity, Intimacy and Suicidality in Young Adults. Arch Suicide Res 2024:1-15. [PMID: 38178556 DOI: 10.1080/13811118.2023.2300320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVE Suicidality in young adults is a serious and growing clinical and social problem. The theory of psychosocial ego development assumes that identity and intimacy are two key factors for adaptation and vulnerability in early adulthood. The aim of the present study was to test whether psychosocial identity and intimacy are related to suicidality in young adults, even when controlling for confounding variables (depressive symptoms, sex, age, health and economic assessment, religious commitment, and pandemic-related distress). METHOD Respondents aged 18-25 (n = 607) completed the Identity-Confusion and Intimacy-Isolation subscales from the Modified Erikson Psychosocial Stage Inventory, as well as the Patient Health Questionnaire-9, the Suicidal Behaviors Questionnaire-Revised and answered questions about the pandemic-related distress and various sociodemographic factors. RESULTS At the level of bivariate analyses, both identity and intimacy were negatively associated with suicidal risk in the overall sample and with the frequency of suicidal ideation in the suicide risk subsample (n = 242). Weaker identity, but not intimacy, was associated with belonging to a suicide risk group in multivariable logistic regression. Moreover, ordinal regression showed that, in the subgroup with suicide risk, identity was negatively associated with the frequency of suicidal thoughts. CONCLUSIONS Identity is a negative correlate of suicidality in young adults. Identity-focused therapy may be a promising target for intervention in suicidal young adults.
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Beaton MA, Gratch I, Cha CB. Specificity, frequency, and intent: Multiple characteristics of adolescents' suicide plan correlate with their history of suicidal behavior. Suicide Life Threat Behav 2023; 53:1025-1037. [PMID: 37720928 DOI: 10.1111/sltb.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/12/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Suicide plans (SP) can be a common precipitant to suicidal behavior (SB) during adolescence, and SPs can vary in how specific they are, how frequently they are thought about, and how strongly they are intended to be enacted. To date, we have limited understanding of how discrete SP characteristics (i.e., specificity, frequency, and intent to act) present among adolescents, and whether they relate to SB. In the current study, we investigated SP characteristics and their association with SB history among adolescents who had previously considered suicide. METHODS Participants were 142 community-based adolescents (14-19 years; M = 17.6, SD = 1.4) who reported a history of suicidal ideation. Adolescents provided responses pertaining to their SP history, SP characteristics, and SB history, via the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R). RESULTS Greater specificity, frequency, and intent were each associated with modestly increased odds of reporting an SB history. The associations between plan specificity and SB history, as well as between frequency of thinking about one's SP and SB history, were mediated by adolescents' intent to act on their SP. CONCLUSIONS It may not only be whether, but how, adolescents plan for suicide that relates to their tendency to engage in SB.
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Affiliation(s)
- Maura A Beaton
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
| | - Ilana Gratch
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
| | - Christine B Cha
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
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Bankwitz A, Rüesch A, Adank A, Hörmann C, Villar de Araujo T, Schoretsanitis G, Kleim B, Olbrich S. EEG source functional connectivity in patients after a recent suicide attempt. Clin Neurophysiol 2023; 154:60-69. [PMID: 37562347 DOI: 10.1016/j.clinph.2023.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/03/2023] [Accepted: 06/30/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Electroencephalogram (EEG) based frequency measures within the alpha frequency range (AFR), including functional connectivity, show potential in assessing the underlying pathophysiology of depression and suicide-related outcomes. We investigated the association between AFR connectivity, suicidal thoughts and behaviors, and depression in a transdiagnostic sample of patients after a recent suicide attempt (SA). METHODS Lagged source-based measures of linear and nonlinear whole-brain connectivity within the standard AFR ([sAFR], 8-12 Hz) and the individually referenced AFR (iAFR) were applied to 70 15-minute resting-state EEGs from patients after a SA and 70 age- and gender-matched healthy controls (HC). Hypotheses were tested using network-based statistics and multiple regression models. RESULTS Results showed no significant differences between patients after a SA and HC in any of the assessed connectivity modalities. However, a subgroup analysis revealed significantly increased nonlinear connectivity within the sAFR for patients after a SA with a depressive disorder or episode ([DD], n = 53) compared to matched HC. Furthermore, a multiple regression model, including significant main effects for group and global nonlinear connectivity within the sAFR outperformed all other models in explaining variance in depressive symptom severity. CONCLUSIONS Our study further supports the importance of the AFR in pathomechanisms of suicidality and depression. The iAFR does not seem to improve validity of phase-based connectivity. SIGNIFICANCE Our results implicate distinct neurophysiological patterns in suicidal subgroups. Exploring the potential of these patterns for treatment stratification might advance targeted interventions for suicidal thoughts and behaviors.
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Affiliation(s)
- Anna Bankwitz
- University of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Lenggstrasse 31, 8032 Zurich, Switzerland; Psychiatric University Hospital Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
| | - Annia Rüesch
- University of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Lenggstrasse 31, 8032 Zurich, Switzerland; Psychiatric University Hospital Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
| | - Atalìa Adank
- University of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Lenggstrasse 31, 8032 Zurich, Switzerland; Psychiatric University Hospital Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
| | - Christoph Hörmann
- University of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Lenggstrasse 31, 8032 Zurich, Switzerland; Psychiatric University Hospital Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
| | - Tania Villar de Araujo
- University of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Lenggstrasse 31, 8032 Zurich, Switzerland; Psychiatric University Hospital Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
| | - Georgios Schoretsanitis
- Psychiatric University Hospital Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, 75-59 263rd St, Queens, NY 11004, USA; Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, 500 Hofstra Blvd, Hempstead, NY 11549, USA.
| | - Birgit Kleim
- University of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Lenggstrasse 31, 8032 Zurich, Switzerland; Psychiatric University Hospital Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; University of Zurich, Department of Psychology, Experimental Psychopathology and Psychotherapy, Binzmühlestrasse 14, 8050 Zurich, Switzerland.
| | - Sebastian Olbrich
- University of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Lenggstrasse 31, 8032 Zurich, Switzerland; Psychiatric University Hospital Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
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Steenkamp LR, de Neve-Enthoven NGM, João AM, Bouter DC, Hillegers MHJ, Hoogendijk WJG, Blanken LME, Kushner SA, Tiemeier H, Grootendorst-van Mil NH, Bolhuis K. Psychotic experiences, suicidality and non-suicidal self-injury in adolescents: Independent findings from two cohorts. Schizophr Res 2023; 257:50-57. [PMID: 37285715 DOI: 10.1016/j.schres.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 01/10/2023] [Accepted: 05/06/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Prior studies have shown that psychotic experiences are prospectively associated with an increased risk of suicidality. However, it is unclear whether this association is causal or arises from shared risk factors. Furthermore, little is known about the association between psychotic experiences and non-suicidal self-injury (NSSI). METHODS We used data from two independent samples of young adolescents, which we analyzed separately. In a population-based cohort, data on hallucinatory experiences and suicidality were collected at ages 10 and 14 years (N = 3435). In a cross-sectional study of a population oversampled for elevated psychopathology levels, psychotic experiences, suicidality, and NSSI were assessed at age 15 years (N = 910). Analyses were adjusted for sociodemographic covariates, maternal psychopathology, intelligence, childhood adversity, and mental health problems. RESULTS Psychotic experiences were prospectively associated with an increased risk of suicidality, even when considering self-harm ideation at baseline. Furthermore, persistent and incident, but not remittent, patterns of psychotic experiences were related to an increased burden of suicidality. Self-harm ideation was also prospectively associated with the risk for psychotic experiences, although of smaller magnitude and only by self-report. Among at-risk adolescents, psychotic experiences were cross-sectionally associated with a greater burden of suicidality and a higher frequency of NSSI events, with more extensive tissue damage. CONCLUSION Psychotic experiences are longitudinally associated with suicidality beyond the effects of shared risk factors. We also found modest support for reverse temporality, which warrants further investigation. Overall, our findings highlight the importance of assessing psychotic experiences as an index of risk for suicidality and NSSI.
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Affiliation(s)
- Lisa R Steenkamp
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | | | - Amanda Moreira João
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Diandra C Bouter
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Witte J G Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Laura M E Blanken
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Steven A Kushner
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, USA
| | | | - Koen Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
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Tyler S, Gunn K, Clifford B, Procter N. "And you feel like you're suffocating … how the fuck am I going to get out of all this?" Drivers and experiences of suicidal ideation in the Australian construction industry. Front Psychiatry 2023; 14:1144314. [PMID: 37252151 PMCID: PMC10213289 DOI: 10.3389/fpsyt.2023.1144314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/14/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction This research was designed to generate understandings of drivers and experiences of suicidal ideation and distress among Australian Construction Industry (ACI) workers, as well as what helped during these experiences. Methods Fifteen participants, from a variety of ACI or closely associated roles, with an average age of 45 years (29-66), engaged in individual, semi-structured interviews. Interviews were audio-recorded with consent and analyzed using descriptive thematic analysis. Results Eight themes relating to what may drive the presence of suicidal ideation and distress were identified; 1) challenges of working within the ACI, 2) relationship and family issues, 3) social disconnection, 4) personal financial hardship, 5) perceived lack of support, 6) alcohol and drug use, 7) child custody/access and legal issues, and 8) experience of mental health challenges, trauma, or a significant adverse life event. Four themes relating to experience and expression of suicidal ideation and distress were identified: 1) suicidal thoughts, 2) impaired thinking, 3) observable expressions of suicidal distress, and 4) lack of observable expressions of suicidal distress. Six themes relating to what helped during experiences and well as what can be done by the ACI to help mitigate experiences, were identified: 1) presence of colleague and managerial support, 2) MATES in Construction, 3) engagement with non-work activities and social support, 4) personal skills and knowledge relating to suicide and mental health, 5) high level industry integration and engagement with support programs, and 6) work hours and expectations changes. Discussion Findings highlight several industry and personal related challenges that may drive experiences, with many potentially mitigatable by ACI changes and focused prevention strategies. Participant suicidal thought descriptions align with previously identified constructs deemed central in suicidal trajectories. While findings highlight several observable expressions of suicidal ideation and distress, challenges associated with identifying and assisting individuals in the ACI who may be struggling were also reported. Several factors that helped ACI workers during their experiences, as well as what the ACI can do to mitigate future experiences, were identified. Recommendations are made based on these findings, encouraging a more supportive work environment, as well as continued development and increased awareness of support and education systems.
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Affiliation(s)
- Simon Tyler
- Mental Health and Suicide Prevention Research and Education Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Kate Gunn
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Bob Clifford
- MATES in Construction South Australia, Adelaide, SA, Australia
| | - Nicholas Procter
- Mental Health and Suicide Prevention Research and Education Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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Koh YS, Shahwan S, Jeyagurunathan A, Abdin E, Vaingankar JA, Chow WL, Chong SA, Subramaniam M. Prevalence and correlates of suicide planning and attempt among individuals with suicidal ideation: Results from a nationwide cross-sectional survey. J Affect Disord 2023; 328:87-94. [PMID: 36791970 DOI: 10.1016/j.jad.2023.02.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Suicidality spans from having suicidal ideation to planning and making an attempt. However, not all individuals with suicidal thoughts will proceed to plan or attempt suicide. Our study investigated (i) the prevalence of suicide planning and attempt among those with suicidal ideation and (ii) their associations with sociodemographic characteristics, mental disorders, adverse childhood events and prior suicidal behaviour. METHOD This cross-sectional analysis utilised data from Singapore Mental Health Study 2016. Only respondents with suicidal ideation were included. A total of 411 and 365 individuals were examined to establish the prevalence of suicide planning and attempt respectively. Multivariable logistic regressions were performed to determine associations. RESULTS The prevalence of suicide planning and attempt were 17.7 % and 10.6 % respectively, with >80.0 % occurring within a year of suicidal ideation. Suicide planning was more likely among those who had mood disorders. Suicide attempt was more likely for those were currently married, had lower educational qualifications, history of anxiety disorders, history of emotional neglect and parental separation. LIMITATIONS Recall bias may be present because the age of onset for various mental disorders and suicidal behaviours were self-reported. As suicide was criminalised when the study was conducted, the prevalence of suicidal behaviours may have been underestimated. CONCLUSION Individuals at risk of suicide planning and attempt should be identified early since most of them progressed within a year. Findings suggest the importance of including prior suicide behaviour and history of dysfunctional family and emotional abuse in suicide risk assessment and intervention.
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Affiliation(s)
- Yen Sin Koh
- Research Division, Institute of Mental Health, Singapore, Singapore.
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Dong QY, Yang XF, Liu BP, Zhang YY, Wan LP, Jia CX. Menstrual pain mediated the association between daytime sleepiness and suicidal risk: A prospective study. J Affect Disord 2023; 328:238-244. [PMID: 36806594 DOI: 10.1016/j.jad.2023.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/05/2023] [Accepted: 02/11/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Adolescents with daytime sleepiness have been demonstrated to have a higher level of suicidal risk than those without. Currently, few studies had examined the pathway from daytime sleepiness to suicidal risk among female adolescents. This study aimed to explore the association among menstrual pain, daytime sleepiness, and suicidal risk among female adolescents in China. METHODS Of 7072 adolescents who participated in the follow-up survey of Shandong Adolescents Behavior & Health Cohort (SABHC), 3001 were female adolescents who had begun to menstruate and included for the analysis. A structured self-administrated questionnaire was used to measure menstrual pain, daytime sleepiness, suicidal risk and demographic characteristics. Participants were first surveyed in November-December 2015 and resurveyed 1 year later. RESULTS Of 3001 participants, 11.43 % had suicidal risk, 79.8 % experienced menstrual pain. Cross-lagged analysis showed that there was cause-and-effect relationship between menstrual pain and daytime sleepiness. Moderate (OR = 1.79, 95%CI: 1.22-2.63) and severe (OR = 2.73, 95%CI: 1.80-4.12) menstrual pain (follow-up) were associated with suicidal risk (follow-up). Daytime sleepiness (baseline: OR = 1.04, 95%CI: 1.02-1.06, follow-up: OR = 1.07, 95%CI: 1.05-1.09) had effects on suicidal risk (follow-up). Mediation analysis showed that menstrual pain played a partially mediating role between daytime sleepiness and suicidal risk, with the indirect effect being 0.002 (95%CI: 0.001-0.004). LIMITATIONS All data were self-reported. CONCLUSIONS Menstrual pain and daytime sleepiness had effects on each other, and they both were the risk factors of suicidal risk. Among female adolescents, the association between daytime sleepiness and suicidal risk could be partially mediated by menstrual pain. Releasing the menstrual pain of female adolescents with daytime sleepiness could reduce their suicidal risk.
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Affiliation(s)
- Qiu-Yue Dong
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Xiao-Fan Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Ying-Ying Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Li-Peng Wan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.
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Stephenson M, Lannoy S, Edwards AC. Shared genetic liability for alcohol consumption, alcohol problems, and suicide attempt: Evaluating the role of impulsivity. Transl Psychiatry 2023; 13:87. [PMID: 36899000 PMCID: PMC10006209 DOI: 10.1038/s41398-023-02389-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/12/2023] Open
Abstract
Heavy drinking and diagnosis with alcohol use disorder (AUD) are consistently associated with risk for suicide attempt (SA). Though the shared genetic architecture among alcohol consumption and problems (ACP) and SA remains largely uncharacterized, impulsivity has been proposed as a heritable, intermediate phenotype for both alcohol problems and suicidal behavior. The present study investigated the extent to which shared liability for ACP and SA is genetically related to five dimensions of impulsivity. Analyses incorporated summary statistics from genome-wide association studies of alcohol consumption (N = 160,824), problems (N = 160,824), and dependence (N = 46,568), alcoholic drinks per week (N = 537,349), suicide attempt (N = 513,497), impulsivity (N = 22,861), and extraversion (N = 63,030). We used genomic structural equation modeling (Genomic SEM) to, first, estimate a common factor model with alcohol consumption, problems, and dependence, drinks per week, and SA included as indicators. Next, we evaluated the correlations between this common genetic factor and five factors representing genetic liability to negative urgency, positive urgency, lack of premeditation, sensation-seeking, and lack of perseverance. Common genetic liability to ACP and SA was significantly correlated with all five impulsive personality traits examined (rs = 0.24-0.53, ps < 0.002), and the largest correlation was with lack of premeditation, though supplementary analyses suggested that these findings were potentially more strongly influenced by ACP than SA. These analyses have potential implications for screening and prevention: Impulsivity can be comprehensively assessed in childhood, whereas heavy drinking and suicide attempt are quite rare prior to adolescence. Our findings provide preliminary evidence that features of impulsivity may serve as early indicators of genetic risk for alcohol problems and suicidality.
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Affiliation(s)
- Mallory Stephenson
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.
| | - Séverine Lannoy
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Alexis C Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
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Fonseca ACDS, Marin AH. Violência Autoprovocada no Brasil: Caracterização dos Casos Notificados entre 2009 e 2021. REVISTA PSICOLOGIA E SAÚDE 2023. [DOI: 10.20435/pssa.v14i3.2005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
A violência autoprovocada consiste em um problema de saúde pública, devido a sua elevada incidência e prejuízos decorrentes. A notificação dessa conduta ocorre por meio do Sistema de Vigilância de Violências e Acidentes (VIVA), que integra o Sistema de Informação de Agravos de Notificação (SINAN). O objetivo deste estudo foi caracterizar os casos notificados no Brasil a partir dos registros do SINAN correspondentes ao período de 2009 a 2021. Análises descritivas revelaram o crescimento dos registros no Brasil, envolvendo, predominantemente, pessoas do sexo feminino, com idades entre 15 e 29 anos, de cor branca e ensino fundamental incompleto ou médio completo. As agressões ocorreram majoritariamente na própria residência e abarcaram mais de um episódio. Reforça-se a relevância de avaliar as características da violência autoprovocada, de modo a vislumbrar fatores de risco e de proteção associados ao fenômeno para o delineamento de ações e políticas públicas.
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Rajhvajn Bulat L, Sušac N, Ajduković M. Predicting prolonged non-suicidal self-injury behaviour and suicidal ideations in adolescence - the role of personal and environmental factors. CURRENT PSYCHOLOGY 2023; 43:1-12. [PMID: 36855643 PMCID: PMC9951151 DOI: 10.1007/s12144-023-04404-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 03/02/2023]
Abstract
Suicide is one of the leading causes of death among adolescents and repetitional suicidal ideations (SI) and non-suicidal self-injury (NSSI) often precede it. In order to improve recognition of youth who are at high risk of suicide, current study aims to identify which individual variables (personality, self-concept and adverse childhood experiences - ACE) predict prolonged NSSI and SI from middle to late adolescence. A 3-year longitudinal study was conducted with 1101 Croatian adolescents (aged 15-17). 181 students (72.4% females) reported either NSSI or SI or both in T1 and were included in all waves of the study. Analyses are focused on differentiation between adolescents who continue with NSSI/SI and those who stop with it in a 3-year period. Results showed that adolescents with prolonged NSSI/SI had more ACE, especially domestic violence, worse family financial status, higher neuroticism and lower results on self-concept variables. The prediction model of classification of those who have prolonged NSSI or SI was better for SI than NSSI, with predictors explaining 31% of variation in SI. Adolescents who experienced more ACE and report more neuroticism have a higher chance of prolonged SI, while youth who perceive better family financial status and have better relationships with parents have a greater chance to stop with it. For NSSI only neuroticism was a significant predictor. Considering significant variables which could predict prolonged NSSI and/or SI, data presented in this paper have both scientific and practical contribution in understanding, treating and preventing adolescents' mental health problems.
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Affiliation(s)
- Linda Rajhvajn Bulat
- Department of Social Work, Faculty of Law, University of Zagreb, Zagreb, Croatia
| | - Nika Sušac
- Department of Social Work, Faculty of Law, University of Zagreb, Zagreb, Croatia
| | - Marina Ajduković
- Department of Social Work, Faculty of Law, University of Zagreb, Zagreb, Croatia
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Banandur P, Hasiruvalli Gangappa V, Koujageri JM, Garady L, Arelingaiah M, Ramamurthy SV, Naik V, Rai V, Giboy S, Sajjanar S, Subhash Chandra KL, Rajneesh S, Gopalkrishna G. Youth and suicidality: Correlates among clients attending youth mental health promotion clinics in India. Int J Soc Psychiatry 2023; 69:146-155. [PMID: 35057650 DOI: 10.1177/00207640211070399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Suicidality among youth is one of the most challenging public health issues. A thorough understanding of the risk factors that contribute to youth suicidality is necessary. The main aim of the study is to estimate the proportion of suicidality and understand factors associated with suicidality amongst clients attending youth mental health promotion clinics in Karnataka, India. METHODS A retrospective cross-sectional case record analysis was performed utilising data from real-time digitised management information system specifically developed for the programme. All case records of clients aged 15 to 35 years who received mental health promotion (MHP) services between January 2017 and December 2020 across 30 districts of Karnataka were included in this analysis. Multivariate logistic regression analysis was performed with suicidality among clients as outcome. Socio-demographic characteristics, issues reported, feelings/emotions that indicate underlying mental health issue/crisis, being aware of suicidality among friends and family and personal habits (smoking/chewing tobacco and drinking alcohol) were considered potential exposure variables. FINDINGS Overall proportion of suicidality among youth presenting to youth mental health promotion clinics in Karnataka was 3.5% (357/10,340). Among factors associated with suicidality, the strongest association was found among those clients who reported attempted suicide among friends (AOR 8.94; 95% CI 5.95-13.45), family members (AOR 5.50; 95% CI 3.66-8.29), being anxious (AOR 4.90; 95% CI 3.43-6.99), inability to trust anyone (AOR 4.07; 95% CI 2.75-6.03), had issues of Gender, Sex and Sexuality (AOR 3.16; 95% CI 1.93-5.17) and relationship issues (AOR 2.77; 95% CI 2.05-3.73). CONCLUSION The results alert all institutions, organisations and departments that cater to services and development of youth, to be sensitive towards risk factors of suicidality. The study advocates youth mental health promotion clinics to be equipped with measures/interventions to identify and manage such risk factors. This study has implications for Youth mental health promotion in India and other similar South-East Asian countries.
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Affiliation(s)
- Pradeep Banandur
- Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | | | | | - Lavanya Garady
- International Centre for Public Health Innovations, Ramaiah, Bengaluru, Karnataka, India
| | - Mutharaju Arelingaiah
- SAMA Program, UK-MRC Funded, Department of Psychiatric Social Work, NIMHANS, Bengaluru, Karnataka, India
| | - Sathya Velu Ramamurthy
- Yuva Spandana Program, Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | - Vani Naik
- Yuva Spandana Program, Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | - Veeksha Rai
- Life Skills Training and Counselling Services Program, Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | - Shalin Giboy
- Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | - Sateesh Sajjanar
- Department of Youth Empowerment and Sports, Government of Karnataka, Bengaluru, Karnataka, India
| | | | - Shalini Rajneesh
- Department of Youth Empowerment and Sports, Government of Karnataka, Bengaluru, Karnataka, India
| | - Gururaj Gopalkrishna
- Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
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McGillivray L, Keng-Meng Hui N, Wong QJJ, Han J, Qian J, Torok M. Does loneliness affect how young adults engage with and benefit from a smartphone intervention targeting suicidal ideation?: Randomised Controlled Trial (Preprint). JMIR Ment Health 2022; 10:e44862. [PMID: 36995752 PMCID: PMC10131597 DOI: 10.2196/44862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Loneliness is commonly reported by young people and has been shown to contribute to the rapid onset and escalation of depression and suicidal ideation during adolescence. Lonely people may also be particularly susceptible to disengaging from treatment early given the likelihood of their more complex clinical profiles leading to cognitive fatigue. While a smartphone intervention (LifeBuoy) has been shown to effectively reduce suicidal ideation in young adults, poor engagement is a well-documented issue for this therapeutic modality and has been shown to result in poorer treatment outcomes. OBJECTIVE This study aims to determine whether loneliness affects how young people experiencing suicidal ideation engage with and benefit from a therapeutic smartphone intervention (LifeBuoy). METHODS A total of 455 community-based Australian young adults (aged 18-25 years) experiencing recent suicidal ideation were randomized to use a dialectical behavioral therapy-based smartphone intervention (LifeBuoy) or an attention-matched control app (LifeBuoy-C) for 6 weeks. Participants completed measures of suicidal ideation, depression, anxiety, and loneliness at baseline (T0), post intervention (T1), and 3 months post intervention (T2). Piecewise linear mixed models were used to examine whether loneliness levels moderated the effect of LifeBuoy and LifeBuoy-C on suicidal ideation and depression across time (T0 to T1; T1 to T2). This statistical method was then used to examine whether app engagement (number of modules completed) influenced the relationship between baseline loneliness and suicidal ideation and depression across time. RESULTS Loneliness was positively associated with higher levels of overall suicidal ideation (B=0.75, 95% CI 0.08-1.42; P=.03) and depression (B=0.88, 95% CI 0.45-1.32; P<.001), regardless of time point or allocated condition. However, loneliness did not affect suicidal ideation scores across time (time 1: B=1.10, 95% CI -0.25 to 2.46; P=.11; time 2: B=0.43, 95% CI -1.25 to 2.12; P=.61) and depression scores across time (time 1: B=0.00, 95% CI -0.67 to 0.66; P=.99; time 2: B=0.41, 95% CI -0.37 to 1.18; P=.30) in either condition. Similarly, engagement with the LifeBuoy app was not found to moderate the impact of loneliness on suicidal ideation (B=0.00, 95% CI -0.17 to 0.18; P=.98) or depression (B=-0.08, 95% CI -0.19 to 0.03; P=.14). CONCLUSIONS Loneliness was not found to affect young adults' engagement with a smartphone intervention (LifeBuoy) nor any clinical benefits derived from the intervention. LifeBuoy, in its current form, can effectively engage and treat individuals regardless of how lonely they may be. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12619001671156; https://tinyurl.com/yvpvn5n8. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/23655.
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Affiliation(s)
| | | | - Quincy J J Wong
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Jin Han
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Jiahui Qian
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
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Mental disorders at the beginning of adolescence: Prevalence estimates in a sample aged 11-14 years. PUBLIC HEALTH IN PRACTICE 2022; 4:100348. [PMID: 36545674 PMCID: PMC9761382 DOI: 10.1016/j.puhip.2022.100348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/15/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
Objectives This study aims to provide a deeper insight into mental disorders in early adolescence. We report prevalence rates (mental health problems, depressive symptoms, eating disorders, NSSI, STBs) to be used in future studies and clinical ventures. We also expected to find gender differences, with girls being be more affected than boys are. Study design 877 adolescents (M = 12.43, SD = 0.65) from seven German high schools completed a series of questionnaires assessing their mental health (SDQ, PHQ-9, SEED, DSHI-9, Paykel Suicide Scale, FAS III). Methods We calculated cut-off-based prevalence estimates for mental health issues for the whole sample and compared estimates between genders. Results 12.5% of the sample reported general mental health problems. The estimated prevalence of depressive symptoms lay at of 11.5%. Additionally, 12.1% and 1.3% of the participants displayed relevant symptoms of anorexia or bulimia nervosa, respectively. A total of 10.8% reported engaging in non-suicidal self-injury (NSSI) at least once in their lifetime, of whom 5.6% reported repetitive NSSI. 30.1% of the participants described suicidal thoughts, 9.9% suicide plans, and 3.5% at least one suicide attempt. Girls were generally more affected than boys, except for bulimia nervosa, suicidal behavior, and partly NSSI. Conclusion Our findings corroborate the established relevance of early adolescence for the development of mental health problems and suggest that a substantial proportion of young adolescents suffer from such problems early on. Considering the ongoing COVID-19 pandemic and reported negative mental health consequences, the current findings underline the importance of preventive interventions to avoid the manifestation of mental disorders during adolescence.
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Liao S, Wang Y, Zhou X, Zhao Q, Li X, Guo W, Ji X, Lv Q, Zhang Y, Zhang Y, Deng W, Chen T, Li T, Qiu P. Prediction of suicidal ideation among Chinese college students based on radial basis function neural network. Front Public Health 2022; 10:1042218. [PMID: 36530695 PMCID: PMC9751327 DOI: 10.3389/fpubh.2022.1042218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background Suicide is one of the leading causes of death for college students. The predictors of suicidal ideation among college students are inconsistent and few studies have systematically investigated psychological symptoms of college students to predict suicide. Therefore, this study aims to develop a suicidal ideation prediction model and explore important predictors of suicidal ideation among college students in China. Methods We recruited 1,500 college students of Sichuan University and followed up for 4 years. Demographic information, behavioral and psychological information of the participants were collected using computer-based questionnaires. The Radial Basis Function Neural Network (RBFNN) method was used to develop three suicidal ideation risk prediction models and to identify important predictive factors for suicidal ideation among college students. Results The incidence of suicidal ideation among college students in the last 12 months ranged from 3.00 to 4.07%. The prediction accuracies of all the three models were over 91.7%. The area under curve scores were up to 0.96. Previous suicidal ideation and poor subjective sleep quality were the most robust predictors. Poor self-rated mental health has also been identified to be an important predictor. Paranoid symptom, internet addiction, poor self-rated physical health, poor self-rated overall health, emotional abuse, low average annual household income per person and heavy study pressure were potential predictors for suicidal ideation. Conclusions The study suggested that the RBFNN method was accurate in predicting suicidal ideation. And students who have ever had previous suicidal ideation and poor sleep quality should be paid consistent attention to.
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Affiliation(s)
- Shiyi Liao
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Yang Wang
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaonan Zhou
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Qin Zhao
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Xiaojing Li
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wanjun Guo
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaoyi Ji
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Qiuyue Lv
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yunyang Zhang
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Yamin Zhang
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wei Deng
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ting Chen
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Tao Li
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China,Tao Li
| | - Peiyuan Qiu
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China,*Correspondence: Peiyuan Qiu
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Lim JS, Yang CM, Baek JW, Lee SY, Kim BN. Prediction Models for Suicide Attempts among Adolescents Using Machine Learning Techniques. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2022; 20:609-620. [PMID: 36263637 PMCID: PMC9606439 DOI: 10.9758/cpn.2022.20.4.609] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/18/2021] [Accepted: 05/27/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Suicide attempts (SAs) in adolescents are difficult to predict although it is a leading cause of death among adolescents. This study aimed to develop and evaluate SA prediction models based on six different machine learning (ML) algorithms for Korean adolescents using data from online surveys. METHODS Data were extracted from the 2011-2018 Korea Youth Risk Behavior Survey (KYRBS), an ongoing annual national survey. The participants comprised 468,482 nationally representative adolescents from 400 middle and 400 high schools, aged 12 to 18. The models were trained using several classic ML methods and then tested on internal and external independent datasets; performance metrics were calculated. Data analysis was performed from March 2020 to June 2020. RESULTS Among the 468,482 adolescents included in the analysis, 15,012 cases (3.2%) were identified as having made an SA. Three features (suicidal ideation, suicide planning, and grade) were identified as the most important predictors. The performance of the six ML models on the internal testing dataset was good, with both the area under the receiver operating characteristic curve (AUROC) and area under the precision-recall curve (AUPRC) ranging from 0.92 to 0.94. Although the AUROC of all models on the external testing dataset (2018 KYRBS) ranged from 0.93 to 0.95, the AUPRC of the models was approximately 0.5. CONCLUSION The developed and validated SA prediction models can be applied to detect high risks of SA. This approach could facilitate early intervention in the suicide crisis and may ultimately contribute to suicide prevention for adolescents.
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Affiliation(s)
- Jae Seok Lim
- Department of Oral and Maxillofacial Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Chan-Mo Yang
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Korea,Division of Child and Adolescent Psychiatry, Department of Psychiatry, Graduate School of Medicine, Seoul National University, Seoul, Korea
| | - Ju-Won Baek
- Dental Clinic Center, Chungbuk National University Hospital, Cheongju, Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Korea,Address for correspondence: Sang-Yeol Lee Department of Psychiatry, School of Medicine, Wonkwang University, 895 Muwang-ro, Iksan 54538, Korea, E-mail: , ORCID: https://orcid.org/0000-0003-1828-9992, Bung-Nyun Kim, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea, E-mail: , ORCID: https://orcid.org/0000-0002-2403-3291
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Graduate School of Medicine, Seoul National University, Seoul, Korea,Address for correspondence: Sang-Yeol Lee Department of Psychiatry, School of Medicine, Wonkwang University, 895 Muwang-ro, Iksan 54538, Korea, E-mail: , ORCID: https://orcid.org/0000-0003-1828-9992, Bung-Nyun Kim, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea, E-mail: , ORCID: https://orcid.org/0000-0002-2403-3291
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Sekowski M, Lengiewicz I, Lester D. The complex relationships between dependency and self-criticism and suicidal behavior and ideation in early adulthood. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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McGillivray L, Shand F, Calear AL, Batterham PJ, Chen NA, Rheinberger D, Rosebrock H, Torok M. Profiles of Passive and Active Suicidal Ideation and Attempts Among Secondary School Students in Australia: A Cross-Sectional Analysis. Arch Suicide Res 2022; 26:1880-1894. [PMID: 34223811 DOI: 10.1080/13811118.2021.1945983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Suicide is a leading cause of death among young people (aged 15-24 years), and as such, identifying targets for early intervention is essential to reducing this risk. Using baseline data from a school-based universal suicide prevention trial, we investigate factors associated with different types of suicidal ideation in secondary school students with implications for youth suicide preventive efforts. METHODS A self-report questionnaire was administered to students aged 13-16 years (Year 9) before program delivery in four regions across New South Wales, Australia (N = 556). Multinomial logistic regression was used to identify correlates of suicidal ideation type (passive vs. active). RESULTS Approximately half the total sample reported recent suicidal ideation (51.6% in the previous two weeks), which included almost one-third reporting active suicidal ideation (32.2% seriously considered suicide or made plans). Participants that were significantly more likely to report active suicidal ideation compared to passive suicidal ideation identified as female (OR = 1.91, 95% CI = 1.02-3.59), Indigenous (OR = 0.21, 95% CI = 0.05-0.80), as sexual minorities (OR = 0.36, 95% CI = 0.13-0.97), and had greater depression severity (OR = 1.11, 95% CI = 1.04-1.19). CONCLUSIONS Suicidal thoughts are prevalent among young people. Universal and indicated preventive interventions that address depression, as well as bullying and discrimination of minority groups would benefit all young people, particularly those more vulnerable to severe suicidal ideation and suicide attempts.HighlightsActive suicidal ideation (SI) was reported by 32.2% of our student sample aged 13-16 years.Active SI is linked to sex (female), Indigeneity status, sexual minority status, and greater depression severity.Improved bullying and discrimination policy within schools, and well-being programs targeting depression and promoting help-seeking, would benefit youth.
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Depressive symptoms and suicidality by menopausal stages among middle-aged Korean women. Epidemiol Psychiatr Sci 2022; 31:e60. [PMID: 36017644 PMCID: PMC9428901 DOI: 10.1017/s2045796022000439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS There has been increasing evidence of hormonal changes during reproductive events that lead to mood changes. However, studies on the severity of psychological problems according to the menopausal stage are limited. Thus, this study aimed to investigate the association between menopausal stages, depression and suicidality. METHODS A total of 45 177 women who underwent regular health check-ups between 2015 and 2018 at Kangbuk Samsung Hospital were included. Participants were stratified into four groups (pre-menopause, early transition, late transition and post-menopause) based on the Stages of Reproductive Aging Workshop Criteria. The Center for Epidemiological Studies-Depression scale (CESD) was used to evaluate depressive symptoms, and the degree of depressive symptoms was classified as moderate (CESD score 16-24) or severe (CESD score ⩾ 25). To measure suicide risk, we administered questionnaires related to suicidal ideation. RESULTS Overall, the prevalence of CESD scores of 16-24 and ⩾ 25 was 7.6 and 2.8%, respectively. Menopausal stages were positively associated with depressive symptoms in a dose-dependent manner. Multivariable-adjusted prevalence ratios (PRs, 95% confidence intervals) for CESD scores of 16-24 comparing the stages of the early menopausal transition (MT), late MT and post-menopause to pre-menopause was 1.28 (1.16-1.42), 1.21 (1.05-1.38) and 1.58 (1.36-1.84), respectively. The multivariable-adjusted PRs for CESD scores ⩾ 25 comparing the stages of the early MT, late MT and post-menopause to pre-menopause were 1.31 (1.11-1.55), 1.39 (1.12-1.72), 1.86 (1.47-2.37), respectively. In addition, the multivariable-adjusted PRs for suicidal ideation comparing the early MT, late MT and post-menopause stages to the pre-menopause stage were 1.24 (1.12-1.38), 1.07 (0.93-1.24) and 1.46 (1.25-1.70) (p for trend <0.001), respectively. CONCLUSIONS These findings indicate that the prevalence of depressive symptoms and suicidal ideation increases with advancing menopausal stage, even pre-menopause.
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Psychosocial Factors and Sociodemographic Characteristics Associated with Suicidality Risk in Chilean Adolescents. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9081185. [PMID: 36010075 PMCID: PMC9406739 DOI: 10.3390/children9081185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022]
Abstract
Background: Suicidality in adolescents is a growing concern and is currently a public health issue in Chile and the world. Objective: To determine the association between the risk of suicidality with self-harm, sociodemographic parameters (that is, gender and type of school), psychosocial variables, and social and family support in Chilean adolescents. Methods: In a cross-sectional study, 829 (377, 45.5% girls) children/adolescents between 10 and 19 years of age participated. Suicidality, self-esteem, health-related quality of life (HRQoL), and social support perception were evaluated by standard, validated questionnaires. The presence of self-harm, dating violence, and family dysfunction was also evaluated through a self-report survey. Results: Suicidality risk was related to low self-esteem (OR = 9.73; 95%; CI = 6.62−14.28; p < 0.001), low HRQoL (OR = 5.0; 95%; CI = 3.51−7.13; p < 0.001), low social support (OR; 3.38, 95%; CI; 2.48−4.6; p < 0.001), and self-harm (OR = 8.03; 95%; CI = 5.69−11.33; p < 0.001). In family terms, suicidality risk was associated with exposure to physical (OR = 2.47, 95%CI; 1.69−3.6; p < 0.001) and psychological (OR = 1.78, 95; 1.33−2.39; p < 0.001) aggression between parents, and with considering their family dysfunctional (OR = 2.41 95%; CI = 1.69−3.41; p < 0.001). Finally, suicidality was associated with feeling mistreated by a boyfriend/girlfriend (OR = 2.18; 95% CI = 1.19−3.98; p = 0.011). Conclusion: Suicidality was associated with self-harm, low social, psychological and family well-being, and/or feeling mistreated by a boyfriend/girlfriend.
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Hartig A, Voss C, Herrmann L, Fahrenkrug S, Bindt C, Becker-Hebly I. Suicidal and nonsuicidal self-harming thoughts and behaviors in clinically referred children and adolescents with gender dysphoria. Clin Child Psychol Psychiatry 2022; 27:716-729. [PMID: 35213240 PMCID: PMC9234769 DOI: 10.1177/13591045211073941] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Young transgender or gender nonconforming (TGNC) children and adolescents or those with a gender dysphoria (GD) diagnosis show an increased risk of suicidal and nonsuicidal self-harming thoughts and behaviors (STBs). Data from German-speaking regions on this topic and studies comparing self- and parent-reported STBs have been scarce. The study aims were therefore to examine: (a) frequencies of self- and parent-reported STBs in a German clinical sample of children and adolescents with GD and (b) differences between age and gender groups, as well as between self- and parent-reports. METHODS Two items from the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR) were used to assess self- and parent-reported STBs in a sample of 343 adolescents and 49 children who presented to the Hamburg Gender Identity Service (Hamburg GIS) between 2013 and 2019. Seventy-eight percent of the analysis sample was assigned female at birth (AFAB), and 22% were assigned male at birth (AMAB). RESULTS Parents reported STBs on the CBCL for 16% and 6% of the cases in childhood and for 20% and 29% of the adolescent cases, respectively. STBs were self-reported by 38% and 45% of the adolescents who could report on the YSR. STBs were higher among adolescents than among children and in self-reports (YSR) compared to parent reports (CBCL). AFAB adolescents reported higher degrees of STBs than AMAB adolescents. CONCLUSIONS Children and adolescents with GD are a high-risk population for STBs, especially pubescent and AFAB individuals. Mental health professionals should screen early for STBs to prevent possible suicidal ideation-to-action transitions.
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Affiliation(s)
- Amelie Hartig
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, 37734University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Catharina Voss
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, 37734University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, 9169Technical University Dresden, Dresden, Germany
| | - Lena Herrmann
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, 37734University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Saskia Fahrenkrug
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, 37734University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, 37734University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Inga Becker-Hebly
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, 37734University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Abstract
We aimed to determine differences between adolescents with non-suicidal self-harm with and without a history of suicide attempt (SA). Sixty-eight adolescents with a mean age of 15.6 years (SD = 1.5) attending child and adolescent psychiatric outpatient clinics for repeated self-harm in Oslo, Norway, were included. A battery of instruments was used to assess sociodemographic information and psychopathology such as Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses, emotional and behavioral problems, borderline symptoms, depression, hopelessness, suicidal ideation, and history of SA. Twenty-six participants (38.2%) reported a lifetime history of SA. Compared to the participants without a history of SA, those with an SA history had used a higher number of methods of self-harm and methods with higher lethality and had higher degrees of emotional and behavioral problems. They also scored higher in depressive symptoms, borderline pathology, emotional dysregulation, hopelessness, and suicidal ideation. History of SA was independently associated with perceived moderate to high risk of death on the most severe episode of self-harm (adjusted odds ratio [aOR], 15.93; 95% confidence interval [CI], 1.96-129.66), a longer duration (months) since self-harm debut (aOR, 1.07; 95% CI, 1.01-1.13), and suicidal ideation severity (aOR, 1.05; 95% CI, 1.01-1.11). Parental report of behavioral problems associated with SA suggested a strong association with externalizing problems. A combination of having a high level of psychopathology, externalizing problems, an extended history of self-harm behavior and use of more lethal self-harm methods seems to entail a significantly increased risk for making SAs among adolescents with non-suicidal self-harm. HIGHLIGHTSNon-suicidal self-harm (NSSH) with suicide attempt may be distinctive from NSSH without suicide attempt.Adolescents with NSSH with suicide attempt had relatively greater psychopathology.Protracted/lethal self-harm methods and externalizing problems indicate comorbidity.
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Finding the Link between Cyberbullying and Suicidal Behaviour among Adolescents in Peninsular Malaysia. Healthcare (Basel) 2022; 10:healthcare10050856. [PMID: 35627992 PMCID: PMC9141303 DOI: 10.3390/healthcare10050856] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 11/23/2022] Open
Abstract
Social media engagement has contributed to the rise of cyberbullying, which has recently triggered tragic suicides among adolescents. The objective of this cross-sectional study is to determine the prevalence of cyberbullying, suicidal behaviour, and their association among adolescents in Peninsular Malaysia. The study was conducted among 1290 secondary school adolescents aged between 13 and 17 years old in Peninsular Malaysia using a self-administered and anonymous online questionnaire. Our findings reveal that the prevalence of cyberbullying victimization and perpetrator is 13.7% and 3.8%, respectively. The prevalence of suicidal behaviour among adolescents is 17.1%, in which 11.9% had suicidal thoughts, 10.2% had a suicide plan, and 8.4% had made a suicide attempt. Multiple logistic regression shows that adolescents experiencing cyberbullying victimization is a significant risk factor (p < 0.001) for suicidal behaviour after adjusting for other confounders. An alarming number of adolescents in Peninsular Malaysia found to be involved in cyberbullying and its significant association with suicidal behaviour warrant the need to strengthen current interventions. Since the study was conducted during the COVID-19 pandemic, our findings make an important contribution in reporting current trends in cyberbullying and suicide among adolescents, especially when they are becoming ever-more present in cyberspaces.
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Ndetei DM, Mutiso VN, Weisz JR, Okoth CA, Musyimi C, Muia EN, Osborn TL, Sourander A, Wasserman D, Mamah D. Socio-demographic, economic and mental health problems were risk factors for suicidal ideation among Kenyan students aged 15 plus. J Affect Disord 2022; 302:74-82. [PMID: 35032509 PMCID: PMC10448955 DOI: 10.1016/j.jad.2022.01.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/09/2021] [Accepted: 01/11/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND About a third of youth with suicidal ideation develop suicidal plans and about 60% of youth with suicidal plans make suicidal attempts. This study aimed to study different types of suicidal ideation and the risk factors in Kenyan youth. METHODS We studied a total of 9742 high school, college and university students using following self-administered instruments: - a researcher design socio-demographic questionnaire, Psychiatric Diagnostic Screening Questionnaire (PDSQ) to document psychiatric disorders and various types of suicidal ideas in previous two weeks, Washington Early Recognition Center Affectivity and Psychosis tool to assess stress, affectivity and psychosis, Wealth index questionnaire to document economic indicators based on household items for the families of the students. We used descriptive statistics, univariate analysis, bivariate logistic regression analysis and variables with a p-value of less than <.05 were entered into generalized linear models using logit links to identify independent predictors. RESULTS The overall prevalence of different types of suicidal ideation was (22.6%), major depression was found in 20.0%, affectivity, psychosis and stress was found in 10.4%, 8.7% and 26.0% respectively. Female gender, major depression, stress, affectivity and psychosis and being in high school were significant (p < 0.05) predictors of suicidal ideation. LIMITATIONS This was a cross sectional study that focused only on suicidal ideas and associated economic factors and mental health disorders. It did not study suicidal behavior. CONCLUSION Future studies are needed to study the progression from suicidal ideas to suicidal attempts and the factors associated with that progression.
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Affiliation(s)
- David M Ndetei
- Department of Psychiatry, University of Nairobi, Kenya and Africa Mental Health Research and Training Foundation, Mawensi Road, Off Elgon road, Mawensi Garden P.O. Box 48423-00100, Nairobi, Kenya; Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - John R Weisz
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Consolate A Okoth
- Department of Public and Community Health, Machakos University, Kenya
| | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Esther N Muia
- Department of Public and Community Health, Machakos University, Kenya
| | - Tom L Osborn
- Department of Psychology, Harvard University, Cambridge, MA, USA; Shamiri Institute - Allston, MA, U.S.A. and Nairobi, Kenya
| | - Andre Sourander
- Department of Child Psychiatry, Turku University Hospital, Finland
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Sweden
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
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Communicating distress: suicide threats/gestures among clinical and community youth. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-01960-5. [PMID: 35226164 PMCID: PMC10326133 DOI: 10.1007/s00787-022-01960-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/11/2022] [Indexed: 11/03/2022]
Abstract
Although self-injurious thoughts and behaviors are a global health concern, little is known about suicidal threat/gesture(s) where a person leads others to believe they want to end their lives when they have no intention to do so. This study assessed the lifetime prevalence of self-injurious thoughts and behaviors among both community adolescents (n = 1117) and in clinical youth (n = 191). Suicide threats/gestures were common among youth; 12.2% of community adolescents and 18.0% of clinical youth reporting having made a suicide threat/gesture, most commonly in the context of other self-injurious thoughts and behaviors. Across both samples, suicide threats/gestures were not uniquely associated with suicide attempts, and youth who reported suicide threats/gestures in the context of a history of self-harm or suicide plan(s) were no more likely to report a history of suicide attempt(s). Suicide threats/gestures were distinguished from suicide attempts in that they primarily fulfilled positive social functions, rather than autonomic functions. Findings suggest that suicidal threats/gestures are common in both community and clinical youth, and are not uniquely associated with suicide attempts, but rather function to communicate distress to others.
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Brager-Larsen A, Zeiner P, Klungsøyr O, Mehlum L. Is age of self-harm onset associated with increased frequency of non-suicidal self-injury and suicide attempts in adolescent outpatients? BMC Psychiatry 2022; 22:58. [PMID: 35081930 PMCID: PMC8790924 DOI: 10.1186/s12888-022-03712-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-harm in adolescents is an increasing public health concern and an important risk factor for suicide. We aimed to examine how age of self-harm onset in adolescents was associated with frequency of subsequent suicidal and non-suicidal self-harm (NSSI) episodes, and how age of onset and duration of self-harm may influence the frequency of self-harm. METHODS Data from 103 adolescents with recurrent self-harm recruited from child and adolescent psychiatric outpatient clinics were collected through clinical interviews and self-reports, and analysed with negative binomial and hurdle models. RESULTS A lower age of self-harm onset and a longer duration of self-harm were both significantly associated with increased frequency of subsequent episodes of NSSI and risk of a first suicide attempt. There was an increase in repeated suicide attempts when the age of onset of self-harm decreased and the duration increased, and dramatically more for long duration of NSSI before first suicide attempt. CONCLUSION Initiating self-harm behaviour at the youngest age had the highest risk of increased frequency of NSSI and suicide attempts. Longer duration of self-harm behaviour increased this risk. This underlines the importance of early identification of self-harm behaviour in adolescents, and the use of effective interventions.
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Affiliation(s)
- Anne Brager-Larsen
- Child and Adolescent Mental Health Research Unit, Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Sognsvannsveien 12, Bygg 12, N-0372, Oslo, Norway.
| | - Pål Zeiner
- grid.55325.340000 0004 0389 8485Child and Adolescent Mental Health Research Unit, Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Sognsvannsveien 12, Bygg 12, N-0372 Oslo, Norway
| | - Ole Klungsøyr
- grid.55325.340000 0004 0389 8485Section for treatment research, Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Lars Mehlum
- grid.5510.10000 0004 1936 8921National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Fan Q, Li Y, Gao Y, Nazari N, Griffiths MD. Self-Compassion Moderates the Association Between Body Dissatisfaction and Suicidal Ideation in Adolescents: A Cross-Sectional Study. Int J Ment Health Addict 2022; 21:1-18. [PMID: 35039750 PMCID: PMC8754517 DOI: 10.1007/s11469-021-00727-4] [Citation(s) in RCA: 4] [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] [Accepted: 11/29/2021] [Indexed: 02/06/2023] Open
Abstract
Identifying risk and protective factors for suicidal ideation during adolescence is essential for suicide prevention. One potential risk factor is body dissatisfaction which appears to peak during adolescence. The present study investigated the self-compassion buffering effects in the relationship between body dissatisfaction and suicidal ideation. A convenience sample comprising 580 adolescents (mean age 16.35 years; SD = .87; range 14-18 years) was recruited from public schools. The results indicated a strong positive association between body dissatisfaction and suicidal ideation (Cohen's f 2 = .25). The association was significantly moderated by the self-compassion (β = - .16, SE = .04, p = .01, t = 2.4.34, .95% CI [- .16, - .01]). Structural equation modeling analysis showed that the lack of self-kindness was associated with a moderate suicidal ideation level (Cohen's f 2 = .14). Also, higher levels of self-judgment predicted suicidal ideation with a moderate to large effect size (Cohen's f 2 = .28). The findings suggest that therapeutic programs designed to develop self-compassion should be implemented to reduce the risk of suicidal ideation among adolescents with body dissatisfaction. The findings empirically show that a higher degree of self-judgment is strongly associated with suicidal thoughts among adolescents, which must be systematically addressed in clinical studies on suicidal risk. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11469-021-00727-4.
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Affiliation(s)
- Qi Fan
- Institute of Mental Health, Nanjing Xiaozhuang University, Nanjing, 210017 Jiangsu Province China
| | - Yang Li
- Mental Health Education Center, Nanjing Forest Police College, Nanjing, 210023 Jiangsu Province China
| | - Yue Gao
- Department of Psychology, School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023 Jiangsu Province China
| | - Nabi Nazari
- Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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McGillivray L, Rheinberger D, Wang J, Burnett A, Torok M. Non-disclosing youth: a cross sectional study to understand why young people do not disclose suicidal thoughts to their mental health professional. BMC Psychiatry 2022; 22:3. [PMID: 34983460 PMCID: PMC8728900 DOI: 10.1186/s12888-021-03636-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Prevalence of suicidal ideation increases rapidly in adolescence, and many choose not to seek help and disclose their ideation. Young people who do disclose suicidal ideation, prefer to do so with peers and family compared to mental health professionals, who are best placed to provide evidence-based treatment. This study aimed to identify key factors associated with young people's decision to, or not to disclose suicidal thoughts to their mental health practitioner. METHODS A community-based sample of young Australians (16 - 25 years), who had experienced suicidal ideation and engaged with a mental health professional, completed an online questionnaire (N=513) which assessed demographic characteristics, severity of depression, anxiety, psychological distress, and suicidal ideation, lifetime suicide attempts, exposure to suicide loss, personal suicide stigma, prioritisation of mental health issues, and therapeutic alliance. Logistic regression analyses were used to identify factors associated with disclosure. RESULTS Though the full sample had engaged in therapy, 39% had never disclosed suicidal ideation to their clinician. Those who had disclosed were more likely to report greater therapeutic alliance (OR=1.04, 95% CI=1.02-1.06), personal suicide stigma (OR=1.04, 95% CI=1.01-1.06), prioritisation of suicidal ideation (OR=.24, 95% CI=0.14-0.42), and lifetime history of suicide attempt (OR=.32, 95% CI=0.18-0.57). The most common reason for not disclosing was concern that it would not remain confidential. CONCLUSION These findings provide new insights into why young people may not seek help by disclosing suicidal ideation, despite having access to a mental health professional, and establish evidence to inform practice decisions and the development of prevention strategies to support young people for suicide.
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Affiliation(s)
- Lauren McGillivray
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia.
| | - Demee Rheinberger
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
| | - Jessica Wang
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
| | - Alexander Burnett
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
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Schafer KM, Clancy KJ, Joiner T. An investigation into the bidirectional relationship between post-traumatic stress disorder and suicidal ideation: A nine year study. J Anxiety Disord 2022; 85:102510. [PMID: 34864539 PMCID: PMC10423636 DOI: 10.1016/j.janxdis.2021.102510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 11/03/2021] [Accepted: 11/21/2021] [Indexed: 11/20/2022]
Abstract
Suicide is the second leading cause of death in adolescents; a frequent precursor of suicide is suicidal ideation (SI). Literature indicates that Post-Traumatic Stress Disorder (PTSD) and SI are robust cross-sectional correlates of one another, with PTSD often being conceptualized as a risk factor (i.e., conferring risk) for SI. Indeed, PTSD is a well-established risk factor for SI; however, SI is an understudied risk factor for PTSD. It is possible that, yet unknown if, PTSD and SI promote each other over time in a bidirectional fashion. We investigated the bidirectional longitudinal associations between PTSD and SI in a large, diverse sample, who at baseline were adolescents. Participants were interviewed between 1995 and 1998 and again between 2004 and 2008. We hypothesized that PTSD and SI would be cross-sectionally, longitudinally, and bidirectionally related and that the number of traumas endorsed at baseline would be positively associated with PTSD and SI at baseline and follow-up. Indeed, PTSD and SI were cross-sectionally correlated at baseline, but not follow-up. PTSD predicted SI over nine years; however, SI during adolescence did not predict PTSD in adulthood. Finally, poly-trauma endorsed at baseline was associated with increased risk of SI, but not PTSD, over nine years.
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Abozaid MME, Aboserea MM, Metwally SM, AbElkhalek HA. Prevalence, psychosocial correlates of youths’ suicidal behaviors and perspectives on the phenomena at Zagazig University: a mixed-methods study. MIDDLE EAST CURRENT PSYCHIATRY, AIN SHAMS UNIVERSITY 2022; 29:86. [PMCID: PMC9628455 DOI: 10.1186/s43045-022-00250-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background Suicidal behaviors are major public health concerns that affect large numbers of youth, leaving not only the youth but also their parents, family, friends, and peers in constant wailing. This study aimed to investigate the prevalence, psychosocial correlates, and perspectives of youths’ suicidal behaviors. A concurrent mixed-methods descriptive study was used in carrying out this study. This study was conducted at Zagazig University, Al Sharkia Governorate. A stratified multi-stage cluster sampling technique was used to enroll 364 youths. Four tools were used to collect quantitative data. They were as follows: The Youth Profile Questionnaire, composed of two parts (socio-demographic data and youth characteristics), the Suicide Behaviors Questionnaire-Revised (SBQ-R), Social Problem-Solving Inventory-Revised Short Form (SPSI-R-SF), and the Short Version of the World Health Organization Quality of Life (WHOQOL-BREF). For the qualitative part, focus group discussions were conducted to explore youths’ perspectives on the phenomenon of suicidal behaviors. Results Quantitative findings revealed that 25% of the youth participants had a significant risk for suicidal behaviors. Being female, in the first years of practical faculties and having no friends are significantly correlated with suicidal behaviors. Further, the quality of life had a statistically significant negative correlation with suicidal behaviors. Qualitative findings were discussed under one main category: youths’ perspectives about suicidal behaviors (pressure/escaping tool, seeking help/ending pain, attention-grabbing behavior, and stain for life). Conclusions According to this mixed-methods study, youths’ suicidal behaviors are prevalent multifaceted phenomena that certain factors have been correlated with. It is suggested that female sex, having no friends, and academic stressors are risk factors for suicidal behaviors. Also, the quality of life was introduced as a protective factor against suicidal behaviors. Therefore, it is recommended to implement prevention and management approaches to realize the complexity of the phenomena of suicidal behaviors among youth; these approaches target the youths themselves (mental health promotion and strategies for coping with stress) and the population (careful media coverage, limit access to suicidal methods, and raise the awareness about mental illness).
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Affiliation(s)
- Mai Mohammed ElSayed Abozaid
- grid.31451.320000 0001 2158 2757Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt
| | - Mona Mostafa Aboserea
- grid.31451.320000 0001 2158 2757Public Health and Preventive Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Safaa Mohammed Metwally
- grid.31451.320000 0001 2158 2757Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt
| | - Hanem Ahmed AbElkhalek
- grid.31451.320000 0001 2158 2757Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt
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Xu W, Su C, Li Y, Rogers S, Wang F, Chen K, Aseltine R. Improving suicide risk prediction via targeted data fusion: proof of concept using medical claims data. J Am Med Inform Assoc 2021; 29:500-511. [PMID: 34850890 DOI: 10.1093/jamia/ocab209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/17/2021] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Reducing suicidal behavior among patients in the healthcare system requires accurate and explainable predictive models of suicide risk across diverse healthcare settings. MATERIALS AND METHODS We proposed a general targeted fusion learning framework that can be used to build a tailored risk prediction model for any specific healthcare setting, drawing on information fusion from a separate more comprehensive dataset with indirect sample linkage through patient similarities. As a proof of concept, we predicted suicide-related hospitalizations for pediatric patients in a limited statewide Hospital Inpatient Discharge Dataset (HIDD) fused with a more comprehensive medical All-Payer Claims Database (APCD) from Connecticut. RESULTS We built a suicide risk prediction model for the source data (APCD) and calculated patient risk scores. Patient similarity scores between patients in the source and target (HIDD) datasets using their demographic characteristics and diagnosis codes were assessed. A fused risk score was generated for each patient in the target dataset using our proposed targeted fusion framework. With this model, the averaged sensitivities at 90% and 95% specificity improved by 67% and 171%, and the positive predictive values for the combined fusion model improved 64% and 135% compared to the conventional model. DISCUSSION AND CONCLUSIONS We proposed a general targeted fusion learning framework that can be used to build a tailored predictive model for any specific healthcare setting. Results from this study suggest we can improve the performance of predictive models in specific target settings without complete integration of the raw records from external data sources.
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Affiliation(s)
- Wanwan Xu
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| | - Chang Su
- Department of Health Service Administration and Policy, Temple University, Philadelphia, Pennsylvania, USA
| | - Yan Li
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| | - Steven Rogers
- Department of Pediatrics, UCONN Health, Farmington, Connecticut, USA.,Injury Prevention Center, Connecticut Children's and Hartford Hospital, Hartford, Connecticut, USA
| | - Fei Wang
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Kun Chen
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| | - Robert Aseltine
- Division of Behavioral Sciences and Community Health, UConn Health, Farmington, Connecticut, USA
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Sadanand A, Rangiah S, Chetty R. Demographic profile of patients and risk factors associated with suicidal behaviour in a South African district hospital. S Afr Fam Pract (2004) 2021; 63:e1-e7. [PMID: 34797092 PMCID: PMC8603102 DOI: 10.4102/safp.v63i1.5330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background Suicidal behaviour comprises self-destructive thoughts coupled with attempts at suicide, which negatively impacts the patient, family, friends, and their community. There is a paucity of data on factors influencing suicidal thoughts and behaviour in South Africa. The aim of this study was to evaluate demographic profile and risk factors associated with suicidal behaviour. Methods In this retrospective descriptive and observational study, 282 medical records of patients with suicidal behaviour were studied. The risk factors and age at occurrence were tabulated. Descriptive analyses were undertaken to understand how they were distributed across key socio-demographic groups. Results Suicidal behaviour was particularly prominent amongst the female population. The suicidal ideation, plan and non-fatal suicide were reported by 48.6%, 29.1% and 36.5%, of patients respectively. The prevalence for suicidal ideation was significantly higher in females (54.5% vs. 31.5%; p < 0.0007) but not for suicidal plan (28.7% vs. 30.1%; p < 0.81) and suicidal attempt (37.3% vs. 34.2%; p = 0.63) as compared with males. Suicidal behaviour was positively associated with depression (r = 0.56, p < 0.001) and negatively associated with age (r = −0.16, p = 0.01). Multivariate logistic regression analysis revealed that suicidal behaviour was influenced by female gender, poor social support, depression and a family history of non-fatal suicide. Conclusion This research has confirmed an association between female sex and factors associated with a higher risk of suicidal behaviour.
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Affiliation(s)
- Aneeth Sadanand
- Department of Family Medicine, College of Health Science, University of KwaZulu-Natal, Durban.
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McGillivray L, Shand F, Calear AL, Batterham PJ, Rheinberger D, Chen NA, Burnett A, Torok M. The Youth Aware of Mental Health program in Australian Secondary Schools: 3- and 6-month outcomes. Int J Ment Health Syst 2021; 15:79. [PMID: 34674726 PMCID: PMC8529373 DOI: 10.1186/s13033-021-00503-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The evidence base for suicide prevention programs in Australian schools is limited. The aim of this study was to examine the impact of a universal, mental health promotion and suicide prevention program-Youth Aware of Mental Health (YAM)-on suicidal ideation, mental health, and help-seeking in Australian secondary school students from baseline to post-intervention and 6-month follow up. METHODS Using a single-arm design, the YAM program was delivered to Year 9 students (13-16 years) in secondary schools located within four regions across New South Wales, Australia. A structured self-report questionnaire using validated scales was administered at each time point. Linear mixed-effects modelling was used to examine differences in suicidal ideation scores across time, while accounting for random effects of individual schools. RESULTS Suicidal ideation reduced significantly from baseline to post, and from baseline to follow-up (p < 0.001). Depression severity declined (p < 0.001) and help-seeking intentions increased (p < 0.001) at post-intervention and 6- months following the intervention period. No suicide deaths were reported for any study participants. CONCLUSION The current findings provide preliminary evidence that the YAM program is a promising preventive intervention for Australian schools, particularly for reducing suicidal ideation, depression and increasing help-seeking intentions in young people. The implementation of YAM in a large number of schools across New South Wales demonstrates the feasibility, and acceptability by schools, of implementing this program at scale. TRIAL REGISTRATION ANZCTR, ACTRN12619000338167. Registered 5 March 2019-Retrospectively registered, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376989&isReview=true .
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Affiliation(s)
- Lauren McGillivray
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia.
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Eggleston Road, Acton, ACT, 2601, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Eggleston Road, Acton, ACT, 2601, Australia
| | - Demee Rheinberger
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
| | - Nicola A Chen
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
| | - Alexander Burnett
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
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Suicidal ideation in adolescents and young adults in Greece: prevalence and association with sociodemographic variables, mental health and substance use. Eur Child Adolesc Psychiatry 2021; 30:1129-1136. [PMID: 33855666 DOI: 10.1007/s00787-021-01747-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Balt E, Mérelle S, van Bergen D, Gilissen R, van der Post P, Looijmans M, Creemers D, Rasing S, Mulder W, van Domburgh L, Popma A. Gender differences in suicide-related communication of young suicide victims. PLoS One 2021; 16:e0252028. [PMID: 34019584 PMCID: PMC8139476 DOI: 10.1371/journal.pone.0252028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/08/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES There is limited insight into gender differences in suicide-related communication (SRC) in youths. SRC is defined as "the act of conveying one's own suicide ideation, intent or behaviours to another person". Increasing our understanding of SRC in youths will enable us to recognize and specify needs of female versus male youths. The current study explores SRC in a sample of Dutch suicide victims aged under 20 and examines gender differences. METHODS Interview data from a psychological autopsy study of 35 youths who died by suicide in the Netherlands in 2017 were analysed. Qualitative analyses were performed to examine explicit SRC throughout the youths' lives and implicit SRC during the last months prior to suicide. We employed the Constant Comparative Method to explore patterns in the debut, form, frequency, medium, content, type of recipient, and SRC in the last months prior to suicide death. RESULTS We identified commonalities in the SRC of youths, including the content of suicide notes and an emphasis on suicide method and preparation in the last months. Girls, however, had an earlier debut of SRC, a higher frequency of explicit SRC, and more often directed SRC towards varied types of recipients compared to boys. Moreover, SRC of girls seemed focused on coping and achieving support from others more than SRC of boys. The SRC of boys in comparison to girls was often ambiguous or diluted by "humorous" connotations. CONCLUSION Unique patterns in SRC of boys and girls posed corresponding challenges for next of kin to interpret communications and respond adequately to SRC. The early debut of girls' SRC highlights the importance of early screening and prevention efforts in girls, while the late debut and ambiguity in boys' SRC implores professionals and next of kin to encourage young males to be unequivocal about suicide ideation or intent.
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Affiliation(s)
- Elias Balt
- Research department, 113 Suicide Prevention, Amsterdam, The Netherlands
| | - Saskia Mérelle
- Research department, 113 Suicide Prevention, Amsterdam, The Netherlands
| | - Diana van Bergen
- Research department, 113 Suicide Prevention, Amsterdam, The Netherlands
- Department of Pedagogical and Educational Sciences, Faculty of Behavioral Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Renske Gilissen
- Research department, 113 Suicide Prevention, Amsterdam, The Netherlands
| | | | - Milou Looijmans
- Research department, 113 Suicide Prevention, Amsterdam, The Netherlands
| | - Daan Creemers
- Child and Adolescent Psychiatry, GGZ Oost Brabant, Boekel, The Netherlands
| | - Sanne Rasing
- Child and Adolescent Psychiatry, GGZ Oost Brabant, Boekel, The Netherlands
- Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Wico Mulder
- Youth healthcare, Dutch Centre for Youth Health (NCJ), Utrecht, The Netherlands
| | - Lieke van Domburgh
- Quality of Care & Innovation, Pluryn, Nijmegen, The Netherlands
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Centre (AUMC), Amsterdam, The Netherlands
| | - Arne Popma
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Centre (AUMC), Amsterdam, The Netherlands
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Xiao Y, Lindsey MA. Adolescent social networks matter for suicidal trajectories: disparities across race/ethnicity, sex, sexual identity, and socioeconomic status. Psychol Med 2021; 52:1-12. [PMID: 33653436 PMCID: PMC9772914 DOI: 10.1017/s0033291721000465] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/26/2021] [Accepted: 02/05/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Examining social networks, characterized by interpersonal interactions across family, peer, school, and neighborhoods, offer alternative explanations to suicidal behaviors and shape effective suicide prevention. This study examines adolescent social networks predicting suicide ideation and attempt trajectories transitioning to adulthood, while revealing differences across racial/ethnic, sex, sexual identity, and socioeconomic status. METHODS Participants included 9421 high school students (Mage = 15.30 years; 54.58% females, baseline) from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health, 1994-2008. Latent class growth analyses were conducted to identify suicide ideation and attempt trajectories. Multivariate multinomial logistic regressions examined the relationships between social network characteristics during adolescence and suicidal trajectories. Interaction terms between social networks and sociodemographic characteristics were included to test moderation effects. RESULTS Three suicidal ideation trajectories (low-stable, high-decreasing, moderate-decreasing-increasing) and two suicide attempt trajectories (low-stable, moderate-decreasing) were identified. Greater family cohesion significantly reduced the probability of belonging to high-decreasing (Trajectory 2) and moderate-decreasing-increasing (Trajectory 3) suicidal ideation trajectories, and moderate-decreasing (Trajectory 2) suicide attempt trajectory. Race/ethnicity, sex, and sexual identity significantly moderated the associations between social networks (household size, peer network density, family cohesion, peer support, neighborhood support) and suicidal trajectories. CONCLUSIONS Social networks during adolescence influenced the odds of belonging to distinct suicidal trajectories. Family cohesion protected youth from being in high-risk developmental courses of suicidal behaviors. Social networks, especially quality of interactions, may improve detecting adolescents and young adults at-risk for suicide behaviors. Network-based interventions are key to prevent suicidal behaviors over time and suicide intervention programming.
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Affiliation(s)
- Yunyu Xiao
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202
- School of Social Work, Indiana University-Bloomington, Bloomington, IN 47401
- McSilver Institute for Poverty Policy and Research, New York University, New York, NY, 10003
| | - Michael A. Lindsey
- McSilver Institute for Poverty Policy and Research, New York University, New York, NY, 10003
- Silver School of Social Work, New York University, New York, NY 10003
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Lieberman A, Joiner TE, Duffy ME, Wonderlich SA, Crosby RD, Mitchell JE, Crow SJ, Peterson CB, Le Grange D, Bardone-Cone AM. An Examination of the Interpersonal Theory of Suicide's Tenets among Women with Bulimic-Spectrum Pathology. Psychiatry 2021; 84:137-149. [PMID: 33944699 DOI: 10.1080/00332747.2021.1917244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Suicide attempts and self-injurious behaviors (SIBs) are known to be elevated among people with bulimia nervosa (BN). The aim of the current study was to examine the Interpersonal-Psychological Theory of Suicide (IPTS) as a framework for understanding, assessing, and mitigating suicidal behavior among women with BN. The IPTS suggests that for individuals to enact lethal suicide attempts, they must have both the desire to die (consisting of thwarted belongingness and perceived burdensomeness) as well as the capability to die (often acquired through repeated exposure to provocative or painful experiences).Method: Two-hundred and four women with eating disorders, the majority of whom met criteria for a current DSM-IV diagnosis of BN, completed measures from which proxies for IPTS variables were formed. Bivariate correlations and multiple regressions tested main effects and interactions of study variables. Tests of the difference between dependent correlations probed differential associations between study variables and suicidal ideation versus suicidal behavior.Results and Conclusions: Results yielded considerable but not unalloyed support for the theory, with desire to die variables (particularly perceived burdensomeness) more strongly associating with suicidal ideation than behavior, and the opposite holding true regarding capability. These findings suggest that the IPTS may provide a useful framework for understanding, assessing, and mitigating suicide risk among individuals with BN.
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Kushal SA, Amin YM, Reza S, Shawon MSR. Parent-adolescent relationships and their associations with adolescent suicidal behaviours: Secondary analysis of data from 52 countries using the Global School-based Health Survey. EClinicalMedicine 2021; 31:100691. [PMID: 33554083 PMCID: PMC7846673 DOI: 10.1016/j.eclinm.2020.100691] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite the potential benefits of parents-adolescent relationships on suicidal behaviours among adolescents, research on these topics are importantly limited by lack of comprehensiveness, difficulties in cross-country comparisons, and limited generalisability, among others. We aimed to estimate the prevalence of various aspects of parents-adolescent relationships and suicidal behaviours by sex and region, and to investigate their associations. METHODS We used data from the Global School-based Health Survey (GSHS) from 52 countries in 2009-2015 for 120 858 adolescents (53.9% girls) aged 12-15 years. Using meta-analysis with random effects, we estimated the prevalence of parents-adolescent relationships (i.e. understanding problems, monitoring academic and leisure time activities, and respecting privacy) and suicidal behaviours (i.e. suicidal ideation, suicide planning, and suicide attempt). Multi-level mixed-effect logistic regressions were used to investigate their associations. FINDINGS Overall, boys and girls reported similar levels of parental understanding of problems (35.8% vs. 36.8%), monitoring academic activities (41.8% vs. 41.1%), and respecting privacy (69.6% vs. 69.7%), whereas girls reported higher level of parental monitoring of leisure time activities than boys (44.9% vs. 40.0%). Adolescents in the Western Pacific region reported the lowest level of parental understanding of problems and monitoring activities, while those in South-East Asia region least reported that their parents respected their privacy. The overall prevalence of any suicidal behaviour was higher in girls than boys (26.2% vs. 23.0%). Suicidal behaviour was less likely in adolescents if their parents understood their problems (odds ratio, 95% confidence intervals: 0.70, 0.68-0.73), monitored their academic (0.81, 0.78-0.84) and leisure time activities (0.73, 0.71-0.75), and respected their privacy (0.83, 0.80-0.86). There was evidence of heterogeneity in those associations by sex and regions. INTERPRETATIONS Although the prevalence of parents-adolescent relationships and adolescent suicidal behaviours varied particularly by sex and region, there were strong and independent associations among them.
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Affiliation(s)
| | - Yahia Md Amin
- Lifespring, 14th floor, Union heights, 55/2, Panthapath, Dhaka 1205, Bangladesh
| | - Shusama Reza
- Lifespring, 14th floor, Union heights, 55/2, Panthapath, Dhaka 1205, Bangladesh
| | - Md Shajedur Rahman Shawon
- Centre for Big Data Research in Health, UNSW Medicine, Level 2, AGSM Building (G27), UNSW Sydney, NSW 2052, Australia
- Corresponding author.
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Voss C, Hoyer J, Venz J, Pieper L, Beesdo-Baum K. Non-suicidal self-injury and its co-occurrence with suicidal behavior: An epidemiological-study among adolescents and young adults. Acta Psychiatr Scand 2020; 142:496-508. [PMID: 32979220 DOI: 10.1111/acps.13237] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/13/2020] [Accepted: 09/17/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) comprising thoughts and behaviors is common and often co-occurring with suicidal behavior like ideation, plan, and attempt. As limited data are available for adolescents and young adults, this study aims to present prevalence estimates for lifetime NSSI, its co-occurrence with suicidal behavior, conditional probabilities and their association with socio-demographic characteristics, severity characteristics of suicidal behavior, and health service utilization. METHOD The epidemiological Behavior and Mind Health (BeMIND) study assessed in 2015/16 a random-community sample of N = 1180 aged 14-21 years from Dresden, Germany, regarding lifetime NSSI via self-administered questionnaire and suicidal behaviors via standardized interview. RESULTS Any lifetime NSSI was reported by 19.3% (thoughts: 18.0%, behaviors: 13.6%) of the sample with higher prevalence in females (OR = 2.7, 95% CI 1.9-3.8, P < 0.001). Lifetime prevalence of co-occurring NSSI and suicidal behavior was 7.7%. Females had a 3.3- to 8.8-fold odds of co-occurrence than males. Among those with any NSSI, 39.6% endorsed suicidal behavior, and 66.3% of those with any suicidal behavior reported NSSI. 42.3% of those with any NSSI reported to have used mental healthcare services at any time during their life with higher rates in those with co-occurring suicidal behavior (62.3%). CONCLUSION Non-suicidal self-injury and co-occurring suicidal behavior is common in adolescents and young adults-especially females. The limited utilization of mental healthcare services underpins the need for improving recognition of NSSI and suicidal behavior as well as the accessibility of mental healthcare services during adolescence and emerging adulthood.
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Affiliation(s)
- C Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - J Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - L Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - K Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
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