1
|
Jones MS, Kevorkian SS, Lehmann PS, Chouhy C, Meldrum RC. Adverse childhood experiences, gender, and suicidality among Florida high school students: Examining intervening mechanisms. CHILD ABUSE & NEGLECT 2024; 153:106834. [PMID: 38704885 DOI: 10.1016/j.chiabu.2024.106834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) represent a key risk factor for suicidal thoughts and behaviors among adolescents. However, the intervening mechanisms linking ACEs and suicidality, and whether such processes vary by gender, remain underexplored. OBJECTIVE The present study examines whether the relationships between ACEs and the likelihood of experiencing suicidal thoughts and attempting suicide are indirect through depressive symptoms and low self-control. This study also investigates whether these direct and indirect paths might be moderated by gender. PARTICIPANTS AND SETTING The analyses make use of data on a statewide representative sample of students enrolled in public high schools in Florida (N = 23,078) from the 2022 Florida Youth Substance Abuse Survey (FYSAS). METHODS Generalized structural equation modeling (GSEM) was used to estimate the direct and indirect effects of ACEs on the likelihood of suicidal thoughts and attempting suicide. The indirect effects were assessed using bootstrapping, and between-gender differences in the coefficients were tested. RESULTS ACEs has direct associations with depressive symptoms, low self-control, and both suicidality outcomes. The effects of ACEs on suicidal thoughts are indirect through both depressive symptoms and low self-control, and the effects of ACEs on suicide attempts are indirect through depressive symptoms. Limited gender differences in these pathways emerge. CONCLUSIONS For male and female youth, ACEs are associated with heightened depression symptoms and reduced self-control, and both of these factors partially explain the previously established relationship between ACEs and suicidality.
Collapse
Affiliation(s)
- Melissa S Jones
- Department of Sociology, Brigham Young University, United States of America
| | - Salpi S Kevorkian
- Department of Criminology and Criminal Justice, Florida International University, United States of America
| | - Peter S Lehmann
- Department of Criminal Justice and Criminology, Sam Houston State University, United States of America
| | - Cecilia Chouhy
- College of Criminology and Criminal Justice, Florida State Univeristy, United States of America
| | - Ryan C Meldrum
- Department of Criminology and Criminal Justice, Florida Atlantic University, United States of America
| |
Collapse
|
2
|
Bravo LG, Meza J, Schiff SJ, Ahmed C, Elliot T, La Charite J, Choi K. Parental Legal System Involvement, Positive Childhood Experiences, and Suicide Risk. Pediatrics 2024; 153:e2023062566. [PMID: 38779781 PMCID: PMC11153318 DOI: 10.1542/peds.2023-062566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES To examine whether adverse parental legal system involvement (incarceration, arrest) was associated with suicide risk, accounting for other adverse childhood experiences, and whether there was a moderating relationship between positive childhood experiences (PCEs) and parental legal system involvement in suicide risk. METHODS This cross-sectional study used 2-year follow-up data from the Adolescent Brain Cognitive Development Study when children were age 11 to 12 years. Outcomes were lifetime suicidal ideation, attempts, and nonsuicidal self-injury (NSSI). Exposures were parent incarceration or arrest. We used generalized linear models to estimate the relative risk of suicide outcomes from adverse parent legal involvement and whether there was an interaction between parent legal system involvement and PCE count, controlling for adverse childhood experiences and demographic factors. RESULTS Among our sample (n = 10 532;), 687 children (6.5%) reported parent incarceration and 1265 (12.0%) reported parent arrest. Suicidal ideation was the most frequent risk outcome (n = 490; 4.7%). Children whose parents had been incarcerated had a relative risk of suicidal ideation of 1.74 (95% CI: 1.32-2.31). Children whose parents had been arrested had a relative risk of suicidal ideation of 1.89 (95% CI: 1.53-2.37) and a relative risk of suicide attempt of 2.69 (95% CI: 1.7-4.25). Parental incarceration/arrest were not associated with NSSI. PCEs were associated with reduced relative risk of suicidal ideation and NSSI, though there was no significant interaction between PCEs and adverse parent legal system involvement exposures. CONCLUSIONS Parental legal system involvement may negatively affect child mental health. Strengthening PCEs in childhood may mitigate suicide-related risks.
Collapse
Affiliation(s)
- Lilian G. Bravo
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California
| | - Jocelyn Meza
- Department of Psychiatry and Biobehavioral Sciences
| | | | - Charisse Ahmed
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California
| | - Thomas Elliot
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California
| | - Jaime La Charite
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Kristen Choi
- School of Nursing
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| |
Collapse
|
3
|
Sun M, Scherffius A, Sun M, Chen C, Wang D. Insomnia symptoms as a mediator between school connectedness and suicidal ideation in Chinese adolescents: A three-wave longitudinal model. Early Interv Psychiatry 2024. [PMID: 38783351 DOI: 10.1111/eip.13579] [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: 08/03/2023] [Revised: 04/02/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
AIM School connectedness is related to suicidal ideation (SI) in adolescents. However, little is known about the mediating role of insomnia symptoms in the school connectedness-SI link. This study aimed to examine the longitudinal mediating effect of insomnia symptoms on the relationship between school connectedness and SI as well as the moderating effect of sex using a three-wave longitudinal design. METHODS A total of 3110 adolescents completed three online surveys. Data were collected over the course of 1 year, in three waves 6 months apart. Participants completed the School Connectedness Scale, Youth Self-Rating Insomnia Scale, Self-rating Idea of Suicide Scale, Beck Depression Inventory and a self-compiled demographic questionnaire. Linear regressions and mediation analyses were performed to examine the associations between school connectedness, insomnia symptoms and SI. RESULTS School connectedness had a significant mediating effect on SI through insomnia symptoms (βa×b = -.03, 95% confidence interval = -0.04, -0.02) after controlling for demographics and depressive symptoms. Mediation analyses showed that insomnia symptoms accounted for 23.1% of the total effects in the entire sample, with 13.3% in males and 27.3% in females. Sex had no significant moderating effect on the school connectedness-SI link association. CONCLUSIONS The association between school connectedness and SI appears to be mediated by insomnia symptoms. Assessing and promoting school connectedness, as well as intervening and treating distress associated with insomnia, may have important clinical implications for reducing the risk of SI in adolescents.
Collapse
Affiliation(s)
- Mingze Sun
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Andrew Scherffius
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| |
Collapse
|
4
|
Welty CW, Bingham L, Morales M, Gerald LB, Ellingson KD, Haynes PL. School Connectedness and Suicide Among High School Youth: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2024; 94:469-480. [PMID: 38383772 DOI: 10.1111/josh.13445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Suicide is a leading cause of death for adolescents, and school connectedness is a potential, modifiable protective factor for suicide. We sought to examine if school connectedness protected against suicide among high school students and if potential moderators affected the relationship between school connectedness and suicide. METHODS We searched online databases (PubMed, EMBASE, CINAHL, and PsycINFO) on December 12, 2021, for studies that examined the effects of school connectedness on suicide among high school students. RESULTS This systematic review identified 34 studies that examined the effects of school connectedness on adolescent suicidality. Results indicated mixed findings of school connectedness on suicidality. Among studies that assessed a suicide ideation outcome, 73.3% found that school connectedness protected against suicide. Among studies that assessed a suicide attempts outcome, 50% found that school connectedness protected against suicide. Most included studies did not control for notable variables in their final models, such as sleep, impulsivity, substance use, or depression. No studies examined moderators of school connectedness and suicide. CONCLUSIONS School connectedness is somewhat protective of suicidality, and more protective of suicidal ideation than suicide attempts. Researchers should examine the construct of school connectedness among modern youth to better understand school connectedness and suicide.
Collapse
Affiliation(s)
- Cody W Welty
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Lindsay Bingham
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Mario Morales
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Lynn B Gerald
- Office of Population Health Sciences, University of Illinois Chicago, 1220 S. Wood Street (MC 619), Chicago, 60608, IL
| | - Katherine D Ellingson
- Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Patricia L Haynes
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| |
Collapse
|
5
|
Berny LM, Tanner-Smith EE. Interpersonal violence and suicide risk: Examining buffering effects of school and community connectedness. CHILDREN AND YOUTH SERVICES REVIEW 2024; 157:107405. [PMID: 38371909 PMCID: PMC10871710 DOI: 10.1016/j.childyouth.2023.107405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Background Exposure to interpersonal violence is associated with elevated suicide risk. Preventing suicide among high-risk adolescents is most often discussed from a clinical treatment perspective, resulting in a gap in research examining whether school and community connectedness can buffer the relationships between forms of interpersonal violence and suicide risk in clinical samples of adolescents. Methods Baseline data from 294 adolescents who received substance use treatment were analyzed to help fill this gap in research. Adolescents in this sample were at greater risk for suicidal thoughts and behaviors given their histories of substance use disorders and high rates of interpersonal violence, with 57% reporting experiencing at least one form of abuse/violence. Independent variables included lifetime exposure to physical abuse, sexual abuse, and weapon violence; moderators included various measures of school and community connectedness. Multinomial logistic regression models were estimated to examine the main and interaction effects predicting a three-category measure of suicide risk: non-suicidal, suicidal ideation only, and prior suicide attempts. Results Sexual abuse survivors had the highest predicted probability of a prior suicide attempt when reporting lower levels of teacher support, school-based positive peer interactions, or neighborhood social connection, but at higher levels of these protective factors, their predicted probability was similar to those not exposed to sexual abuse. The same protective pattern was observed for physical abuse survivors with high neighborhood social connection. Conclusion The buffering effects observed in this study identified dimensions of school and community social connectedness as protective factors for youth exposed to abuse. Although promoting social connectedness is often cited as a universal suicide prevention approach, tailored efforts to enhance connectedness within this population may also be a promising secondary prevention strategy. Thus, in addition to clinical treatment, more emphasis should be placed on systems-level approaches to reducing risk among youth most vulnerable to suicide.
Collapse
Affiliation(s)
- Lauren M. Berny
- University of Oregon, Department of Counseling Psychology and Human Services, USA
- University of Oregon, Prevention Science Institute, USA
| | - Emily E. Tanner-Smith
- University of Oregon, Department of Counseling Psychology and Human Services, USA
- University of Oregon, Prevention Science Institute, USA
- University of Oregon, HEDCO Institute for Evidence-Based Educational Practice, USA
| |
Collapse
|
6
|
Suh BC, Gallaway MS, Celaya MF. Supportive Relationships Mitigate the Effect of Cumulative Exposure to Adverse Childhood Experiences on Depression, Anxiety, Stress, and Suicide Considerations-The Arizona Youth Risk Behavior Survey. CHILDREN (BASEL, SWITZERLAND) 2024; 11:161. [PMID: 38397273 PMCID: PMC10887230 DOI: 10.3390/children11020161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
Declining adolescent mental health is a significant public health concern during the COVID-19 pandemic. Social distancing and stay-at-home orders have led to missed social connections with peers and adults outside households, and this has increased the risk of mental health problems in children and adolescents, particularly those with adverse childhood experiences (ACEs). Studies have shown that strong interpersonal support improves adolescent mental health. We examined the association between ACEs and poor mental health (including stress, anxiety, and depression) and how the presence of interpersonal support from caring adults and friends and school connectedness can mitigate this relationship among adolescents in Arizona. This study analyzed data from the 2021 Arizona Youth Risk Behavior Survey (YRBS; n = 1181), a population-based survey conducted biennially across the United States. The Arizona sample included high school students in grades 9-12 who were enrolled in public and charter schools. This study revealed that nearly three of four adolescents experienced an ACE, and one of five experienced ≥4 ACEs. Compared with adolescents who experienced zero ACEs, those with ≥4 ACEs experienced less interpersonal support from caring adults, friends, and school and more frequently reported poor mental health and suicidal thoughts. However, adolescents with interpersonal support consistently reported lower rates of mental health issues, even with exposure to multiple ACEs. Post-pandemic programs to improve social relationships with adults, peers, and schools are critical, especially for adolescents with multiple adversities.
Collapse
Affiliation(s)
- Bin C. Suh
- Arizona Department of Health Services, Phoenix, AZ 85007, USA;
| | | | | |
Collapse
|
7
|
School connectedness and psychological resilience as mediators in the relationship between childhood abuse and suicidal ideation among Chinese adolescents. Eur J Psychotraumatol 2023; 14:2172650. [PMID: 37052111 PMCID: PMC9930799 DOI: 10.1080/20008066.2023.2172650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Background: Suicide among adolescents is a huge public health concern around the world. Although childhood abuse has been established as a substantial risk factor for suicide behaviours, potential mediators in this relationship remain unclear.Objective: This study aimed to examine the mediating roles of school connectedness and psychological resilience in the association between childhood abuse and suicidal ideation among Chinese high school students.Methods: The sample involved 1607 adolescents from four high schools in Central China. Structural equation modelling (SEM) was conducted to investigate the mediation effects of school connectedness and psychological resilience on the relationship between childhood abuse and suicidal ideation.Results: The prevalence of suicidal ideation during the past week was 21.9%. Childhood abuse was positively related to the development of suicidal ideation directly and indirectly through school connectedness and psychological resilience. School connectedness and psychological resilience were also partial mediators of all three types of childhood abuse (emotional abuse, physical abuse and sexual abuse) when the types were examined separately.Conclusions: Suicidal ideation was widespread among Chinese high school students. Psychological resilience and school connectedness could attenuate the detrimental impact of childhood abuse on suicidal ideation. Findings underscore the improvement of psychological resilience and the connection to the school would be beneficial to suicide prevention among Chinese adolescents with childhood abuse.
Collapse
|
8
|
Moody RL, Carter JA, Talan A, Sizemore KM, Russell ST, Rendina HJ. Associations of adverse and protective childhood experiences with thwarted belongingness, perceived burdensomeness, and suicide risk among sexual minority men. Psychol Med 2023; 53:5615-5624. [PMID: 36117279 PMCID: PMC10024646 DOI: 10.1017/s0033291722002823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/04/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sexual minority men (SMM) experience higher suicidal ideation and suicide attempts than the general population. We examined the associations of adverse childhood experiences (ACES) and protective and compensatory childhood experiences (PACES) with suicidal ideation and suicide attempts in adulthood via thwarted belongingness and perceived burdensomeness among SMM. METHODS Data are from the UNITE study, a national longitudinal cohort study of HIV-negative SMM from the 50 U.S. states and Puerto Rico. Between 2017 and 2019, participants (N = 6303) completed web-based assessments at baseline and 12-month follow-up. ACES and PACES occurring before the age of 18, and current symptoms of thwarted belongingness and perceived burdensomeness were assessed at baseline. Past-week suicidal ideation and past-year suicide attempt were assessed at follow-up. RESULTS 424 (6.7%) participants reported past-week suicidal ideation and 123 (2.0%) reported a past-year suicide attempt. The results of our multivariate model suggest that each additional adverse childhood experience was prospectively associated with 14% higher odds of past-week suicidal ideation (AOR = 1.14, 95% CI 1.09-1.19) and 19% higher odds of past-year suicide attempt (AOR = 1.19, 95% CI 1.11-1.29). Each additional protective childhood experience was prospectively associated with 15% lower odds of past-week suicidal ideation (AOR = 0.85, 95% CI 0.81-0.90) and 11% lower odds of past-year suicide attempt (AOR = 0.89, 95% CI 0.82-0.98). Perceived burdensomeness partially mediated these prospective associations. CONCLUSION To reduce suicide, screening and treating perceived burdensomeness among SMM with high ACES may be warranted. PACES may decrease perceived burdensomeness and associated suicide risk.
Collapse
Affiliation(s)
- Raymond L. Moody
- Department of Epidemiology, Columbia University Mailman School of Public Health, 772 West 181st Street, New York, NY 10032, USA
| | - Joseph A. Carter
- Department of Psychology, City University of New York Graduate Center, Health Psychology and Clinical Sciences Program, New York, NY, USA
| | - Ali Talan
- Whitman-Walker Institute, Washington, DC, USA
| | - K. Marie Sizemore
- Department of Psychiatry, Rutgers University Institute for Health, Health Care Policy, and Aging, New Brunswick, NJ, USA
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas at Austin School of Human Ecology, Austin, TX, USA
| | - H. Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, and Whitman-Walker Institute, Washington, DC, USA
| |
Collapse
|
9
|
Zhang M, Xu X, Jiang J, Ji Y, Yang R, Liu Q, Li S, Li Y, Liu Q. The association between physical activity and subjective well-being among adolescents in southwest China by parental absence: a moderated mediation model. BMC Psychiatry 2023; 23:493. [PMID: 37430260 DOI: 10.1186/s12888-023-04982-8] [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] [Received: 01/30/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVES Built on the Positive Youth Development (PYD) framework, this study examined how physical activity affected the subjective well-being of adolescents in the multi-ethnic area of southwest China. The mediating role of school connectedness as an external development asset and the moderating role of resilience as an internal development asset were specified and tested within the framework of sport-based PYD. METHODS A cross-sectional survey of 3143 adolescents (47.2% boys with mean age = 12.88 and SD = 1.68) was conducted in 2020. A structural equation model (SEM) was developed to estimate the direct effect of physical activity, the mediating effect of school connectedness, and the moderating effect of resilience on adolescents' subjective well-being. Multi-group comparison was made to investigate differences and similarities across three parental absence subgroups: (1) both parents present, (2) one parent absent, and (3) both parents absent. RESULTS As surmised, physical activity, school connectedness, and resilience all positively and significantly affected adolescents' subjective well-being. SEM analyses revealed that school connectedness mediated the effect of physical activity on subjective well-being. Moreover, resilience moderated both the direct and indirect effects of physical activity (through school connectedness) on subjective well-being. Finally, the multi-group comparison revealed a moderating effect of parental absence on the moderated mediation model. LIMITATIONS This study is a cross-sectional survey, so inference of causal associations among the study variables is impossible. CONCLUSIONS Healthy lifestyle behaviors, school-supportive settings, and positive individual development assets can enhance the subjective well-being of adolescents in southwest China, especially those whose parents were absent. Physical activity interventions informed by the PYD framework should be incorporated into public health programs designed to foster the physical and mental health of left-behind adolescents in southwest China.
Collapse
Affiliation(s)
- Ming Zhang
- Department of Health Behavior and Social Medicine, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China
| | - Xiaohe Xu
- Department of Sociology, University of Texas at San Antonio, San Antonio, USA
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, P.R. China
| | - Jianjun Jiang
- Department of Palliative Care, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China
| | - Yuanyi Ji
- Nosocomial Infection Management Department, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, P.R. China
| | - Ruixi Yang
- Department of Health Behavior and Social Medicine, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China
| | - Qijiao Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China
| | - Shiying Li
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, P.R. China
| | - Yuchen Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, P.R. China
| | - Qiaolan Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China.
| |
Collapse
|
10
|
Xiao W, Li S, Xu H, Zhang Y, Wei R, Tao F, Wan Y. Population attributable fractions of adverse childhood experiences for emotional problems and self-harming behaviors among middle school students in China. Asian J Psychiatr 2023; 85:103621. [PMID: 37201384 DOI: 10.1016/j.ajp.2023.103621] [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] [Received: 04/04/2023] [Revised: 04/24/2023] [Accepted: 05/06/2023] [Indexed: 05/20/2023]
Abstract
The population attributable fractions of health outcomes attributed to adverse childhood experiences (ACEs) among Chinese middle school students is unknown. Of all the 22,868 middle school students, 29.8 % had exposure to four or more ACEs. Findings showed a graded relationship between ACE scores and those adverse outcomes. The PAFs of six outcomes attributed to experiencing ≥ 4 ACEs ranged from 23.1 % to 44.2 %. The results emphasized the significance of preventive interventions to alleviate the negative legacies of ACEs.
Collapse
Affiliation(s)
- Wan Xiao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Shuqin Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China
| | - Huiqiong Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China
| | - Yi Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Ruihong Wei
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China.
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China; Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Anhui, China.
| |
Collapse
|
11
|
Pierce H, Jones MS, Shoaf H, Heim M. Early Adverse Childhood Experiences and Positive Functioning during Adolescence. J Youth Adolesc 2023; 52:913-930. [PMID: 36592321 DOI: 10.1007/s10964-022-01729-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/20/2022] [Indexed: 01/03/2023]
Abstract
Adverse childhood experiences (ACEs) have been shown to have consequences for adolescent development, yet little is known about the association between ACEs and positive functioning. Positive functioning evaluates engagement, perseverance, optimism, connectedness, and happiness, which are intimately related to pro-social behavior. As skills associated with sociability in adolescence often carry on into adulthood, understanding the developmental origins in inequalities in pro-social behavior, as measured by positive functioning, is key to ensuring equitable life chances across the life course. Subsequently, the Fragile Families and Child Wellbeing Study (FFCWS; n = 3444) was used to examine how early exposure to cumulative ACEs, plus the timing and duration of those ACEs may be associated with positive functioning development in adolescence. The sample consisted of urban-born youth (49% female) with the mean age of 15. Racial/ethnic breakdown of the sample is 18% non-Hispanic White, 49% non-Hispanic Black, 25% Hispanic, and 8% "Other". Overall, estimates suggest that roughly 88% of these youth experienced at least one ACE by age five. The findings indicate that cumulation, timing, and duration of early ACEs are related to overall adolescent positive functioning and four out of the five domains (perseverance, optimism, connectedness, and happiness), even after controlling for more recent ACEs. This study highlights the critical impact of very early ACEs on youth positive functioning, which may confer further physical, mental, and social disadvantages into adulthood. Positive functioning can serve as a protective factor against some of the negative consequences of adversity, and ensuring that all families receive proper supports may limit the lifelong effects of adversity, and most importantly, prevent ACEs from occurring in the first place.
Collapse
Affiliation(s)
- Hayley Pierce
- Department of Sociology, Brigham Young University, 2036 JFSB, Provo, UT, 84602, USA.
| | - Melissa S Jones
- Department of Sociology, Brigham Young University, 2036 JFSB, Provo, UT, 84602, USA
| | - Hannah Shoaf
- Department of Sociology, Brigham Young University, 2036 JFSB, Provo, UT, 84602, USA
| | - Mackenzie Heim
- Department of Sociology, Brigham Young University, 2036 JFSB, Provo, UT, 84602, USA
| |
Collapse
|
12
|
Celedonia KL, Karukivi M, Abio A, Valenti MW, Lowery Wilson M. Correlates for Suicidality Among At-risk Youth Receiving Community-Based Mental Health Services. Community Ment Health J 2023; 59:335-344. [PMID: 35915295 PMCID: PMC9342600 DOI: 10.1007/s10597-022-01011-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/12/2022] [Indexed: 01/25/2023]
Abstract
"At-risk" adolescents are at high risk of unsuccessfully transitioning into adulthood and are also at elevated risk for suicidal behavior. Though much research has been conducted on risk factors for suicidality among the general adolescent population, research on suicidality among "at-risk" adolescents is lacking. This is a notable gap in the literature given that "at-risk" adolescents may be three times more likely to exhibit suicidality. The present study addressed this research gap by examining correlates for suicidality among "at-risk" adolescents receiving mental health services in the community. Using Electronic Health Record (EHR) data, risk factors for suicidality were analyzed at the bivariate and multivariate levels. Sexual abuse was a significant predictor of suicidality, as well as impulsivity for suicide attempt only. These findings may serve as useful adjuncts in the design of suicidality-screening tools and follow-up practices within the context of community-based mental health organizations which target at-risk adolescents.
Collapse
Affiliation(s)
- Karen L Celedonia
- Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Turku University Hospital and University of Turku, Turku, Finland.
- Social Research and Innovation Center, Pressley Ridge, Pittsburgh, PA, USA.
| | - Max Karukivi
- Department of Adolescent Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Anne Abio
- Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Turku University Hospital and University of Turku, Turku, Finland
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Michael W Valenti
- Social Research and Innovation Center, Pressley Ridge, Pittsburgh, PA, USA
| | | |
Collapse
|
13
|
Dissecting early life stress-induced adolescent depression through epigenomic approach. Mol Psychiatry 2023; 28:141-153. [PMID: 36517640 PMCID: PMC9812796 DOI: 10.1038/s41380-022-01907-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022]
Abstract
Early life stress (ELS), such as abuse and neglect during childhood, can lead to psychiatric disorders in later life. Previous studies have suggested that ELS can cause profound changes in gene expression through epigenetic mechanisms, which can lead to psychiatric disorders in adulthood; however, studies on epigenetic modifications associated with ELS and psychiatric disorders in adolescents are limited. Moreover, how these epigenetic modifications can lead to psychiatric disorders in adolescents is not fully understood. Commonly, DNA methylation, histone modification, and the regulation of noncoding RNAs have been attributed to the reprogramming of epigenetic profiling associated with ELS. Although only a few studies have attempted to examine epigenetic modifications in adolescents with ELS, existing evidence suggests that there are commonalities and differences in epigenetic profiling between adolescents and adults. In addition, epigenetic modifications are sex-dependent and are influenced by the type of ELS. In this review, we have critically evaluated the current evidence on epigenetic modifications in adolescents with ELS, particularly DNA methylation and the expression of microRNAs in both preclinical models and humans. We have also clarified the impact of ELS on psychiatric disorders in adolescents to predict the development of neuropsychiatric disorders and to prevent and recover these disorders through personalized medicine.
Collapse
|
14
|
Verlenden J, Kaczkowski W, Li J, Hertz M, Anderson KN, Bacon S, Dittus P. Associations between Adverse Childhood Experiences and Pandemic-Related Stress and the Impact on Adolescent Mental Health during the COVID-19 Pandemic. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 17:1-15. [PMID: 36532141 PMCID: PMC9747542 DOI: 10.1007/s40653-022-00502-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 06/01/2023]
Abstract
Vulnerabilities of adolescents during times of crisis have been previously identified, but little research has investigated the compounding effects of lifetime adversities and pandemic-related stress on adolescent mental health. This study uses adolescent self-report data to model relationships between stress exposures and indicators of poor mental health from the longitudinal COVID Experiences (CovEx) Surveys. These surveys were administered online in English to U.S. adolescents ages 13-19 using the NORC AmeriSpeak® panel, a probability-based panel designed to be representative of the U.S. household population. Two waves of data were collected (Wave 1: October-November 2020, n = 727; Wave 2: March-May 2021, n = 569). Measures included demographics, adverse childhood experiences (ACEs, 8 items), pandemic-related stress (Pandemic-Related Stress Index [PRSI], 7 items), and depression symptoms (Patient Health Questionnaire for Adolescents [PHQ-A], 9 items). Path analyses were conducted to examine pathways between Wave 1 ACEs, Wave 1 PRSI, and Wave 2 PHQ with covariates of sex and race/ethnicity. Females had higher ACEs, PRSI, and PHQ scores than males. The PRSI score at Wave 1 was positively associated with the PHQ at Wave 2 (b = 0.29, SE = 0.14, p < 0.001). ACEs at Wave 1 were positively associated with PRSI at Wave 1 (b = 0.31, SE = 0.03, p < 0.001) and with PHQ at Wave 2 (b = 0.32, SE = 0.12, p < 0.001). The direct effect of ACEs on PHQ (b = 0.23, SE = 0.12, p < 0.001) remained significant even after accounting for the indirect effect of pandemic-related stress (b = 0.09, SE = 0.05, p < 0.001). Pandemic-related stress had a direct, adverse impact on adolescent depressive symptoms and demonstrates a compounding effect of childhood adversity and pandemic-related stress on depression. Findings can aid the design of interventions that promote mental health and support adolescent coping and recovery. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-022-00502-0.
Collapse
Affiliation(s)
- Jorge Verlenden
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
| | - Wojciech Kaczkowski
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
| | - Jingjing Li
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
| | - Marci Hertz
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
| | - Kayla N. Anderson
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention (CDC/NCIPC/DVP), Atlanta, GA USA
| | - Sarah Bacon
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Office of Strategy and Innovation (CDC/NCIPC/OSI), Atlanta, GA USA
| | - Patricia Dittus
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
| |
Collapse
|
15
|
Lambert SF, Boyd RC, Ialongo NS. Protective factors for suicidal ideation among Black adolescents indirectly exposed to community violence. Suicide Life Threat Behav 2022; 52:478-489. [PMID: 35150017 DOI: 10.1111/sltb.12839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/25/2021] [Accepted: 11/12/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Community violence exposure has been identified as a risk factor for Black youth suicide ideation. However, little is known about factors that protect community violence exposed youth against suicide ideation. The current study examined associations between knowledge of family member and peers' community violence exposure and Black youth's subsequent suicidal ideation, and investigated self-worth and social support as protective factors. METHOD Participants were a community sample of Black youth (N = 447, 47.4% female; Mage = 11.77, SD = 0.35) who reported about community violence exposure, self-worth, social support, and suicide ideation in grades 6 and 7. RESULTS Regression analyses revealed that grade 6 knowledge of family member and peers' community violence exposure was associated with increases in suicide ideation assessed in grade 7. Self-worth attenuated the association between knowledge of others' community violence exposure and suicide ideation for male adolescents. For female adolescents, social support attenuated the association between knowledge of others' community violence and suicide ideation. CONCLUSIONS Findings highlight the consequential impact of knowledge about community violence for Black youth's suicidal ideation. Enhancing protective factors for Black youth is an important target for intervening with exposure to violence and reducing suicide ideation.
Collapse
Affiliation(s)
- Sharon F Lambert
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Rhonda C Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
16
|
Risk and Protective Factors Associated with Suicidal Thoughts and Behaviors Among Maryland Middle School Students. SCHOOL MENTAL HEALTH 2022; 14:1024-1043. [PMID: 35669255 PMCID: PMC9145114 DOI: 10.1007/s12310-022-09521-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 11/25/2022]
Abstract
The aim of this study was to identify independent risk and protective factors associated with self-reported suicidal thoughts and behaviors (STB) among young adolescents by examining self-report data on mental health, substance abuse, violence involvement, social and economic challenges and supports, physical health and demographics in relation to STB. Data from nearly 27,000 students who completed the 2018-19 Maryland Middle School Youth Risk Behavior Survey/Youth Tobacco Survey (YRBS/YTS) were used to identify independent risk and protective factors associated with STB among middle school students (grades 6–8; ages 11-14). Twenty-three percent of students reported lifetime suicidal ideation and nine percent reported lifetime attempt(s). Independent risk factors associated with STB include depression, substance abuse or misuse, violence involvement, bullying victimization at school or electronically, sexual activity, and sleep deprivation. Protective factors include having an adult outside of school to confide in and feeling that teachers care and provide encouragement. Interactive effects by gender and/or race/ethnicity were observed for some factors in relation to STB. These results suggest that evidence-based programs and policies at the universal and selective/indicated levels in school settings are needed and should be introduced earlier on to address the widespread prevalence of STB in young adolescents. Program planners should take into consideration social, cultural and language needs when implementing and developing intervention strategies.
Collapse
|