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McGorry PD, Mei C, Dalal N, Alvarez-Jimenez M, Blakemore SJ, Browne V, Dooley B, Hickie IB, Jones PB, McDaid D, Mihalopoulos C, Wood SJ, El Azzouzi FA, Fazio J, Gow E, Hanjabam S, Hayes A, Morris A, Pang E, Paramasivam K, Quagliato Nogueira I, Tan J, Adelsheim S, Broome MR, Cannon M, Chanen AM, Chen EYH, Danese A, Davis M, Ford T, Gonsalves PP, Hamilton MP, Henderson J, John A, Kay-Lambkin F, Le LKD, Kieling C, Mac Dhonnagáin N, Malla A, Nieman DH, Rickwood D, Robinson J, Shah JL, Singh S, Soosay I, Tee K, Twenge J, Valmaggia L, van Amelsvoort T, Verma S, Wilson J, Yung A, Iyer SN, Killackey E. The Lancet Psychiatry Commission on youth mental health. Lancet Psychiatry 2024; 11:731-774. [PMID: 39147461 DOI: 10.1016/s2215-0366(24)00163-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 08/17/2024]
Affiliation(s)
- Patrick D McGorry
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Cristina Mei
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Vivienne Browne
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Barbara Dooley
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Cathrine Mihalopoulos
- Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Stephen J Wood
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; School of Psychology, University of Birmingham, Birmingham, UK
| | | | | | - Ella Gow
- Orygen, Melbourne, VIC, Australia; Melbourne, VIC, Australia
| | | | | | | | - Elina Pang
- Hong Kong Special Administrative Region, China
| | | | | | | | - Steven Adelsheim
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Matthew R Broome
- Institute for Mental Health, University of Birmingham, Birmingham, UK; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Mary Cannon
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Andrew M Chanen
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Eric Y H Chen
- Institute of Mental Health, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; LKS School of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Andrea Danese
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; National and Specialist Child and Adolescent Mental Health Service Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Maryann Davis
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Pattie P Gonsalves
- Youth Mental Health Group, Sangath, New Delhi, India; School of Psychology, University of Sussex, Brighton, UK
| | - Matthew P Hamilton
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jo Henderson
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Long K-D Le
- Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Ashok Malla
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; ACCESS Open Minds and Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Dorien H Nieman
- Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, ACT, Australia; headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia
| | - Jo Robinson
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jai L Shah
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; ACCESS Open Minds and Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Swaran Singh
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick and Coventry and Warwickshire Partnership Trust, Coventry, UK
| | - Ian Soosay
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Karen Tee
- Foundry, Providence Health Care, Vancouver, BC, Canada
| | - Jean Twenge
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Lucia Valmaggia
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | | | - Jon Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Alison Yung
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia; School of Health Sciences, The University of Manchester, Manchester, UK
| | - Srividya N Iyer
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; ACCESS Open Minds and Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Eóin Killackey
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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Prodi T, Dragogna F, Benatti B, Varinelli A, Vanzetto S, Gianfelice L, Dell'Osso B. COVID-19 and psychiatric disorders among young people: a cross-sectional study. Int Clin Psychopharmacol 2024:00004850-990000000-00148. [PMID: 39120982 DOI: 10.1097/yic.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
During the COVID-19 pandemic, a significant rise in mental health issues was observed. Particularly, children and adolescents have shown a higher risk of developing mental disorders than adults. This study aimed to describe the evolving features of the requests for psychiatric emergency interventions during the COVID-19 pandemic in young people. We conducted a cross-sectional study comparing the number, characteristics, and symptoms of people aged between 12 and 18 years old attending one Emergency Department (ED) for psychiatric issues, considering three different periods: T0 (8 March 2019-7 March 2020), T1 (8 March 2020-7 March 2021), and T2 (8 March 2021-7 March 2022). Total admissions were 220: 99 (45%) during T0, 40 (18.1%) for T1, and 81 (36.8%) for T2 ( P < 0.001). A significant decrease in the mean age from T0 to T1 was found ( P < 0.01). Admissions for psychomotor agitation decreased, while admission due to anxiety disorder and nonsuicidal self-injury raised significantly ( P < 0.05), as for first psychiatric presentation ( P < 0.01). Regarding substance use, a significant reduction was observed ( P < 0.05). The rates of eating disorders ( P < 0.001) and early insomnia ( P < 0.01) increased from T0. These findings highlight the worsening of psychiatric symptoms in the young population during the COVID-19 pandemic.
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Affiliation(s)
- Tiziano Prodi
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | - Filippo Dragogna
- Department of Mental Health, Psychiatry 1 Unit, Fatebenefratelli Hospital, Milan
| | - Beatrice Benatti
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | - Alberto Varinelli
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | | | - Letizia Gianfelice
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | - Bernardo Dell'Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
- Department of Mental Health, Psychiatry 1 Unit, Fatebenefratelli Hospital, Milan
- "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
- Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche, University of Milan, Milan, Italy
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3
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Hedley D, Uljarević M, Bury SM, Haschek A, Richdale AL, Trollor JN, Stokes MA. Examination of the Potential Moderating Role of Psychological Wellbeing in the Relationship Between Depression and Thoughts of Self-Harm in Autistic Adolescents and Adults: A Two-Year Longitudinal Study. J Autism Dev Disord 2024:10.1007/s10803-024-06489-x. [PMID: 39078579 DOI: 10.1007/s10803-024-06489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2024] [Indexed: 07/31/2024]
Abstract
PURPOSE Autistic people have a significantly increased risk of death by suicide relative to the general population. In non-autistic samples, psychological wellbeing has been shown to moderate the relationship between depression and suicidal thoughts and behavior. Thoughts of self-harm may provide a useful indicator of suicidal risk. In this longitudinal study we examined (a) the potential role for psychological wellbeing to moderate the relationship between depressive symptoms and thoughts of self-harm and (b) the contribution of autistic traits to thoughts of self-harm. METHODS Participants were 209 autistic adolescents and adults aged 15 to 80 years (Mage = 34.20, SD = 15.38 years). RESULTS At both baseline and 2-year follow-up, 35% of participants reported recent thoughts of self-harm. Wellbeing was associated with autistic traits (r = - .350 to - 0.404) and depression (r = - .480 to - 0.759). Thoughts of self-harm were positively associated with autistic traits and depression (r = .242 to 0.659), and negatively associated with wellbeing (r = - .287 to - 0.609). Controlling for baseline thoughts of self-harm, depression (β = 0.254, p = .001) and autistic traits (β = 0.162, p = .007) significantly predicted thoughts of self-harm at 2-year follow-up. CONCLUSION Despite a lack of support for the hypothesis that wellbeing would moderate the relationship between depression and thoughts of self-harm, correlational data demonstrated significant associations between wellbeing and both depression and thoughts of self-harm. Future research considering psychological wellbeing as a potential protective factor for self-harm in autistic people is warranted.
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Affiliation(s)
- Darren Hedley
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
| | | | - Simon M Bury
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Alexandra Haschek
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry, School of Clinical Medicine, UNSW, Sydney, NSW, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC),, Brisbane, QLD, Australia
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4
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Shi K, Chen XX, Zhang XH. Butane misuse and its consequences: Unmasking the silent epidemic of burn injuries among adolescents. Burns 2024:S0305-4179(24)00220-1. [PMID: 39127576 DOI: 10.1016/j.burns.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 07/12/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024]
Affiliation(s)
- Kai Shi
- Department of Burns, The First Hospital of Jilin University, Changchun 130021, China.
| | - Xin-Xin Chen
- Department of Burns, The First Hospital of Jilin University, Changchun 130021, China.
| | - Xiu-Hang Zhang
- Department of Burns, The First Hospital of Jilin University, Changchun 130021, China.
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5
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Michalek IM, Koczkodaj P, Michalek M, Caetano Dos Santos FL. Unveiling the silent crisis: global burden of suicide-related deaths among children aged 10-14 years. World J Pediatr 2024; 20:371-391. [PMID: 38238639 PMCID: PMC11052841 DOI: 10.1007/s12519-023-00781-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/22/2023] [Indexed: 04/29/2024]
Abstract
BACKGROUND The rise in suicides among children aged 10-14 years demands urgent attention globally. This study aims to assess the global burden of suicide-related deaths in this age group from 1990 to 2019, considering factors such as sex, geography, and sociodemographics, to inform prevention strategies and interventions. METHODS The data from Global Burden of Disease 2019, encompassing 204 countries and territories, were analyzed to investigate deaths and years of life lost (YLLs) due to suicide among children aged 10-14 years. Statistical analyses, including mortality rates, YLLs, and the sociodemographic index (SDI), were conducted using standardized tools. RESULTS In 2019, a total of 8327 [95% uncertainty interval (UI) = 7073-9685] children aged 10-14 years died globally due to suicide, with a mortality rate of 1.30 (95% UI = 1.10-1.51) per 100,000. The rates varied across countries/territories ranging between 0.05 (95% UI = 0.02-0.10) in South Africa and 7.49 (95% UI = 5.13-10.57) in Greenland. The contribution of suicide-related deaths to all-cause mortality ranged from 0.07% (95% UI = 0.04%-0.15%) in South Africa to 33.02% (95% UI = 24.36%-41.53%) in Greenland. Worldwide, there were approximately 636,196 (95% UI = 540,383-740,009) YLLs due to suicide, with a rate of 99.07 (95% UI = 84.15-115.23) per 100,000. The association between SDI and suicide-related deaths was evident, with higher contributions observed in countries with higher SDI. CONCLUSIONS This study reveals a concerning global burden of suicide-related deaths among children aged 10-14 years. Despite progress in reducing mortality rates, suicide remains a significant issue. While overall rates have declined, the percentage of deaths caused by suicide in this age group is increasing.
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Affiliation(s)
- Irmina Maria Michalek
- Department of Cancer Epidemiology and Primary Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, ul. Wawelska 15 B, Warsaw, Poland.
| | - Pawel Koczkodaj
- Department of Cancer Epidemiology and Primary Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, ul. Wawelska 15 B, Warsaw, Poland
| | - Marzena Michalek
- Private Psychiatric Practice-Marzena Michalek, MD, Siedlce, Poland
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Kim DH, Yop KJ, Han KJ. The influence of sexual violence on suicide risk among runaway youth in South Korea: The multiple additive moderating effect of peer attachment and parental attachment. CHILD ABUSE & NEGLECT 2024; 149:106665. [PMID: 38335562 DOI: 10.1016/j.chiabu.2024.106665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/12/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Runaway youth without an adequate and safe place are vulnerable to sexual violence. Sexual violence is strongly associated with suicide risk, but peers and family are important factors in attenuating the negative outcomes of sexual violence; however, research on this relationship is insufficient because previous studies have focused only on runaway youth's problematic behavior. OBJECTIVE This study's specific aims were as follows: 1) to verify the association between sexual violence and suicide risk among runaway youth, and 2) to assess whether peer and parental attachment moderated the association between sexual violence and suicide risk among runaway youth. PARTICIPANTS AND SETTING The participants comprised 232 runaway youth (51.3 % girls); more than half were aged 17-19 years and approximately two-thirds of them had experienced child abuse. METHODS Self-administered questionnaires were provided to the participating runaway youth in youth shelters in South Korea. The data were analyzed using a multiple additive moderating model that simultaneously included moderating and control variables. RESULTS In total, 18.5 % of runaway youth were exposed to sexual violence (10.6 % boys, 26.1 % girls). Sexual violence victimization affected suicide risk among runaway youth. Peer attachment alleviated the negative relationship between sexual violence and suicide risk, and acted as a protective factor. Although the moderating effect of parental attachment was not significant, it significantly influenced suicide risk. CONCLUSION Our findings demonstrate that runaway youth are vulnerable to sexual violence victimization, especially severe types of sexual violence. Our study verified the role of peer and parental attachment in the association between sexual violence and suicide risk among runaway youth. These findings suggest the need to improve positive peer and parent relationships to mitigate suicide risk among runaway youth.
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Affiliation(s)
- Dong Hyeon Kim
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Kim Jae Yop
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea.
| | - Ki Ju Han
- Youthsehlter FOR YOU, Republic of Korea
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7
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Zhou L, Qiao C, Huang J, Lin J, Zhang H, Xie J, Yuan Y, Hu C. The Impact of Recent Life Events, Internalizing Symptoms, and Emotion Regulation on the Severity of Non-Suicidal Self-Injury in Adolescents: A Mediation Analysis. Neuropsychiatr Dis Treat 2024; 20:415-428. [PMID: 38469207 PMCID: PMC10926171 DOI: 10.2147/ndt.s444729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024] Open
Abstract
Background Previous studies have demonstrated a strong association between recent stressful life events and non-suicidal self-injury (NSSI) among adolescents. Internalizing symptoms and difficulty in emotion regulation (DER) may mediate this relationship. This study aimed to investigate the relationship between recent stressful life events and NSSI severity in adolescents and the potential moderating role of internalizing symptoms and DER. Methods A total of 224 adolescent inpatients (78.6% female) participated in the study, with an age range of 12-18 years old. Data on recent stressful life events, internalizing symptoms, DER, and NSSI behaviors were collected using a clinician-rated questionnaire. A structural equation model was used to test the hypothesized model. Results The rate of NSSI reporting among adolescents in the past 12 months was 65.18%. Recent stressful life events were found to be directly associated with NSSI severity (β = 0.128, P = 0.023). A chain-mediating effect between recent stressful life events and NSSI was also confirmed (β = 0.034, P = 0.023), with DER and internalizing symptoms playing a chain-mediating role and DER having a significantly indirect association with NSSI through internalizing symptoms. Conclusion Recent stressful life events appear to play a role in the etiology of NSSI, particularly punishment and interpersonal relationship events that warrant special attention. DER and internalizing symptoms play a chain-mediating role in the relationship between life events and NSSI. Reducing recent stressful life events, screening for internalizing symptoms, and improving emotion regulation may decrease NSSI behavior among adolescents.
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Affiliation(s)
- Linqi Zhou
- School of the Fourth Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Changyuan Qiao
- School of the Fourth Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Jialing Huang
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Jian Lin
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Haisheng Zhang
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Jian Xie
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Changchun Hu
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
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8
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Pennington ML, Ylitalo KR, Thomas KL, Coe E, Humphries M, Gulliver SB. Suicides among American Indian/Alaska Native firefighters: Data from the National Violent Death Reporting System, 2003 - 2017. Psychiatry Res 2023; 330:115593. [PMID: 37951031 DOI: 10.1016/j.psychres.2023.115593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/13/2023]
Abstract
Suicide is a significant public health problem in the United States and disproportionally affects male American Indian/Alaska Natives (AI/AN). Suicide is particularly problematic among AI/AN firefighters who are more likely to report suicide ideation, planning, attempts, and risk compared to non-Hispanic white (NHW) firefighters. The aim of the current study was to compare non-Hispanic AI/AN firefighter and NHW firefighter suicide decedents by demographics and risk/precipitating factors using National Violent Death Reporting System data for 45 male non-Hispanic AI/AN firefighter and 588 male NHW firefighter decedents who died by suicide. Compared to NHW firefighter decedents, AI/AN firefighter decedents were significantly younger and had significantly higher odds of experiencing alcohol use problems and a recent death/suicide of a family member/friend. AI/AN firefighter decedents had significantly lower odds of documented mental health problems, documented diagnosis of depression/dysthymia, receipt of mental health treatment, or leaving a suicide note compared to NHW firefighter decedents. Results from this study may inform tailored suicide prevention and screening efforts among first responders with the goal of lowering suicide mortality among AI/AN firefighters and fire service as a whole.
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Affiliation(s)
- Michelle L Pennington
- Department of Public Health, Baylor University, Waco, TX, USA; Warriors Research Institute, Baylor Scott & White Health, Waco, TX, USA.
| | - Kelly R Ylitalo
- Department of Public Health, Baylor University, Waco, TX, USA
| | | | - Elizabeth Coe
- Warriors Research Institute, Baylor Scott & White Health, Waco, TX, USA
| | - Mariah Humphries
- George W. Truett Theological Seminary, Baylor University, Waco, TX, USA
| | - Suzy B Gulliver
- Warriors Research Institute, Baylor Scott & White Health, Waco, TX, USA; Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, Temple, TX, USA
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9
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Zhao J, Zhao H, Zhou A. Negative Parenting Styles and Psychological Crisis in Adolescents: Testing a Moderated Mediating Model of School Connectedness and Self-Esteem. Behav Sci (Basel) 2023; 13:929. [PMID: 37998676 PMCID: PMC10669031 DOI: 10.3390/bs13110929] [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: 08/17/2023] [Revised: 10/28/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
Little is known about how rejecting and controlling parenting styles may influence adolescent psychological crisis and what conditions may buffer the detrimental effects of psychological crisis. By integrating multiple theories, this study investigated self-esteem as an underlying mediator and school connectedness as a potential moderator to explain the link between negative parenting and the two psychological crises among Chinese adolescents. In this study, the questionnaire method is adopted to examine the combined mechanism of rejecting parenting style and controlling parenting style on the psychological crisis of adolescents. In total, 1863 adolescents were involved in this study, ranging from 13 to 17 years old. The results showed that both the rejecting parenting style and the controlling parenting style can significantly and positively predict the level of psychological crisis of adolescents, but the predictive power of the rejecting parenting style was stronger. Self-esteem partially mediates the relationship between rejecting parenting style, controlling parenting style, and psychological crisis. School connectedness moderates both the effects of rejecting parenting styles on self-esteem and the effects of self-esteem on the psychological crisis. This study identifies the internal mechanisms by which negative parenting styles affect adolescents' psychological crisis, and reveals the mediating and moderating roles of self-esteem and school connectedness, providing additional explanatory paths for the mechanisms of adolescents' psychological crisis.
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Affiliation(s)
| | | | - Aibao Zhou
- School of Psychology, Northwest Normal University, Lanzhou 730070, China; (J.Z.); (H.Z.)
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10
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Tørmoen AJ, Myhre MØ, Kildahl AT, Walby FA, Rossow I. A nationwide study on time spent on social media and self-harm among adolescents. Sci Rep 2023; 13:19111. [PMID: 37925469 PMCID: PMC10625526 DOI: 10.1038/s41598-023-46370-y] [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: 05/16/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
Self-harm among adolescents has increased in many countries, but few studies have examined possible explanations. One explanation could be the changes in the way adolescents socialize and use of social media. We explored the relationship between past year self-harm and time spent on social media, employing data from a nationwide cross-sectional survey among students in grades 8 through 11 in Norway (N = 37,268). The association was estimated in logistic regression models and we adjusted for identified confounders and stratified on gender, age group and depressive symptoms. A total of 16.1% of the study population reported to have self-harmed in the past year. This proportion was elevated among those spending more than 3 h daily on social media (unadjusted OR = 2.74 (CI 2.58.-2.90)). Adjustment for confounders modified the association (OR = 1.49 (CI 1.39-1.60)). In stratified analyses, adjusted OR did not differ significantly by gender or age The association between time spent on social media and self-harm was weaker among adolescents with severe depressive symptoms (adjusted OR = 1.38 (CI 1.22-1.55)), than among those with mild or no symptoms (adjusted OR = 1.70 (CI 1.56-1.86)). Risk of self-harm was elevated among those who spent 3 or more hours daily on social media, also after controlling for other factors. Further studies are needed to explore the nature and underlying mechanisms of this association. Strengthening the evidence will help informing the development of adequate measures to prevent self-harm.
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Affiliation(s)
- Anita Johanna Tørmoen
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway.
| | - Martin Øverlien Myhre
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Anine Therese Kildahl
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Fredrik Andreas Walby
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
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11
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Vidal C, Jun HJ, Latkin C. The Effects of Social Rank and Neighborhood and School Environment on Adolescent Depression and Suicidal Ideation: A Structural Equation Modeling Approach. Child Psychiatry Hum Dev 2023; 54:1425-1437. [PMID: 35347499 PMCID: PMC10120529 DOI: 10.1007/s10578-022-01347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/29/2022]
Abstract
Depression and suicide constitute major public health problems, and their prevalence has been increasing among adolescents in the United States. More research is needed to understand the association between multilevel risk factors and depression and suicidal ideation in adolescents, particularly factors related to perceived social rank and environmental stress. The present study examined relationships among family mental history of mental illness, in-utero and perinatal complications, social rank factors, environmental factors, and depression and suicidal ideation in the past month in a clinical population of adolescents. A cross-sectional survey was administered in outpatient clinics to 197 adolescents ages 12-18 who were primarily Black and female. Findings from structural equation modeling showed the largest effects for the social rank factor on depression and suicidal ideation in the past month. These findings highlight the importance of preventive interventions for coping with social hierarchies to prevent depression and suicidal ideation.
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Affiliation(s)
- Carol Vidal
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street/Bloomberg 12N, Baltimore, MD, 21287-3335, USA.
| | - Hyun-Jin Jun
- Graduate School, University of Maryland Baltimore, Baltimore, MD, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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12
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Diallo I, Aldridge LR, Bass J, Adams LB, Spira AP. Factors Associated With Suicide in Four West African Countries Among Adolescent Students: An Analysis Using the Global School-Based Student Health Survey. J Adolesc Health 2023; 73:494-502. [PMID: 37330706 DOI: 10.1016/j.jadohealth.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 03/21/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Globally, suicide is a leading cause of death among adolescents, with the highest burden of suicide occurring in Africa. Despite this, little is known about the epidemiology of suicide among adolescents in West Africa. In this study, we explore suicidality among West African adolescents. METHODS Using pooled data from the Global School-Based Student Health Survey in four West African countries (Ghana, Benin, Liberia, and Sierra Leone), we investigated the prevalence of suicidal ideation and suicide attempt and examined associations with 15 covariates using univariate and multivariable logistic regression. RESULTS Overall, 18.6% of adolescents in the pooled sample (N = 9,726) had considered suicide, while 24.7% reported attempting suicide. Significant correlates of suicide attempt included older age (16+ years; odds ratio [OR]: 1.70, confidence interval [CI]: 1.09-2.63), difficulty sleeping due to worry (OR: 1.27, CI: 1.04-1.56), loneliness (OR: 1.65, CI: 1.39-1.96), truancy (OR: 1.38. CI: 1.05-1.82), being a target of bullying (OR: 1.53, CI: 1.26-1.85), getting physically attacked (OR: 1.73, CI: 1.42-2.11), physical fighting (OR: 1.47, CI: 1.21-1.79), current cigarette use (OR: 2.71, CI: 1.88-3.89), and initiation of drug use (OR: 2.19, CI: 1.71-2.81). Conversely, having close friends was associated with lower odds of suicide attempt (OR: 0.67, CI: 0.48-0.93). Several covariates were also significantly associated with suicidal ideation. DISCUSSION Suicidal ideation and attempts are highly prevalent among school-going adolescents in these West African countries. Multiple modifiable risk and protective factors were identified. Programs, interventions, and policies aimed at addressing these factors may play a significant role in preventing suicides in these countries.
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Affiliation(s)
- Idiatou Diallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Luke R Aldridge
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Judith Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Leslie B Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychiatry and Behavioral Services, Johns Hopkins School of Medicine, Baltimore, Maryland; Johns Hopkins Center on Aging and Health, Baltimore, Maryland
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13
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Moller CI, Badcock PB, Hetrick SE, Rice S, Berk M, Witt K, Chanen AM, Dean OM, Gao C, Cotton SM, Davey CG. Predictors of suicidal ideation severity among treatment-seeking young people with major depressive disorder: The role of state and trait anxiety. Aust N Z J Psychiatry 2023; 57:1150-1162. [PMID: 36629043 DOI: 10.1177/00048674221144262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Depression and suicidal ideation are closely intertwined. Yet, among young people with depression, the specific factors that contribute to changes in suicidal ideation over time are uncertain. Factors other than depressive symptom severity, such as comorbid psychopathology and personality traits, might be important contributors. Our aim was to identify contributors to fluctuations in suicidal ideation severity over a 12-week period in young people with major depressive disorder receiving cognitive behavioural therapy. METHODS Data were drawn from two 12-week randomised, placebo-controlled treatment trials. Participants (N = 283) were 15-25 years old, with moderate to severe major depressive disorder. The primary outcome measure was the Suicidal Ideation Questionnaire, administered at baseline and weeks 4, 8 and 12. A series of linear mixed models was conducted to examine the relationship between Suicidal Ideation Questionnaire score and demographic characteristics, comorbid psychopathology, personality traits and alcohol use. RESULTS Depression and anxiety symptom severity, and trait anxiety, independently predicted higher suicidal ideation, after adjusting for the effects of time, demographics, affective instability, non-suicidal self-injury and alcohol use. CONCLUSIONS Both state and trait anxiety are important longitudinal correlates of suicidal ideation in depressed young people receiving cognitive behavioural therapy, independent of depression severity. Reducing acute psychological distress, through reducing depression and anxiety symptom severity, is important, but interventions aimed at treating trait anxiety could also potentially be an effective intervention approach for suicidal ideation in young people with depression.
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Affiliation(s)
- Carl I Moller
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul B Badcock
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah E Hetrick
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Simon Rice
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Katrina Witt
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew M Chanen
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Olivia M Dean
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Caroline Gao
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sue M Cotton
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G Davey
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
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14
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Huang X, Liu H, Lan Z, Deng F. The Effect of Loneliness on Non-Suicidal Self-Injury Behavior in Chinese Junior High School Adolescents: A Moderated Mediation Model. Psychol Res Behav Manag 2023; 16:1831-1843. [PMID: 37215700 PMCID: PMC10199677 DOI: 10.2147/prbm.s410535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose This study explore the interaction between loneliness and non-suicidal self-injury behaviors (hereinafter "NSSI"), and to further examine the mediating role of self-control and the moderating role of social connection. Methods A total of 414 junior high school students (age 14.05±0.84) in Sichuan province in China were investigated on their loneliness, self-control, social connection and NSSI by questionnaire. Results (1) there was a significant positive correlation between loneliness and NSSI; (2) self-control played a mediating role in the relationship between loneliness and NSSI; and (3) after controlling for gender, family structure, and family economic level, the social connectedness played a moderating role in the relationship between loneliness and NSSI, as well as between self-control and NSSI. Conclusion The results verify the relationship between loneliness and NSSI, expands and deepens the internal logical relationship between them, and provides a reference that can be used in the future for the prevention and intervention of NSSI in adolescents.
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Affiliation(s)
- Xuefang Huang
- School of Teacher Education, Hechi University, Yizhou, 546300, People’s Republic of China
| | - Huaqiang Liu
- School of Law and Public Administration, Yibin University, Yibin, 644000, People’s Republic of China
| | - Zhensong Lan
- School of Public Administrations, Hechi University, Yizhou, 546300, People’s Republic of China
| | - Fafang Deng
- School of Public Administrations, Hechi University, Yizhou, 546300, People’s Republic of China
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15
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Donnelly HK, Han Y, Kim S, Lee DH. Predictors of suicide ideation among South Korean adolescents: A machine learning approach. J Affect Disord 2023; 329:557-565. [PMID: 36828148 DOI: 10.1016/j.jad.2023.02.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND The current study developed a predictive model for suicide ideation among South Korean (Korean) adolescents using a comprehensive set of factors across demographic, physical and mental health, academic, social, and behavioral domains. The aim of this study was to address the pressing public health concerns of adolescent suicide in Korea and the methodological limitations of suicidal research. METHODS This study used machine learning methods (decision tree, logistic regression, naive Bayes classifier) to improve the accuracy of predicting suicidal ideation and related factors among a nationally representative sample of Korean middle school students (N = 6666). RESULTS Factors within all domains, including demographic characteristics, physical and mental health, and academic, social, and behavioral, were important in predicting suicidal thoughts among Korean adolescents, with mental health being the most important factor. LIMITATIONS The predictive model of the current research does not infer causality, and there may have been some loss of information due to measurement issues. CONCLUSIONS Study results provide insights for taking a multidimensional approach when identifying adolescents at risk of suicide, which may be used to further address their needs through intervention programs within the school setting. Considering the cultural stigma attached to disclosing suicidal ideation and behavior, the current study proposes the need for a preventive screening process based on the observation and assessment of adolescents' general characteristics and experiences in everyday life.
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Affiliation(s)
- Hayoung Kim Donnelly
- Boston University, Department of Counseling Psychology and Applied Human Development, USA.
| | - Yoonsun Han
- Seoul National University, Department of Social Welfare, South Korea.
| | - Suna Kim
- Seoul National University, Department of International Studies, South Korea.
| | - Dong Hun Lee
- Sungkyunkwan University, Traumatic Stress Center, Department of Education, South Korea.
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Altavini CS, Asciutti APR, Santana GL, Solis ACO, Andrade LH, Oliveira LG, Andrade AG, Gorenstein C, Wang YP. Suicide ideation among Brazilian college students: Relationship with academic factors, mental health, and sexual abuse. J Affect Disord 2023; 329:324-334. [PMID: 36849006 DOI: 10.1016/j.jad.2023.02.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Suicide is one of the leading causes of death among youth and its occurrence among college students is a matter of great concern. Challenges of transitional adulting and mental illness increase the likelihood of suicidal cognition in students. The objective of present study was to investigate the prevalence of suicide ideation and associated factors in a representative sample of Brazilian college students (n = 12,245). METHODS Data were drawn from a nationwide survey and further subjected to estimate the prevalence of suicide ideation and its association with socio-demographic and academic characteristics. We performed logistic regression analyses upon a conceptual framework, considering individual and academic factors. RESULTS The point-prevalence of suicide ideation among college students was 5.9 % (SE = 0.37). In the final regression model, variables associated with the likelihood of suicide ideation were psychopathology, sexual abuse, and academic variables, such as dissatisfaction with the chosen undergraduate course (OR = 1.86; IC95 % 1.43-2.41) and low academic performance (OR = 3.56; IC95 % 1.69-7.48). Having children and religious affiliation were inversely associated with the likelihood of suicide ideation. LIMITATIONS Participants were recruited from state capitals, which limited data generalizability to non-urban college students. CONCLUSIONS The impact of academic life on the mental health of students should be carefully monitored in in-campus pedagogical and health services. Early identification of poor-performance students with social disadvantages could indicate vulnerable ones who are much in need of psycho-social support.
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Affiliation(s)
- Camila Siebert Altavini
- Instituto & Departamento de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Centro de Atendimento e Estudos Psicológicos, Instituto de Psicologia, Universidade de Brasilia, Brasilia, DF, Brazil
| | - Antônio Paulo Rinaldi Asciutti
- Instituto & Departamento de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Geilson Lima Santana
- Instituto & Departamento de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ana Cristina Oliveira Solis
- Instituto & Departamento de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Laura Helena Andrade
- Instituto & Departamento de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | - Arthur Guerra Andrade
- Instituto & Departamento de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Faculdade de Medicina, Fundacao do ABC, Santo Andre, SP, Brazil
| | - Clarice Gorenstein
- Instituto & Departamento de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Instituto de Ciencias Biomedicas, Universidade Sao Paulo, Sao Paulo, SP, Brazil
| | - Yuan-Pang Wang
- Instituto & Departamento de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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McAllister J, Skinner J, Hayhow R, Heron J, Wren Y. The Association Between Atypical Speech Development and Adolescent Self-Harm. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1600-1617. [PMID: 37080239 PMCID: PMC10457079 DOI: 10.1044/2023_jslhr-21-00652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 06/09/2022] [Accepted: 02/06/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Adolescent self-harm is a major public health issue internationally. Various factors associated with adolescent self-harm have been identified, including being bullied and experiencing mental health problems. Stuttering and speech sound disorder are associated with both of these factors. It was hypothesized that both stuttering and speech sound disorder would be associated with self-harm. This is the first study to explore the relationship between communication disorders and adolescent self-harm. METHOD Secondary analysis of a large, longitudinal, prospective, community sample, the Avon Longitudinal Study of Parents and Children, was carried out. Clinicians identified children who stuttered or exhibited speech sound disorder at the age of 8 years. When the cohort members were 16 years old, they were asked to complete a questionnaire about self-harm. Multinomial logistic regression was used to examine the associations between stuttering and speech sound disorder and the self-harm outcomes, adjusting for other relevant factors. RESULTS Of 3,824 participants with data for both speech status and self-harm, 94 (2.5%; 95% confidence interval [CI; 2.0, 3.0]) stuttered at 8 years of age and 127 (3.3%; 95% CI [2.8, 3.9]) displayed speech sound disorder. Speech sound disorder at the age of 8 years was associated with self-harm with suicidal intent in both unadjusted and adjusted models. Differences between the adjusted and unadjusted models were small, suggesting that speech sound disorder is largely an independent risk factor for self-harm with suicidal intent. Stuttering at the age of 8 years was not associated with adolescent self-harm, and there was no association between speech sound disorder and self-harm without suicidal intent. CONCLUSION Compared with individuals without speech sound disorder, adolescents with speech sound disorder at the age of 8 years have twice the risk of reporting self-harm with suicidal intent, even when other important predictors are taken into account. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22573030.
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Affiliation(s)
- Jan McAllister
- School of Health and Social Care, University of Essex, Colchester, United Kingdom
| | - Jane Skinner
- Norwich Medical School, University of East Anglia, United Kingdom
| | - Rosemarie Hayhow
- Bristol Speech & Language Therapy Research Unit, North Bristol NHS Trust, United Kingdom
| | - Jon Heron
- Bristol School of Medicine,University of Bristol, United Kingdom
| | - Yvonne Wren
- Bristol Speech & Language Therapy Research Unit, North Bristol NHS Trust, United Kingdom
- Bristol Dental School, University of Bristol, United Kingdom
- Cardiff Metropolitan University, United Kingdom
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18
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Pitkänen J, Remes H, Aaltonen M, Martikainen P. Moderating role of sociodemographic factors in parental psychiatric treatment before and after offspring severe self-harm. J Affect Disord 2023; 327:145-154. [PMID: 36758868 DOI: 10.1016/j.jad.2023.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Parental psychiatric disorders are known risk factors for adolescent self-harm. Although this association is likely to have a bidirectional element, evidence on changes in parental psychiatric treatment following offspring self-harm is scarce. METHODS Finnish children born in 1987-1996 with a hospital-treated episode of self-harm between the ages 13 and 19 years (N = 3636) were identified using administrative register data, and their biological mothers (N = 3432) and fathers (N = 3167) were followed two years before and after the episode. Data on purchases of psychotropic medication, specialized psychiatric treatment and psychiatric sickness allowances were used to examine psychiatric treatment among parents. Differences by parental education, employment and living arrangements were assessed, and offspring self-harm was compared with offspring accidental poisonings and traffic accidents. RESULTS Psychiatric treatment peaked among mothers during the three-month period after offspring self-harm, after which the treatment prevalence decreased but remained slightly elevated relative to the time preceding offspring self-harm. Higher levels of education and being employed increased the likelihood of treatment right after the episode. Among fathers, changes in treatment were negligible. Treatment trajectories around the comparison events of accidents were similar in shape but more muted than among the parents whose children had self-harmed. LIMITATIONS General practitioner visits or other data from primary health care were not available. CONCLUSION Mothers receive increased psychiatric treatment after stressful offspring events. Our results indicate that prevention of self-harm and accidents would be beneficial not only for those directly concerned but also for their family members.
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Affiliation(s)
- Joonas Pitkänen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland; International Max Planck Research School for Population, Health and Data Science, Rostock, Germany.
| | - Hanna Remes
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland
| | - Mikko Aaltonen
- Institute of Criminology and Legal Policy, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland; Law School, University of Eastern Finland, Joensuu, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland; Max Planck Institute for Demographic Research, Rostock, Germany; Department of Public Health Sciences, Stockholm University, Sweden
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Liverpool S, Draoui Y, Tucker J, Pereira B, Prescod J, Owen M, Trotman C. Factors associated with children and young people's mental health in the English-speaking Caribbean region: Systematic review and narrative synthesis. PLoS One 2023; 18:e0282666. [PMID: 36888635 PMCID: PMC9994705 DOI: 10.1371/journal.pone.0282666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Studies conducted in regions consisting of low and middle income and developing countries often report high prevalence of mental health problems among children and young people (CYP). To identify some of the contributing factors we examined the available evidence from research in one such setting. METHODS Multiple academic databases and grey literature sources were searched until January 2022. We then identified primary research focusing on CYP's mental health in the English-speaking Caribbean region. Data was extracted and summarized to form a narrative synthesis of the factors associated with CYP's mental health. The synthesis was then organised according to the social-ecological model. The Joanna Briggs Institute's critical appraisal tools were used to examine the quality of the reviewed evidence. The study protocol was registered with PROSPERO, CRD42021283161. RESULTS From 9684 records, 83 publications representing CYP ages 3 to 24 years from 13 countries met our inclusion criteria. The evidence was varied in quality, quantity and consistency for 21 factors associated with CYP's mental health. Adverse events and negative peer to peer and sibling relationships were consistently associated with mental health problems, while helpful coping strategies were associated with better mental health. There were mixed findings for age, sex/gender, race/ethnicity, academic level, comorbidity, positive affect, health risks behaviours, religion/prayer, parent history, parent to parent and parent to child relationships, school/employment, geography and social status. There was also some limited evidence for associations between sexuality, screen time and policies/procedures and CYP's mental health. At least 40% of the evidence contributing to each of the factors was judged as high quality. CONCLUSION Individual, relationship, community and societal factors may influence CYP's mental health outcomes in the English-speaking Caribbean. Knowledge of these factors is useful to inform early identification and early interventions. More research is needed to explore inconsistent findings and understudied areas.
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Affiliation(s)
- Shaun Liverpool
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Yasmin Draoui
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Judea Tucker
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Brent Pereira
- Department of Counselor Education, The Chicago School of Professional Psychology, Chicago, IL, United States of America
| | - Jamal Prescod
- Faculty of Social Sciences, University of the West Indies, Cave Hill, St Michael, Barbados
| | - Michael Owen
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Catherine Trotman
- Faculty of Social Sciences, University of the West Indies, Cave Hill, St Michael, Barbados
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Zhang N, Sandler I, Tein JY, Wolchik S. Reducing suicide risk in parentally bereaved youth through promoting effective parenting: testing a developmental cascade model. Dev Psychopathol 2023; 35:433-446. [PMID: 34872628 PMCID: PMC9170840 DOI: 10.1017/s0954579421001474] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Children who experience parental death are at increased risk for suicide. The Family Bereavement Program (FBP) is an upstream preventive intervention for parentally bereaved families that was found to reduce suicide risk in parentally bereaved youth up to 6 and 15 years later. We tested whether FBP-induced improvements in effective parenting led to changes in multiple proximal factors that prior theory and research implicated in the cascading pathway to suicide risk, namely, aversive self-views, caregiver connectedness, peer connectedness, complicated grief, depressive symptoms, and emotion suppression. The sample was 244 bereaved youth and their surviving caregiver from 156 families. Families were randomized into the FBP (12 group-based sessions for parents, youth, and two joint sessions) or a literature control condition. Multimethod and multiinformant data were collected at baseline, posttest, 6-year and 15-year follow-up assessments. Results showed that program-induced improvements in effective parenting at posttest were associated with reduced aversive self-views and increased caregiver connectedness at the 6-year follow-up, and each mediator was in turn associated with reduced suicide risk at the 6- and 15-year follow-up. The mediated pathways via aversive self-views remained significant while controlling for caregiver connectedness. Self-related concepts may be important targets in upstream suicide prevention for at-risk youth.
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Affiliation(s)
- Na Zhang
- Department of Human Development and Family Sciences, University of Connecticut, Stamford, CT, USA
| | - Irwin Sandler
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Jenn-Yun Tein
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Sharlene Wolchik
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
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Ashworth E, Jarman I, McCabe P, McCarthy M, Provazza S, Crosbie V, Quigg Z, Saini P. Suicidal Crisis among Children and Young People: Associations with Adverse Childhood Experiences and Socio-Demographic Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1251. [PMID: 36674021 PMCID: PMC9858613 DOI: 10.3390/ijerph20021251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Suicide is a major public health issue and a leading cause of death among children and young people (CYP) worldwide. There is strong evidence linking adverse childhood experiences (ACEs) to an increased risk of suicidal behaviours in adults, but there is limited understanding regarding ACEs and suicidal crises in CYP. This study aims to examine the ACEs associated with CYP presenting at Emergency Departments for suicidal crises, and specifically the factors associated with repeat attendances. This is a case series study of CYP (aged 8-16) experiencing suicidal crisis who presented in a paediatric Emergency Department in England between March 2019 and March 2021 (n = 240). The dataset was subjected to conditional independence graphical analysis. Results revealed a significant association between suicidal crisis and several ACEs. Specifically, evidence of clusters of ACE variables suggests two distinct groups of CYP associated with experiencing a suicidal crisis: those experiencing "household risk" and those experiencing "parental risk". Female sex, history of self-harm, mental health difficulties, and previous input from mental health services were also associated with repeat hospital attendances. Findings have implications for early identification of and intervention with children who may be at a heightened risk for ACEs and associated suicidal crises.
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Affiliation(s)
- Emma Ashworth
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Ian Jarman
- Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Philippa McCabe
- Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Molly McCarthy
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Serena Provazza
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Vivienne Crosbie
- Alder Hey Children’s NHS Foundation Trust, Liverpool L14 5AB, UK
| | - Zara Quigg
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Pooja Saini
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
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22
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Rodríguez-Otero JE, Campos-Mouriño X, Meilán-Fernández D, Pintos-Bailón S, Cabo-Escribano G. Where is the social in the biopsychosocial model of suicide prevention? Int J Soc Psychiatry 2022; 68:1403-1410. [PMID: 34533396 DOI: 10.1177/00207640211027210] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Each year, around 800,000 people die by suicide. The prevalence of suicidal behaviors is much higher when suicidal attempts and persistent self-injurious ideation are included. Therefore, suicide is a public health concern. Research has been sensitive to this problem, deepening the study of risk factors and the development of theoretical frameworks of suicidal behavior, with the aim of generating effective suicide prevention policies around the biopsychosocial model. AIM We aimed to explore the role of relational, community, and social factors in current suicide prevention strategies. METHOD Studies of risk and protective factors for suicidal behavior and the consequent development of theoretical frameworks were reviewed to verify if this knowledge was really used in suicide prevention policies. RESULTS Studies of risk and protective factors focus mainly on the individual, while theoretical frameworks emphasize the role of the relational, community, and social. Suicide prevention strategies more closely follow individual models derived from studies of risk factors. CONCLUSIONS Suicide prevention strategies should broaden their individual narrative to include relational, community, and social interventions as anti-suicide measures.
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Affiliation(s)
- José Eduardo Rodríguez-Otero
- Suicide Prevention Unit, Psychiatry Service, Galician Health Service SERGAS, South Galicia Health Research Institute - Instituto de Investigación Sanitaria Galicia Sur, CIBERSAM, Vigo, Spain
| | - Xiana Campos-Mouriño
- Suicide Prevention Unit, Psychiatry Service, Galician Health Service SERGAS, South Galicia Health Research Institute - Instituto de Investigación Sanitaria Galicia Sur, CIBERSAM, Vigo, Spain
| | - David Meilán-Fernández
- Suicide Prevention Unit, Psychiatry Service, Galician Health Service SERGAS, South Galicia Health Research Institute - Instituto de Investigación Sanitaria Galicia Sur, CIBERSAM, Vigo, Spain
| | - Sarai Pintos-Bailón
- Suicide Prevention Unit, Psychiatry Service, Galician Health Service SERGAS, South Galicia Health Research Institute - Instituto de Investigación Sanitaria Galicia Sur, CIBERSAM, Vigo, Spain
| | - Graciela Cabo-Escribano
- Suicide Prevention Unit, Psychiatry Service, Galician Health Service SERGAS, South Galicia Health Research Institute - Instituto de Investigación Sanitaria Galicia Sur, CIBERSAM, Vigo, Spain
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23
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Özlü-Erkilic Z, Diehm R, Wenzel T, Bingöl Ҫağlayan RH, Güneş H, Üneri ÖŞ, Winter S, Akkaya-Kalayci T. Transcultural differences in suicide attempts among children and adolescents with and without migration background, a multicentre study: in Vienna, Berlin, Istanbul. Eur Child Adolesc Psychiatry 2022; 31:1671-1683. [PMID: 34050830 PMCID: PMC9666344 DOI: 10.1007/s00787-021-01805-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
While suicide can occur throughout the lifespan, worldwide suicide is the second leading cause of death among young people aged between 15 and 29 years. The aim of this multicentre study, conducted in Austria, Germany and Turkey, is to investigate the transcultural differences of suicide attempts among children and adolescents with and without migration background. The present study is a retrospective analyses of the records of 247 young people, who were admitted after a suicide attempt to Emergency Outpatient Clinics of Departments of Child and Adolescent Psychiatry of the collaborating Universities including Medical University of Vienna, Charité University Medicine Berlin and Cerrahpaşa School of Medicine and Bakirkoy Training and Research Hospital for Mental Health in Istanbul over a 3-year period. The results of the present study show significant transcultural differences between minors with and without migration background in regard to triggering reasons, method of suicide attempts and psychiatric diagnosis. The trigger event "intra-familial conflicts" and the use of "low-risk methods" for their suicide attempt were more frequent among patients with migration background. Moreover among native parents living in Vienna and Berlin divorce of parents were more frequent compared to parents living in Istanbul and migrants in Vienna. These results can be partly explained by cultural differences between migrants and host society. Also disadvantages in socio-economic situations of migrants and their poorer access to the healthcare system can mostly lead to acute and delayed treatments. Larger longitudinal studies are needed to understand better the impact of migration on the suicidal behaviour of young people.
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Affiliation(s)
- Zeliha Özlü-Erkilic
- Department of Child and Adolescent Psychiatry, Outpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Robert Diehm
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Thomas Wenzel
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - R Hülya Bingöl Ҫağlayan
- Department of Child and Adolescents Psychiatry, Cerrahpaşa School of Medicine, İstanbul University-Cerrahpaşa, Kocamustafapasa Cd. No: 53, Fatih, Istanbul, Turkey
| | - Hatice Güneş
- Department of Psychology, İstanbul Gelisim University, Cihangir Mahallesi Şehit Jandarma Komando Er Hakan Oner Sk. No:1, Avcilar, Istanbul, Turkey
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Zuhuratbaba Mah. Dr Tevfik Sağlam Cad. No:25/2, Bakirköy, Istanbul, Turkey
| | - Özden Şükran Üneri
- Department of Child and Adolescents Psychiatry, Ankara City Hospital, AYBÜ Ankara Şehir Hastanesi Çocuk Hastanesi 06800 Bilkent, Ankara, Turkey
| | - Sibylle Winter
- Departement of Child and Adolescent Psychiatry, Psychsomatics and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Virchow, Augustenbruger Platz 1, 13353, Berlin, Germany
| | - Türkan Akkaya-Kalayci
- Department of Child and Adolescent Psychiatry, Outpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
- Postgraduate University Program Transcultural Medicine and Diversity Care, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
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24
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Zhu S, Wong PWC. What matters for adolescent suicidality: Depressive symptoms or fixed mindsets? Examination of cross-sectional and longitudinal associations between fixed mindsets and suicidal ideation. Suicide Life Threat Behav 2022; 52:932-942. [PMID: 35686883 PMCID: PMC9796128 DOI: 10.1111/sltb.12891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 04/07/2022] [Accepted: 05/18/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Fixed mindsets or beliefs about the non-malleability of self-attributes are linked to a wide range of negative psychological outcomes. Its association with suicidal ideation (SI) among young people has not been explored. OBJECTIVES To examine the association of fixed mindsets of depression, anxiety, and stress and SI; and its mediating role underlying the association between depression and SI. METHODS A sample of 1393 adolescents (Mage = 13.04, SD = 0.85, 640 boys) from 11 middle schools voluntarily participated in a two-wave longitudinal study before and during the COVID-19 pandemic with a 9-month interval. RESULTS Both depressive symptoms and fixed mindsets were positively and significantly associated with concurrent and future suicidality, after controlling for demographic and socioeconomic status and previous SI. Participants with stronger fixed mindsets were more likely to have SI than those with only depressive symptoms. Also, fixed mindsets mediated the association between depressive symptoms and SI in both cross-sectional and longitudinal models. CONCLUSION The current study provides empirical evidence of the effects of fixed mindsets and SI and the mediating role of fixed mindset between depressive symptoms and SI among young people. Interventions to foster a growth mindset may enhance hope and reduce suicidality among adolescents.
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Affiliation(s)
- Shimin Zhu
- Department of Applied Social SciencesThe Hong Kong Polytechnic UniversityKowloonHong Kong SARChina
| | - Paul W. C. Wong
- Department of Social Work and Social AdministrationThe University of Hong KongHong KongChina
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25
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Hornor G, Tucker S. Child Sexual Abuse and Suicide: Essentials for the Forensic Nurse. JOURNAL OF FORENSIC NURSING 2022; 18:237-246. [PMID: 35704502 DOI: 10.1097/jfn.0000000000000394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sexual abuse can result in significant negative sequelae for victims. One particularly harmful consequence is suicidal ideation, which can lead to suicide attempts and even death. It is essential to screen children and adolescents for suicidal ideation when providing medical forensic care after disclosure of acute or nonacute sexual abuse/assault. Forensic nurses must feel confident in their abilities to assess suicide risk and provide appropriate intervention and referrals. A thorough understanding of the relationship between sexual abuse and suicidal ideation and behaviors can assist the forensic nurse in the development of practice behaviors to better identify, intervene, and prevent suicidal ideation and behaviors among youth experiencing sexual abuse.
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Affiliation(s)
- Gail Hornor
- Author Affiliations: International Association of Forensic Nurses
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26
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Geulayov G, Mansfield K, Jindra C, Hawton K, Fazel M. Loneliness and self-harm in adolescents during the first national COVID-19 lockdown: results from a survey of 10,000 secondary school pupils in England. CURRENT PSYCHOLOGY 2022:1-12. [PMID: 36124048 PMCID: PMC9476392 DOI: 10.1007/s12144-022-03651-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 12/02/2022]
Abstract
Adolescents' loneliness and self-harm have received considerable attention during the COVID-19 pandemic with concerns that the socioecological changes taking place would contribute to an escalation of both loneliness and self-harm. However, empirical evidence is scant. We estimated the prevalence of loneliness and self-harm in adolescent school pupils and investigated the association of loneliness and change in loneliness during the UK's first lockdown with self-harm during lockdown in a cross-sectional school survey (OxWell) involving 10,460 12-18-year-olds from south England. Loneliness was measured with four items. Self-harm was ascertained through a detailed questionnaire. The prevalence of loneliness and self-harm were estimated applying post-stratification weights to account for differences between the study sample and the target population. The associations between indicators of loneliness and self-harm were examined using mixed effect models. 1,896 of 10,460 adolescents (18.1%) reported feeling lonely 'often' (weighted proportion 16.8%). 3,802/10,460 (36.4%; weighted proportion 35%) felt more lonely since lockdown. Self-harm during lockdown was reported by 787/10,460 adolescents (7.5%; weighted proportion 6.7%). Controlling for confounders, adolescents who reported feeling lonely 'often' [adjusted odds ratio (aOR) 2.8, 95% CI 2.1-3.9, p < 0.0001] or 'sometimes' (aOR 2.2, 95% CI 1.5-3.2, p < 0.0001) were more likely to self-harm during lockdown relative to adolescents who reported 'never' or 'hardly ever' feeling lonely. Exacerbation in loneliness during lockdown was associated with an increase in the odds of self-harm during lockdown. Loneliness, heightened loneliness and self-harm were common during lockdown and closely linked. It is important to support schools in address loneliness and self-harm as part of efforts to improve well-being as the long tail of the pandemic continues to impact on child and adolescent mental health. Understanding how loneliness and self-harm may co-vary could be important for future self-harm reduction strategies in young persons. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-03651-5.
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Affiliation(s)
- Galit Geulayov
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Karen Mansfield
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Christoph Jindra
- Institute for Educational Quality Improvement, Humboldt University, Berlin, Germany
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Mina Fazel
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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27
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Yin X, Shen J, Jiang N, Sun J, Wang Y, Sun H. Relationship of explicit/implicit self-esteem discrepancies, suicide ideation, and suicide risk in patients with major depressive disorder. Psych J 2022; 11:936-944. [PMID: 35996046 DOI: 10.1002/pchj.580] [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: 06/21/2021] [Accepted: 04/25/2022] [Indexed: 11/10/2022]
Abstract
The present study was conducted to explore the associations between explicit self-esteem (ESE), implicit self-esteem (ISE), ESE/ISE discrepancies, depression severity, suicidal ideation (SI), and suicide risk among patients with major depressive disorder (MDD). To this end, 36 MDD patients with SI, 35 MDD patients without SI, and 32 healthy controls were recruited. All participants were interviewed using the Mini International Neuropsychiatric Interview (MINI), and they also completed the Beck Depression Inventory (BDI). The Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) and the Rosenberg Self-Esteem Scale (SES) were used for the analysis. Further, the Implicit Association Test (IAT) was conducted to assess participants' ISE. The study revealed significant differences in ESE among the three groups, F(2, 90) = 44.88, p < .001. In particular, the group of MDD patients with SI had the lowest score. The interaction between the size and direction of ESE/ISE discrepancy was associated with depression severity, β = -.50, p = .004, and SI, β = -.39, p = .045. Among the four types of self-esteem, individuals with diminished self-esteem had the highest SI score whereas individuals with low congruent self-esteem had the highest suicide risk score. Based on these findings, the study suggested that diminished self-esteem could help in the early detection of depression and SI. Low-congruent self-esteem may also be considered a screening factor for suicide risk.
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Affiliation(s)
- Xunbao Yin
- Weifang University, Weifang, China.,School of Psychology, Weifang Medical University, Weifang, China
| | - Jianfei Shen
- School of Psychology, Weifang Medical University, Weifang, China
| | - Nengzhi Jiang
- School of Psychology, Weifang Medical University, Weifang, China
| | - Jing Sun
- School of Psychology, Weifang Medical University, Weifang, China
| | - Yanyu Wang
- School of Psychology, Weifang Medical University, Weifang, China
| | - Hongwei Sun
- School of Psychology, Weifang Medical University, Weifang, China
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28
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Moller CI, Davey CG, Badcock PB, Wrobel AL, Cao A, Murrihy S, Sharmin S, Cotton SM. Correlates of suicidality in young people with depressive disorders: A systematic review. Aust N Z J Psychiatry 2022; 56:910-948. [PMID: 35362327 DOI: 10.1177/00048674221086498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Depression is one of the most prevalent and disabling mental health conditions among young people worldwide. The health and economic burdens associated with depressive illness are substantial. Suicide and depression are closely intertwined, yet a diagnosis of depression itself lacks predictive specificity for suicidal behaviour. To better inform suicide prevention and early intervention strategies for young people, improved identification of modifiable intervention targets is needed. The objective of this review was to identify clinical, psychosocial and biological correlates of suicidality in young people diagnosed with a broad range of unipolar and bipolar depressive disorders. METHOD Systematic searches were conducted across MEDLINE, Embase and PsycINFO to identify studies of young people aged 15-25 years diagnosed with unipolar or bipolar depressive disorders. An assessment of suicidality was required for inclusion. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Synthesis Without Meta-analysis guidelines. RESULTS We integrated findings from 71 studies including approximately 24,670 young people with clinically diagnosed depression. We identified 26 clinical, psychosocial and biological correlates of suicidality. Depression characteristics (type and severity), psychiatric comorbidity (particularly anxiety and substance use disorders) and neurological characteristics emerged as having the most evidence for being associated with suicidal outcomes. Our ability to pool data and conduct meaningful quantitative synthesis was hampered by substantial heterogeneity across studies and incomplete reporting; thus, meta-analysis was not possible. CONCLUSION Findings of this review reinforce the notion that suicidality is a complex phenomenon arising from the interplay of multiple contributing factors. Our findings question the utility of considering a diagnosis of depression as a specific risk factor for suicidality in young people. Suicidality itself is transdiagnostic; adoption of a transdiagnostic approach to investigating its aetiology and treatment is perhaps warranted. Future research investigating specific symptoms, or symptom networks, might help to further our understanding of suicidality among young people experiencing mental illness.
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Affiliation(s)
- Carl I Moller
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G Davey
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Paul B Badcock
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Anna L Wrobel
- Orygen, The University of Melbourne, Parkville, VIC, Australia
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Alice Cao
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sean Murrihy
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
| | - Sonia Sharmin
- Department of Occupational Therapy, Social Work and Social Policy, La Trobe University, Bundoora, VIC, Australia
- Research and Evaluation, Take Two, Berry Street, Eaglemont, VIC, Australia
- Department of Public Health, Torrens University Australia, Melbourne, VIC, Australia
| | - Sue M Cotton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
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29
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Lee MS, Jhone JH, Kim JB, Kweon YS, Hong HJ. Characteristics of Korean Children and Adolescents Who Die by Suicide Based on Teachers' Reports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116812. [PMID: 35682396 PMCID: PMC9180601 DOI: 10.3390/ijerph19116812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 02/01/2023]
Abstract
We analyzed the clinical characteristics and suicide-related factors of students who died by suicide in Korea in 2016–2020, based on teachers’ reports. Using data on total suicide deaths (N = 654, mean age = 16.0, 52.6% boys) collected by the Ministry of Education of Korea, we investigated the demographic and clinical characteristics and suicide-related factors of suicide deaths in students aged 9–18 years. Considering gender, more boys (52.6%, N = 344) died by suicide than girls (47.4%, N = 310). About 425 (65.0%) of the suicides were among high school students. The most common suicide method was jumping from a high place (70.6%, N = 454), followed by hanging (25.7%, N = 165). Additionally, 9.4% (N = 48) of the students who died by suicide had a history of attempted suicide, 13.4% (N = 73) had attempted self-harm, and 12.8% (N = 48) were acquainted with someone who had died by suicide. Teachers observed 20.6% (N = 120) of the suicide warning signs at school. Girls tended to have higher rates of attempted suicide, emotional problems, and psychiatric disorders than boys. This study was conducted with the largest sample of Korean suicide students observed at school. Effective suicide-related mental health training for teachers could contribute to suicide prevention in students.
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Affiliation(s)
- Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Jin Ho Jhone
- Department of Social Welfare, Soongsil University, Seoul 06978, Korea;
| | - Joon Beom Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Korea;
| | - Yong-Sil Kweon
- Department of Psychiatry, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Hyun Ju Hong
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
- Suicide and School Mental Health Institute, Hallym University, Anyang 14068, Korea
- Correspondence: ; Tel.: +82-31-380-3750
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30
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Diamond GM, Boruchovitz‐Zamir R, Nir‐Gotlieb O, Gat I, Bar‐Kalifa E, Fitoussi P, Katz S. Attachment-based family therapy for sexual and gender minority young adults and their nonaccepting parents. FAMILY PROCESS 2022; 61:530-548. [PMID: 35362553 PMCID: PMC9325072 DOI: 10.1111/famp.12770] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 05/26/2023]
Abstract
This pilot open trial examined the efficacy of attachment-based family therapy (ABFT) for Israeli sexual and gender minority (SGM) young adults and their persistently nonaccepting parents. Thirty families received up to 26 weeks of treatment, with parental rejection, parental acceptance, and young adults' attachment avoidance and attachment anxiety assessed at baseline, 8, 16, 24, and 36 weeks (three months post-treatment). Analyses using multilevel growth models revealed that both young adults and their mothers independently reported increases in mothers' acceptance of their young adult's same-sex orientation or noncisgender identity. In addition, young adults reported decreases in both parents' levels of rejection. Also, mothers, but not fathers, reported decreases in their own level of rejection. Finally, young adults reported a decrease in attachment avoidance in their relationships with both mothers and fathers, but not a decrease in attachment anxiety. Importantly, these treatment gains were maintained three months after the end of treatment. Together, these results suggest that ABFT-SGM, a manualized, affirmative, experiential, family-based treatment, may be effective in reducing long-standing parental rejection, promoting parental acceptance, and improving the quality of LGBTQ+ young adults' relationships with their parents. These findings are encouraging in light of the urgent need for efficacious interventions to reduce family generated minority stress and promote safer, more supportive environments for sexual and gender minority people.
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Affiliation(s)
- Gary M. Diamond
- Department of PsychologyBen‐Gurion UniversityBeer‐ShevaIsrael
| | | | | | - Inbal Gat
- Department of PsychologyBen‐Gurion UniversityBeer‐ShevaIsrael
| | - Eran Bar‐Kalifa
- Department of PsychologyBen‐Gurion UniversityBeer‐ShevaIsrael
| | | | - Shira Katz
- Department of PsychologyBen‐Gurion UniversityBeer‐ShevaIsrael
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31
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Chen PJ, Mackes N, Sacchi C, Lawrence AJ, Ma X, Pollard R, Matter M, Morgan C, Harding S, Schumann G, Pariante C, Mehta MA, Montana G, Nosarti C, Dazzan P. Parental education and youth suicidal behaviours: a systematic review and meta-analysis. Epidemiol Psychiatr Sci 2022; 31:e19. [PMID: 35352676 PMCID: PMC8967699 DOI: 10.1017/s204579602200004x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 01/04/2023] Open
Abstract
AIMS Lower parental education has been linked to adverse youth mental health outcomes. However, the relationship between parental education and youth suicidal behaviours remains unclear. We explored the association between parental education and youth suicidal ideation and attempts, and examined whether sociocultural contexts moderate such associations. METHODS We conducted a systematic review and meta-analysis with a systematic literature search in PubMed, PsycINFO, Medline and Embase from 1900 to December 2020 for studies with participants aged 0-18, and provided quantitative data on the association between parental education and youth suicidal ideation and attempts (death included). Only articles published in English in peer-reviewed journals were considered. Two authors independently assessed eligibility of the articles. One author extracted data [e.g. number of cases and non-cases in each parental education level, effect sizes in forms of odds ratios (ORs) or beta coefficients]. We then calculated pooled ORs using a random-effects model and used moderator analysis to investigate heterogeneity. RESULTS We included a total of 59 articles (63 study samples, totalling 2 738 374 subjects) in the meta-analysis. Lower parental education was associated with youth suicidal attempts [OR = 1.12, 95% Confidence Interval (CI) = 1.04-1.21] but not with suicidal ideation (OR = 1.05, 95% CI = 0.98-1.12). Geographical region and country income level moderated the associations. Lower parental education was associated with an increased risk of youth suicidal attempts in Northern America (OR = 1.26, 95% CI = 1.10-1.45), but with a decreased risk in Eastern and South-Eastern Asia (OR = 0.72, 95% CI = 0.54-0.96). An association of lower parental education and increased risk of youth suicidal ideation was present in high- income countries (HICs) (OR = 1.14, 95% CI = 1.05-1.25), and absent in low- and middle-income countries (LMICs) (OR = 0.91, 95% CI = 0.77-1.08). CONCLUSIONS The association between youth suicidal behaviours and parental education seems to differ across geographical and economical contexts, suggesting that cultural, psychosocial or biological factors may play a role in explaining this association. Although there was high heterogeneity in the studies reviewed, this evidence suggests that the role of familial sociodemographic characteristics in youth suicidality may not be universal. This highlights the need to consider cultural, as well as familial factors in the clinical assessment and management of youth's suicidal behaviours in our increasingly multicultural societies, as well as in developing prevention and intervention strategies for youth suicide.
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Affiliation(s)
- P. J. Chen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan and Chang Gung University, Taoyuan, Taiwan
| | - N. Mackes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - C. Sacchi
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
| | - A. J. Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - X. Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - R. Pollard
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - M. Matter
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - C. Morgan
- Health Service & Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - S. Harding
- Division of Diabetes and Nutritional Sciences, King's College London, London, UK
| | - G. Schumann
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C. Pariante
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M. A. Mehta
- Department of Neuroimaging & Psychopharmacology, Centre of Neuroimaging Sciences, King's College London, London, UK
| | - G. Montana
- Department of Data Science, University of Warwick, Coventry, UK
| | - C. Nosarti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - P. Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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Depressive symptomatology and different dimensions of social support serially mediate the effect of negative automatic thoughts on suicidal ideation. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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May T, Younan R, Pilkington PD. Adolescent Maladaptive Schemas and Childhood Abuse and Neglect: A Systematic Review and Meta‐Analysis. Clin Psychol Psychother 2022; 29:1159-1171. [PMID: 35060262 PMCID: PMC9544896 DOI: 10.1002/cpp.2712] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Tamara May
- Department of PaediatricsMonash UniversityClaytonVictoriaAustralia
| | - Rita Younan
- Schema Therapy Institute of AustraliaEssendonVictoriaAustralia
| | - Pamela D. Pilkington
- School of Behavioural and Health SciencesAustralian Catholic UniversityFitzroyVictoriaAustralia
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Geulayov G, Casey D, Bale L, Brand F, Townsend E, Ness J, Rehman M, Waters K, Clements C, Farooq B, Kapur N, Hawton K. Self-harm in children 12 years and younger: characteristics and outcomes based on the Multicentre Study of Self-harm in England. Soc Psychiatry Psychiatr Epidemiol 2022; 57:139-148. [PMID: 34282487 PMCID: PMC8761160 DOI: 10.1007/s00127-021-02133-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Very little is known about self-harm in children. We describe the characteristics and outcomes of children under 13 years who presented following self-harm to five hospitals in England. METHODS We included children under 13 years who presented after self-harm to hospitals in the Multicentre Study of Self-harm in England. Information on patients' characteristics and method of self-harm was available through monitoring of self-harm in the hospitals. Area level of socioeconomic deprivation was based on the English Index of Multiple Deprivation (IMD). RESULTS 387 children aged 5-12 years presented to the study hospitals in 2000-2016, 39% of whom were 5-11 years. Boys outnumbered girls 2:1 at 5-10 years. The numbers of boys and girls were similar at age 11, while at 12 years there were 3.8 girls to every boy. The proportion of study children living in neighbourhoods ranked most deprived (43.4%) was twice the national average. 61.5% of children self-poisoned, 50.6% of them by ingesting analgesics. Of children who self-injured, 45.0% self-cut/stabbed, while 28.9% used hanging/asphyxiation. 32% of the children had a repeat hospital presentation for self-harm, 13.5% re-presented within a year. CONCLUSIONS Gender patterns of self-harm until age 11 years are different to those of adolescents, with a male preponderance, especially in 5-10 years, and hanging/suffocation being more common. The frequent use of self-poisoning in this age group highlights the need for public health messages to encourage safer household storage of medicines. Self-harm in children is strongly associated with socioeconomic deprivation; understanding the mechanisms involved could be important in effective prevention.
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Affiliation(s)
- Galit Geulayov
- Centre for Suicide Research, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
| | - Debbie Casey
- Centre for Suicide Research, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Liz Bale
- Centre for Suicide Research, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Fiona Brand
- Centre for Suicide Research, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK ,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK
| | - Jennifer Ness
- Centre for Self-Harm and Suicide Prevention Research, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Muzamal Rehman
- Centre for Self-Harm and Suicide Prevention Research, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Keith Waters
- Centre for Self-Harm and Suicide Prevention Research, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Caroline Clements
- Centre for Suicide Prevention, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Bushra Farooq
- Centre for Suicide Prevention, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Nav Kapur
- Centre for Suicide Prevention, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK ,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK ,Oxford Health NHS Foundation Trust, Oxford, UK
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Flores MW, Granados S, Cook BL. US trends in the association of suicide ideation/behaviors with marijuana use among adolescents ages 12-17 and differences by gender and race/ethnicity. Front Psychiatry 2022; 13:1057784. [PMID: 36684023 PMCID: PMC9849946 DOI: 10.3389/fpsyt.2022.1057784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/02/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In the US over the past decade, there has been a steady increase in marijuana use rates among adolescents, in part due to marijuana legalization laws. It is unknown whether these greater marijuana use rates are associated with rising rates of adolescent suicide ideation and behaviors (plan and attempt) or whether these associations differ by gender or race/ethnicity. OBJECTIVE To determine whether marijuana use is associated with suicide ideation/behaviors among adolescents and if differences exist by gender and race/ethnicity. MATERIALS AND METHODS Using the 2015-2019 National Surveys on Drug Use and Health, we assessed the relationship between marijuana use frequency and suicide ideation/behaviors among adolescents (12-17, n = 73,986). We also examined the association with marijuana use disorder (MUD) and assessed differences by gender and race/ethnicity. Marijuana use frequency in the past year was categorized as no use, non-weekly use, and weekly-plus use. We estimated multivariable logistic regression models, adjusting for sociodemographics, health status, common co-occurring behavioral health disorders, and criminal history. For interpretability, regression coefficients were converted into predicted probabilities using predictive margin methods. RESULTS In primary analyses, adolescents with non-weekly use and weekly-plus use had higher rates of any suicide ideation, 61.5% (+ 10.4 percentage-points; 95% CI: 7.0-13.8%) and 64.5% (+ 13.4 percentage-points; 95% CI: 9.1-17.7%), relative to no use (51.1%). Non-weekly and weekly-plus use was associated with higher rates of any suicide plan 58.2% (+ 11.8 percentage-points; 95% CI: 7.8-16.0%) and 59.0% (+ 12.6 percentage-points; 95% CI: 6.4-18.9%), and any suicide attempt, 42.0% (+ 11.6 percentage-points; 95% CI: 7.0-16.2%) and 47.3% (+ 16.9 percentage-points; 95% CI: 10.9-22.9%) compared to no use (46.4 and 30.4%, respectively). Similar results were found among adolescents with a MUD (all p < 0.05). Positive associations between marijuana use and suicide ideation/behaviors persisted among males and females as well as White, Black, and Latinx adolescents (all p < 0.05). CONCLUSION Between 2015 and 2019, suicide ideation/behaviors increased for adolescents that used marijuana. As marijuana is legalized in more states, public health efforts are needed to curb increases in marijuana use among adolescents and to better understand the causal linkages between marijuana use and suicide ideation/behaviors.
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Affiliation(s)
- Michael William Flores
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Saul Granados
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States
| | - Benjamin Lê Cook
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Romanelli M, Sheftall AH, Irsheid SB, Lindsey MA, Grogan TM. Factors Associated with Distinct Patterns of Suicidal Thoughts, Suicide Plans, and Suicide Attempts Among US Adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:73-84. [PMID: 34482517 PMCID: PMC8792183 DOI: 10.1007/s11121-021-01295-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 01/03/2023]
Abstract
The current study examined demographic, psychosocial, and substance use factors associated with distinct patterns of past 12-month suicide thoughts, plans, and attempts among adolescents drawn from a nationally representative sample of high schoolers. Data were from the 2015, 2017, and 2019 National Youth Risk Behavior Survey. Four mutually exclusive 12-month suicidal behavior patterns were identified: suicide thoughts only (pattern 1), suicide thoughts and plans without suicide attempt (pattern 2), suicide attempt with thoughts and/or plans (pattern 3), and suicide attempt without thoughts or plans (pattern 4). Multinomial logistic regression analyses were conducted to examine factors correlated with these distinct patterns. Psychosocial and substance use factors were modeled as independent predictors, controlling for demographic characteristics, as well as simultaneously to represent the potential for co-occurrence. The analytic sample included 7491 respondents. About 24% (n = 1734) of youth endorsed pattern 1, 38% (n = 2779) pattern 2, 35% (n = 2716) pattern 3, and 3% (n = 262) pattern 4. All psychosocial and substance use factors measured were individually associated with greater odds of suicide attempts with thoughts or plans (pattern 3) than patterns 1 or 2. Black and male youth were at greater odds of suicide attempts without thoughts or plans (pattern 4) than all other patterns. When modeled simultaneously, respondents who were bullied online, sad or hopeless, had a history of sexual violence, used cigarettes, and misused prescription opiates retained greater odds of suicide attempts with thoughts or plans (pattern 3) than patterns 1 or 2. Findings suggest screening for suicidal behaviors should include factors that differentiate between varying suicidal expressions and that may cue providers to intervene in the absence of suicide thoughts and plans.
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Affiliation(s)
- Meghan Romanelli
- School of Social Work, University of Washington, 4101 15th Avenue NE, WA, 98105-6250, Seattle, USA.
| | - Arielle H Sheftall
- Department of Pediatrics, Center for Suicide Prevention and Research, The Abigail Wexner Research Institute At Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sireen B Irsheid
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, USA
| | - Michael A Lindsey
- Silver School of Social Work, NYU McSilver Institute for Poverty Policy and Research, New York University, New York, NY, USA
| | - Tracy M Grogan
- NYU McSilver Institute for Poverty Policy and Research, New York, NY, USA
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Okado I, Floyd FJ, Goebert D, Sugimoto-Matsuda J, Hayashi K. Applying ideation-to-action theories to predict suicidal behavior among adolescents. J Affect Disord 2021; 295:1292-1300. [PMID: 34706443 DOI: 10.1016/j.jad.2021.08.137] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/31/2021] [Accepted: 08/27/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although many risk factors for adolescent suicidal behavior have been identified, less is known about distinct risk factors associated with the progression from suicide ideation to attempts. Based on theories grounded in the ideation-to-action framework, we used structural equation modeling to examine risk and protective factors associated with the escalation from suicide ideation to attempts in adolescents. METHODS In this cross-sectional study, data from the 2013 and 2015 Hawaii High School Youth Risk Behavior Surveys (N = 8,113) were analyzed. The sample was 54.0% female and racially/ethnically diverse. Risk factors included depression, victimization, self-harm, violent behavior, disinhibition, and hard substance use, and protective factors included adult support, sports participation, academic achievement and school safety. RESULTS One in 6 adolescents (16.4%) reported suicide ideation, and nearly 1 in 10 (9.8%) adolescents had made a suicide attempt. Overall, disinhibition predicted the escalation to attempts among adolescents with suicide ideation, and higher academic performance was associated with lower suicide attempt risk. Depression and victimization were associated with suicide ideation. LIMITATIONS This study examined data from the Youth Risk Behavior Survey, and other known risk factors such as anxiety and family history of suicide were not available in these data. CONCLUSIONS Findings provide guidance for targets for clinical interventions focused on suicide prevention. Programs that incorporate behavioral disinhibition may have the greatest potential for reducing suicide attempt risk in adolescents with suicidal thoughts.
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Affiliation(s)
- Izumi Okado
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States.
| | - Frank J Floyd
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Deborah Goebert
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Jeanelle Sugimoto-Matsuda
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Kentaro Hayashi
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
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Yeo JH, Kim EY, Kim MT. Association Between Timing of Sexual Initiation and Suicidal Ideation Among Adolescents in South Korea: A Cross-Sectional Study. J Nurs Res 2021; 30:e190. [PMID: 34750339 DOI: 10.1097/jnr.0000000000000466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The age of adolescents' sexual initiation is decreasing worldwide. Early sexual initiation has been reported to affect social, physical, and mental health, but little is known about the relationship between the timing of sexual initiation and suicidal ideation. PURPOSE This study was designed to identify the association between the timing of sexual initiation and suicidal ideation by gender. METHODS This cross-sectional study used data from South Korea's Youth Health Behavior Online Survey for 2016. Data on first- to 12th-grade students (N = 10,810) were analyzed using descriptive statistics, χ2 tests, and hierarchical logistic regression. RESULTS The results revealed a significant relationship between early sexual initiation and suicidal ideation among both boys and girls. This relationship remained significant after controlling for confounding variables that are known to affect suicidal ideation, including perceived stress, hopelessness, school grades, and sociodemographic characteristics. The risk of suicidal ideation was higher among students who first experienced sex in earlier grades (before the ninth grade) and was also higher in girls than in boys. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Health providers should be aware of the potentially higher risk of suicidal behavior among adolescents after early sexual initiation. Given the extreme sensitivity and vulnerability of this target population, a multidisciplinary school- or community-based intervention program to promote the mental health of affected individuals and the general student population is warranted.
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Affiliation(s)
- Jung Hee Yeo
- PhD, RN, Professor, College of Nursing, Dong-A University, Republic of Korea
| | - Eun-Young Kim
- PhD, RN, Professor, College of Nursing, Dong-A University, Republic of Korea
| | - Miyong T Kim
- PhD, RN, FAAN, Professor, School of Nursing, University of Texas at Austin, USA
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Wasserman D, Carli V, Iosue M, Javed A, Herrman H. Suicide prevention in childhood and adolescence: a narrative review of current knowledge on risk and protective factors and effectiveness of interventions. Asia Pac Psychiatry 2021; 13:e12452. [PMID: 33646646 DOI: 10.1111/appy.12452] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/28/2021] [Accepted: 02/15/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Suicide is a global mental health problem for people of all ages. While rates of suicide in children and adolescents are reported as lower than those in older populations worldwide, they represent the third leading cause of death in 15-19-year-olds. The rates are higher among boys than girls worldwide, though the death rates for girls exceed those for boys in Bangladesh, China, India, and Nepal. There has been a general decrease in adolescent suicide rates over recent decades. However, increases are reported in South East Asia as well as South America over the same time period. METHODS A narrative review method has been used to summarize current knowledge about risk and protective factors for suicide among children and adolescents and to discuss evidence-based strategy for suicide prevention in this age group. RESULTS Identified suicide risk and protective factors for children and adolescents largely overlap with those for adults. Nevertheless, developmental characteristics may strengthen the impact of some factors, such as decision-making style, coping strategies, family and peer relationships, and victimization. The implementation of evidence-based suicide preventive strategies is needed. Restricting access to lethal means, school-based awareness and skill training programs, and interventions delivered in clinical and community settings have been proven effective. The effectiveness of gatekeeper training and screening programs in reducing suicidal ideation and behavior is unproven but widely examined in selected settings. DISCUSSION Since most studies have been conducted in western countries, future research should assess the effectiveness of these promising strategies in different cultural contexts. The use of more rigorous study designs, the use of both short- and long-term follow-up evaluations, the larger inclusion of individuals belonging to vulnerable groups, the evaluation of online intervention, and the analysis of programs' cost-effectiveness are also required.
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Affiliation(s)
- Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.,Section on Suicidology, World Psychiatric Association (WPA), Geneva, Switzerland
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.,Section on Suicidology, World Psychiatric Association (WPA), Geneva, Switzerland
| | - Miriam Iosue
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.,Section on Suicidology, World Psychiatric Association (WPA), Geneva, Switzerland
| | - Afzal Javed
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Helen Herrman
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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Keefner TP, Stenvig T. Rethinking Suicide Risk With a New Generation of Suicide Theories. Res Theory Nurs Pract 2021; 34:389-408. [PMID: 33199410 DOI: 10.1891/rtnp-d-19-00128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicide is a global concern to nurses and other health-care providers. However, deaths by suicide are only part of the spectrum of suicide, as suicidal thinking and behaviors may precede a suicide attempt. Theoretical models are used infrequently in research to explain how the individual progresses from suicidal ideation to a suicide attempt. Thus, there is a critical need to advance the study of suicide with useful theoretical models to describe and explain processes whereby suicidal thoughts transition to attempts and to suicide. PURPOSE This article provides a conceptual discussion and scoping review comparing historical and contemporary ideation-to-action theories of suicide. METHOD Systematic reviews and meta-analyses from three databases (CINAHL, JSTOR, and PsychINFO) were reviewed to find literature describing suicide theories. RESULTS Historically, theory applications have limited capacity to differentiate between those individuals with suicidal ideations and those who attempt suicide. Newer theories, grounded in the ideation-to-action framework, propose distinct processes explaining what moves an individual from suicidal ideations toward suicidal behaviors. IMPLICATIONS FOR PRACTICE The ideation-to-action theories can guide health-care providers' assessment of at-risk individuals beyond merely asking about suicidal thinking. CONCLUSION The new generation of suicide theories suggest that suicidal ideations are only one component of risk. The common factor in ideation-to-action theories that distinguishes ideators from attempters is the acquired capability for suicide.
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Affiliation(s)
- Tamara P Keefner
- College of Nursing, South Dakota State University, Brookings, South Dakota
| | - Thomas Stenvig
- College of Nursing, South Dakota State University, Brookings, South Dakota
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Folayan MO, Arowolo O, Mapayi B, Chukwumah NM, Alade MA, Yassin RH, El Tantawi M. Associations between mental health problems and risky oral and sexual behaviour in adolescents in a sub-urban community in Southwest Nigeria. BMC Oral Health 2021; 21:401. [PMID: 34399740 PMCID: PMC8365974 DOI: 10.1186/s12903-021-01768-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study determined the association between mental health and risky oral health and sexual health behaviours. METHODS A household cross-sectional survey was conducted in Ile-Ife, Nigeria between December 2019 and January 2020. Data were collected from 10 to 19-year-old on the sociodemographic profile (age, sex at birth and socioeconomic status); mental health problems (psychological distress, depressive symptoms and suicidal ideation); and mental (smoking habit, consumption of alcohol, use of psychoactive substances), sexual (history of vaginal or anal sexual intercourse; transactional sex, multiple sex partners, use of condom at last sexual intercourse) and oral (frequency of daily tooth brushing, daily frequency of consumption of refined carbohydrate in-between-meals, frequency of use of dental floss, history of dental service utilization in the last 12 months and dental anxiety) health risk factors. Binary logistic regression analysis was conducted to determine the association between risky oral (neglecting to brush twice daily and frequent consumption of refined carbohydrates in-between-meals), and sexual (neglecting to use condoms during the last sex act and having multiple sex partners) health behaviours as outcome variables, and mental health status as the explanatory variables. An ordinal logistic regression model was also developed where the outcome variable was the number of risky health behaviours. The models were adjusted for the socio-demographic variables and history of dental service utilisation in the last 12 months of the survey. RESULTS High psychological distress was significantly associated with lower odds of frequent consumption of refined carbohydrates in-between-meals (AOR = 0.32; 95%CI 0.23, 0.47), and having multiple sex partners (AOR = 0.10; 95%CI 0.02, 0.57); but higher odds of having a higher number of risky behaviours (AOR = 3.04; 95%CI 2.13, 4.33). Having depressive symptoms was significantly associated with higher odds of neglecting to use condom at the last sexual intercourse (AOR = 7.20; 95%CI 1.94, 26.76) and having multiple partners (AOR = 95.43; 95%CI 24.55, 370.90). Suicidal ideation was significantly associated with lower odds of neglecting to use condom at the last sexual intercourse (AOR = 0.00; 95%CI 0.00, 0.00) and having multiple sex partners (AOR = 0.00; 95%CI 0.00, 0.00). CONCLUSION The associations between psychological distress and oral and sexual health risk behaviours in adolescents seem complex and need to be studied further.
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Affiliation(s)
| | - Olaniyi Arowolo
- Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Boladale Mapayi
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Nneka Maureen Chukwumah
- Department of Preventive Dentistry, School of Dentistry, University of Benin, Benin City, Nigeria
| | - Michael A Alade
- Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Randa H Yassin
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Tørmoen AJ, Myhre M, Walby FA, Grøholt B, Rossow I. Change in prevalence of self-harm from 2002 to 2018 among Norwegian adolescents. Eur J Public Health 2021; 30:688-692. [PMID: 32134469 PMCID: PMC7445045 DOI: 10.1093/eurpub/ckaa042] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Self-harm is prevalent among adolescents and associated with mental health problems and negative life-events. Few studies have examined changes in its prevalence related to these factors. This study explored whether changes in prevalence of self-harm among adolescents had occurred, and to what extent changes in associated factors may have contributed. Methods Two cross-sectional school-based surveys among adolescents (grades 8–10) in Norway were conducted in 2002 (N = 5842) and in 2017/18 (N = 29 063). Past year prevalence of self-harm and identical variables on risk factors was analyzed in hierarchical logistic regression to examine whether and to what extent changes in self-harm correlates could explain periodical change in prevalence of self-harm. Results An increase from 4.1% to 16.2% in self-harm prevalence was observed from 2002 to 2017/18. The increase was relatively larger among girls compared to boys and among 8th graders compared to 10th graders. Among the assessed risk factors for self-harm, depressive symptoms increased, while anti-social behavior, exposure to violent acts and drinking to intoxication decreased. The increase in depressive symptoms contributed to explain increase in self-harm. This contribution was outweighed by the decrease in other risk factors. Conclusions Self-harm prevalence increased 4-fold among Norwegian adolescents over a 15-year period. While exposure to several risk factors for self-harm changed substantially in this period, these risk factors could in sum not explain any of the increase in self-harm.
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Affiliation(s)
- Anita J Tørmoen
- Institute of Clinical Medicine, National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Martin Myhre
- Institute of Clinical Medicine, National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Fredrik A Walby
- Institute of Clinical Medicine, National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Berit Grøholt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Allison GO, Benau EM, Asbaghi S, Pagliacco D, Stewart JG, Auerbach RP. Neurophysiological Markers Related to Negative Self-referential Processing Differentiate Adolescent Suicide Ideators and Attempters. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:16-27. [PMID: 36324429 PMCID: PMC9616352 DOI: 10.1016/j.bpsgos.2021.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background Adolescent suicide is a major public health concern, and presently, there is a limited understanding of the neurophysiological correlates of suicidal behaviors. Cognitive models of suicide indicate that negative views of the self are related to suicidal thoughts and behaviors, and this study investigated whether behavioral and neural correlates of self-referential processing differentiate suicide ideators from recent attempters. Methods Adolescents with depression reporting current suicidal ideation and no lifetime suicide attempts (suicide ideators, n = 30) and past-year suicide attempts (recent attempters, n = 26) completed a self-referential encoding task while high-density electroencephalogram data were recorded. Behavioral analyses focused on negative processing bias (i.e., tendency to attribute negative information as being self-relevant) and drift rate (i.e., slope of reaction time and response type that corresponds to how quickly information is accumulated to make a decision about whether words are self-referent). Neurophysiological markers probing components reflecting early semantic monitoring (P2), engagement (early late positive potential), and effortful encoding (late late positive potential) also were tested. Results Adolescent suicide ideators and recent suicide attempters reported comparable symptom severity, suicide ideation, and mental disorders. Although there were no behavioral differences, compared with suicide ideators, suicide attempters exhibited greater P2 amplitudes for negative versus positive words, which may reflect enhanced attention and arousal in response to negative self-referential stimuli. There were no group differences for the early or late late positive potential. Conclusions Enhanced sensory arousal in response to negative stimuli-that is, attentional orienting to semantic, emotional, and self-relevant features-differentiates adolescent suicide attempters from ideators and thus may signal risk for suicidal behavior.
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Affiliation(s)
- Grace O. Allison
- Department of Psychiatry, Columbia University, New York, New York
| | - Erik M. Benau
- Department of Psychiatry, Columbia University, New York, New York
| | - Steven Asbaghi
- Department of Psychiatry, Columbia University, New York, New York
| | - David Pagliacco
- Department of Psychiatry, Columbia University, New York, New York
| | - Jeremy G. Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen’s University, Kingston, Ontario, Canada
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, New York
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44
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Bozzini AB, Bauer A, Maruyama J, Simões R, Matijasevich A. Factors associated with risk behaviors in adolescence: a systematic review. ACTA ACUST UNITED AC 2021; 43:210-221. [PMID: 32756805 PMCID: PMC8023154 DOI: 10.1590/1516-4446-2019-0835] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/15/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Understanding the distal (≤ 6 years of age) and proximal (between 6 years of age and early adolescence) factors in adolescent risk behavior is important for preventing and reducing morbidity and mortality in this population. This study sought to investigate the factors associated with the following adolescent risk behaviors: i) aggressiveness and violence, ii) tobacco, alcohol, and illicit substance use, iii) depressive behavior and self-harm (including suicidal ideation and attempts), iv) sexual risk behavior, and v) multiple risk behavior. METHODS A systematic review was conducted to identify longitudinal studies that examined factors associated with adolescent risk behaviors. The PubMed, PsycINFO, and LILACS databases were searched. RESULTS Of the 249 included studies, 23% reported distal risk factors, while the remaining reported proximal risk factors. Risk factors were related to sociodemographic characteristics (neighborhood, school, and peers), family patterns, and the presence of other adolescent risk behaviors. CONCLUSION Distal and proximal factors in adolescent risk behavior that are not exclusively socioeconomic, familial, environmental, or social should be explored more thoroughly.
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Affiliation(s)
- Ana Beatriz Bozzini
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Andreas Bauer
- Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Jessica Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Ricardo Simões
- Departamento de Ginecologia, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Departamento de Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
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45
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Waraan L, Mehlum L, Rognli EW, Czajkowski NO, Aalberg M. Associations between insecure attachment styles to parents and suicidal ideation in adolescents with depression. Scand J Child Adolesc Psychiatr Psychol 2021; 9:41-51. [PMID: 33928053 PMCID: PMC8077417 DOI: 10.21307/sjcapp-2021-006] [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] [Indexed: 11/11/2022] Open
Abstract
Objective Suicidal ideation and depressive symptoms are often interrelated in clinical settings. Insecure attachment may be a risk factor for suicidal ideation in depressed adolescents. To our knowledge, this study is the first to examine the association between self-reported insecure attachment styles to both parents and suicidal ideation in a clinical sample of adolescents with depression. Methods Fifty clinically depressed adolescents (13-17 years, 84% girls) completed self-reported measures of suicidal ideation, depressive symptoms, and attachment style to parents. Results There was a statistically significant bivariate association between higher levels of attachment anxiety in relation to mothers and fathers and higher levels of suicidal ideation. When attachments to both parents were included in the same multivariate model, only attachment anxiety to the mother was significantly associated with the level of suicidal ideation. Self-reported depressive symptoms remained significantly associated with the level of suicidal ideation in all analyses. Younger adolescents with attachment anxiety reported higher levels of suicidal ideation than older adolescents. Conclusion Conclusions about directionality and causality of associations between insecure attachment and suicidal ideation are limited due to the cross-sectional design. Our findings suggest that attachment anxiety in relation to the mother and father is associated with increased levels of suicidal ideation. Implication of these findings for treatment selection is discussed.
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Affiliation(s)
- Luxsiya Waraan
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Lars Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway
| | - Erling W Rognli
- Department of Psychology, University of Oslo, Norway.,Department of Child and Adolescent Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Nikolai O Czajkowski
- PROMENTA Research Centre, Department of Psychology, University of Oslo, Norway.,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Marianne Aalberg
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
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46
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Araneda N, Sanhueza P, Pacheco G, Sanhueza A. [Suicide in adolescents and young adults in Chile: relative risks, trends, and inequalitiesSuicídio em adolescentes e jovens no Chile: riscos relativos, tendências e desigualdades]. Rev Panam Salud Publica 2021; 45:e4. [PMID: 33815490 PMCID: PMC8007116 DOI: 10.26633/rpsp.2021.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/19/2020] [Indexed: 12/28/2022] Open
Abstract
Objetivo. Describir cuantitativamente el riesgo relativo, la tendencia y la desigualdad geográfica del suicidio en adolescentes y jóvenes entre las regiones de Chile, en el periodo 2000 al 2017. Método. Estudio ecológico poblacional a partir de los registros de defunciones por suicidio. Se estimaron tasas de mortalidad y riesgos relativos (RR) de suicidio por sexo, edad y región. Se estudió la tendencia y desigualdad geográfica del suicidio entre las regiones de Chile; medidas absolutas y relativas de desigualdades geográficas fueron estimadas. Resultados. Entre 2000 y 2017 se registraron 6 292 suicidios en adolescentes y jóvenes en Chile. Las tasas promedio de mortalidad por suicidio en Chile fueron de 8,5; 5,4 y 14.7 por 100 000 en los grupos 10-24, 10-19 y 20-24 años, respectivamente, en el periodo 2000-2017. Las tasas más altas de mortalidad por suicidio se encontraron en las regiones de Aisén, Los Lagos, Magallanes y Los Ríos. El riesgo más alto de suicidio se estimó en los hombres (RR=3,5), los jóvenes (RR=2,7) y en la región de Aisén (RR=2,0). La tasa promedio nacional en el grupo 10-24 años se mantuvo en 8,5 por 100 000 en los periodos 2000-2008 y 2009-2017. La mayor desigualdad geográfica se encontró en hombres de 20-24 años en el periodo 2000-2008. Conclusiones. El suicidio en jóvenes y adolescentes de Chile se ha mantenido sin mayores cambios en el periodo de estudio. Los hombres tienen un mayor riesgo de suicidio que las mujeres. Existen desigualdades geográficas entre las regiones de Chile en el suicidio y son más elevadas en hombres de 20 a 24 años. Se recomienda evaluar y fortalecer los programas de prevención del suicidio en los adolescentes y jóvenes, en especial en las regiones y los grupos poblacionales específicos en situación de mayor vulnerabilidad.
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Affiliation(s)
- Nelson Araneda
- Departamento de Educación, Universidad de La Frontera Temuco Chile Departamento de Educación, Universidad de La Frontera, Temuco, Chile
| | - Pablo Sanhueza
- Departamento de Ingeniería Robótica, Universidad de Maryland College Park Estados Unidos de América Departamento de Ingeniería Robótica, Universidad de Maryland, College Park, Estados Unidos de América
| | - Giovanni Pacheco
- SEREMI de Salud de La Araucanía, Ministerio de Salud de Chile Santiago Chile SEREMI de Salud de La Araucanía, Ministerio de Salud de Chile, Santiago, Chile
| | - Antonio Sanhueza
- Organización Panamericana de la Salud Washington D.C. Estados Unidos de América Organización Panamericana de la Salud, Washington D.C., Estados Unidos de América
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47
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Suicide Behavior Among Vocational High School Students: The Role of School-Related Factors. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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48
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Pitkänen J, Bijlsma MJ, Remes H, Aaltonen M, Martikainen P. The effect of low childhood income on self-harm in young adulthood: Mediation by adolescent mental health, behavioural factors and school performance. SSM Popul Health 2021; 13:100756. [PMID: 33681447 PMCID: PMC7910518 DOI: 10.1016/j.ssmph.2021.100756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/26/2022] Open
Abstract
Low childhood income is an established risk factor of self-harm in adolescence and young adulthood, and childhood income is additionally associated with various correlates of self-harm. How these correlates, such as psychiatric disorders, substance abuse, violent behaviour and school problems, mediate the effect of childhood income on self-harm, is less understood. The purpose of the current paper is to examine this mediation. The study is based on administrative register data on all Finnish children born in 1990–1995. An analytical sample of 384,121 children is followed from age 8 to 22. We apply the parametric g-formula to study the effect of childhood income on the risk of self-harm in young adulthood. Adolescent psychiatric disorders, substance abuse, prior self-harm, violent criminality and victimization, out-of-home placements, not being in education, employment or training and school performance are considered as potential mediators. We control for confounding factors related to childhood family characteristics. As a hypothetical intervention, we moved those in the lowest childhood income quintile to the second-lowest quintile, which resulted in a 7% reduction in hospital-presenting self-harm in young adulthood among those targeted by the intervention (2% reduction in the total population). 67% of the effect was mediated through the chosen mediators. The results indicate that increases in childhood material resources could protect from self-harm in young adulthood. Moreover, the large proportion of mediation suggests that targeted interventions for high-risk adolescents may be beneficial. To our knowledge, this is the first paper to use the parametric g-formula to study youth self-harm. Future applications are encouraged as the method offers several further opportunities for analysing the complex life course pathways to self-harm. We study mediation in the association between low childhood income and self-harm. Effects of a hypothetical intervention are examined. Most of the effect of low childhood income on the risk of self-harm is indirect. Distinct pathways are identified. The parametric g-formula offers further avenues for self-harm research.
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Affiliation(s)
- Joonas Pitkänen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FIN-00014, Helsinki, Finland.,International Max Planck Research School for Population, Health and Data Science, Max Planck Institute for Demographic Research, Rostock, Germany
| | | | - Hanna Remes
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FIN-00014, Helsinki, Finland
| | - Mikko Aaltonen
- Institute of Criminology and Legal Policy, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Law School. University of Eastern Finland, Joensuu, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FIN-00014, Helsinki, Finland.,Max Planck Institute for Demographic Research, Rostock, Germany.,Department of Public Health Sciences, Stockholm University, Sweden
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49
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Rockstroh F, Reichl C, Lerch S, Fischer-Waldschmidt G, Ghinea D, Koenig J, Resch F, Kaess M. Self-rated risk as a predictor of suicide attempts among high-risk adolescents. J Affect Disord 2021; 282:852-857. [PMID: 33601728 DOI: 10.1016/j.jad.2020.12.110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/30/2020] [Accepted: 12/24/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Predicting suicide attempts is a challenging task for clinicians and researchers, particularly among high-risk individuals (i.e. adolescents with lifetime suicide attempts). In this study, we examined whether adolescents were able to predict their own risk of attempting suicide in the future and whether borderline personality disorder (BPD) or depressive symptoms impacted the predictive value of self-ratings. METHODS Structured clinical assessments were conducted at baseline and after 12 months in a high-risk sample of treatment-seeking adolescents (n = 134; 12-17y.; 90% female) with at least one lifetime suicide attempt. RESULTS During the follow-up period, n = 51 participants (38%) attempted suicide at least once. Self-rated risk was a significant predictor for the recurrence of a suicide attempt, whereas BPD and depression were not. While there was no significant interaction between self-rated risk and BPD, a negative interaction emerged between self-rated risk and depression in the prediction of a suicide attempt. Greater depression severity diminished the predictive value of self-ratings. LIMITATIONS Depression severity was measured using a questionnaire, not a clinical interview. The findings may not be applicable to less burdened samples. CONCLUSIONS Asking high-risk adolescents to rate their own risk of attempting suicide appears to be an easy to apply method in improving the prediction of future suicide attempts in the clinical context.
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Affiliation(s)
- Franziska Rockstroh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Denisa Ghinea
- Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Section for Experimental Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Franz Resch
- Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany.
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50
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Gårdvik KS, Torgersen T, Rygg M, Lydersen S, Indredavik MS. Suicidality, function and associated negative life events in an adolescent psychiatric population at 3-year follow-up. BMC Psychiatry 2021; 21:109. [PMID: 33602162 PMCID: PMC7893950 DOI: 10.1186/s12888-021-03100-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/25/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We aimed to examine psychosocial function, suicidality and school dropout in a clinical psychiatric population over a 3-year period from adolescence to young adulthood and explore associations with negative life events. METHODS This study is part of the Health Survey in Department of Children and Youth, St. Olavs hospital, Norway. In the first study visit (T1), 717 (43.5% of eligible) participated, aged 13-18 years (2009-2011), and 3 years later (T2), 570 answered a questionnaire (school functioning and negative life events), and 549 completed Kiddie SADS as telephone interview assessing DSM-IV diagnoses, psychosocial functioning and suicidality. RESULTS Suicidal ideation was more frequent among girls (17.9%) than among boys (5.4%) (risk difference; RD = 12.5%, CI (7.2 to 17.7), p < 0.001), as was suicidal behavior (25.0% vs. 9.5%, RD = 15.5%, CI (9.2 to 21.4), p < 0.001). Girls had lower psychosocial functioning than boys (Children's Global Assessment Scale; Mean score 68.2 vs. 75.2, Mean difference = - 7.0, CI (- 9.4 to - 4.7), p < 0.001), and more school dropout (22.5% vs. 13.2%, RD = 9.3%, CI (2.8 to 15.5), p = 0.006). For those with a psychiatric disorder, 24.8% of girls had suicidal ideation and 30.0% suicidal behavior, which was larger than for boys (RD = 18.0%, CI (10.8 to 24.7), p < 0.001, and RD = 18.3%, CI (10.2 to 25.8), p < 0.001, respectively). Exposure to negative life events was frequent for both genders, but more girls had experienced sexually uncomfortable or abusive situations, the last 3 years (23.5% vs. 2.9%, RD = 20.6%, CI (15.4 to 25.7), p < 0.001), and ever (44.4% vs. 7.9%, RD = 36.5%, CI (29.9 to 42.7), p < 0.001). Suicidal behavior was associated with having been threatened, physically harassed or violently hurt (RD = 16.7%, CI (9.5 to 23.9), p < 0.001), and for girls been put into sexually uncomfortable or abusive situations (RD = 20.1%, CI (10.4 to 29.9), p < 0.001) and seen others violently hurt (RD = 14.6%, CI (3.4 to 25.8), p = 0.011). CONCLUSIONS The high frequency of suicidality and school dropout confirms the severity of adolescent psychiatric disorders, especially among girls. Specific life events were associated risk factors and should be target points for prevention and intervention.
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Affiliation(s)
- Kari Skulstad Gårdvik
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
- Department of Children and Youth, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Terje Torgersen
- Orkdal District Psychiatric Centre, Division of Mental Health Care, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit Sæbø Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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