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Olds KL, Tse R, Stables S, Baker AM, Hird K, Langlois NE, Byard RW. An analysis of risk factors for child suicide in three centres from 2008 to 2017. MEDICINE, SCIENCE, AND THE LAW 2024:258024241274914. [PMID: 39175390 DOI: 10.1177/00258024241274914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
As a part of a study of suicide in children aged 17 years and under in three centers-Hennepin County in the United States (US), Auckland in New Zealand (NZ), and South Australia in Australia (AUS) from 2008 to 2017 it was decided to characterize potential risk factors and to determine whether these differed by jurisdiction. Reviewed data included a history of psychiatric illness, symptoms prior to suicide, events preceding suicide, previous suicidal ideation or suicide attempts, and communication of suicidal intent. The most common events preceding suicide were arguments with family/friends and relationship issues; in addition depression with or without expressed suicidal ideation, self-harming behavior, sadness, distress, drug/substance abuse, and anorexia were documented. Suicidal intent was on occasion communicated via technological means. In 79.5% of cases in South Australia decedents had a previously diagnosed psychiatric illness, with 62% in Hennepin County. This compared to a much lower proportion of cases in Auckland (23.8%). Whether this reflects more limited access to psychiatric services or a reluctance to seek support and therapy in Auckland is unclear. It does, however, demonstrate that risk factors for child suicide are not uniform among communities and so extrapolation of data from one area to another may not be appropriate. Disturbingly parents/carers were not aware of the decedent's suicidal intent in 84-87.2% of cases.
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Affiliation(s)
- Kelly L Olds
- Clinpath Pathology, Mile End, Adelaide, Australia
| | - Rexson Tse
- LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Simon Stables
- LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | | | - Kathryn Hird
- School of Medicine, The University of Notre Dame, Fremantle, Australia
| | - Neil E Langlois
- School of Biomedicine, The University of Adelaide, Adelaide, Australia
- Forensic Science South Australia, Adelaide, Australia
| | - Roger W Byard
- School of Biomedicine, The University of Adelaide, Adelaide, Australia
- Forensic Science South Australia, Adelaide, Australia
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Thompson RJ, Whalen DJ, Gilbert K, Tillman R, Hennefield L, Donohue MR, Hoyniak CP, Barch DM, Luby JL. Preadolescent Suicidal Thoughts and Behaviors: An Intensive Longitudinal Study of Risk Factors. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00184-9. [PMID: 38604472 DOI: 10.1016/j.jaac.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/06/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Dramatic increases in rates of suicidal thoughts and behaviors (STBs) among youth highlight the need to pinpoint early risk factors. This study used intensive longitudinal sampling to assess what the concurrent associations were between risk factors and STB status, how proximal changes in risk factors were related to STB status, and how risk factors prospectively predicted changes in STB status in a preadolescent sample enriched for early childhood psychopathology. METHOD A total of 192 participants were included from the Parent-Child Interaction Therapy-Emotional Development (PCIT-ED) Study, a longitudinal study of children with and without preschool depression. Participants 7 to 12 years of age completed a diagnostic interview, followed by 12 months of intensive longitudinal sampling, assessing experiences of suicidal ideation and 11 psychosocial variables with known links to STBs in adolescents and adults. Preadolescents with STB history (high-risk) received surveys weekly, and those without STB history (lower-risk) received surveys monthly. RESULTS Female sex, elevated depressive symptoms, greater use of expressive suppression and rumination, emotional clarity, and perceived burdensomeness were uniquely concurrently associated with the likelihood of STB endorsement. Within the high-risk group, (1) increases in depression, expressive suppression, rumination, and perceived burdensomeness, and decreases in positive affect from weekt to weekt+1 were associated with a higher likelihood of a positive STB status at weekt+1; and (2) higher expressive suppression, perceived burdensomeness, and caregiver criticism and conflict at weekt compared to participants' mean levels prospectively predicted increases in the likelihood of a positive STB report from weekt to weekt+1. CONCLUSION Psychosocial factors influencing STBs in adolescents and adults also affect preadolescents in day-to-day life. Expressive suppression and perceived burdensomeness consistently emerged as novel risk indicators and potential targets for treatment. In addition, increases in depression, rumination, and caregiver criticism and conflict, as well as decreases in positive affect, might prompt heightened STB screening and assessments for preadolescents with a history of STBs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Joan L Luby
- Washington University in St. Louis, St. Louis, Missouri
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Liu X, Yang Y, Liu ZZ, Jia CX. Life stress and suicidality mediated by insomnia and depressive symptoms in adolescents: a three-wave longitudinal study. Sleep 2024; 47:zsad121. [PMID: 37075813 DOI: 10.1093/sleep/zsad121] [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: 02/03/2023] [Revised: 04/07/2023] [Indexed: 04/21/2023] Open
Abstract
STUDY OBJECTIVES Little empirical work has investigated the associations between life stress (LS), insomnia, depression, and suicidality in multi-wave longitudinal studies. With three waves of data collection 1-year apart, this longitudinal study with a large sample of adolescents examined the predicting effects of LS on suicidality 1-year later and 2 years later and the mediating roles of insomnia and depression in the LS-suicidality link. METHODS A total of 6995 adolescents (mean age = 14.86 years, 51.4% male) participated in a three-wave longitudinal study of behavior and health in Shandong, China. A self-administered structured questionnaire and standardized scales were used to assess suicidality (including suicidal thought [ST], suicide plan [SP], and suicide attempt [SA]), LS, insomnia, and depression in 2015 (T1), 1-year later (T2), and 2 years later (T3). Mediation effects were examined with path models. RESULTS The overall prevalence rates of past-year suicidality were 13.4% at T1, 10.0% at T2, and 9.5% at T3, respectively. The prevalence rates of suicidality across T1-T3 significantly increased with elevated levels of baseline LS, insomnia, and depression (p < .001). Path models indicated that the relationship between baseline LS and suicidal ideation (i.e., ST/SP) 2 years later was significantly mediated by both insomnia and depression. Depression was also a significant mediator between LS and SA. CONCLUSIONS LS is a significant predictor of suicidality 1-2 years later in adolescents. Depression mediates the association between LS and suicidal ideation and suicide attempt while insomnia appears to be a mediator for suicidal ideation rather than suicide attempt.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan, China
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Blázquez-Fernández C, Lanza-León P, Cantarero-Prieto D. A systematic review on suicide because of social isolation/and loneliness: does COVID-19 make a difference? J Public Health (Oxf) 2023; 45:680-688. [PMID: 36680431 DOI: 10.1093/pubmed/fdad001] [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: 05/30/2022] [Revised: 11/29/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Suicide is a significant cause of death worldwide. Various purposes can explain why people choose to attempt or commit suicide such as mental-health disorders, income-related-factors, quality of life or issues related to social context. This study aims to identify an updated association between 'isolation' and suicides. METHODS In this regard, we had made a systematic review of the most recent papers, published from January 2016 to March 2022, thought the most acknowledged databases. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. To the best of our knowledge, this issue is very important due to the indirect relationship between COVID-19 and suicides. RESULTS Our analysis demonstrates that suicide and -social isolation and loneliness- have a positive and direct relationship although these findings varied slightly by areas. Moreover, most of the attention is focused on the youth during the most recent period and this is a real problem because economies cannot afford losing (young) population. CONCLUSIONS In order to prevent suicides, public policies should prevent suicidal thoughts that it could induce to terminate the lives of individuals in their most productive years and harmful outcomes to their families and friends.
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Affiliation(s)
- Carla Blázquez-Fernández
- Department of Economics, Universidad de Cantabria, 39005 Santander, Spain
- Research Group of Health Economics and Health Services Management-Research Institute Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Paloma Lanza-León
- Department of Economics, Universidad de Cantabria, 39005 Santander, Spain
- Research Group of Health Economics and Health Services Management-Research Institute Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - David Cantarero-Prieto
- Department of Economics, Universidad de Cantabria, 39005 Santander, Spain
- Research Group of Health Economics and Health Services Management-Research Institute Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
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Dang LN, Kahsay ET, James LN, Johns LJ, Rios IE, Mezuk B. Research utility and limitations of textual data in the National Violent Death Reporting System: a scoping review and recommendations. Inj Epidemiol 2023; 10:23. [PMID: 37161610 PMCID: PMC10170777 DOI: 10.1186/s40621-023-00433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Many studies of injury deaths rely on mortality data that contain limited contextual information about decedents. The National Violent Death Reporting System (NVDRS) is unique among such data systems in that each observation includes both quantitative variables and qualitative texts (called "narratives") abstracted from original source documents. These narratives provide rich data regarding salient circumstances that can be used to inform prevention efforts. This review provides a comprehensive summary of peer-reviewed research using NVDRS narratives over the past 20 years, including the limitations of these texts and provides recommendations on utilizing and improving narrative quality for researchers and practitioners. MAIN BODY Studies that used narratives to examine deaths related to suicide, homicide, undetermined intent, accidental firearm, or legal intervention were identified by a title/abstract screening, followed by a full-text review. The search was conducted on English-language, peer-reviewed literature and government reports published from 2002 to 2022 in PubMed, PsycInfo, Scopus, and Google Scholar. Abstracted elements focused on the methodologies used to analyze the narratives, including approaches to explore potential biases in these texts. Articles were abstracted independently by two reviewers, with disagreements resolved through consensus discussion. During the 20-year period, 111 articles used narratives. Two-thirds studied suicide (n = 48, 43%) and homicides (n = 25, 23%). Most studies analyzed the narratives using manual review (n = 81, 73%) and keyword searches (n = 9, 8%), with only 6 (5%) using machine learning tools. Narratives were mainly used for case finding (n = 49, 44%) and characterization of circumstances around deaths (n = 38, 34%). Common challenges included variability in the narratives and lack of relevant circumstantial details for case characterization. CONCLUSION Although the use of narratives has increased over time, these efforts would be enhanced by detailed abstraction of circumstances with greater salience to injury research and prevention. Moreover, researchers and practitioners would benefit from guidance on integrating narratives with quantitative variables and standardized approaches to address variability in the completeness and length of narratives. Such efforts will increase the reliability of findings and set the stage for more widespread applications of data science methods to these texts.
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Affiliation(s)
- Linh N Dang
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Eskira T Kahsay
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - LaTeesa N James
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI, USA
| | - Lily J Johns
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Isabella E Rios
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Briana Mezuk
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
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McLoughlin LT, Simcock G, Schwenn P, Beaudequin D, Boyes A, Parker M, Lagopoulos J, Hermens DF. Social Connectedness, Cyberbullying, and Well-Being: Preliminary Findings from the Longitudinal Adolescent Brain Study. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2022; 25:301-309. [PMID: 35404094 DOI: 10.1089/cyber.2020.0539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Social connectedness is well established as an important aspect of adolescence, with higher levels typically resulting in positive mental health and well-being. Cyberbullying is a prevalent concern during adolescence and is a significant contributor to poor mental health outcomes during this important phase of life. Research shows that social connectedness may act as a protective factor for mental health and well-being when young people experience cyberbullying. However, further research is required to elucidate associations between social connectedness, well-being, and cyberbullying over time. This article outlines preliminary findings from the Longitudinal Adolescent Brain Study (LABS). Data are reported from N = 64 LABS participants recruited at age 12 and assessed at four timepoints over a 12-month period, with a total of 204 completed assessments. Structural equation modeling revealed a mediating effect of social connectedness on the relationship between cyberbullying and well-being. In other words, the negative influences of cyberbullying and cybervictimization on well-being scores over time are influenced by levels of social connectedness. The present findings highlight that increased social connectedness in young people is vital to promoting positive well-being over time and can protect well-being in those experiencing cyberbullying and/or cybervictimization. Findings can inform cyberbullying education programs, health care practitioners, parents, and educators on the importance of young people remaining socially connected when experiencing cyberbullying and/or cybervictimization.
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Affiliation(s)
| | - Gabrielle Simcock
- Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Paul Schwenn
- Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Denise Beaudequin
- Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Amanda Boyes
- Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Marcella Parker
- Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, Queensland, Australia
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Diamond G, Kodish T, Ewing ESK, Hunt QA, Russon JM. Family processes: Risk, protective and treatment factors for youth at risk for suicide. AGGRESSION AND VIOLENT BEHAVIOR 2022; 64:101586. [PMID: 35662798 PMCID: PMC9159634 DOI: 10.1016/j.avb.2021.101586] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Family factors have continually been identified as potential risk and protective factors for youth at risk for suicide. This paper reviews family processes that not only are associated with suicide risk, but also might be malleable enough to target in treatment. We also review family intervention components have been incorporated into most youth suicide treatments. Unfortunately research on if these family processes moderator, mediator or change as a result of treatment is limited. Recommendations for future research are offered.
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Chen YL, Kuo PH. Social Support Reduces the Risk of Unfavorable Parenting Styles for Suicidal Behaviors in Early Adolescents. Arch Suicide Res 2022; 27:780-795. [PMID: 35481803 DOI: 10.1080/13811118.2022.2066590] [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: 11/02/2022]
Abstract
OBJECTIVE Depression and perceived stress are important risk factors for suicidal behaviors among adolescents. The current study examined the joint effects of parenting styles on suicidal ideation (SI) and attempt (SA) in early adolescents while considering relevant individual factors, and evaluated whether social support can offset the risk. METHODS The present study was part of a large cohort study aiming at tracing the mental health and risk behaviors in adolescents, and we utilized baseline data collected from 645 4th grade students with complete assessment of suicidal behaviors, social support, parental bonding, depression, and perceived stress. Participants' mean age was 9.97 years (SD = 0.38) with 53.02% boys. Logistic regression was performed to analyze the associations between independent variables and youth suicidal behaviors. RESULTS 16.28% students reported to have SI and 4.96% had SA. Depression (SI: OR = 3.66-3.89; SA: OR = 3.98-4.50), father's low care and high authoritarian (LCHA) (SI: OR = 3.04; SA: OR = 2.43), and low acceptance and high authoritarian (LAHA) (SI: OR = 3.58; SA: OR = 4.77) parenting styles were strong risk factors, while overall social support (SI: OR = 0.98; SA: OR = 0.97) was a protective factor of SI and SA for early adolescents. Perceived stress (OR = 1.07-1.08) and mother's LCHA parenting style (OR = 2.03) were risk factors of SI. Overall, a family with LCHA parenting (OR = 2.82) or LAHA parenting (OR = 3.35-3.72) regardless parental gender had increased risk for SI and SA. CONCLUSION Family and social factors are important to consider in suicidal prevention and interventions among early adolescents, in addition to assessing individual risk factors. HighlightsSuicidal ideations (16.28%) and attempts (4.96%) were prevalent in early adolescents at elementary schools. Depression status remains a significant risk factor for both SI and SA in early adolescents.Unfavorable parenting styles (LCHA or LAHA) increased the risk of SI and SA, especially received from father.Overall social support had independent protective effect on suicidal behaviors, when taking aforementioned individual and family risk factors into account.
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Lee JH. Relationships between neighborhood collective efficacy and adolescent suicidal ideation. J Adolesc 2021; 93:10-19. [PMID: 34626886 DOI: 10.1016/j.adolescence.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Until now, South Korean adolescent suicidal ideation literature has focused mainly on individual-level characteristics. Little is known about the contextual effects of social integration and social regulation on an individual's suicide behavior in South Korea as identified through the use of Durkheim's sociological insights. This study drew on Durkheim's suicide and collective efficacy theories and analyzed the effects of the structural characteristics and collective efficacy of neighborhoods on adolescents' suicidal ideation. METHODS The data analyzed was from three sources: the 2013 Korean National Survey of the Present Status of Children (n = 1,915; 50.41% girls; mean age = 13.04 years), government census data from the Korea Statistical Information System, and administrative data from the Korea Ministry of Health and Welfare. The Hierarchical Generalized Linear Model was used to investigate the effects of neighborhood structural characteristics and collective efficacy on adolescent suicidal ideation. RESULTS There were no significant associations between neighborhood characteristics such as concentrated poverty, divorce rate, and residential instability; however, adoles cents' perceptions of collective efficacy in neighborhoods was associated with lower suicidal ideation after accounting for individual adolescent differences. CONCLUSION The findings provide significant implications for the prevention of suicide in adolescents and suggest that enhancing the collective efficacy of neighborhoods through community-based intervention may be an important target of future suicide prevention strategies in South Korea.
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Affiliation(s)
- Ji Hyeon Lee
- Department of Christianity and Culture-Social Welfare, Presbyterian University and Theological Seminary, Gwangjang-ro(st) 5-gil(rd), Gwangjin-gu, Seoul, 04965, South Korea.
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Angelakis I, Gooding P. Adverse Social Relationships in Childhood: Are there Links with Depression, Obsessive-Compulsive Disorder and Suicidality in Adulthood? Child Psychiatry Hum Dev 2021; 52:945-956. [PMID: 33040218 DOI: 10.1007/s10578-020-01077-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 11/30/2022]
Abstract
This study aimed to (i) explore the association between perceptions of negative social relationships in childhood with significant others, including peers, guardians and teachers, symptoms of depression and OCD, and suicide behaviors, and (ii) examine whether depression and OCD severity meditated the association between these perceptions and suicide experiences. In total, 783 individuals from the community were invited to complete self-report measures. There were strong associations between perceptions of adverse social relationships in childhood, severity of depression and OCD, and suicide behaviors. Furthermore, depression and OCD partially mediated the association between perceptions of adverse social relationships, especially with peers, and suicide behaviors. These results provide strong evidence for the importance of developing clinical interventions that directly target negative experiences of social relationships in childhood, and for raising public and scientific awareness that everyday adverse social interactions with significant others can impact negatively on mental health including suicide behaviors.
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Affiliation(s)
- Ioannis Angelakis
- School of Psychology, University of South Wales, Pontypridd, CF37 1DL, Wales, UK.
| | - Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre, MAHSC, Manchester, UK
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Orlins E, DeBois K, Chatfield SL. Characteristics of interpersonal conflicts preceding youth suicide: analysis of data from the 2017 National Violent Death Reporting System. Child Adolesc Ment Health 2021; 26:204-210. [PMID: 33289270 DOI: 10.1111/camh.12439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Deaths by suicide among US adolescents aged 10 to 19 increased by more than 85% between 2007 and 2017. Interpersonal conflicts with peers or family members, in combination with biological, psychological, and cognitive attributes of adolescents, are among risk factors. More insight about contextual factors, including timing of conflicts relative to suicide, would be useful for professionals and programmers. METHOD We used data from the 2017 National Violent Death Reporting System (NVDRS) reflecting most cases in 37 US states to explore contextual circumstances in adolescent death by suicide preceded by interpersonal conflicts. We calculated descriptive statistics and conducted content analysis of narratives to identify attributes of 197 cases. RESULTS Most deaths by suicide (n = 155) occurred within 24 hr of the conflict; most conflicts involved the adolescent and family members (n = 138). When subject matter was described, most conflicts (n = 27) focused on concerns with an adolescent's behavior. Nearly a quarter of cases (n = 49) involved technology, including technology restrictions as punishment, as either a primary or additional aspect of the conflict. CONCLUSIONS Our findings provide support for prior research suggesting links between technology and mental health concerns, including suicidality, among adolescents. While previous works have identified both positive and negative aspects of the use of technology by adolescents, our findings suggest that restriction of technology as a punishment may be an additional contextual factor of interest in a proportion of youth suicides preceded by an argument. Given ongoing regular use of technology, practitioners should address these potential risk factors regardless of risk status.
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Affiliation(s)
- Erin Orlins
- College of Public Health, Kent State University, Kent, OH, USA
| | - Kristen DeBois
- College of Public Health, Kent State University, Kent, OH, USA
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Schlagbaum P, Tissue JL, Sheftall AH, Ruch DA, Ackerman JP, Bridge JA. The impact of peer influencing on adolescent suicidal ideation and suicide attempts. J Psychiatr Res 2021; 140:529-532. [PMID: 34167026 DOI: 10.1016/j.jpsychires.2021.06.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 04/09/2021] [Accepted: 06/13/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the role of peer influence on adolescent suicidal ideation and attempts within youth seeking emergency care or outpatient mental health services. We examined whether affiliation with peers reporting suicidal thoughts/behaviors was associated with an adolescent's own suicidal ideation and/or suicide attempt beyond individual risk factors. METHODS One hundred and eighteen adolescents, ages 13-18, were recruited from the emergency department and outpatient mental health clinics at a large, metropolitan children's hospital. Adolescents with suicidal ideation in the past six months (ideators, n=19) and with a suicide attempt in the past year (attempters, n=40) were matched with controls with no history of ideation or attempt on age (±1 year), sex, and race. Adolescents and parents completed semi-structured interviews and self-report questionnaires to examine individual and peer associated risk factors. RESULTS Both ideators and attempters were more likely to affiliate with peers with suicidal behavior compared to their matched controls. However, affiliation with suicidal peers was only associated with attempter group status after controlling for individual risk factors. CONCLUSION Affiliation with peers reporting suicidal thoughts/behaviors was linked to an adolescent's own history of suicide attempt. Through understanding peer affiliation, peers may be an important resource for both identifying and preventing youth suicidal behavior. Evidence-based programs that focus and utilize peer influence may be invaluable for prevention efforts.
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Affiliation(s)
- Paige Schlagbaum
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jaclyn L Tissue
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Arielle H Sheftall
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Donna A Ruch
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - John P Ackerman
- Department of Behavioral Health, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jeffrey A Bridge
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.
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Abstract
OBJECTIVE The COVID-19 pandemic has drastically changed society and introduced many new factors to consider in adolescent suicide risk assessment and prevention. One complexity that warrants consideration is the male-specific impacts of the pandemic within adolescence. METHODS A review of the relevant literature. RESULTS Matters of social distancing, virtual education, and substance use may impact adolescent men in fashions that raise their suicide risk more significantly relative to adolescent women. Social distancing may impact adolescents' friendships and generate a regression back to the nuclear family; qualities of male adolescents' friendships and of masculinity suggest that these impacts may be more severe in adolescent men and may directly raise suicide risk. Virtual schooling yields educational and social setbacks; losses of team sports, male mentors, and the implications of diminished educational advancement may more adversely affect adolescent men and raise risk. Substance use has increased in the pandemic, particularly amongst adolescent men. There are direct associations with suicide risk as well as indirectly through increased parental conflict and punishment. CONCLUSION As adolescent men die by suicide at significantly elevated rates relative to adolescent women, a male-specific consideration of these impacts is indicated to address adolescent suicide in our current era. Recommendations are made for integrating these considerations into updated adolescent suicide risk assessment and prevention efforts.
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Brock SE, Lieberman R, Cruz MA, Coad R. Conducting School Suicide Risk Assessment in Distance Learning Environments. ACTA ACUST UNITED AC 2021; 25:3-11. [PMID: 33425480 PMCID: PMC7781167 DOI: 10.1007/s40688-020-00333-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 04/10/2023]
Abstract
The social distancing mandate, implemented in response to the coronavirus disease 2019 (COVID-19) global pandemic, has guided many schools to deliver instruction via distance learning. Among the many challenges generated by this delivery system is the need for school mental health services, including school suicide prevention and intervention, to be conducted remotely. After briefly discussing the magnitude of the problem of youth suicide and how the COVID-19 pandemic has likely increased risk for youth suicidal ideation and behaviors, this article provides guidance on how school systems can prepare for and conduct suicide risk assessments in distance learning environments.
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Affiliation(s)
- Stephen E Brock
- California State University, 6000 J Street, Sacramento, CA 95819-6079 USA
| | | | - Melinda A Cruz
- Department of Psychology, Radford University, Radford, VA USA
| | - Robert Coad
- Walnut Valley Unified School District, Walnut, CA USA
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Cortés Rico O, Gallego Iborra A, García Aguado J, Pallás Alonso CR, Rando Diego Á, San Miguel Muñoz MJ, Sánchez Ruiz-Cabello FJ, Colomer Revuelta J, Esparza Olcina MJ, Galbe Sánchez-Ventura J, Mengual Gil JM. [Childhood and adolescence PAPPS summary 2020]. Aten Primaria 2020; 52 Suppl 2:149-160. [PMID: 33388113 PMCID: PMC7801204 DOI: 10.1016/j.aprim.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 08/18/2020] [Indexed: 11/25/2022] Open
Abstract
Four important topics about children and adolescents in our Primary Care activity are presented in this update document: support for breastfeeding, promotion of physical activity, prevention of child injuries due to traffic accidents, and screening for major depression.
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Affiliation(s)
- Olga Cortés Rico
- Centro de Salud Delicias Sur, Servicio Aragonés de Salud, Zaragoza, España.
| | - Ana Gallego Iborra
- Centro de Salud Delicias Sur, Servicio Aragonés de Salud, Zaragoza, España
| | | | | | - Álvaro Rando Diego
- Centro de Salud Delicias Sur, Servicio Aragonés de Salud, Zaragoza, España
| | | | | | | | | | | | - José M Mengual Gil
- Centro de Salud Delicias Sur, Servicio Aragonés de Salud, Zaragoza, España
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16
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Schlagbaum P, Ruch DA, Tissue JL, Sheftall AH, Bridge JA. Depressed Mood Prior to Death. CRISIS 2020; 41:445-452. [DOI: 10.1027/0227-5910/a000660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Abstract. Background: Suicide is a leading cause of death among youth in the United States. Multiple factors have been shown to increase risk for suicidal behavior, including depressed mood. Aims: The purpose of this study was to examine individual characteristics and precipitating circumstances of suicide in youth decedents with and without depressed mood at the time of death. Method: Data from the National Violent Death Reporting System (NVDRS) were analyzed for 17 US states from 2003 to 2012. Participants included suicide decedents aged 10–19 years ( N = 4,053). Analyses compared youth suicide decedents with depressed mood at time of death with those without depressed mood using logistic regression. Sex-specific differences in youth with depressed mood were also explored. Results: Youth suicide decedents with depressed mood were more likely than those without depressed mood to exhibit clinical characteristics and precipitating circumstances associated with suicide. Comparison of males and females with depressed mood found unique sex-specific differences. Limitations: Data were limited to 17 states, analyses did not include a control group, and data were collected through postmortem reporting. Conclusion: Findings support a significant association between depressed mood and factors associated with suicidal behavior in youth and offer potential areas to focus prevention strategies.
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Affiliation(s)
- Paige Schlagbaum
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Donna A. Ruch
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jaclyn L. Tissue
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Arielle H. Sheftall
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Jeffrey A. Bridge
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, OH, USA
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17
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Ream GL. An Investigation of the LGBTQ+ Youth Suicide Disparity Using National Violent Death Reporting System Narrative Data. J Adolesc Health 2020; 66:470-477. [PMID: 31982330 DOI: 10.1016/j.jadohealth.2019.10.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/17/2019] [Accepted: 10/14/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE This study explored law enforcement and medical examiner reports about adolescent and young adult deaths by suicide for novel and understudied risk factors and described variability by sexual orientation and gender identity in those risk factors' prevalence. It also sought to explain why the suicide disparity between lesbian, gay, bisexual, transgender, queer/questioning, and other sexual/gender minority (LGBTQ+) youth and non-LGBTQ+ youth is wider in adolescence than in young adulthood. METHODS This study involved coding of law enforcement and medical examiner reports from the National Violent Death Reporting System (NVDRS) for all 394 LGBTQ+ youth who died by suicide in NVDRS participating states between 2013 (the year that NVDRS began coding for sexual orientation and transgender status) and 2016 (the latest year of NVDRS available), along with 394 non-LGBTQ+ cases matched with them on dimensions of sex, urbanicity, race, and military service. RESULTS Fifty-nine percent of 12- to 17-year-old LGBTQ+'s cases mentioned an LGBTQ+-specific contributing circumstance, whereas only 30% of 18- to 29-year-old LGBTQ+'s cases mentioned an LGBTQ+-specific contributing circumstance. However, there were 3.6 times as many cases of LGBTQ+ 18- to 29-year-olds as there were of LGBTQ+ 12- to 17-year-olds. Cases of gay males, bisexual males, and bisexual females were particularly likely to include family/peer rejection and bullying as contributing circumstances, while lesbians' cases more often mentioned romantic breakups. CONCLUSIONS The LGBTQ+/non-LGBTQ+ suicide disparity may be greater for adolescents because LGBTQ+-specific contributing circumstances are more prevalent among adolescents. Prevention efforts should be tailored to clients' age and specific LGBTQ+ subgroup.
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Affiliation(s)
- Geoffrey L Ream
- School of Social Work, Adelphi University, Garden City, New York.
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18
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Erps KH, Ochs S, Myers CL. School psychologists and suicide risk assessment: Role perception and competency. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Kristen H. Erps
- Department of Psychological, Health, and Learning Sciences; University of Houston; Houston Texas
| | - Sarah Ochs
- Department of Psychology; Western Kentucky University; Bowling Green Kentucky
| | - Carl L. Myers
- Department of Psychology; Western Kentucky University; Bowling Green Kentucky
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19
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Trends in Firearm Injuries Among Children and Teenagers in the United States. J Surg Res 2020; 245:529-536. [DOI: 10.1016/j.jss.2019.07.056] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/22/2019] [Accepted: 07/18/2019] [Indexed: 01/12/2023]
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20
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Saminathan TA, Ganapathy SS, Sooryanarayana R, Hasim MHB, Mohd Anuar MF, Ahmad FH, Tan L, Awaluddin SM, Aris T, Rosman A. Prevalence and Factors Associated With Physical Abuse at Home Among School-Going Adolescents in Malaysia: A Population-Based Nationwide Study. Asia Pac J Public Health 2019; 31:88S-96S. [PMID: 31680535 DOI: 10.1177/1010539519883139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We assessed the current situation of physical abuse among adolescents at home in Malaysia. A total of 27 497 school-going adolescents answered a self-administered questionnaire during the Malaysian National Health and Morbidity Survey 2017. A complex sampling analysis was applied to identify factors associated with physical abuse among adolescents using multivariate logistic regression analysis. The prevalence of physical abuse at home among students was 11.8%. Our result shows that adolescents aged 13 years had significantly higher odds of such abuse, with odds decreasing as the adolescents age. Girls and adolescents from Indian ethnicity (minority ethnic group) had higher odds of such abuse. Other associated factors were mental health problems, substance abuse, and problems at school. Physical abuse among adolescents at home should be countered with appropriate measures.
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Affiliation(s)
- Thamil Arasu Saminathan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Shubash Shander Ganapathy
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Rajini Sooryanarayana
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Hazrin Bin Hasim
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Fuad Mohd Anuar
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Fazila Haryati Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - LeeAnn Tan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - S Maria Awaluddin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Tahir Aris
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Azriman Rosman
- Violence and Injury Prevention Unit, Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
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21
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Lindsey MA, Sheftall AH, Xiao Y, Joe S. Trends of Suicidal Behaviors Among High School Students in the United States: 1991-2017. Pediatrics 2019; 144:peds.2019-1187. [PMID: 31611338 PMCID: PMC7299440 DOI: 10.1542/peds.2019-1187] [Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine if racial and ethnic subgroups of adolescents are at high risk for engagement in suicidal behaviors. METHODS Using the nationally representative school-based Youth Risk Behavior Survey from the years 1991 to 2017, we conducted logistic regression analyses to examine trends by different racial and ethnic groups, with each suicide indicator serving as a dichotomous outcome. Participants included 198 540 high school students. RESULTS Across all sex and race and ethnic groups, there were significant linear decreases in self-reported suicidal ideation and suicide plans from 1991 to 2017. Female adolescents (odds ratio [OR], 0.98; P < .001) had significant decreases in attempts over time. Black adolescents had positive linear trends for suicide attempts among both boys (OR, 1.04; P < .001) and girls (OR, 1.02; P = .003). Black adolescent boys (OR, 1.04; P = .048) had a significant linear increase in injury by attempt. CONCLUSIONS The results suggest that, over time, black youth have experienced an increase in suicide attempts, which is troubling because attempts are the most prominent risk factor associated with suicide death. For black boys, a significant increase in injury by attempt occurred, which suggests that black boys may be engaging in increasingly lethal means when attempting suicide. Examining trends of suicidal thoughts and behaviors over time by sex and race and ethnicity allow us to determine where to focus prevention and intervention efforts. Future research should examine the underlying reasons for these changes observed in US high school students.
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Affiliation(s)
- Michael A. Lindsey
- McSilver Institute for Poverty Policy and Research, New York University, New York, New York;,Silver School of Social Work, New York University, New York, New York
| | - Arielle H. Sheftall
- Center for Suicide Prevention and Research, Nationwide Children’s Hospital, Columbus, Ohio;,Center for Innovation in Pediatric Practice, Nationwide Children’s Hospital, Columbus, Ohio;,The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio;,Department of Pediatrics, College of Medicine, Ohio State University, Columbus, Ohio
| | - Yunyu Xiao
- McSilver Institute for Poverty Policy and Research, New York University, New York, New York;,Silver School of Social Work, New York University, New York, New York
| | - Sean Joe
- George Warren Brown School of Social Work, Washington University in St Louis, St Louis, Missouri
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22
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Clarke S, Allerhand LA, Berk MS. Recent advances in understanding and managing self-harm in adolescents. F1000Res 2019; 8:F1000 Faculty Rev-1794. [PMID: 31681470 PMCID: PMC6816451 DOI: 10.12688/f1000research.19868.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2019] [Indexed: 12/28/2022] Open
Abstract
Adolescent suicide is a serious public health problem, and non-suicidal self-injury (NSSI) is both highly comorbid with suicidality among adolescents and a significant predictor of suicide attempts (SAs) in adolescents. We will clarify extant definitions related to suicidality and NSSI and the important similarities and differences between these constructs. We will also review several significant risk factors for suicidality, evidence-based and evidence-informed safety management strategies, and evidence-based treatment for adolescent self-harming behaviors. Currently, dialectical behavior therapy (DBT) for adolescents is the first and only treatment meeting the threshold of a well-established treatment for self-harming adolescents at high risk for suicide. Areas in need of future study include processes underlying the association between NSSI and SAs, clarification of warning signs and risk factors that are both sensitive and specific enough to accurately predict who is at imminent risk for suicide, and further efforts to sustain the effects of DBT post-treatment. DBT is a time- and labor-intensive treatment that requires extensive training for therapists and a significant time commitment for families (generally 6 months). It will therefore be helpful to assess whether other less-intensive treatment options can be established as evidence-based treatment for suicidal adolescents.
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Affiliation(s)
- Stephanie Clarke
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
| | - Lauren A. Allerhand
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
| | - Michele S. Berk
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
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23
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Ngwane VE, van der Wath AE. The psychosocial needs of parents of adolescents who attempt suicide. JOURNAL OF PSYCHOLOGY IN AFRICA 2019. [DOI: 10.1080/14330237.2019.1647494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Vangi E. Ngwane
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Anna E. van der Wath
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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24
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Ream GL. What's Unique About Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth and Young Adult Suicides? Findings From the National Violent Death Reporting System. J Adolesc Health 2019; 64:602-607. [PMID: 30711364 DOI: 10.1016/j.jadohealth.2018.10.303] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 10/23/2018] [Accepted: 10/26/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of the study was to explore variability in circumstances around suicide deaths among youth and young adults by sexual/gender identity category (gay male, lesbian/gay female, bisexual male, bisexual female, transgender male, transgender female, non-LGBT [lesbian, gay, bisexual, and transgender] male, and non-LGBT female). METHODS Secondary analysis of National Violent Death Reporting System (NVDRS) data for all 12- to 29-year-olds who died by suicide in NVDRS participating states. Coverage begins in 2013, the year that NVDRS began coding for sexual orientation and transgender status, and ends in 2015, the latest year of NVDRS data available. The valid sample was limited to cases in which sexual orientation or transgender status could be determined postmortem, n = 2,209. RESULTS Almost one quarter (24%) of 12- to 14-year-olds who died by suicide were LGBT, whereas only 8% of 25- to 29-year-olds who died by suicide were LGBT. Most non-LGBT males and bisexual males died by firearm and had intimate partner problems contribute to their deaths. Non-LGBT females and LGBT persons other than bisexual males were generally less likely to use firearms. They were also more likely to have psychiatric diagnoses, prior suicidality, and family problems contributing to their deaths. Rates of many circumstances varied widely among LGBT subgroups. CONCLUSIONS The LGBT versus non-LGBT suicide disparity is greatest at younger ages, and each LGBT subgroup has its own specific risk profile for suicide. Suicide prevention and intervention efforts targeted at LGBT youth may increase their effectiveness by attending to these distinct risk profiles.
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Affiliation(s)
- Geoffrey L Ream
- School of Social Work, Adelphi University, Garden City, New York.
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25
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McLoughlin LT, Spears BA, Taddeo CM, Hermens DF. Remaining connected in the face of cyberbullying: Why social connectedness is important for mental health. PSYCHOLOGY IN THE SCHOOLS 2019. [DOI: 10.1002/pits.22232] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Larisa T. McLoughlin
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine CoastBirtinya Queensland Australia
| | - Barbara A. Spears
- School of Education, Magill Campus, University of South AustraliaAdelaide South Australia Australia
| | - Carmel M. Taddeo
- School of Education, Magill Campus, University of South AustraliaAdelaide South Australia Australia
| | - Daniel F. Hermens
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine CoastBirtinya Queensland Australia
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