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Kılıçarslan Ş, Çelik S, Güngör AY, Alkan Ö. The role of effective factors on suicidal tendency of women in Turkey. Front Public Health 2024; 11:1332937. [PMID: 38274522 PMCID: PMC10809711 DOI: 10.3389/fpubh.2023.1332937] [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: 11/09/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Background/Aim This study aims to identify the variables that influence the suicidal tendency of women who are married, have had a relationship or are currently in a relationship in Turkey. Methods This study uses cross-sectional data from the 2014 Hacettepe University Institute of Population Studies National Research on Domestic Violence Against Women in Turkey. Data from 6,458 women between the ages of 15 and 49 were analyzed in this dataset. Binary logistic regression was used to determine the factors influencing women's suicidal tendencies. Results Based on the analysis's findings, age, education level, health status, number of children, the sector in which the spouse/partner works, the drinking status of the spouse/partner, the situation where the spouse/partner fights with another man in a way that involves physical violence, the cheating status of the spouse/partner, the controlling behaviour of the spouse/partner, exposure to various types of violence by both the spouse/partner and someone other than the partner, and the household income level variables were found to be associated with the suicidal tendency of women. Conclusion Prioritizing women who are, in particular, between the ages of 15 and 24, live in the south of Turkey, have a high school education, are in poor health, are childless, have low household incomes, live with an unemployed spouse or partner, and are exposed to various forms of violence from their partner or other sources can be achieved more effective results in reducing and preventing women's suicidal behaviors.
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Affiliation(s)
- Şerife Kılıçarslan
- Oltu Faculty of Humanities and Social Sciences, Department of Finance and Banking, Ataturk University, Erzurum, Türkiye
| | - Sefa Çelik
- Faculty of Economics and Administrative Sciences, Department of Business Administration, Ataturk University, Erzurum, Türkiye
| | - Abdullah Y. Güngör
- Oltu Faculty of Humanities and Social Sciences, Department of Business Administration, Ataturk University, Erzurum, Türkiye
| | - Ömer Alkan
- Faculty of Economics and Administrative Sciences, Department of Econometrics, Ataturk University, Erzurum, Türkiye
- Master Araştırma Eğitim ve Danışmanlık Hizmetleri Ltd. Şti., Erzurum, Türkiye
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Heterogeneity of adolescent health risk behaviors in rural western China: A latent class analysis. PLoS One 2018; 13:e0199286. [PMID: 29944679 PMCID: PMC6019255 DOI: 10.1371/journal.pone.0199286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 06/05/2018] [Indexed: 12/11/2022] Open
Abstract
Background Adolescent health risk behaviors are a public health priority given their prevalence and their associations with chronic diseases and life quality in adulthood. This study examined the heterogeneity of adolescent health risk behaviors and the associations between demographic characteristics and subgroup membership in rural western China. Methods In fall 2015, 2805 students from rural middle schools in Sichuan Province were surveyed using the Health-Related Behavior Questionnaire for Adolescents. Latent class analysis (LCA) was used to identify subgroups of adolescents with distinct patterns of health risk behaviors. Differences in class membership related to selected demographic characteristics were examined using multinomial logistic regression analysis. Results A four-class model emerged: (1) high-risk group (n = 108, 4.0%), (2) high-physical-inactivity and suicide-risk group (n = 340, 12.1%), (3) moderate-risk group (n = 897, 32.0%), and (4) low-risk group (n = 1460, 52.1%). The multinomial logistic regression analysis revealed that boys and adolescents with poor parental relationships and high allowances (spending money) were significantly more likely to be in the high-risk group than the low-risk group. Conclusions Adolescents in rural western China are a heterogeneous population requiring different tailored and effective interventions.
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Dialektisch-Behaviorale Therapie für männliche Jugendliche mit Symptomen einer Borderline-Persönlichkeitsstörung. Prax Kinderpsychol Kinderpsychiatr 2017; 66:104-120. [DOI: 10.13109/prkk.2017.66.2.104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hawton K, Witt KG, Taylor Salisbury TL, Arensman E, Gunnell D, Townsend E, van Heeringen K, Hazell P. Interventions for self-harm in children and adolescents. Cochrane Database Syst Rev 2015; 2015:CD012013. [PMID: 26688129 PMCID: PMC8786270 DOI: 10.1002/14651858.cd012013] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Self-harm (SH; intentional self-poisoning or self-injury) is common in children and adolescents, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for deliberate SH first published in 1998 and previously updated in 1999. We have now divided the review into three separate reviews; this review is focused on psychosocial and pharmacological interventions for SH in children and adolescents. OBJECTIVES To identify all randomised controlled trials of psychosocial interventions, pharmacological agents, or natural products for SH in children and adolescents, and to conduct meta-analyses (where possible) to compare the effects of specific treatments with comparison types of treatment (e.g., treatment as usual (TAU), placebo, or alternative pharmacological treatment) for children and adolescents who SH. SEARCH METHODS For this update the Cochrane Depression, Anxiety and Neurosis Group (CCDAN) Trials Search Co-ordinator searched the CCDAN Specialised Register (30 January 2015). SELECTION CRITERIA We included randomised controlled trials comparing psychosocial or pharmacological treatments with treatment as usual, alternative treatments, or placebo or alternative pharmacological treatment in children and adolescents (up to 18 years of age) with a recent (within six months) episode of SH resulting in presentation to clinical services. DATA COLLECTION AND ANALYSIS Two reviewers independently selected trials, extracted data, and appraised study quality, with consensus. For binary outcomes, we calculated odds ratios (OR) and their 95% confidence intervals (CI). For continuous outcomes measured using the same scale we calculated the mean difference (MD) and 95% CI; for those measured using different scales we calculated the standard mean difference (SMD) and 95% CI. Meta-analysis was only possible for two interventions: dialectical behaviour therapy for adolescents and group-based psychotherapy. For these analyses, we pooled data using a random-effects model. MAIN RESULTS We included 11 trials, with a total of 1,126 participants. The majority of participants were female (mean = 80.6% in 10 trials reporting gender). All trials were of psychosocial interventions; there were none of pharmacological treatments. With the exception of dialectical behaviour therapy for adolescents (DBT-A) and group-based therapy, assessments of specific interventions were based on single trials. We downgraded the quality of evidence owing to risk of bias or imprecision for many outcomes.Therapeutic assessment appeared to increase adherence with subsequent treatment compared with TAU (i.e., standard assessment; n = 70; k = 1; OR = 5.12, 95% CI 1.70 to 15.39), but this had no apparent impact on repetition of SH at either 12 (n = 69; k = 1; OR 0.75, 95% CI 0.18 to 3.06; GRADE: low quality) or 24 months (n = 69; k = 1; OR = 0.69, 05% CI 0.23 to 2.14; GRADE: low quality evidence). These results are based on a single cluster randomised trial, which may overestimate the effectiveness of the intervention.For patients with multiple episodes of SH or emerging personality problems, mentalisation therapy was associated with fewer adolescents scoring above the cut-off for repetition of SH based on the Risk-Taking and Self-Harm Inventory 12 months post-intervention (n = 71; k = 1; OR = 0.26, 95% CI 0.09 to 0.78; GRADE: moderate quality). DBT-A was not associated with a reduction in the proportion of adolescents repeating SH when compared to either TAU or enhanced usual care (n = 104; k = 2; OR 0.72, 95% CI 0.12 to 4.40; GRADE: low quality). In the latter trial, however, the authors reported a significantly greater reduction over time in frequency of repeated SH in adolescents in the DBT condition, in whom there were also significantly greater reductions in depression, hopelessness, and suicidal ideation.We found no significant treatment effects for group-based therapy on repetition of SH for individuals with multiple episodes of SH at either the six (n = 430; k = 2; OR 1.72, 95% CI 0.56 to 5.24; GRADE: low quality) or 12 month (n = 490; k = 3; OR 0.80, 95% CI 0.22 to 2.97; GRADE: low quality) assessments, although considerable heterogeneity was associated with both (I(2) = 65% and 77% respectively). We also found no significant differences between the following treatments and TAU in terms of reduced repetition of SH: compliance enhancement (three month follow-up assessment: n = 63; k = 1; OR = 0.67, 95% CI 0.15 to 3.08; GRADE: very low quality), CBT-based psychotherapy (six month follow-up assessment: n = 39; k = 1; OR = 1.88, 95% CI 0.30 to 11.73; GRADE: very low quality), home-based family intervention (six month follow-up assessment: n = 149; k = 1; OR = 1.02, 95% CI 0.41 to 2.51; GRADE: low quality), and provision of an emergency card (12 month follow-up assessment: n = 105, k = 1; OR = 0.50, 95% CI 0.12 to 2.04; GRADE: very low quality). No data on adverse effects, other than the planned outcomes relating to suicidal behaviour, were reported. AUTHORS' CONCLUSIONS There are relatively few trials of interventions for children and adolescents who have engaged in SH, and only single trials contributed to all but two comparisons in this review. The quality of evidence according to GRADE criteria was mostly very low. There is little support for the effectiveness of group-based psychotherapy for adolescents with multiple episodes of SH based on the results of three trials, the evidence from which was of very low quality according to GRADE criteria. Results for therapeutic assessment, mentalisation, and dialectical behaviour therapy indicated that these approaches warrant further evaluation. Despite the scale of the problem of SH in children and adolescents there is a paucity of evidence of effective interventions. Further large-scale trials, with a range of outcome measures including adverse events, and investigation of therapeutic mechanisms underpinning these interventions, are required. It is increasingly apparent that development of new interventions should be done in collaboration with patients to ensure that these are likely to meet their needs. Use of an agreed set of outcome measures would assist evaluation and both comparison and meta-analysis of trials.
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Affiliation(s)
- Keith Hawton
- Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford, UK, OX3 7JX
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Govender K, Naicker SN, Meyer-Weitz A, Fanner J, Naidoo A, Penfold WL. Associations between perceptions of school connectedness and adolescent health risk behaviors in South African high school learners. THE JOURNAL OF SCHOOL HEALTH 2013; 83:614-622. [PMID: 23879780 DOI: 10.1111/josh.12073] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 01/07/2013] [Accepted: 02/21/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND This study investigated the relationship between school connectedness and health risk behaviors, specifically, substance abuse, violence-related behaviors, sexual risk behaviors, and suicidal ideation among school-going adolescents. School connectedness was understood to encompass a range of aspects pertaining to a learner's sense of belonging to the school. We hypothesized that strong perceptions of school connectedness will more likely be associated with lower levels of risk behaviors among school-going adolescents. METHODS The study was conducted in 2 neighboring public co-educational schools in Durban, South Africa. Independent measures assessed school connectedness, substance abuse, violence-related behaviors, sexual risk behaviors, and suicidal ideation. RESULTS Strong negative correlations were found between adolescents' perceptions of school connectedness and the 4 health risk behaviors, particularly suicidal ideation. The relative importance of risk factors was also evidenced in the sample. CONCLUSIONS Adolescents with lower perceptions of school connectedness were more likely to engage in various risk behaviors, supporting the literature that a lack of school connectedness can act as a risk factor for adolescent involvement in clustering of risk behaviors. Further the relative weighting of individual risk factors, it is argued, was an effect of the sociocultural context of the study.
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Affiliation(s)
- Kaymarlin Govender
- School of Psychology, Howard College, University of KwaZulu-Natal, King George V Avenue, Durban 4001, South Africa.
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Memel B. A Quality Improvement Project to Decrease the Length of Stay on a Psychiatric Adolescent Partial Hospital Program. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2012; 25:207-18. [DOI: 10.1111/jcap.12005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Brenda Memel
- Johns Hopkins Bayview's Adolescent Intensive Outpatient Program; Baltimore MD USA
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Hooper LM, Epstein SA, Weinfurt KP, DeCoster J, Qu L, Hannah NJ. Predictors of primary care physicians' self-reported intention to conduct suicide risk assessments. J Behav Health Serv Res 2012; 39:103-15. [PMID: 22218814 PMCID: PMC3586785 DOI: 10.1007/s11414-011-9268-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Primary care physicians play a significant role in depression care, suicide assessment, and suicide prevention. However, little is known about what factors relate to and predict quality of depression care (assessment, diagnosis, and treatment), including suicide assessment. The authors explored the extent to which select patient and physician factors increase the probability of one element of quality of care: namely, intention to conduct suicide assessment. Data were collected from 404 randomly selected primary care physicians after their interaction with CD-ROM vignettes of actors portraying major depression with moderate levels of severity. The authors examined which patient factors and physician factors increase the likelihood of physicians' intention to conduct a suicide assessment. Data from the study revealed that physician-participants inquired about suicide 36% of the time. A random effects logistic model indicated that several factors were predictive of physicians' intention to conduct a suicide assessment: patient's comorbidity status (odds ratio (OR) = 0.61; 95% confidence interval (CI) = 0.37-1.00), physicians' age (OR = 0.67; 95% CI = 0.49-0.92), physicians' race (OR = 1.84; 95% CI = 1.08-3.13), and how depressed the physician perceived the virtual patient to be (OR = 0.58; 95% CI = 0.39-0.87). A substantial number of primary care physicians in this study indicated they would not assess for suicide, even though most physicians perceived the virtual patient to be depressed or very depressed. Further study is needed to establish factors that may be modified and targeted to increase the likelihood of physicians' providing one element of quality of care--suicide assessment--for depressed patients.
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Affiliation(s)
- Lisa M. Hooper
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, Box 870231; 315-B Graves Hall, Tuscaloosa, AL 35487, USA. Phone: 1+205-348-5611; Fax: 1+205-348-7584;
| | - Steven A. Epstein
- Department of Psychiatry, Georgetown University Hospital and School of Medicine, 2115Wisconsin Avenue NW, Suite 200, Washington, DC 20007, USA. Phone: 1+202-944-5444;
| | - Kevin P. Weinfurt
- Duke Clinical Research Institute, P.O. Box 17969, Durham, NC, USA. Phone: +1-919-6688019; Fax: +1-919-6687124;
| | - Jamie DeCoster
- University of Virginia, Charlottesville, VA, USA. Phone: +1-205-5340939;
| | - Lixin Qu
- The University of Alabama, Box 870348 Tuscaloosa, AL, USA. Phone: +1-205-3484254; Fax: +1-205-3483526;
| | - Natalie J. Hannah
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, Tuscaloosa, AL, USA. Phone: +1-205-3485611; Fax: +1-205-3485487;
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Fleischhaker C, Böhme R, Sixt B, Brück C, Schneider C, Schulz E. Dialectical Behavioral Therapy for Adolescents (DBT-A): a clinical Trial for Patients with suicidal and self-injurious Behavior and Borderline Symptoms with a one-year Follow-up. Child Adolesc Psychiatry Ment Health 2011; 5:3. [PMID: 21276211 PMCID: PMC3037874 DOI: 10.1186/1753-2000-5-3] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 01/28/2011] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To date, there are no empirically validated treatments of good quality for adolescents showing suicidality and non-suicidal self-injurious behavior. Risk factors for suicide are impulsive and non-suicidal self-injurious behavior, depression, conduct disorders and child abuse. Behind this background, we tested the main hypothesis of our study; that Dialectical Behavioral Therapy for Adolescents is an effective treatment for these patients. METHODS Dialectical Behavioral Therapy (DBT) has been developed by Marsha Linehan - especially for the outpatient treatment of chronically non-suicidal patients diagnosed with borderline personality disorder. The modified version of DBT for Adolescents (DBT-A) from Rathus & Miller has been adapted for a 16-24 week outpatient treatment in the German-speaking area by our group. The efficacy of treatment was measured by a pre-/post- comparison and a one-year follow-up with the aid of standardized instruments (SCL-90-R, CBCL, YSR, ILC, CGI). RESULTS In the pilot study, 12 adolescents were treated. At the beginning of therapy, 83% of patients fulfilled five or more DSM-IV criteria for borderline personality disorder. From the beginning of therapy to one year after its end, the mean value of these diagnostic criteria decreased significantly from 5.8 to 2.75. 75% of patients were kept in therapy. For the behavioral domains according to the SCL-90-R and YSR, we have found effect sizes between 0.54 and 2.14.During treatment, non-suicidal self-injurious behavior reduced significantly. Before the start of therapy, 8 of 12 patients had attempted suicide at least once. There were neither suicidal attempts during treatment with DBT-A nor at the one-year follow-up. CONCLUSIONS The promising results suggest that the interventions were well accepted by the patients and their families, and were associated with improvement in multiple domains including suicidality, non-suicidal self-injurious behavior, emotion dysregulation and depression from the beginning of therapy to the one-year follow-up.
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Affiliation(s)
- Christian Fleischhaker
- Division of Child and Adolescent Psychiatry and Psychotherapy, Department of Psychiatry and Psychosomatic Medicine, Albert Ludwig University Medical Center Freiburg, Hauptstr. 8, 79104 Freiburg, Germany
| | - Renate Böhme
- Gemeinschaftspraxis Kinder- und Jugendpsychiatrie Dres. Renate Böhme und Mariele Ritter-Gekeler, Hauptstr. 49, 79379 Müllheim, Germany
| | - Barbara Sixt
- Division of Child and Adolescent Psychiatry and Psychotherapy, Department of Psychiatry and Psychosomatic Medicine, Albert Ludwig University Medical Center Freiburg, Hauptstr. 8, 79104 Freiburg, Germany
| | - Christiane Brück
- Division of Child and Adolescent Psychiatry and Psychotherapy, Department of Psychiatry and Psychosomatic Medicine, Albert Ludwig University Medical Center Freiburg, Hauptstr. 8, 79104 Freiburg, Germany
| | - Csilla Schneider
- Division of Child and Adolescent Psychiatry and Psychotherapy, Department of Psychiatry and Psychosomatic Medicine, Albert Ludwig University Medical Center Freiburg, Hauptstr. 8, 79104 Freiburg, Germany
| | - Eberhard Schulz
- Division of Child and Adolescent Psychiatry and Psychotherapy, Department of Psychiatry and Psychosomatic Medicine, Albert Ludwig University Medical Center Freiburg, Hauptstr. 8, 79104 Freiburg, Germany
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Hodgkinson SC, Colantuoni E, Roberts D, Berg-Cross L, Belcher HME. Depressive symptoms and birth outcomes among pregnant teenagers. J Pediatr Adolesc Gynecol 2010; 23:16-22. [PMID: 19679498 PMCID: PMC2946319 DOI: 10.1016/j.jpag.2009.04.006] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Revised: 04/17/2009] [Accepted: 04/27/2009] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVE Few studies have examined the effects of maternal depressive symptoms among adolescent women. The purpose of this study was to investigate the impact of depressive symptoms on birth outcomes of infants born to adolescent mothers. DESIGN The medical records of pregnant adolescent patients were examined. Information about maternal depressive symptoms and birth outcomes was collected. SETTING Data were collected at Washington Hospital Center, a nonprofit, community-based hospital that serves residents throughout the Washington, DC area. PARTICIPANTS Participants were 294 African-American and Latina adolescent mothers. Mean age was 16.2 years (standard deviation [SD] 1.4). Based on self-reports of depressive symptoms, adolescents were categorized by the following: no reported symptoms, depressive symptoms without SI/SA (suicidal ideation or attempt), and depressive symptoms with SI/SA. MAIN OUTCOME MEASURES Infant birth weight and gestational age at delivery. RESULTS Over one-quarter of pregnant adolescents in this study reported symptoms of depression. Adolescents reporting depressive symptoms with SI/SA delivered babies that weighed 239.5 grams (98.3% confidence interval [CI] 3.9 to 475.1) less than babies born to mothers reporting depressive symptoms without SI/SA. There was no association between reported symptoms and gestational age. CONCLUSIONS Results suggest that compared to nonpregnant teens and adults, pregnant teens may have an increased risk for depression. Additionally, pregnant adolescents with suicidal ideation are at greater risk for delivering infants of lower birth weight compared with teens reporting depressive symptoms without SI/SA and teens reporting no symptoms. This study supports the need for early screening and treatment of depression for young pregnant women.
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Quinn A, Shera W. Evidence-based practice in group work with incarcerated youth. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2009; 32:288-293. [PMID: 19647875 DOI: 10.1016/j.ijlp.2009.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
As a result of the Youth Criminal Justice Act's increased focus on restorative justice, treatment, rehabilitation, and reintegration of youth, many more juvenile offenders require mental health services while resident in youth detention facilities [Youth Criminal Justice Act (2002, c.1). Ottawa: Department of Justice Canada. Retrieved September 19, 2008 from http://laws.justice.gc.ca/en/Y-1.5]. Several common characteristics such as violence, aggression, and other antisocial behaviors, associated with criminal behavior, have been identified among male and female offenders. Dialectical behavior therapy, originally developed by Linehan [Linehan, M. M., 1993a. Cognitive-behavioural treatment of borderline personality disorder. New York: Guildford Press] for chronically parasuicidal women diagnosed with borderline personality disorder, has been successfully modified for use with other populations, including violent and impulse-oriented male and female adolescents residing in correctional facilities. The intent of this article is to encourage the wider use of dialectical behavior therapy (DBT) with young offenders. It includes an extensive review of the evidence-base to date and describes some of the creative modifications that have been made to standard DBT program format to meet the particular needs of various groups in both Canada and the United States. In keeping with the movement toward more evidence-based practice, the authors argue that DBT is a promising approach in group work with incarcerated adolescents and should be more widely used.
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Miller AL, Smith HL. Adolescent non-suicidal self-injurious behavior: The latest epidemic to assess and treat. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.appsy.2008.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fleischhaker C, Munz M, Böhme R, Sixt B, Schulz E. [Dialectical Behaviour Therapy for adolescents (DBT-A)--a pilot study on the therapy of suicidal, parasuicidal, and self-injurious behaviour in female patients with a borderline disorder]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2006; 34:15-25; quiz 26-7. [PMID: 16485610 DOI: 10.1024/1422-4917.34.1.15] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES In Germany suicide ranks as the second leading cause of death in adolescents. Risk factors for suicide are impulsive and self-injurious behaviour, depression, and conduct disorder. The main hypothesis of our study is that Dialectical Behavior Therapy (DBT) for adolescents is an effective method of treatment for these patients. METHODS DBT was developed by Marsha Linehan specifically for the outpatient treatment of chronically parasuicidal female patients with a diagnosis of borderline personality disorder. Miller & Rathus modified DBT for use with adolescents (DBT-A). and our group adapted the DBT-A for use in an outpatient treatment setting in Germany. In a pre-post comparison, the efficacy of treatment was measured using standardized instruments (SCL-90-R, CBCL, YSR, ILK, CGI, etc.). RESULTS In a pilot study of 12 adolescents, we found effect sizes between 1.1 and 2.9. During treatment, self-injurious behaviour declined significantly. Prior to entering therapy, 8 of the 12 patients had attempted suicide at least once. During treatment according to DBT-A there were no suicide attempts. CONCLUSIONS These results are so promising that we are now planning a randomized, multi-centre study.
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Affiliation(s)
- Christian Fleischhaker
- Universitätsklinikum Freiburg, Universitätsklinik für Psychiatrie und Psychosomatik, Abteilung für Psychiatrie und Psychotherapie im Kindes- und Jugendalter, Freiburg.
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Weisz JR, Sandler IN, Durlak JA, Anton BS. Promoting and protecting youth mental health through evidence-based prevention and treatment. ACTA ACUST UNITED AC 2006; 60:628-48. [PMID: 16173895 DOI: 10.1037/0003-066x.60.6.628] [Citation(s) in RCA: 351] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
For decades, empirically tested youth interventions have prevented dysfunction by addressing risk and ameliorated dysfunction through treatment. The authors propose linking prevention and treatment within an integrated model. The model suggests a research agenda: Identify effective programs for a broadened array of problems and disorders, examine ethnicity and culture in relation to intervention adoption and impact, clarify conditions under which programs do and do not work, identify change mechanisms that account for effects, test interventions in real-world contexts, and make tested interventions accessible and effective in community and practice settings. Connecting the science and practice of prevention and treatment will be good for science, for practice, and for children, adolescents, and their families.
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Affiliation(s)
- John R Weisz
- Harvard University, Judge Baker Children's Center, Boston, MA 02120-3225, USA.
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Esposito-Smythers C, McClung TJ, Fairlie AM. Adolescent perceptions of a suicide prevention group on an inpatient unit. Arch Suicide Res 2006; 10:265-75. [PMID: 16717043 DOI: 10.1080/13811110600582554] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to present a psychoeducational suicide prevention group for psychiatrically hospitalized suicidal adolescents, and explore participant perceptions of the strengths and weaknesses of this group therapy experience using archival data. Over the course of approximately three years, 250 adolescents admitted to a psychiatric inpatient unit attended the suicide prevention group. Almost all adolescents indicated that they learned something helpful in the group that would keep them from attempting suicide in the future. The creation of a "Reasons To Live List" was reported as most helpful by adolescents while the creation of a "Safety List" was deemed least helpful. However, some differences did emerge as a function of history of prior suicidal behavior. Recommendations for future treatment research with suicidal adolescent psychiatric inpatients are offered.
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Putnins AL. Correlates and predictors of self-reported suicide attempts among incarcerated youths. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2005; 49:143-157. [PMID: 15746266 DOI: 10.1177/0306624x04269412] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The correlates and predictors of suicidal behaviors among 900 young offenders in detention centers in South Australia are investigated. That young offenders are a high-risk population is confirmed, with a quarter of the youths reporting recent suicidal ideation and more than a quarter reporting having made a suicide attempt. Past suicide attempts are significantly predictive of future suicide attempts. Other variables both concurrently and prospectively associated with suicidal behaviors (even after controlling for prior suicide attempt status) are substance use, prolonged dysphoric mood, attention deficit hyperactivity disorder signs, and having a bad temper. These variables not only have predictive value but should also be considered as appropriate targets when intervening to reduce suicide risk. It is suggested that impulsiveness is an underlying common factor.
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Affiliation(s)
- Aldis L Putnins
- Department for Families and Communities-South Australia, and University of South Australia, 2 Norton Summit Rd., Magill, SA 5072, Australia.
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Fleischhaker C, Böhme R, Sixt B, Schulz E. Suizidalität, Parasuizidalität und selbstverletzende Verhaltensweisen von Patientinnen mit Symptomen einer Borderline-Störung. KINDHEIT UND ENTWICKLUNG 2005. [DOI: 10.1026/0942-5403.14.2.112] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. In Deutschland ist Tod durch Suizid die zweithäufigste, in den USA die dritthäufigste Todesursache im Jugendalter. Als Risikofaktoren für vollendete Suizide werden impulsive Handlungsmuster, Selbstverletzungen, Depressionen, Sozialstörungen sowie frühkindlicher Missbrauch benannt. Für Patienten mit einer Borderline-Störung liegt die Suizidrate bei fünf bis zehn Prozent. Die Dialektisch-Behaviorale Therapie (DBT) wurde von Marsha Linehan zur Behandlung von Frauen mit Borderline-Persönlichkeitsstörungen (Diagnosestellung nach DSM-Kriterien) entwickelt, die entweder chronisch suizidal sind und/oder sich selber verletzen. Gegenüber der Standard-DBT wurde für die Arbeit mit Jugendlichen eine Reihe von Modifikationen vorgenommen, um die Behandlung der jugendlichen Zielgruppe anzupassen. Durch unsere Arbeitsgruppe wurde die Dialektisch-Behaviorale Therapie für Adoleszente (DBT-A) für den deutschen Sprachraum überarbeitet und angepasst. In der vorliegenden Arbeit werden die ersten Ergebnisse der DBT-A-Pilotstudie mit zwölf Jugendlichen vorgestellt. Die Ergebnisse sind sehr vielversprechend.
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Affiliation(s)
- Christian Fleischhaker
- Klinik für Psychiatrie und Psychosomatik, Abteilung für Psychiatrie und Psychotherapie im Kindes- und Jugendalter der Universität Freiburg
| | - Renate Böhme
- Klinik für Psychiatrie und Psychosomatik, Abteilung für Psychiatrie und Psychotherapie im Kindes- und Jugendalter der Universität Freiburg
| | - Barbara Sixt
- Klinik für Psychiatrie und Psychosomatik, Abteilung für Psychiatrie und Psychotherapie im Kindes- und Jugendalter der Universität Freiburg
| | - Eberhard Schulz
- Klinik für Psychiatrie und Psychosomatik, Abteilung für Psychiatrie und Psychotherapie im Kindes- und Jugendalter der Universität Freiburg
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Osman A, Gutierrez PM, Jiandani J, Kopper BA, Barrios FX, Linden SC, Truelove RS. A preliminary validation of the Positive and Negative Suicide Ideation (PANSI) inventory with normal adolescent samples. J Clin Psychol 2003; 59:493-512. [PMID: 12652640 DOI: 10.1002/jclp.10154] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The present study evaluated the factor structure, reliability, and validity of the Positive and Negative Suicide Ideation (PANSI; Osman, Gutierrez, Kopper, Barrios, & Chiros, 1998) inventory in a sample of high-school youths. The PANSI is designed as a measure of risk and protective factors related to suicidal behavior. Participants (114 boys and 103 girls) completed the PANSI and other self-report instruments. Results of the confirmatory factor analyses supported adequate fit of the 2-factor oblique model to the sample data. Both factor scales attained adequate levels of reliability. Boys and girls did not differ in their responses to the PANSI scales. The PANSI scale scores were associated with scores from related measures. Logistic-regression analyses were used to evaluate the contributions of the PANSI scale scores to differentiate between the study groups. Receiver Operating Characteristic (ROC) analyses, using data from the psychiatric suicide risk and high-school control youths, were used to identify cutoff scores of 1.63 and 3.33 for the PANSI-negative and PANSI-positive scales, respectively.
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Affiliation(s)
- Augustine Osman
- Department of Psychology, University of Northern Iowa, Cedar Falls, 50614-0505, USA.
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Abstract
Most empirically supported interventions for adolescent mental health problems are either downward adaptations of adult treatments or upward adaptations of child treatments. Although these treatments show respectable effects with teens, a review of the outcome research reveals significant gaps. both in coverage of adolescent conditions and problems (e.g., eating disorders, suicidality) and in attention to the biological, psychological, and social dimensions of adolescent development. The authors critique the field, propose a biopsychosocial framework for the development of dysfunction and intervention, and discuss ways the developmental literature can and cannot inform intervention and research. A long-term goal is an array of developmentally tailored treatments that are effective with clinically referred teens and an enriched understanding of when, how, and why the treatments work.
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Affiliation(s)
- John R Weisz
- Department of Psychology, University of California, Los Angeles 90095-1563, USA
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Abstract
Suicide is a major public health problem in the United States. Suicide and attempted suicide are important causes of morbidity and mortality in adolescents. Epidemiologic trends in adolescent suicide point to increasing rates of suicide and increasing access to lethal attempts, particularly firearms. It is important for clinicians to recognize risk factors for suicide, but it is even more important to screen all adolescents for suicidal thoughts and feelings. This article highlights important publications from the past year (April 2000 to April 2001) regarding adolescent suicidal behavior, with particular focus on risk factors, recognition, and management.
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Affiliation(s)
- M Catallozzi
- The Craig Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
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