Psychopathology, family functioning, and cognitive style in urban adolescents with suicide attempts

Neural substrates of rewarding and punishing self representations in depressed suicide-attempting adolescents

Adolescence is a period of plasticity in neural substrates underpinning self-processing. Such substrates are worth studying in depressed youth at risks for suicide because altered neurobiology of self-processing might partially explain differences between suicide attempting youth versus youth who contemplate but do not attempt suicide. Understanding altered substrates of self-processing among depressed adolescents with suicide attempts is critical for developing targeted prevention and treatment. Healthy youth (N = 40), youth with depression and low (N = 33) or high suicide ideation (N = 28), and youth with depression and past suicide attempt (N = 28) heard positive or negative self-descriptors during fMRI and evaluated them from their own, their mother's, classmates', and best friend's perspectives. Lower bilateral caudate activity during positive self-processing distinguished suicide attempting adolescents from all other youth. Higher bilateral caudate activity during negatively valenced self-processing tended to distinguish youth with depression. Blunted reward circuitry during positive vs. negative self-related material tended to distinguish suicide attempting youth, reflecting potentially enhanced behavioral preparedness for punishing vs. rewarding self-relevant cues.

The Effectiveness of Predicting Suicidal Ideation through Depressive Symptoms and Social Isolation Using Machine Learning Techniques

(1) Background: Social isolation is a major risk factor for suicidal ideation. In this study, we investigated whether the evaluation of both depression and social isolation in combination could effectively predict suicidal ideation; (2) Methods: A total of 7994 data collected from community residents were analyzed. Statistical analysis was performed using age, the Patient Health Questionnaire-9, and the Lubben Social Network Scale as predictors as the dependent variables for suicidal ideation; machine learning (ML) methods K-Nearest Neighbors, Random Forest, and Neural Network Classification were used; (3) Results: The prediction of suicidal ideation using depression and social isolation showed high area under the curve (0.643–0.836) and specificity (0.959–0.987) in all ML techniques. In the predictor model (model 2) that additionally evaluated social isolation, the validation accuracy consistently increased compared to the depression-only model (model 1); (4) Conclusions: It is confirmed that the machine learning technique using depression and social isolation can be an effective method when predicting suicidal ideation.

Examining the Complexities of Suicidal Behavior in the African American Community

Once considered a “White thing,” suicide is now the third leading cause of death for African Americans, behind only homicide and unintentional injury. Although the rates of suicide for African American women remain low and relatively unchanged, the rates for African American men have increased dramatically during the past 20 years. The changes in the suicide rates for African American youth have motivated researchers to investigate protective and risk factors associated with suicide. In light of some of the current findings that identify religious participation as a protective factor against suicide for African Americans, an alternative perspective is provided that examines the contribution of spirituality and specific religious practices on gender differences in suicide risk.

Suicide, negative interaction and emotional support among black Americans

OBJECTIVES

This study is the first to investigate the relationship between perceived emotional support and negative interaction with family members and suicide ideation and attempts among African American and Caribbean black adults.

METHOD

Cross-sectional epidemiologic data from the National Survey of American Life and multivariable logistic regression analyses were used to examine the association between perceived emotional support and negative interaction and suicide behaviors among 3,570 African Americans and 1,621 Caribbean blacks age 18 and older.

RESULTS

Multivariate analyses found that perceived emotional support was associated with lower odds of suicide ideation and attempts for African Americans and Caribbean blacks. Negative interaction with family was associated with greater odds of suicide ideation among African Americans and Caribbean blacks. Ethnicity moderated the impact of emotional support and negative interaction on suicide attempts; among Caribbean blacks, those who reported more frequent emotional support from their family had a significantly greater reduced risk for suicide attempts than African Americans. The effect of negative interaction on suicide attempts was also more pronounced for Caribbean blacks compared to African Americans.

DISCUSSION

Negative interaction was a risk factor for suicide ideation and emotional support was a protective factor for attempts and ideation. These associations were observed even after controlling for any mental disorder. The findings demonstrate the importance of social relationships as both risk and protective factors for suicide and ethnic differences in suicidal ideation and attempts among black Americans.

Suicidal thoughts and depressive feelings amongst Estonian schoolchildren: effect of family relationship and family structure

Depressive feelings and suicidal ideation in a non-clinical sample of adolescents in Estonia were analysed in the context of family structure, mutual relationships amongst family members and schoolchildren's preferences regarding intimate personal contacts with particular family members. Data from the WHO collaborative study 'Health Behaviour in School-aged Children 2005/2006' (HBSC) were used. A representative sample of schoolchildren aged 11, 13 and 15 years completed the semi-structured questionnaire. The analyses included only adolescents living in households with at least one birth parent. The subjects were 4,389 schoolchildren (2,178 boys and 2,211 girls), who were divided into three groups based on: (1) suicidal thoughts, with or without depressive feelings; (2) depressive feelings; and (3) neither suicidal thoughts nor depressive feelings. Multinomial logistic regression was used. The proportion of depressive feelings increased with age for both boys and girls. Girls expressed depressive feelings more frequently than boys from ages 13 and 15 years, and suicidal thoughts from age 15 years. Self-reported satisfaction with relationships in the family reduced the likelihood of depressive feelings and suicidal thoughts. Good communication with the parents reduced the likelihood of suicidal thoughts in all age groups. Adolescents who were satisfied with their family relationships suffered less frequently from depressive feelings and suicidal thoughts. The best environment for an adolescent was a family with both birth parents. Of the adolescents in 'non-intact' families, those with a step-parent in the family showed suicidal thoughts more frequently than those in single-parent families. Associations between family-related variables and suicidal thoughts were significant even after adjusting for family economic deprivation score.

Prospective study on suicidal ideation among Japanese undergraduate students: correlation with stressful life events, depression, and depressogenic cognitive patterns

The present study examines the effects of stressful life events, depression, and depressogenic cognitive patterns on suicidal ideation in 500 Japanese undergraduate students. The above factors were assessed at baseline (T1) and two weeks later (T3). At T1, structural equation modeling confirmed that (1) cognitive patterns and depression, but not stressful life events, influence suicidal ideation, and (2) cognitive patterns also influence suicidal ideation through depression. These findings were confirmed in a longitudinal analysis. The results suggest that the effects of stressful life events on suicidal ideation are indirect and are mediated by depressogenic cognitive styles and depressed mood.

An Analysis of Parent-Female Adolescent Relationships in Female Adolescent Suicides

This study analyzed Turkish female adolescent-family relations, which is believed to be one of the significant factors in female adolescents' suicide attempts, from a multidimensional perspective. The Parent-Adolescent Relationship Inventory, a multidimensional evaluation tool based on the behavioral family-system approach was used as a research tool. The inventory consists of the concepts and techniques of behavioral theory, family system theory, and cognitive theory in parent-adolescent' problems and conflicts. Based on these theories, the parent-adolescent relations inventory (PARQ), involves three main dimensions: problem solving and communication skills, cognitive/internalized beliefs, and functions and structures in family systems. There are two forms of the inventory, the adolescent form and the parent form. Only the adolescent form of PARQ, including 284 items, was used in this research. The inventory also consists of 16 subscales. It was adapted into Turkish by Eryüksel (1996) . The subjects of the study were 52 female adolescents who had attempted suicide and were taken to the Emergency Department of The Faculty of Medicine in Çukurova University, and 52 normal female adolescents from two different secondary schools at the southern province in Turkey. The age range of the clinical and normal groups were 14–18 ([Formula: see text] = 16). The results of the study revealed that the general stress level of female adolescents who attempted suicide is higher than those of normal groups. The examination of family structures of these female adolescents made it clear that mothers were the mediator between fathers and adolescents. It was also observed that both mothers and fathers shared many somatic concerns.

Impact of Familial Factors and Psychopathology on Suicidality Among African American Adolescents

Racial differences in familial factors, psychopathology, perceptions of social support, and socioeconomic status were examined in a matched sample of African American and White suicidal adolescents (N = 90) during a psychiatric hospitalization. Exploratory analyses suggest that significant differences were found in family support and its association with psychopathology, but most noteworthy were the many similarities between the two adolescent groups. The results presented in this study represent new knowledge on the characteristics of African-American adolescents at high risk of suicidal behavior, and replace conventional wisdom with empirical knowledge about an aspect of human behavior for this population. Implications for social work practice, suicide prevention, and future research are discussed.

The associations between peer and parental relationships and suicidal behaviours in early adolescents

OBJECTIVE

To investigate associations between suicidal behaviours, including suicidal ideation and attempts, and poor peer and parental relationships in a nationally representative sample of Canadian adolescents aged 12 to 13 years.

METHODS

We used Statistics Canada's National Longitudinal Survey of Children and Youth as the dataset. This cross-sectional sample included 1049 girls and 1041 boys aged 12 to 13 years. We obtained answers to self-report questionnaires that included measures of peer relationships, parental nurturance, and parental rejection, as well as information regarding suicidal ideation and attempts. Unadjusted and adjusted logistic regression models were used for the analysis. We included depression in the multiple logistic regression analysis. Analyses were run separately for boys and girls.

RESULTS

The unadjusted logistic regression models found that, among early adolescent boys and girls, depression, poor peer relationships, decreased parental nurturance, and increased parental rejection were all significantly associated with suicidal ideation and attempts. However, after adjusting for all other variables in the multiple logistic regression models, poor peer relationships were no longer significantly associated with suicidal ideation among early adolescent boys and were only weakly associated among early adolescent girls.

CONCLUSIONS

Poor parental relationships and depression were more powerfully associated with suicidal ideation and attempts than were peer relationships in a nationally representative sample of boys and girls aged 12 to 13 years, and these factors may be important early intervention targets.

Implications of National Suicide Trends for Social Work Practice with Black Youth

Although homicide is the leading cause of death for African-Americans aged 15-24, suicide is silently claiming the lives of many African-American youth, males in particular. Given the disproportionate number of African-American adolescents in many of the primary human service institutions, it is important to increase social workers' understanding of the nature and trends in self-destructive behaviors of this population. This paper presents the descriptive epidemiological trend data on African-American adolescent suicide completion and parasuicidal behavior, reviews current explanatory hypotheses, highlights important risk and protective factors, and outlines several culturally-congruent practice guidelines for working with suicidal African-Americans adolescents.

Explaining Changes in the Patterns of Black Suicide in the United States From 1981 to 2002: An Age, Cohort, and Period Analysis

To explore the different trends of suicide incidence among Blacks and possible contributing factors, the current study compared national epidemiologic data of suicide in the United States from 1981 to 2002. For the first time, period and birth-cohort effects on the incidence trends of Black suicide were evaluated using an age-period-cohort analysis. Cohort effects were found for males and females, suggesting that younger generations of Blacks are at higher risk. If younger cohorts carry their increased suicide risk into later life, then the recent decline in Black suicide rates will be reversed. The results of the current study are only interpretable in terms of group-level characteristics and population suicide rates and not individual-level characteristics. The possible explanation and the implications for prevention and future research are discussed.

Writing characteristics of suicidal people on the Internet: a psychological investigation of emerging social environments

Three studies were carried out to investigate the writings of suicidal people on the Internet, hypothesizing consistent findings to equivalent research of offline writing. In Study 1, suicidal persons' (n = 34) attributions as the cause of their condition, as expressed in their free online writing, were compared to those of emotionally distressed, nonsuicidal (n = 16) and to nondistressed (n = 15) individuals. Results showed that suicidal persons have significantly more stable and global attributions than do the other groups. In Study 2, expressions of self-focus in online written messages were compared among suicidal, two levels of nonsuicidal but distressed, and nondistressed individuals (200 messages in each group). With the use of various expressions of self-focus, findings showed that suicidal people were distinctively self-focused in their writing, unlike their counterparts. In Study 3, psychologically relevant themes in the online writing of suicidal (n = 39) and highly distressed, nonsuicidal persons (n = 24) were compared. Results revealed that the former expressed significantly more unbearable psychological pain and cognitive constriction than did the latter. The findings of the three studies are consistent with those found in examinations of offline writing. The research has important implications for the use of online environments for psychological research and means for assessment, as well as for understanding suicidality.

Social environment factors associated with suicide attempt among low-income African Americans: the protective role of family relationships and social support

BACKGROUND

Suicide and suicide attempts are important public health concerns, and recent decades have witnessed a rising rate of suicide among African Americans. A history of prior attempts is a leading risk factor for completed suicide. Further research is needed into the social environment risk factors for suicide attempt among African Americans. This study focused on two important dimensions of the social environment, family relationships and social support, as well as an important person-level risk factor--depressive symptoms.

METHOD

Data were obtained from a case-control study of 200 African American men and women aged 18-64 years, who sought services at a large, urban, public hospital. Odds ratios adjusted for significant sociodemographic differences between groups (aORs) were calculated for environment risk factors for suicide attempt among the cases and controls. The role of depressive symptoms was also studied.

RESULTS

Lower levels of family adaptability and family cohesion increased the relative rate of suicide attempt in the sample. The aOR associated with the lowest quartile of family adaptability was 3.90, and the aORs associated with the first and second quartiles of family cohesion were 8.91 and 5.51, respectively. Lower levels of social embeddedness and social support increased the relative rate of suicide attempt in our sample. The aOR associated with the first and second quartiles of social embeddedness were 5.67 and 4.93, respectively, and the aOR associated with the lowest quartile of social support was 6.29. A mediating role of depression was discovered when depressive symptoms were entered into the logistic regression models.

CONCLUSIONS

Our findings indicate that social environment factors including deficits in family functioning and social support are associated strongly with suicide attempts among low-income African American men and women seeking treatment in a large, urban hospital. Thus, better family functioning and social supports can be considered protective factors in this population. The presence of depressive symptoms, a well-known risk factor for suicide attempts and suicide, appears to mediate the association between social environment factors and suicide attempt.

Is There a Universal Positivity Bias in Attributions? A Meta-Analytic Review of Individual, Developmental, and Cultural Differences in the Self-Serving Attributional Bias

Researchers have suggested the presence of a self-serving attributional bias, with people making more internal, stable, and global attributions for positive events than for negative events. This study examined the magnitude, ubiquity, and adaptiveness of this bias. The authors conducted a meta-analysis of 266 studies, yielding 503 independent effect sizes. The average d was 0.96, indicating a large bias. The bias was present in nearly all samples. There were significant age differences, with children and older adults displaying the largest biases. Asian samples displayed significantly smaller biases (d = 0.30) than U.S. (d = 1.05) or Western (d = 0.70) samples. Psychopathology was associated with a significantly attenuated bias (d = 0.48) compared with samples without psychopathology (d = 1.28) and community samples (d = 1.08). The bias was smallest for samples with depression (0.21), anxiety (0.46), and attention-deficit/hyperactivity disorder (0.55). Findings confirm that the self-serving attributional bias is pervasive in the general population but demonstrates significant variability across age, culture, and psychopathology.

Family and Community Factors that Predict Internalizing and Externalizing Symptoms in Low-Income, African-American Children

To learn more about the roots of internalizing and externalizing problems in low-income, African-American children, aged 8-12 years, particularly for family and community factors, we aimed to determine which variables (mother's psychological functioning, mother's intimate partner violence status [IPV], family cohesion and adaptability, neighborhood disorder) uniquely predicted a child's internalizing distress and externalizing distress, and the amount of variance explained by the model. Results from the regression model predicting internalizing distress indicates that the five predictor variables accounted for 38% of the variance. Two of the five predictors were significantly related to child's internalizing distress scores: mother's intimate partner violence status and maternal psychological distress. Results from the regression model predicting externalizing distress indicates that the five predictor variables accounted for 8% of the variance. The two predictors significantly related to child's externalizing distress scores were levels of family cohesion and maternal psychological distress. Directions for future research and clinical implications are provided.

The relative contribution of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation

Examined the relative importance of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation. Seventy-three high school students exhibiting emotional disturbance in the school setting completed a diagnostic interview and self-report measures assessing social support, family environment, negative life events, and problem solving. Using hierarchical regression analyses, only the presence of a pure internalizing disorder predicted suicidal ideation in addition to psychosocial variables. Interactions were found between psychiatric disorders and psychosocial variables. These results underscore the importance of including both diagnostic and psychosocial variables in research examining risk factors for adolescent suicidal behavior. Further, they suggest that adolescents presenting with psychiatric disorders, high levels of stress, and poor social support networks should be monitored for suicidality.

Correlates of suicidal behaviors among Asian American outpatient youths

Medical record abstraction was conducted at an ethnic-specific mental health outpatient clinic to identify correlates of suicidal behaviors in a sample of 285 Asian American youths. Some risk factors, such as parent-child conflict and age, which have been associated with suicidality in majority group youths, predicted suicidality in this sample, whereas other risk factors, such as gender, did not generalize to this sample. Acculturation interacted with the risk factor of parent-child conflict to predict suicidality. Less acculturated Asian youths were at proportionally greater risk for suicidality under conditions of high parent-child conflict than were their more acculturated counterparts. This finding underscores the importance of culture as a context for determining the relevance of stressors for potentiating psychopathology.

Ratings of family functioning of suicidal and nonsuicidal African American women

This study compared ratings of family functioning between female African American suicide attempters (n = 126) and nonattempters (n = 112). Attempters reported poorer family-of-creation (physical and nonphysical partner abuse, family strengths, and marital adjustment) and family-of-origin (physical, sexual, and emotional abuse and emotional neglect) functioning than did controls. In a multivariate logistic regression, only marital discord and childhood sexual abuse were risk factors for suicide attempts. A cumulative risk model was also tested and indicated that the presence of 4 or more of the risk factors increased a woman's likelihood of making a nonfatal suicide attempt more than threefold. This study offers one of the first investigations of the families of suicidal African American women and highlights the importance of focusing on family concerns when working with this population.

Family dimensions in anxious-depressed school refusers

The Family Adaptability and Cohesion Evaluation Scale II (FACES II) was administered to 46 adolescents with comorbid anxiety and major depressive disorders and to their parents in a treatment study of school refusal. FACES II measures cohesion and adaptability dimensions, as well as family type (balanced to extreme). Generally, adolescents and parents reported low cohesion (i.e.. disengagement) and low adaptability (i.e.. rigidity) on FACES II. Adolescents and parents described their ideal families as significantly less disengaged and less rigid than their own families. Fifty percent of adolescents, 38% of fathers, and 24% of mothers classified their families as the extreme type. Adolescents in extreme families, when compared with adolescents in more balanced families, reported significantly higher scores on two of three depression instruments and on a measure of somatic symptoms. Family therapy to improve cohesion and adaptability and treatments focused on improving depression and somatic symptoms may improve family functioning and decrease the severity and course of school refusal.