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Okada M, Matsumoto R, Motomura E. Suicide mortality rates in Japan before and beyond the COVID-19 pandemic era. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e188. [PMID: 38868081 PMCID: PMC11114309 DOI: 10.1002/pcn5.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/06/2024] [Indexed: 06/14/2024]
Abstract
Statistical analyses from Japan reported increasing suicides in 2020, first in the world, proving the severity of the public health crisis during the COVID-19 pandemic; however, so far, international suicides have not been shown to be objectively increasing at population level. Followed studies reported the existence of a substantial heterogeneity of suicides among subgroups and time-lag impacts. Against public health crisis in Japan, policymakers, psychiatrists and public health personnel should prioritize improving suicide prevention programs following evidence-based policymaking. Understanding how/what factors relate to the COVID-19 pandemic and what other factors have shaped the increasing suicide numbers since 2020 through objectively well-controlled/fine-grained analyses of high-quality longitudinal/cross-sectional data at the individual, regional, and national levels is important for identifying the reasons for the recent trend. For this purpose, this study examined suicide statistics, statistical analysis methods, and their interpretations. Recent analyses suggest an increased suicide risk among females <50 years and males <30 years in 2020-2022. Notably, time-series analyses revealed that adolescent suicides began increasing before the pandemic, while working-age female suicides sharply increased synchronously with the pandemic outbreak. Causality analyses suggest that social issues facing Japan and recent global psychosocial and socioeconomic transformations are risk factors for suicide in high-risk groups. Finally, this report demonstrates the importance of providing appropriate support based on an objective understanding of individuals who are at risk for suicide, without being bound by traditional established knowledges.
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Affiliation(s)
- Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of MedicineMie UniversityTsuJapan
| | - Ryusuke Matsumoto
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of MedicineMie UniversityTsuJapan
| | - Eishi Motomura
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of MedicineMie UniversityTsuJapan
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Matsumoto R, Motomura E, Okada M. Temporal Fluctuations of Suicide Mortality in Japan from 2009 to 2023 Using Government Databases. Eur J Investig Health Psychol Educ 2024; 14:1086-1100. [PMID: 38667826 PMCID: PMC11048886 DOI: 10.3390/ejihpe14040071] [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: 03/29/2024] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
In Japan, suicide mortalities consistently decreased before the COVID-19 pandemic (from 2009 to 2019) but, conversely, increased after the pandemic outbreak from 2020 to 2022. To provide up-to-date suicide statistics in Japan, this study determined the temporal fluctuations of standardized suicide mortalities (SMRs), disaggregated by sex and age, by joinpoint regression analysis using the government suicide database, named the "Basic Data on Suicide in Region". From January 2009 to December 2023, three temporal fluctuation patterns of SMRs pertaining to working age and older adults were detected, such as attenuations of decreasing trends before the COVID-19 pandemic (from around the mid-2010s), a sharply increasing trend that coincided with the pandemic outbreak, and gradually decreased during the pandemic, but no changes at the end of the COVID-19 pandemic. In particular, the SMRs of working-age females sharply increased concurrently with the pandemic outbreak, whereas those of males did not change. However, before the pandemic, decreasing trends of the SMRs of working-age males diminished in the mid-2010s, but those of females consistently decreased. The SMRs of working-age males indicated non-significant but sharply increasing trends in early 2022, a trend that was not observed for females. In contrast to working-age adults, the SMRs of adolescents already began to increase in the mid-2010s and also indicated consistently increasing trends between the periods during and after the pandemic. These results suggest, contrary to our expectations, that the impacts of both the outbreak and end of the COVID-19 pandemic were limited regarding the increase in SMRs from 2020. Therefore, when revising suicide prevention programs in the post-COVID-19 era, it should be noted that focusing on pandemic-associated factors alone is not sufficient.
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Affiliation(s)
| | | | - Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan; (R.M.); (E.M.)
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Matsumoto R, Motomura E, Shiroyama T, Okada M. Impact of the Japanese Government's 'General Principles of Suicide Prevention Policy' on youth suicide from 2007 to 2022. BJPsych Open 2023; 10:e16. [PMID: 38112073 PMCID: PMC10755549 DOI: 10.1192/bjo.2023.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/05/2023] [Accepted: 10/27/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The Japanese Government programme 'General Principles of Suicide Prevention Policy' (GPSPP) contributed to decreasing suicide mortality rates (SMRs) before the COVID-19 pandemic, but they increased after the pandemic. AIMS To identify risk factors for youth suicide and the impact of GPSPP on youth suicide. METHOD Annual suicide numbers during 2007-2022 were obtained from government databases. SMRs of student and non-student youths were analysed with a linear mixed-effects model. Interrupted time-series analysis was conducted to investigate temporal relations between three GPSPP periods and SMRs with 52 suicide motives among high school, special vocational school and university students. Multiple regression analysis was conducted to investigate the influence of grade repetition on university student SMRs. RESULTS Non-student youth SMRs were higher than student SMRs. School-related (worrying about the future/underachievement), health-related (mainly mental illness) and family-related (conflict with parent and severe verbal reprimands) motives were major motives for student SMRs. During the first GPSPP period (2007-2012), no student SMRs decreased. During the second period (2012-2017), university and special vocational school student SMRs increased, but high school student SMRs were unchanged. In contrast, during the third period (2017-2022), with the exception of male special vocational school students, all SMRs increased. Unexpectedly, long-term grade repetition was negatively associated with health-related SMRs. CONCLUSIONS These findings suggest that GPSPP-supported programmes in schools partially contributed to student suicide prevention. To suppress increasing student SMRs, social/life support specialists should participate in in-school support services to bolster the social standing and lives of students who repeat grades or experience setbacks.
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Affiliation(s)
- Ryusuke Matsumoto
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Japan
| | - Eishi Motomura
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Japan
| | - Takashi Shiroyama
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Japan
| | - Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Japan
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Zhang J, Wu Z, Tao H, Chen M, Yu M, Zhou L, Sun M, Lv D, Cui G, Yi Q, Tang H, An C, Liu Z, Huang X, Long Y. Profile and mental health characterization of childhood overprotection/overcontrol experiences among Chinese university students: a nationwide survey. Front Psychiatry 2023; 14:1238254. [PMID: 37908593 PMCID: PMC10614290 DOI: 10.3389/fpsyt.2023.1238254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/15/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction The childhood experiences of being overprotected and overcontrolled by family members have been suggested to be potentially traumatic. However, the possible associated factors of these experiences among young people are still not well studied. This study aimed to partly fill such gaps by a relatively large, nationwide survey of Chinese university students. Methods A total of 5,823 university students across nine different provinces in China were included by the convenience sampling method in the data analyses. All participants completed the overprotection/overcontrol (OP/OC) subscale in a recently developed 33-item childhood trauma questionnaire (CTQ- 33). Data were also collected on all participants' socio-demographic profiles and characterization of mental health. Binary logistic regression was conducted to investigate the associated socio-demographic and psychological factors of OP/ OC. Results The prevalence of childhood OP/OC was estimated as 15.63% (910/5,823) based on a cutoff OP/OC subscale score of ≥ 13. Binary logistic regression suggested that being male, being a single child, having depression, having psychotic-like experiences, lower family functioning, and lower psychological resilience were independently associated with childhood OP/OC experiences (all corrected-p < 0.05). The OP/OC was also positively associated with all the other trauma subtypes (abuses and neglects) in the CTQ-33, while there are both shared and unique associated factors between the OP/OC and other trauma subtypes. Post-hoc analyses suggested that OP/OC experiences were associated with depression in only females and associated with anxiety in only males. Discussion Our results may provide initial evidence that childhood OP/OC experiences would have negative effects on young people's mental health which merits further investigations, especially in clinical populations.
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Affiliation(s)
- Jiamei Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhipeng Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Haojuan Tao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Min Chen
- Department of Psychiatry, Jining Medical University, Jining, Shandong, China
| | - Miaoyu Yu
- Department of Mental Health, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Liang Zhou
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Dongsheng Lv
- Department of Mental Health Institute of Inner Mongolia Autonomous Region, The Affiliated Mental Center of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
| | - Guangcheng Cui
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - Qizhong Yi
- Xinjiang Clinical Research Center for Mental Disorders, The Psychological Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hong Tang
- Department of Psychiatry, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Cuixia An
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaojun Huang
- Department of Psychiatry, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Yicheng Long
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Geng S, Wang L, Sun J, Xu M, Zhang L, Yi Z, Ji J, Zhang X. Risk factors and protective factors for nonsuicidal self-injury in adolescents: A hospital- and school-based case-control study. Clin Child Psychol Psychiatry 2023; 28:1321-1332. [PMID: 37038624 DOI: 10.1177/13591045231169087] [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: 04/12/2023]
Abstract
OBJECTIVE Nonsuicidal Self-Injury (NSSI) in China has increasingly interested clinicians, although few studies have investigated its risk and protective factors. This study examined the risk factors of NSSI among Chinese adolescents. METHODS The researchers recruited adolescent participants with NSSI from a hospital outpatient clinic to form a case group and recruited adolescents without NSSI who provided informed consent from the school to form a control group. Participants completed a questionnaire, and data were analyzed using logistic regression. RESULTS A total of 138 cases and 276 controls participated in this study. Binary multivariate logistic regression analysis with adjusting for age and sex showed that domestic violence (OR = 8.615, 95%CI: 3.081-24.091), parental overconcern (OR = 6.995, 95%CI: 3.447-14.192), guilt (OR = 4.949, 95%CI: 2.227-10.996), and school bullying (OR = 21.676, 95%CI: 6.799-69.109) increased the risk of NSSI, while peer support (OR = 0.068, 95%CI: 0.030-0.150) and living in an urban environment (OR = 0.157, 95%CI: 0.056-0.437) decreased the risk of NSSI. CONCLUSION Some psychosocial factors were confirmed to be independent risk and protective factors for NSSI in this study. However, the clinical significance of the results needs to be interpreted with caution due to sample size limitations.
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Affiliation(s)
- Shuo Geng
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Wang
- Sleep Medicine Center, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinping Sun
- Department of Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mingdong Xu
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Li Zhang
- Department of Psychology, Qingdao University, Qingdao, China
| | - Zhi Yi
- Department of Pediatric Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jun Ji
- College of Computer Science and Technology, Qingdao University, Qingdao, China
| | - Xu Zhang
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
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Okada M, Matsumoto R, Shiroyama T, Motomura E. Suicidal Mortality and Motives Among Middle-School, High-School, and University Students. JAMA Netw Open 2023; 6:e2328144. [PMID: 37548975 PMCID: PMC10407687 DOI: 10.1001/jamanetworkopen.2023.28144] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
IMPORTANCE The suicide mortality rate per 100 000 population (SMRP) consistently decreased before the COVID-19 pandemic outbreak in Japan and then unexpectedly increased during the pandemic. However, the underlying mechanisms remain poorly understood. OBJECTIVE To identify trends in and factors associated with suicidal mortality and motives among students in Japan from 2007 to 2022. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, data on SMRPs among Japanese middle-school, high-school, and university students were obtained from the government suicide database Suicide Statistics of the National Police Agency. MAIN OUTCOMES AND MEASURES Age-dependent and temporal fluctuations in annual SMRPs, disaggregated by suicidal motive (7 categories and 52 subcategories), sex, and school, were analyzed using linear mixed-effect and joinpoint regression models, respectively. RESULTS Total suicide numbers from 2007 to 2022 were as follows: 760 male middle-school students, 635 female middle-school students, 2376 male high-school students, 1566 female high-school students, 5179 male university students, and 1880 female university students. The mean (SD) student populations from 2007 to 2022 were as follows: 1 752 737 (81 334) male middle-school students, 1 675 572 (78 824) female middle-school students, 1 648 274 (67 520) male high-school students, 1 614 828 (60 032) female high-school students, 1 652 689 (32 724) male university students, and 1 229 142 (57 484) female university students. Among male students, the leading motives were school-related factors (underachievement and worrying about the future), followed by family-related and health-related motives. Among female students, school-related and family-related motives decreased, but health-related motives showed an age-dependent increase. The SMRPs of middle-school male students and female students were almost equal (mean [SD], 2.7 [1.0] vs 2.4 [1.4]), but the age-dependent increase in SMRPs among male students was pronounced (mean [SD], high-school vs university male students, 9.1 [2.4] vs 19.6 [3.0]; high-school vs university female students, 6.1 [2.4] vs 9.6 [1.8]). However, the incidence of suicide among high-school students associated with health-related motives was greater in female students. The majority of suicides associated with major impactable suicidal motives (school-related, health-related, and family-related motives) began increasing before the pandemic. Changes in SMRP associated with interpersonal relationships, such as conflict with classmates or parents, were not significant, but the rates increased greatly during the pandemic. CONCLUSIONS AND RELEVANCE School-related, health-related, and family-related problems were major motives, whereas the impacts of health-related and family-related motives increased and decreased with age, respectively. Notably, most SMRPs associated with major impactable motives (underachievement, conflict with a parent or classmate, and mental illnesses) had already begun increasing in the late 2010s, indicating that recent increasing SMRPs among school-aged individuals were associated with pandemic-related factors and other factors affecting this generation before the pandemic. It may be inappropriate to uniformly apply research findings based on school-aged individuals to school-based suicide prevention programs for students in middle school, high school, and university.
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Affiliation(s)
- Motohiro Okada
- Division of Neuroscience, Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Ryusuke Matsumoto
- Division of Neuroscience, Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Takashi Shiroyama
- Division of Neuroscience, Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Eishi Motomura
- Division of Neuroscience, Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Japan
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Nie Z, Xie X, Kang L, Wang W, Xu S, Chen M, Yao L, Gong Q, Zhou E, Li M, Wang H, Bu L, Liu Z. A Cross-Sectional Study: Structural and Related Functional Connectivity Changes in the Brain: Stigmata of Adverse Parenting in Patients with Major Depressive Disorder? Brain Sci 2023; 13:brainsci13040694. [PMID: 37190659 DOI: 10.3390/brainsci13040694] [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: 03/20/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023] Open
Abstract
Background: There is a high correlation between the risk of major depressive disorder (MDD) and adverse childhood experiences (ACEs) such as adverse parenting (AP). While there appears to be an association between ACEs and changes in brain structure and function, there have yet to be multimodal neuroimaging studies of associations between parenting style and brain developmental changes in MDD patients. To explore the effect of AP on brain structure and function. Methods: In this cross-sectional study, 125 MDD outpatients were included in the study and divided into the AP group and the optimal parenting (OP) group. Participants completed self-rating scales to assess depressive severity, symptoms, and their parents' styles. They also completed magnetic resonance imaging within one week of filling out the instruments. The differences between groups of gender, educational level, and medications were analyzed using the chi-squared test and those of age, duration of illness, and scores on scales using the independent samples t-test. Differences in gray matter volume (GMV) and resting-state functional connectivity (RS-FC) were assessed between groups. Results: AP was associated with a significant increase in GMV in the right superior parietal lobule (SPL) and FC between the right SPL and the bilateral medial superior frontal cortex in MDD patients. Limitations: The cross-cultural characteristics of AP will result in the lack of generalizability of the findings. Conclusions: The results support the hypothesis that AP during childhood may imprint the brain and affect depressive symptoms in adulthood. Parents should pay attention to the parenting style and avoid a style that lacks warmth.
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Affiliation(s)
- Zhaowen Nie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Xinhui Xie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Lijun Kang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Wei Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Shuxian Xu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Mianmian Chen
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Lihua Yao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Qian Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Enqi Zhou
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Meng Li
- PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Lihong Bu
- PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan 430072, China
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Alvarez-Subiela X, Castellano-Tejedor C, Villar-Cabeza F, Vila-Grifoll M, Palao-Vidal D. Family Factors Related to Suicidal Behavior in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9892. [PMID: 36011528 PMCID: PMC9408664 DOI: 10.3390/ijerph19169892] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
Objective: This research aims to investigate what type of family patterns (specifically attachment, bonding and family functioning) and stressful life events can trigger or protect adolescents from developing suicidal behavior. Methods: For these purposes, a case-control study (adolescents with suicidal behavior vs. paired adolescents with no suicidal behavior) was conducted with one hundred 12 to 17-year-old adolescents (50 controls, 50 cases, 74% females), assessed between 2018 and 2020. Results: Negligent (p < 0.001) or affection-less control bonding (p < 0.001), insecure attachment (p = 0.001) and stressful life events (p < 0.001) revealed to be significant risk factors for suicidal behavior. On the contrary, parents’ care (p < 0.001) and security (p < 0.001) were revealed as protective factors for suicidal behavior. Conclusions: Considering these results, family interventions and improving coping skills seem to be two essential targets for any suicide prevention intervention in adolescents.
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Affiliation(s)
- Xavier Alvarez-Subiela
- Suicide Conduct Unit, Psychiatry and Psychology Department, Sant Joan de Déu Hospital, 08950 Esplugues del Llobregat, Spain
- Doctoral Program in Psychiatry, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Carmina Castellano-Tejedor
- Research Group on Stress and Health (GIES), Department of Basic Psychology, Faculty of Psychology, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain
- RE-FIT Research Group, Parc Sanitari Pere Virgili & Vall d’Hebron Institute of Research, 08023 Barcelona, Spain
| | - Francisco Villar-Cabeza
- Suicide Conduct Unit, Psychiatry and Psychology Department, Sant Joan de Déu Hospital, 08950 Esplugues del Llobregat, Spain
| | - Mar Vila-Grifoll
- Suicide Conduct Unit, Psychiatry and Psychology Department, Sant Joan de Déu Hospital, 08950 Esplugues del Llobregat, Spain
| | - Diego Palao-Vidal
- Doctoral Program in Psychiatry, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain
- Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, 08208 Barcelona, Spain
- Department of Mental Health, University Hospital Parc Taulí, Sabadell, 08208 Barcelona, Spain
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Tugnoli S, Casetta I, Caracciolo S, Salviato J. Parental bonding, depression, and suicidal ideation in medical students. Front Psychol 2022; 13:877306. [PMID: 35992478 PMCID: PMC9386274 DOI: 10.3389/fpsyg.2022.877306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe psychological condition of university students has been the focus of research since several years. In this population, prevalence rates of depression, suicidal ideation, anxiety disorders and substance abuse are higher than those of the general population, and medical students are more likely to have mental health issues than other students.AimsThis study deals with the psychological condition of medical students, with a focus on correlations between depression, suicidal ideation and the quality of the perceived parenting style. Gender differences were also considered.MethodsA cross-sectional study was conducted on a population of medical students, with an online questionnaire consisting of a personal data sheet for demographic and anamnestic data, and of three self-rating scales: the Beck Depression Inventory II (BDI-II), for the screening of depressive symptoms; the Beck Hopelessness Scale (BHS), to assess suicidal ideation; the Parental Bonding Instrument (PBI), to investigate the memory of the attitude of one’s parents in the first 16 years of life. Two main affective dimensions were considered by PBI: “care” (affection and empathy) and “protection” (intrusiveness, controlling and constraint). Four different patterns of parenting styles are so evidenced: Neglectful Parenting (low care/low protection), Affectionless Control (low care/high protection), Optimal Parenting (high care/low protection), and Affectionate Constraint (high care/high protection).ResultsOverall, 671 students (182 males and 489 females) participated. Females, compared to males, experienced more distress and self-injurious behaviors, while males experienced more drugs or alcohol abuse. The BHS and BDI-II scores correlated positively with the PBI score for “protection” and negatively with that for “care.” Affectionless Control and Neglectful Parenting were associated with higher medians of BHS and BDI-II scores.ConclusionThe study confirms that the undergraduate medical student population has higher prevalence of depression and suicidal ideation than those detectable in the general population (respectively, 50.2% and 16.7% vs. 15–18% and 9.2%) and that some specific parenting styles correlate with these two clinical variables. The impact of Affectionless Control and Neglectful Parenting on suicidal ideation and depressive symptomatology was more pronounced in females than in males. For males, the role of the father seemed to have less impact on the affective roots of suicidal thoughts and depression.
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Chiu H, Vargo EJ. Bullying and other risk factors related to adolescent suicidal behaviours in the Philippines: a look into the 2011 GSHS Survey. BMC Psychiatry 2022; 22:445. [PMID: 35787791 PMCID: PMC9251019 DOI: 10.1186/s12888-022-04085-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUNDS The present study retrospectively examined gender differences in bullying and suicidal behaviour (ideation, plan, and attempts) as well as associations between selected risk factors and suicidal behaviour among secondary school Filipino students. METHODS The study used a secondary data set from the GSHS developed by the World Health Organization, which was conducted in the Philippines in 2011. Participants included 5290 Filipino students (male N = 2279, female N = 2986). A two-tailed Chi-square of independence was used to test for gender differences and a multivariate logistic regression model explored statistical associations between risk factors and outcome variables. RESULTS Chi-square results suggested that gender differences were statistically significant for being bullied χ2 (1, N = 2384) = 10.6, p = .001, experiencing suicidal ideation χ2 (1, N = 857) = 61.7, p = .000, making suicide plans χ2 (1, N = 590) = 10.2, p = .001, and suicide attempts χ2 (1, N = 674) = 8.4, p = .004, with females showing higher vulnerability to examined risk factors. The logistic regression model also suggested that adolescents claiming to have no close friends were three to four times more likely to attempt suicide. Other strong predictors of suicidal behaviours were loneliness and getting in trouble due to alcohol consumption. CONCLUSIONS Bullying is an independent yet, not the strongest predictor associated with adolescents' suicidal behaviour in the present study. The strongest predictors of Filipino adolescents' suicidal behaviours in the 2011 cohort included having no close friends, loneliness, anxiety and getting in trouble due to alcohol use among both genders. Peer and mental health support programmes need to be made available and accessible for adolescents in the Philippines. Considering the increase in suicide rates in 2020/2021 among Filipino young adults due to the Coronavirus pandemic, it is suggested that preventing suicidal vulnerability in adolescence can hinder this occurrence later on in the lifetime.
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Affiliation(s)
- Hsuan Chiu
- grid.7728.a0000 0001 0724 6933College of Health, Medicine and Life Sciences, Brunel University London,, Uxbridge, UK
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11
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Chen YL, Kuo PH. Social Support Reduces the Risk of Unfavorable Parenting Styles for Suicidal Behaviors in Early Adolescents. Arch Suicide Res 2022; 27:780-795. [PMID: 35481803 DOI: 10.1080/13811118.2022.2066590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Depression and perceived stress are important risk factors for suicidal behaviors among adolescents. The current study examined the joint effects of parenting styles on suicidal ideation (SI) and attempt (SA) in early adolescents while considering relevant individual factors, and evaluated whether social support can offset the risk. METHODS The present study was part of a large cohort study aiming at tracing the mental health and risk behaviors in adolescents, and we utilized baseline data collected from 645 4th grade students with complete assessment of suicidal behaviors, social support, parental bonding, depression, and perceived stress. Participants' mean age was 9.97 years (SD = 0.38) with 53.02% boys. Logistic regression was performed to analyze the associations between independent variables and youth suicidal behaviors. RESULTS 16.28% students reported to have SI and 4.96% had SA. Depression (SI: OR = 3.66-3.89; SA: OR = 3.98-4.50), father's low care and high authoritarian (LCHA) (SI: OR = 3.04; SA: OR = 2.43), and low acceptance and high authoritarian (LAHA) (SI: OR = 3.58; SA: OR = 4.77) parenting styles were strong risk factors, while overall social support (SI: OR = 0.98; SA: OR = 0.97) was a protective factor of SI and SA for early adolescents. Perceived stress (OR = 1.07-1.08) and mother's LCHA parenting style (OR = 2.03) were risk factors of SI. Overall, a family with LCHA parenting (OR = 2.82) or LAHA parenting (OR = 3.35-3.72) regardless parental gender had increased risk for SI and SA. CONCLUSION Family and social factors are important to consider in suicidal prevention and interventions among early adolescents, in addition to assessing individual risk factors. HighlightsSuicidal ideations (16.28%) and attempts (4.96%) were prevalent in early adolescents at elementary schools. Depression status remains a significant risk factor for both SI and SA in early adolescents.Unfavorable parenting styles (LCHA or LAHA) increased the risk of SI and SA, especially received from father.Overall social support had independent protective effect on suicidal behaviors, when taking aforementioned individual and family risk factors into account.
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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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Perquier F, Hetrick S, Rodak T, Jing X, Wang W, Cost KT, Szatmari P, Aitken M. Association of parenting with suicidal ideation and attempts in children and youth: protocol for a systematic review and meta-analysis of observational studies. Syst Rev 2021; 10:232. [PMID: 34391481 PMCID: PMC8364684 DOI: 10.1186/s13643-021-01727-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 06/01/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Suicide is a leading cause of death in children and youth, with suicidal thoughts and suicide attempts (referred to as non-fatal suicidal behaviors (NFSB)) being among its strongest predictors. Positive parenting (e.g., warmth, responsiveness), negative parenting (e.g., control, hostility), and parent-child relationship quality (e.g., trust, communication) have been reported to be associated with differences in NFSB in this population. To date, no comprehensive systematic review has considered together the wide range of parenting factors studied in relation to NFSB, and no meta-analysis of existing findings has been conducted. The present study will critically appraise and synthesize the existing evidence from observational studies that examine the relationships between parenting factors and (i) suicidal ideation and (ii) suicide attempt in children and youth. METHODS Studies will be retrieved from APA PsycInfo, MEDLINE, CINAHL, Embase, Scopus, and the Cochrane Library databases. Retrospective, cross-sectional, and longitudinal studies, conducted in clinical and population settings, among youth aged less than 25 years and published as articles and dissertations in English or French will be eligible. Two reviewers will select articles using the Covidence Software after title and abstract screening and full-text assessment, will extract information using double data entry, and will appraise studies' quality using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Any disagreements will be discussed with a third reviewer. Publication bias will be evaluated using funnel plots and Egger's test. In addition to a narrative summary of results, meta-analyses will be conducted using results from at least three studies. Three-level random effect models will allow to derive pooled estimates from dependent effect sizes (from the same sample or study). In case of significant heterogeneity, moderation analyses will be performed considering participants' characteristics and methodological aspects of studies. The results will be reported according to the PRISMA guidelines, and the certainty of evidence will be assessed using the GRADE approach. DISCUSSION In highlighting parenting factors associated with NFSB and in estimating the overall strength of these associations in children and youth, our results will inform further intervention and prevention strategies designed for young people experiencing NFSB and their families. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020165345.
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Affiliation(s)
- Florence Perquier
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Sarah Hetrick
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
- Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Melbourne, VIC 3052 Australia
| | - Terri Rodak
- CAMH Education, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
| | - Xin Jing
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, 1001 Queen St W, Toronto, ON M6J 1H4 Canada
| | - Katherine T. Cost
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Burton Wing, Toronto, ON M5G 1X8 Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Burton Wing, Toronto, ON M5G 1X8 Canada
| | - Madison Aitken
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
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Siqueira-Campos VM, De Deus MSC, Carneiro LA, Naghettini AV, Pereira MAD, De Deus JM, Conde DM. Dysfunctional Parenting Styles Are Associated with Mental Disorders and Low Self-Efficacy Beliefs in Brazilian Undergraduate Medical Students. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6372922. [PMID: 34337033 PMCID: PMC8294955 DOI: 10.1155/2021/6372922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/06/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate the association between parental bonding styles and anxiety, depression, suicidal ideation, and self-efficacy beliefs in undergraduate medical students. METHODS A cross-sectional, self-administered survey involving 315 Brazilian medical students was conducted online. The Parental Bonding Instrument (PBI), the Generalized Anxiety Disorder-7 (GAD-7) scale, the 9-item Patient Health Questionnaire (PHQ-9), the Suicidal Behaviors Questionnaire-Revised (SBQ-R), and the general self-efficacy (GSE) scale were used. The internal consistency of the instruments used in the study was analyzed using Cronbach's alpha. Multiple logistic regression models were applied, and the odds ratios (OR) and respective 95% confidence intervals (CI) were calculated to determine the association between parental bonding styles and anxiety, depression, suicidal ideation, and general self-efficacy beliefs. RESULTS In the analysis adjusted for sociodemographic variables, maternal affectionless control was associated with a greater risk of anxiety (OR = 2.48; 95% CI: 1.15-5.33), depression (OR = 7.54; 95% CI: 3.20-17.78), suicidal ideation (OR = 3.62; 95% CI: 1.58-8.27), and low self-efficacy (OR = 3.81; 95% CI: 1.76-8.25), while maternal neglectful parenting was associated with depression (OR = 3.24; 95% CI: 1.17-8.96) and paternal affectionate constraint with suicidal ideation (OR = 3.09; 95% CI: 1.36-7.02). CONCLUSIONS These findings showed dysfunctional parenting styles to be associated with mental illnesses and low self-efficacy in Brazilian undergraduate medical students. This should be taken into consideration when treating medical students with mental disorders.
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Affiliation(s)
| | | | - Larissa Arbués Carneiro
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Maria Amélia Dias Pereira
- Department of Mental Health, School of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - José Miguel De Deus
- Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Délio Marques Conde
- Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil
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Abstract
Suicide is a preventable health problem. Multiple definitions and inconsistent use of the term suicidality can result in failure to properly recognize suicide risk and behavior and confuses suicide research. Clarification of the suicidality concept is needed to facilitate the care for individuals at risk for suicide. Using Rodgers' evolutionary concept analysis method, this analysis describes the breadth and scope of the suicidality concept. Findings indicate suicidality covers a spectrum of suicidal risk and levels of emotional suffering and intent. The analysis does not draw definite conclusions, but outlines a direction for further research.
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Affiliation(s)
- Tamara Pike Keefner
- Nursing, South Dakota State University - College of Nursing, Rapid City, South Dakota, USA
| | - Thomas Stenvig
- Graduate Nursing, South Dakota State University - College of Nursing, Brookings, Rapid City, South Dakota, USA
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Amianto F, Martini M, Olandese F, Davico C, Abbate-Daga G, Fassino S, Vitiello B. Affectionless control: A parenting style associated with obesity and binge eating disorder in adulthood. EUROPEAN EATING DISORDERS REVIEW 2020; 29:178-192. [PMID: 33247868 DOI: 10.1002/erv.2809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Obesity is rising globally with a heavy health and economic burden. Early attachment experiences are relevant to the development of obesity. The purpose of this study was to investigate if parental care and attachment style experienced in childhood is associated with obesity, with or without binge eating disorder (BED), in adulthood. METHOD Parental style, personality traits, and psychopathology were assessed in 810 clinically referred adults with obesity, of whom 357 with BED and 453 without BED (non-BED), and 463 healthy subjects (HS). Assessments included the Parental Bonding Instrument, Temperament and Character Inventory, Eating Disorder Inventory-2, Symptom Checklist-90 and Beck Depression Inventory-II. RESULTS Both BED and non-BED reported lower maternal and paternal care and higher overprotection than HS. BED reported worse levels of parental care than non-BED and HS. 'Affectionless control' parenting style was more frequently reported by both BED and non-BED than HS. No significant differences in parenting style emerged between BED and non-BED. CONCLUSIONS Perception of parental 'affectionless control' was associated with obesity in adults, and lower quality of parental care was more frequently reported by participants with BED. Parental style may constitute an important target for early interventions to prevent obesity.
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Affiliation(s)
- Federico Amianto
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Matteo Martini
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Francesco Olandese
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Chiara Davico
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
| | - Giovanni Abbate-Daga
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Secondo Fassino
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Benedetto Vitiello
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
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Shen Y, Zhang W, Chan BSM, Zhang Y, Meng F, Kennon EA, Wu HE, Luo X, Zhang X. Detecting risk of suicide attempts among Chinese medical college students using a machine learning algorithm. J Affect Disord 2020; 273:18-23. [PMID: 32421600 DOI: 10.1016/j.jad.2020.04.057] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/17/2020] [Accepted: 04/27/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Suicide has become one of the most prominent concerns for public health and wellness; however, detecting suicide risk factors among individuals remains a big challenge. The aim of this study was to develop a machine learning algorithm that could effectively and accurately identify the probability of suicide attempts in medical college students. METHODS A total of 4,882 medical students were enrolled in this cross-sectional study. Self-report data on socio-demographic and clinical characteristics were collected online via website or through the widely used social media app, WeChat. 5-fold cross validation was used to build a random forest model with 37 suicide attempt predictors. Model performance was measured for sensitivity, specificity, area under the curve (AUC), and accuracy. All analyses were conducted in MATLAB. RESULTS The random forest model achieved good performance [area under the curve (AUC) = 0.9255] in predicting suicide attempts with an accuracy of 90.1% (SD = 0.67%), sensitivity of 73.51% (SD = 2.33%) and specificity of 91.68% (SD = 0.82%). LIMITATION The participants are primarily females and medical students. CONCLUSIONS This study demonstrates that the random forest model has the potential to predict suicide attempts among medical college students with high accuracy. Our findings suggest that application of the machine learning model may assist in improving the efficiency of suicide prevention.
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Affiliation(s)
- Yanmei Shen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China; The Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, Canada
| | - Wenyu Zhang
- School of Electronic and Information Engineering, Key Laboratory of Communication and Information Systems, Beijing Municipal Commission of Education, Beijing Jiaotong University, Beijing, 100044, China
| | - Bella Siu Man Chan
- The Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, Canada
| | - Yaru Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Fanchao Meng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Elizabeth A Kennon
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hanjing Emily Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xuerong Luo
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China.
| | - Xiangyang Zhang
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Tsvieli N, Nir-Gottlieb O, Lifshitz C, Diamond GS, Kobak R, Diamond GM. Therapist Interventions Associated with Productive Emotional Processing in the Context of Attachment-Based Family Therapy for Depressed and Suicidal Adolescents. FAMILY PROCESS 2020; 59:428-444. [PMID: 30908627 DOI: 10.1111/famp.12445] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Productive emotional processing is considered a key change mechanism in attachment-based family therapy (ABFT). This study examined the impact of attachment-based family therapy therapist interventions aimed to promote productive emotional processing of primary adaptive emotions in a sample of 30 depressed and suicidal adolescents who had participated in a larger randomized clinical trial. Results of sequential analyses revealed that relational reframes and therapists' focus on primary adaptive emotions were associated with the subsequent initiation of adolescents' productive emotional processing of primary adaptive emotions. In contrast, interpretations, reassurances, and therapists' focus on adolescents' rejecting anger toward their parents were all followed by the discontinuation of adolescents' emotional processing that had already begun. Finally, therapists' general encouragement of affect and focus on adolescents' unmet attachment/identity needs were associated with both the initiation of adolescents' productive emotional processing, and with the discontinuation of such processing once it had already begun. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Noa Tsvieli
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Chen Lifshitz
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
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19
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Lifshitz C, Tsvieli N, Bar-Kalifa E, Abbott C, Diamond GS, Roger Kobak R, Diamond GM. Emotional processing in attachment-based family therapy for suicidal adolescents. Psychother Res 2020; 31:267-279. [PMID: 32228168 DOI: 10.1080/10503307.2020.1745315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective: This study examined proposed sequential pathways through which suicidal adolescents are thought to shift from secondary global distress and rejecting anger to primary adaptive hurt, grief and assertive anger in the context of attachment-based family therapy (ABFT). Method: Participants were 39 suicidal adolescents who had received 16 weeks of ABFT as part of a randomized clinical trial, and who had been assigned to one of three outcome groups (i.e., good responders, slow responders and non-responders). Adolescents' in-session emotions were observationally coded using the Classification of Affective-Meaning States. Results: Across outcome groups, adolescents evidenced shifts from global distress to maladaptive shame, from maladaptive rejecting anger to adaptive assertive anger, and from adaptive assertive anger to adaptive grief/hurt. Adolescents who did not respond to treatment evidenced higher rates of maladaptive global distress. Conclusions: Findings are discussed in the context of ABFT and sequential emotional processing theories.
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Affiliation(s)
- Chen Lifshitz
- Department of Psychology, Ben-Gurion University, Beer-Sheva, Israel
| | - Noa Tsvieli
- Department of Psychology, Ben-Gurion University, Beer-Sheva, Israel
| | - Eran Bar-Kalifa
- Department of Psychology, Ben-Gurion University, Beer-Sheva, Israel
| | - Caroline Abbott
- Department of Psychology, University of Delaware, Newark, DE, USA
| | - Guy S Diamond
- Counseling and Family Therapy Department, Drexel University, Philadelphia, PA, USA
| | - R Roger Kobak
- Department of Psychology, University of Delaware, Newark, DE, USA
| | - Gary M Diamond
- Department of Psychology, Ben-Gurion University, Beer-Sheva, Israel
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20
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Marlowe NI, Nicholson Perry K, Lee J. Ontological insecurity II: Relationship to attachment, childhood trauma, and subclinical psychotic-like experiences. J Clin Psychol 2019; 76:440-460. [PMID: 31800105 DOI: 10.1002/jclp.22905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To examine ontological insecurity as a predictor of positive psychotic-like experiences (PLEs) relative to concepts of childhood trauma, parental bonding, and adult attachment style. METHODS A nonclinical sample (N = 298) completed the Ontological Insecurity Scale (OIS-34), a new measure of ontological insecurity, along with measures of the above concepts. RESULTS The OIS-34 accounted for a significantly greater proportion of unique variance in positive PLEs than any other theoretical variable. Anxious and avoidant adult attachment were also strongly associated with positive PLEs, but these relationships were mediated by the OIS-34, ceasing to be significant once this latter variable entered the hierarchical regression equation. CONCLUSIONS The results are consistent with R. D. Laing's theory that ontological insecurity plays a significant role in psychosis. Moreover, the results suggest that this concept may mediate the established relationship between anxious/avoidant adult attachment and positive PLEs. Implications for psychological approaches to clinical psychosis are discussed.
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Affiliation(s)
| | - Kathryn Nicholson Perry
- Discipline of Psychological Science, Australian College of Applied Psychology, Sydney, New South Wales, Australia
| | - Jacob Lee
- Discipline of Psychological Science, Australian College of Applied Psychology, Sydney, New South Wales, Australia
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21
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Lahat E, Mikulincer M, Lifshin U, Shaver PR. Mothers never retire: Contextual priming of working models of mother affects adults' representations of self and romantic partners. J Pers 2019; 88:501-514. [PMID: 31442306 DOI: 10.1111/jopy.12506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/26/2019] [Accepted: 08/20/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The main goal of these studies is to provide an experimental test of a core hypothesis based on attachment theory: Working models of mother are active in adults' minds and can bias their views of self and romantic partners. METHOD In two studies, we conducted clinical interviews to identify positive and negative core traits that participants used to describe their mothers. We then implicitly primed either positive or negative traits extracted from the interviews and compared this priming condition to control conditions in which we primed either positive or negative control traits (traits that described the mother of another study participant). Following this manipulation, we assessed participants' self-appraisals (Study 1) and explanations of their romantic partner's hurtful behaviors (Study 2). RESULTS Priming with one's mother's positive traits led to more positive views of self and romantic partner (compared with the effects of priming with positive control traits). In contrast, as compared to negative control traits, the priming of one's mother's negative traits led to less positive views of self and romantic partner. CONCLUSIONS Findings support the hypothesis that working models of mother play a causal role in shaping adults' representations of self and romantic partners.
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Affiliation(s)
- Eileen Lahat
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Mario Mikulincer
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel
| | - Uri Lifshin
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel
| | - Phillip R Shaver
- Department of Psychology, University of California, Davis, Davis, California
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Kim HHS. Parental overprotection and youth suicide behavior in low- and middle-income countries: a multilevel analysis of cross-national data. Int J Public Health 2018; 64:173-184. [PMID: 30406419 DOI: 10.1007/s00038-018-1169-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Research on youth suicide behavior has emphasized parent-child relations as a critical protective factor. This study investigates whether "too much" regulation of children, i.e., overprotection, may actually increase the likelihoods of youth suicide intent and plan. METHODS Data are drawn from the subset of the Global School-based Student Health Survey (2000-2012), consisting of children living in 48 low- and middle-income countries. Two-level hierarchical linear models are fitted to examine the potential curvilinear (U-shaped) association between parental monitoring and suicide behavior among youth. RESULTS Adjusting for individual- and country-level covariates, significant support is found for non-monotonicity specifically among boys: Greater parental involvement in male children's lives lowers both suicide ideation and suicide plan to some extent but, after certain thresholds, increases the odds of both outcomes. Results for girls, however, are much less pronounced. CONCLUSIONS In resource-poor countries marked by some of the highest teenage suicide rates in the world, overprotective parenting style is found to have negative and gendered consequences on the mental health of youth. More research is needed to confirm its replicability in economically more developed societies.
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Affiliation(s)
- Harris Hyun-Soo Kim
- Department of Sociology, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 120-750, Republic of Korea.
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Lachal J, Moro MR, Spodenkiewicz M. [An overview of suicide risk in adolescence]. Soins Psychiatr 2018; 39:10-13. [PMID: 29753431 DOI: 10.1016/j.spsy.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Suicidal behaviour in adolescence is a major public health issue. It is the consequence of a sum of individual, relational and environmental difficulties that weaken the subject in a period of great vulnerability. The main aspects of their care consist in developing a good therapeutic link and adapting the adolescent's environment. Prevention is the concern of everyone, especially healthcare professionals who are regularly consulted before suicidal acts.
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Affiliation(s)
- Jonathan Lachal
- Université Paris Descartes, faculté de médecine, Sorbonne Paris-Cité, 15, rue de l'École-de-médecine, 75006 Paris, France; Maison de Solenn-MDA, hôpital Cochin, 97, boulevard Port-Royal, 75014 Paris, France; CESP, faculté de médecine, université Paris-Sud, faculté de médecine-UVSQ, Inserm, Université Paris-Saclay, 16, avenue Paul-Vaillant-Couturier, 94805 Villejuif, France.
| | - Marie Rose Moro
- Université Paris Descartes, faculté de médecine, Sorbonne Paris-Cité, 15, rue de l'École-de-médecine, 75006 Paris, France; Maison de Solenn-MDA, hôpital Cochin, 97, boulevard Port-Royal, 75014 Paris, France; CESP, faculté de médecine, université Paris-Sud, faculté de médecine-UVSQ, Inserm, Université Paris-Saclay, 16, avenue Paul-Vaillant-Couturier, 94805 Villejuif, France
| | - Michel Spodenkiewicz
- CESP, faculté de médecine, université Paris-Sud, faculté de médecine-UVSQ, Inserm, Université Paris-Saclay, 16, avenue Paul-Vaillant-Couturier, 94805 Villejuif, France; CEPOI EA 7388, unité de pédopsychiatrie de liaison, pôle de santé mentale, CHU Sud Réunion, Université de la Réunion, avenue Président-Mitterrand, 97448 Saint-Pierre, France
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Systematic Literature Review of Attempted Suicide and Offspring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050937. [PMID: 29738447 PMCID: PMC5981976 DOI: 10.3390/ijerph15050937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 11/27/2022]
Abstract
Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic literature search. Results: The search resulted in a total of 1275 article titles, of which all abstracts were screened. Out of these, 72 full text papers were read, and a final four articles were included. Three of the included papers described parts of the same study from an emergency department in The Hague, where a protocol was implemented for monitoring and referring children of parents attempting suicide. The fourth article described the association between maternal attempted suicide and risk of abuse or neglect of their children. Conclusions: The lack of research in this particular area is striking. The circumstances surrounding a parent’s suicide attempt call for appropriate familial care.
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Kang Y, Kim C, Lee S, Youn S. Insomnia and Parental Overprotection are Associated with Academic Stress among Medical Students. SLEEP MEDICINE RESEARCH 2017. [DOI: 10.17241/smr.2017.00066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Huang KC, Tzeng DS, Lin CH, Chung WC. Interpersonal-psychological theory and parental bonding predict suicidal ideation among soldiers in Taiwan. Asia Pac Psychiatry 2017; 9. [PMID: 26932826 DOI: 10.1111/appy.12236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 12/30/2015] [Accepted: 01/28/2016] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Suicide is an important issue among military personnel, who have higher suicide rates compared with the general population. The interpersonal-psychological theory of suicide (IPTS) might provide an empirical explanation of this phenomenon, and parental bonding influences social adjustment and suicide. To investigate the relevance of IPTS and parental bonding for suicide among Taiwanese soldiers, a case-control study was conducted. METHODS Using a suicide-reporting system in a teaching general hospital in Southern Taiwan, 226 at-risk maladjusted soldiers and 229 well-adjusted controls were enrolled. We collected basic information, and participants answered four IPTS-based questions. Suicide risk was assessed using the Brief Symptom Rating Scale item 6. A four-factor model of the Parental Bonding Instrument assessed parental bonding. All participants were interviewed using the Mini International Neuropsychiatric Interview for primary screening and to recheck the accuracy of the Brief Symptom Rating Scale item 6 score. RESULTS A parsimonious model obtained by regression analysis of risk factors indicated that poor academic performance, conduct-related issues in childhood, and exposure to life-threatening situations are risk factors for suicide intention. Maladjusted suicidal soldiers showed a sense of thwarted belongingness (β = 0.145; P < 0.001), higher perceived burdensomeness (β = 0.311; P < 0.001), less fear of death (β = 0.124; P < 0.05), lower paternal autonomy (β = -0.122; P < 0.05), and higher maternal indifference (β = 0.162; P < 0.0001). DISCUSSION Interpersonal-psychological theory of suicide, accompanied by an assessment of parental bonding, could be used for assessing suicide risk and preventing suicide attempts.
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Affiliation(s)
- Kai-Cheng Huang
- Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Lingya District, Kaohsiung City, Taiwan
| | - Dong-Sheng Tzeng
- Tri-Service General Hospital Beitou Branch, Beitou, Taipei, Taiwan.,College of Pharmacy and Biotechnology, Tajen University, Pingtung, Taiwan.,Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hung Lin
- Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Lingya District, Kaohsiung City, Taiwan
| | - Wei-Ching Chung
- School of Nursing, Fooyin University, Kaohsiung City, Taiwan
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Parental bonding and hoarding in obsessive-compulsive disorder. Compr Psychiatry 2017; 73:43-52. [PMID: 27915218 PMCID: PMC5479319 DOI: 10.1016/j.comppsych.2016.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/07/2016] [Accepted: 11/11/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Hoarding behavior may indicate a clinically and possibly etiologically distinct subtype of obsessive-compulsive disorder (OCD). Empirical evidence supports a relationship between hoarding and emotional over-attachment to objects. However, little is known about the relationship between hoarding and parental attachment in OCD. METHOD The study sample included 894 adults diagnosed with DSM-IV OCD who had participated in family and genetic studies of OCD. Participants were assessed for Axis I disorders, personality disorders, and general personality dimensions. The Parental Bonding Instrument (PBI) was used to assess dimensions of perceived parental rearing (care, overprotection, and control). We compared parental PBI scores in the 334 hoarding and 560 non-hoarding participants, separately in men and women. We used logistic regression to evaluate the relationship between parenting scores and hoarding in women, adjusting for other clinical features associated with hoarding. RESULTS In men, there were no significant differences between hoarding and non-hoarding groups in maternal or paternal parenting scores. In women, the hoarding group had a lower mean score on maternal care (23.4 vs. 25.7, p<0.01); a higher mean score on maternal protection (9.4 vs. 7.7, p<0.001); and a higher mean score on maternal control (7.0 vs. 6.2, p<0.05), compared to the non-hoarding group. The magnitude of the relationships between maternal bonding dimensions and hoarding in women did not change after adjustment for other clinical features. Women who reported low maternal care/high maternal protection had significantly greater odds of hoarding compared to women with high maternal care/low maternal protection (OR=2.54, 95% CI=1.60-4.02, p<0.001). CONCLUSIONS Perceived poor maternal care, maternal overprotection, and maternal overcontrol are associated with hoarding in women with OCD. Parenting dimensions are not related to hoarding in men. These findings provide further support for a hoarding subtype of OCD and for sex-specific differences in etiologic pathways for hoarding in OCD.
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Cohen LJ, Ardalan F, Tanis T, Halmi W, Galynker I, Von Wyl A, Hengartner MP. Attachment anxiety and avoidance as mediators of the association between childhood maltreatment and adult personality dysfunction. Attach Hum Dev 2016; 19:58-75. [DOI: 10.1080/14616734.2016.1253639] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Effort-reward Imbalance at Work, Parental Support, and Suicidal Ideation in Adolescents: A Cross-sectional Study from Chinese Dual-earner Families. Saf Health Work 2016; 8:77-83. [PMID: 28344844 PMCID: PMC5355538 DOI: 10.1016/j.shaw.2016.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 07/27/2016] [Accepted: 09/08/2016] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In contemporary China, most parents are dual-earner couples and there is only one child in the family. We aimed to examine the associations of parents' work stress with suicidal ideation among the corresponding adolescent. We further hypothesized that low parental support experienced by adolescents may mediate the associations. METHODS Cross-sectional data from school students and their working parents were used, with 907 families from Kunming City, China. Stress at work was measured by the effort-reward imbalance questionnaire. Perceived parental support was assessed by an item on parental empathy and their willingness to communicate with the adolescent. Suicidal ideation was considered positive if students reported thoughts about suicide every month or more frequently during the previous 6 months. Logistic regression was used to examine the associations. RESULTS We observed that parents' work stress was positively associated with low parental support, which was in turn associated with adolescent suicidal ideation. The odds ratio for parents' work stress and adolescent suicidal ideation was 2.91 (95% confidence interval: 1.53-5.53), and this association was markedly attenuated to 2.24 (95% confidence interval: 1.15-4.36) after additional adjustment for parental support. Notably, mothers' work stress levels exerted stronger effects on children's suicidal ideation than those of fathers. CONCLUSION Parents' work stress (particularly mother's work stress) was strongly associated with adolescent's suicidal ideation, and the association was partially mediated by low parental support. These results need to be replicated and extended in prospective investigations within and beyond China, in order to explore potential causal pathways as a basis of preventive action.
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Sharaf AY, Thompson EA, Abd El-Salam HF. Perception of Parental Bonds and Suicide Intent Among Egyptian Adolescents. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2016; 29:15-22. [PMID: 26988071 DOI: 10.1111/jcap.12130] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 01/15/2016] [Indexed: 12/23/2022]
Abstract
PROBLEM Suicidal adolescents, compared to their nonsuicidal peers, tend to perceive their parents as less "caring" and more "controlling"-which characterizes the "affectionless control" parenting style. Research findings are inconsistent regarding the distinct influence of mother versus father parenting on youth suicide intent; moreover, the influence of parents' joint parenting styles on suicide intent has not been investigated. METHODS Using a cross-sectional design and large sample (N = 150 youth, 13-21 years old), currently hospitalized in a treatment center in Egypt for a recent suicide attempt, data were collected using the Suicide Intent Scale, Parental Bonding Instrument, and Center for Epidemiologic Studies Depression Scale. FINDINGS Seventy percent of youth reported high suicide intent. Mother and father parenting styles, assessed independently, were not associated with adolescent suicide intent. The joint effect of both parents' parenting style, however, was positively associated with suicide intent (Wald χ(2) = 8.79, p = .03). Suicide intent was stronger among adolescents who experienced neglectful compared with optimal parenting style (B = 1.93, Wald χ(2) = 4.28, p = .04). CONCLUSIONS The findings have direct implications for mental health nursing interventions, signaling the critical need to engage both parents in family-based interventions to address youth suicidal behavior.
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Affiliation(s)
- Amira Y Sharaf
- Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Elaine A Thompson
- Psychosocial & Community Health, School of Nursing, University of Washington, Seattle, WA, USA
| | - Hoda F Abd El-Salam
- Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Werbart Törnblom A, Werbart A, Rydelius PA. Shame and Gender Differences in Paths to Youth Suicide: Parents' Perspective. QUALITATIVE HEALTH RESEARCH 2015; 25:1099-1116. [PMID: 25810465 DOI: 10.1177/1049732315578402] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Risk factors, suicidal behavior, and help-seeking patterns differ between young women and men. We constructed a generic conceptual model of the processes underlying youth suicide, grounded in 78 interviews with parents in 52 consecutive cases of suicide (19 women, 33 men) identified at forensic medical autopsy and compared by sex. We found different forms of shame hidden behind gender-specific masks, as well as gender differences in their paths to suicide. Several interacting factors formed negative feedback loops. Finding no way out, the young persons looked for an "emergency exit." Signs and preparations could be observed at different times but recognized only in retrospect. Typically, the young persons and their parents asked for professional help but did not receive the help they needed. We discuss parents' experiences from the theoretical perspective on gender identity and developmental breakdown. Giving voice to the parents' tacit knowledge can contribute to better prevention and treatment.
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Saffer BY, Glenn CR, David Klonsky E. Clarifying the Relationship of Parental Bonding to Suicide Ideation and Attempts. Suicide Life Threat Behav 2015; 45:518-28. [PMID: 25530006 DOI: 10.1111/sltb.12146] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 10/13/2014] [Indexed: 12/18/2022]
Abstract
Suicide and suicidal behavior are major public health problems, especially among adolescents and young adults. Previous research has established links between parental bonding and suicidality; however, it remains unclear whether parental bonding is associated with suicide ideation, the progression from suicide ideation to suicide attempts, or both. This study examined the relation of parental bonding to suicide ideation and suicide attempts in adolescents from two settings: (1) acute psychiatric care (n = 172) and (2) high school (n = 426). All participants were administered validated measures of parental bonding, suicide ideation, and suicide attempts, as well as emotion dysregulation, loneliness, and self-worth. In the psychiatric sample, lower parental care significantly differentiated adolescents with a history of suicide attempts from those with suicide ideation only or without histories of suicidality. This pattern remained even after controlling for other known correlates of suicidality (i.e., emotional dysregulation, loneliness, and low self-worth). Similar effects were found in the community sample, although these findings failed to reach statistical significance. In both samples, parental overprotection was not associated with suicide ideation or suicide attempts. Results suggest that parental care may be an important risk factor for youth suicidal behavior and may help differentiate suicide attempters from suicide ideators.
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Affiliation(s)
- Boaz Y Saffer
- The University of British Columbia, Vancouver, BC, Canada
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Dilillo D, Mauri S, Mantegazza C, Fabiano V, Mameli C, Zuccotti GV. Suicide in pediatrics: epidemiology, risk factors, warning signs and the role of the pediatrician in detecting them. Ital J Pediatr 2015; 41:49. [PMID: 26149466 PMCID: PMC4494780 DOI: 10.1186/s13052-015-0153-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 06/16/2015] [Indexed: 01/07/2023] Open
Abstract
Epidemiological data suggests suicide is uncommon in childhood but becomes an extremely serious issue among adolescents. Several risk factors have been identified and include the presence of psychiatric illness, a previous suicide attempt, family factors, substance abuse, sexual and physical abuse, disorders in gender identity or bullying. Pediatricians have a primary role in searching for these risk factors, recognizing them and acting synergistically with other specialists to prevent and treat suicidal behavior. Pediatricians should also be able to identify the “warning signs” for suicide since their presence implies a need for immediate action, as attempted suicide may occur in a few hours or days. The use of antidepressant drugs and its association with suicidal risk in pediatric age is another topic of ongoing debate. Food and Drug Administration has recently introduced the so-called “black box” on antidepressants’ packages with the aim of gaining attention to the possible risk of suicide among adolescents who are treated with antidepressants, with a warning that the risk of suicide is higher when starting a therapy or while adjusting its dosage.
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Affiliation(s)
- Dario Dilillo
- Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy.
| | - Silvia Mauri
- Department of Pediatrics, Luigi Sacco Hospital, University of Milan, Milan, Italy.
| | - Cecilia Mantegazza
- Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy.
| | - Valentina Fabiano
- Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy.
| | - Chiara Mameli
- Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy.
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy.
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Csala I, Egervari L, Dome P, Faludi G, Dome B, Lazary J. The possible role of maternal bonding style and CHRNB2 gene polymorphisms in nicotine dependence and related depressive phenotype. Prog Neuropsychopharmacol Biol Psychiatry 2015; 59:84-90. [PMID: 25640319 DOI: 10.1016/j.pnpbp.2015.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 01/21/2015] [Accepted: 01/21/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Neuronal nicotinic acetylcholinergic receptors (nAChR) and especially α4β2 nAChRs are the major targets for cessation medications and also for some promising antidepressant agents. Furthermore, depressive symptoms pose multifacet difficulties during cessation therapy. However, gene encoding for the β2 subunit of nAChRs has been poorly investigated in association with depression. Since both nicotine dependence (ND) and depressive phenotype are complex disorders, we investigated the effects of a significant early life experience, maternal bonding style (MB) and CHRNB2 gene SNPs on smoking-related depression. METHODS We recruited two hundred and thirty-two treatment-seeking smokers in our study. Phenotypic variants were evaluated using the Fagerstrom Test for Nicotine Dependence (FTND), the Zung Self-Rating Depression Scale (ZSDS) and the Parental Bonding Instrument (PBI). Besides the total score (TS) of ZSDS, impulsivity (ZSDS-I) and suicidal ideation (ZSDS-S) were distinguished as phenotypic variable. DNAs were extracted from buccal mucosa samples and one SNP in promoter and two SNPs in 3' UTR of CHRNB2 gene were genotyped. GLM and ANOVA tests were performed for genotype associations and interaction analyses. RESULTS Maternal bonding had a significant impact on depressive phenotypes. Low care, high protection and affectionless control (ALC) were associated with ZSDS-TS and all subphenotypes of ZSDS. One SNP, the rs2072660 in 3' UTR, had a significant effect on the FTND score (p=0.010). Direct association of CHRNB2 variants and depressive phenotypes were not significant. However, in interaction with ALC, rs2072660 was significantly associated with ZSDS-S (p=0.005). MB had no significant effect on smoking-related phenotype. CONCLUSIONS Our results highlight the important role of 3' UTR in the CHRNB2 gene in the shared molecular background of ND and depressive phenotype. Parental bonding style can be suggested as a significant environmental factor in further GxE studies of depression. The presented significant GxE interaction on smoking-related suicidal subphenotype may help establish further investigations on development of more effective and safer smoking cessation and antidepressant agents.
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Affiliation(s)
- Iren Csala
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary; Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
| | - Luca Egervari
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary
| | - Peter Dome
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary; National Institute of Psychiatry and Addiction, Budapest, Hungary
| | - Gabor Faludi
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary
| | - Balazs Dome
- Department of Tumor Biology, National Koranyi Institute of Pulmonology, Budapest, Hungary; Department of Thoracic Surgery, Medical University of Vienna, Austria; Department of Thoracic Surgery, National Institute of Oncology and Semmelweis University, Budapest, Hungary; Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Austria
| | - Judit Lazary
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary.
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