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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.
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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
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Stewart JG, Pizzagalli DA, Auerbach RP. Stress exposure in at-risk, depressed, and suicidal adolescents. J Child Psychol Psychiatry 2024; 65:942-958. [PMID: 38100210 PMCID: PMC11161328 DOI: 10.1111/jcpp.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Stress exposure contributes to the onset, maintenance, and recurrence of major depressive disorder (MDD) in adolescents. However, the precise stress facets (e.g. chronicity, domain) most strongly linked to outcomes at different stages along the depression severity continuum remain unclear. Across two studies, chronic and episodic stressors were comprehensively assessed among: (a) healthy youth with (High-Risk [HR]) and without (Low-Risk [LR]) a maternal history of MDD and (b) adolescents with current MDD and suicide ideation and healthy controls (HC). METHOD Study 1 included LR (n = 65) and HR (n = 22) 12- to 14-year-olds (49 females; 56.32%) with no lifetime history of mental disorders. Study 2 enrolled 87 mid-to-late adolescents (64 females; 73.56%), including 57 MDD youth from a short-term intensive treatment service and 30 HCs from the community. All depressed youth reported recent suicide ideation; some had no lifetime history suicide attempts (SI; n = 31) and others reported at least one past year attempt (SA; n = 26). The Life Events and Difficulties Schedule was used to capture stressor severity in both studies. RESULTS We used multiple linear regression models that adjusted for demographic and clinical covariates. Being in the HR versus LR group was associated with more severe chronic (β = .22, CI95 = 0.01-0.42, p = .041), independent (β = .34, CI95 = 0.12-0.56, p = .003), and interpersonal (β = .23, CI95 = 0.004-0.45, p = .047) stress severity. By contrast, the MDD group reported significantly more severe chronic (β = .62, CI95 = 0.45-0.79, p < .001) and dependent (β = .41, CI95 = 0.21-0.61, p < .001) stress than the HC group, but not independent (p = .083) stress. Stress severity did not differ between recent attempters versus youth who reported suicide ideation alone (SA vs. SI contrast). However, the SA group reported a higher rate of targeted rejection events (RR = 3.53, CI95 = 1.17-10.70, p = .026). CONCLUSIONS Our findings clarify the stressor features that may most strongly contribute to adolescent depression and its clinical correlates at two important points along depression's clinical course.
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Affiliation(s)
- Jeremy G. Stewart
- Department of Psychology, Queen’s University, Kingston, Ontario, Canada
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
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Kirshenbaum JS, Pagliaccio D, Bitran A, Xu E, Auerbach RP. Why do adolescents attempt suicide? Insights from leading ideation-to-action suicide theories: a systematic review. Transl Psychiatry 2024; 14:266. [PMID: 38937430 PMCID: PMC11211511 DOI: 10.1038/s41398-024-02914-y] [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: 10/14/2022] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 06/29/2024] Open
Abstract
Suicide is a leading cause of death among adolescents, and recent suicide theories have sought to clarify the factors that facilitate the transition from suicide ideation to action. Specifically, the Interpersonal Theory of Suicide (IPTS), Integrated Motivational-Volitional Model (IMV), and Three Step Theory (3ST) have highlighted risk factors central to the formation of suicidal ideation and suicidal behaviors, which is necessary for suicide death. However, these models were initially developed and tested among adults, and given core socioemotional and neurodevelopmental differences in adolescents, the applicability of these models remains unclear. Directly addressing this gap in knowledge, this systematic review aimed to (1) describe the evidence of leading ideation-to-action theories (i.e., IPTS, IMV, 3ST) as they relate to suicide risk among adolescents, (2) integrate ideation-to-action theories within prevailing biological frameworks of adolescent suicide, and (3) provide recommendations for future adolescent suicide research. Overall, few studies provided a complete test of models in adolescent samples, and empirical research testing components of these theories provided mixed support. Future research would benefit from integrating neurodevelopmental and developmentally sensitive psychosocial frameworks to increase the applicability of ideation-to-action theories to adolescents. Further, utilizing real-time monitoring approaches may serve to further clarify the temporal association among risk factors and suicide.
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Affiliation(s)
- Jaclyn S Kirshenbaum
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Alma Bitran
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Elisa Xu
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
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Bao J, Wan J, Li H, Sun F. Psychological pain and sociodemographic factors classified suicide attempt and non-suicidal self-injury in adolescents. Acta Psychol (Amst) 2024; 246:104271. [PMID: 38631150 DOI: 10.1016/j.actpsy.2024.104271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/01/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
This study aimed to utilize machine learning to explore the psychological similarities and differences between suicide attempt (SA) and non-suicidal self-injury (NSSI), with a particular focus on the role of psychological pain. A total of 2385 middle school students were recruited using cluster sampling. The random forest algorithm was used with 25 predictors to develop classification models of SA and NSSI, respectively, and to estimate the importance scores of each predictor. Based on these scores and related theories, shared risk factors (control feature set) and distinct risk factors (distinction feature set) were selected and tested to distinguish between NSSI and SA. The machine learning algorithm exhibited fair to good performance in classifying SA history [Area Under Curves (AUCs): 0.65-0.87] and poor performance in classifying NSSI history (AUC: 0.61-0.68). The distinction feature set comprised pain avoidance, family togetherness, and deviant peer affiliation, while the control feature set included pain arousal, painful feelings, and crisis events. The distinction feature set slightly but stably outperformed the control feature set in classifying SA from NSSI. The three-dimensional psychological pain model, especially pain avoidance, might play a dominant role in understanding the similarities and differences between SA and NSSI.
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Affiliation(s)
- Jiamin Bao
- Department of Psychology, Renmin University of China, Beijing 100872, PR China
| | - Jiachen Wan
- Department of Psychology, Renmin University of China, Beijing 100872, PR China
| | - Huanhuan Li
- Department of Psychology, Renmin University of China, Beijing 100872, PR China.
| | - Fang Sun
- Department of Psychology, Renmin University of China, Beijing 100872, PR China
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Lee MS, Lee H. Latent class analysis of health behaviors, anxiety, and suicidal behaviors among Korean adolescents. J Affect Disord 2024; 354:339-346. [PMID: 38484891 DOI: 10.1016/j.jad.2024.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND This study examined how health behavior patterns are associated with anxiety and suicidal behaviors among Korean adolescents. METHODS Data were collected from a national cross-sectional sample of adolescents (n = 54,948, 51.5 % boys) in the 2020 Korea Youth Risk Behavior Web-based Survey. Latent class analysis was conducted based on 12 health behaviors (e.g., eating habits, physical activity, and substance use) using the R-based Jamovi 2.3.21 program. RESULTS Four classes of health behaviors were identified: Class 1 (boys: 45.4 %, girls: 34.4 %) engaged in healthy behaviors; Class 2 (boys: 31.7 %; girls: 22.3 %) had unhealthy eating habits; Class 3 (boys: 18.0 %; girls: 39.9 %) had the lowest physical activity; and Class 4 (boys: 5.0 %, girls: 3.4 %) engaged in substance use, including smoking, drinking, and problematic smartphone use. Overall, girls had a higher odds ratio (OR) for anxiety and suicidal behaviors than boys did. Among girls, Class 4 had a higher OR for anxiety (OR = 2.78, 95 % confidence interval [CI] = 2.40-3.21), suicidal ideation (OR = 3.99, 95 % CI = 3.46-4.62), suicide plan (OR = 3.32, 95 % CI = 2.66-4.16), and suicide attempts (OR = 5.62, 95 % CI = 4.43-7.12) than Class 1. LIMITATIONS This study has a few limitations including the participants' response bias, the use of a self-report survey, and the lack of diagnosis by clinicians. CONCLUSION Adolescents engaging in substance abuse (Class 4) were more prone to anxiety symptoms and suicidal behaviors (ideation, plan, and attempts) than those engaged in healthy behaviors (Class 1). We suggest that more attention is needed to develop suicide prevention strategies that consider adolescent substance use patterns such as current smoking, drinking, and problematic smartphone use.
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Affiliation(s)
- Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hooyeon Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
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Stephenson M, Ohlsson H, Lannoy S, Sundquist J, Sundquist K, Edwards AC. Clarifying the relationship between physical injuries and risk for suicide attempt in a Swedish national sample. Acta Psychiatr Scand 2024; 149:389-403. [PMID: 38414134 PMCID: PMC10987261 DOI: 10.1111/acps.13675] [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: 09/19/2023] [Revised: 01/09/2024] [Accepted: 02/14/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION The Interpersonal-Psychological Theory of Suicide proposes that capability for suicide is acquired through exposure to painful and provocative events (PPEs). Although there is robust evidence for a positive association between aggregate measures of PPEs and risk for suicidal behavior, little is known about the contributions of physical injuries. The present study investigated the relationship between injuries and risk of subsequent suicide attempt (SA). METHODS Data were from Swedish population-based registers. All individuals born in Sweden between 1970 and 1990 were included (N = 1,011,725 females and 1,067,709 males). We used Cox regression models to test associations between 10 types of injuries (eye injury; fracture; dislocation/sprain/strain; injury to nerves and spinal cord; injury to blood vessels; intracranial injury; crushing injury; internal injury; traumatic amputation; and other or unspecified injuries) and risk for later SA. Analyses were stratified by sex and adjusted for year of birth and parental education. Additional models tested for differences in the pattern of associations based on age group and genetic liability for SA. In co-relative models, we tested the association between each injury type and risk for SA in relative pairs of varying genetic relatedness to control for unmeasured familial confounders. RESULTS All 10 injury types were associated with elevated risk for SA (hazard ratios [HRs] = 1.2-7.0). Associations were stronger in the first year following an injury (HRs = 1.8-7.0), but HRs remained above 1 more than 1 year after injury exposure (HRs = 1.2-2.6). The strength of associations varied across injury type, sex, age, and genetic liability for SA. For example, the magnitude of the association between crushing injury and risk for SA was larger in females than males, whereas other injuries showed a similar pattern of associations across sex. Moreover, there was evidence to support positive additive interaction effects between several injury types and aggregate genetic liability for SA (relative excess risk due to interaction [RERI] = 0.1-0.3), but the majority of these interactions became non-significant or changed direction after accounting for comorbid psychiatric and substance use disorders. In co-relative models, the pattern of associations differed by injury type, such that there was evidence to support a potential causal effect of eye injury, fracture, dislocation/sprain/strain, intracranial injury, and other and unspecified injuries on risk for SA. For the remaining injury types, HRs were not significantly different from 1 in monozygotic twins, which is consistent with confounding by familial factors. CONCLUSIONS Injuries are associated with increased risk for subsequent SA, particularly in the first year following an injury. While genetic and familial environmental factors may partly explain these associations, there is also evidence to support a potential causal effect of several injury types on future risk for SA.
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Affiliation(s)
- Mallory Stephenson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Séverine Lannoy
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America
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Schantell M, Taylor BK, Mansouri A, Arif Y, Coutant AT, Rice DL, Wang YP, Calhoun VD, Stephen JM, Wilson TW. Theta oscillatory dynamics serving cognitive control index psychosocial distress in youth. Neurobiol Stress 2024; 29:100599. [PMID: 38213830 PMCID: PMC10776433 DOI: 10.1016/j.ynstr.2023.100599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/09/2023] [Accepted: 12/10/2023] [Indexed: 01/13/2024] Open
Abstract
Background Psychosocial distress among youth is a major public health issue characterized by disruptions in cognitive control processing. Using the National Institute of Mental Health's Research Domain Criteria (RDoC) framework, we quantified multidimensional neural oscillatory markers of psychosocial distress serving cognitive control in youth. Methods The sample consisted of 39 peri-adolescent participants who completed the NIH Toolbox Emotion Battery (NIHTB-EB) and the Eriksen flanker task during magnetoencephalography (MEG). A psychosocial distress index was computed with exploratory factor analysis using assessments from the NIHTB-EB. MEG data were analyzed in the time-frequency domain and peak voxels from oscillatory maps depicting the neural cognitive interference effect were extracted for voxel time series analyses to identify spontaneous and oscillatory aberrations in dynamics serving cognitive control as a function of psychosocial distress. Further, we quantified the relationship between psychosocial distress and dynamic functional connectivity between regions supporting cognitive control. Results The continuous psychosocial distress index was strongly associated with validated measures of pediatric psychopathology. Theta-band neural cognitive interference was identified in the left dorsolateral prefrontal cortex (dlPFC) and middle cingulate cortex (MCC). Time series analyses of these regions indicated that greater psychosocial distress was associated with elevated spontaneous activity in both the dlPFC and MCC and blunted theta oscillations in the MCC. Finally, we found that stronger phase coherence between the dlPFC and MCC was associated with greater psychosocial distress. Conclusions Greater psychosocial distress was marked by alterations in spontaneous and oscillatory theta activity serving cognitive control, along with hyperconnectivity between the dlPFC and MCC.
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Affiliation(s)
- Mikki Schantell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Brittany K. Taylor
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
| | - Amirsalar Mansouri
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Yasra Arif
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Anna T. Coutant
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Danielle L. Rice
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Yu-Ping Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, LA, USA
| | - Vince D. Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging & Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | | | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
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Park Y, Qu W, Ammerman BA. Characteristics and Functions of Non-Suicidal Self-Injury That Inform Suicide Risk. Arch Suicide Res 2024:1-14. [PMID: 38314767 DOI: 10.1080/13811118.2024.2310556] [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: 02/07/2024]
Abstract
OBJECTIVE Although non-suicidal self-injury (i.e., NSSI) has been suggested as a robust risk factor of suicide, NSSI related information that is most related to suicide risk remains unclear. Commonly studied NSSI characteristics are its frequency and the number of methods endorsed. However, it may not be merely how frequent or how many different methods that matters, but "why," which alludes to the importance of NSSI functions (or why individuals engage in NSSI). Thus, this study examined how the interactions between NSSI characteristics and functions are associated with suicide risk. METHODS Undergraduate students (n = 820) with a lifetime history of NSSI, filled out self-report measures on NSSI and suicide risk. A hierarchical regression analysis was conducted to examine the moderation effects between four 2-way interactions (i.e., method X intrapersonal; method X interpersonal; frequency X intrapersonal; frequency X interpersonal) on suicide risk. RESULTS Main effects of all four independent variables were statistically significant. In terms of interactions, the intrapersonal function moderated both the effects of NSSI frequency and methods on suicide risk, whereas the interpersonal function moderated the effects of NSSI frequency on suicide risk. CONCLUSION Our results highlight that some NSSI related information than others are more indicative of suicide risk. In particular, the combination of NSSI functions, along with its frequency and number of methods, holds promise when assessing for current and lifetime suicidal thoughts and behaviors.
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Berny LM, Mojekwu F, Nichols LM, Tanner-Smith EE. Investigating the Interplay Between Mental Health Conditions and Social Connectedness on Suicide Risk: Findings from a Clinical Sample of Adolescents. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01659-x. [PMID: 38308712 DOI: 10.1007/s10578-023-01659-x] [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] [Accepted: 12/15/2023] [Indexed: 02/05/2024]
Abstract
This study examined whether school and community connectedness buffer the relationships between mental health conditions and suicide risk in a clinical sample of adolescents with histories of substance use disorders. Data from 294 adolescents were examined, with approximately 58% reporting lifetime suicidal ideation and/or prior attempts. Multinomial logistic regression was used to examine main and interaction effects on a three-category measure of suicide risk. Depression severity and panic disorder were associated with elevated suicidal ideation risk, whereas disordered eating was associated with elevated risk of attempts. Higher school-based positive peer interactions, school safety, and neighborhood social connection levels were associated with reduced suicide attempt risk. Moderation analyses revealed that high neighborhood social connection levels may partially mitigate the elevated likelihood of attempting suicide associated with disordered eating. Findings suggest clinical populations of adolescents may benefit from approaches aiming to promote social connectedness, further supporting a comprehensive approach to suicide prevention.
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Affiliation(s)
- Lauren M Berny
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR, 97403, USA.
| | - Frank Mojekwu
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR, 97403, USA
| | - Lindsey M Nichols
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR, 97403, USA
| | - Emily E Tanner-Smith
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR, 97403, USA
- Prevention Science Institute, University of Oregon, Eugene, USA
- HEDCO Institute for Evidence-Based Educational Practice, University of Oregon, Eugene, USA
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Millon EM, Alqueza KL, Kamath RA, Marsh R, Pagliaccio D, Blumberg HP, Stewart JG, Auerbach RP. Non-suicidal Self-injurious Thoughts and Behaviors Among Adolescent Inpatients. Child Psychiatry Hum Dev 2024; 55:48-59. [PMID: 35727385 PMCID: PMC9782727 DOI: 10.1007/s10578-022-01380-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 01/07/2023]
Abstract
Non-suicidal self-injury (NSSI) is a serious public health concern that typically onsets during early adolescence. Adolescents (N = 980, ages 12-19 years) admitted for acute, residential psychiatric treatment completed baseline clinical interviews assessing mental disorders and questionnaires measuring demographics, early life adversity, and symptom severity. Prevalence rates of NSSI for lifetime (thoughts: 78%; behaviors: 72%), past year (thoughts: 74%; behaviors: 65%), and past month (thoughts: 68%; behaviors: 51%) were high. Although effect sizes were modest, the presence of a lifetime depressive disorder, sexual abuse, and comorbidity (i.e., three or more current disorders) were significant correlates of experiencing NSSI thoughts and behaviors. Furthermore, lifetime depressive disorder, current anxiety disorder, and comorbidity were associated with a greater odds of persistent NSSI thoughts and/or behaviors. Longitudinal studies are needed to determine whether targeting these factors reduces the persistence of NSSI thoughts and behaviors.
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Affiliation(s)
- Emma M Millon
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Kira L Alqueza
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rahil A Kamath
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rachel Marsh
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy G Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA.
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
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Barker J, Oakes-Rogers S, Lince K, Roberts A, Keddie R, Bruce H, Selvarajah S, Fish D, Aspen C, Leddy A. Can clinician's risk assessments distinguish those who disclose suicidal ideation from those who attempt suicide? DEATH STUDIES 2024; 48:129-139. [PMID: 36961770 DOI: 10.1080/07481187.2023.2192532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Participants were 85 individuals who made suicide attempts within two years of their Improving Access to Psychological Therapies (IAPT) assessment, identified using record linkage. Two comparison groups, non-suicidal controls (n = 1416) and (ideators, n = 743) were compared on variables extracted from the standardized IAPT risk assessment interview. Disclosure of a historical suicide attempt or non-suicidal self-injury (NSSI) distinguished those making an attempt from those with suicidal ideation only, but suicidal intent did not. A third of the participants concealed a historical suicide attempt. The IAPT Phobia Scale classified 49.30% of attempters with 100% specificity. The IAPT Phobia Scale may have clinical value in assessing risk but requires validation. Past suicide attempt and NSSI have better clinical risk assessment utility than current suicidal ideation intensity. Risk assessment relying on disclosure is likely to be flawed and risks support being withheld from those assumed to be at lower risk.
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Affiliation(s)
- Joseph Barker
- Department of Clinical Psychology, University of East Anglia, Norwich Research Park, Norwich, UK
| | - Sophie Oakes-Rogers
- Department of Clinical Psychology, University of East Anglia, Norwich Research Park, Norwich, UK
| | - Karen Lince
- Wellbeing Norfolk and Suffolk, The Conifers, Norwich, UK
| | - Ashley Roberts
- Wellbeing Norfolk and Suffolk, The Conifers, Norwich, UK
| | - Ronan Keddie
- Wellbeing Norfolk and Suffolk, The Conifers, Norwich, UK
| | - Harley Bruce
- Wellbeing Norfolk and Suffolk, The Conifers, Norwich, UK
| | | | - Daisy Fish
- Wellbeing Norfolk and Suffolk, The Conifers, Norwich, UK
| | - Caitlin Aspen
- Wellbeing Norfolk and Suffolk, The Conifers, Norwich, UK
| | - Adrian Leddy
- Department of Clinical Psychology, University of East Anglia, Norwich Research Park, Norwich, UK
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Mittermeier S, Seidel A, Scheiner C, Kleindienst N, Romanos M, Buerger A. Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:15. [PMID: 38245793 PMCID: PMC10800042 DOI: 10.1186/s13034-023-00699-4] [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: 08/01/2023] [Accepted: 12/20/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE Effective suicide prevention for adolescents is urgently needed but difficult, as suicide models lack a focus on age-specific influencing factors such as emotional dysregulation. Moreover, examined predictors often do not specifically consider the contribution to the severity of suicidality. To determine which adolescents are at high risk of more severe suicidality, we examined the association between emotional dysregulation and severity of suicidality directly as well as indirectly via depressiveness and nonsuicidal self-injury. METHOD Adolescents from 18 high schools in Bavaria were included in this cross-sectional and questionnaire-based study as part of a larger prevention study. Data were collected between November 2021 and March 2022 and were analyzed from January 2023 to April 2023. Students in the 6th or 7th grade of high school (11-14 years) were eligible to participate. A total of 2350 adolescents were surveyed and data from 2117 students were used for the analyses after excluding incomplete data sets. Our main outcome variable was severity of suicidality (Paykel Suicide Scale, PSS). Additionally, we assessed emotional dysregulation (Difficulties in Emotion Regulation Scale, DERS-SF), depressiveness (Patient Health Questionnaire, PHQ-9) and nonsuicidal self-injury (Deliberate Self-Harm Inventory, DSHI). RESULTS In total, 2117 adolescents (51.6% female; mean age, 12.31 years [standard deviation: 0.67]) were included in the structural equation model (SEM). Due to a clear gender-specific influence, the model was calculated separately for male and female adolescents. For male adolescents, there was a significant indirect association between emotional dysregulation and severity of suicidality, mediated by depressiveness (β = 0.15, SE = .03, p = .008). For female adolescents, there was a significant direct path from emotional dysregulation to severity of suicidality and also indirect paths via depressiveness (β = 0.12, SE = .05, p = 0.02) and NSSI (β = 0.18, SE = .04, p < .001). CONCLUSIONS Our results suggest that gender-related risk markers in 11-14-year-olds need to be included in future suicide models to increase their predictive power. According to our findings, early detection and prevention interventions based on emotion regulation skills might be enhanced by including gender-specific adjustments for the co-occurrence of emotional dysregulation, depressiveness, and nonsuicidal self-injury in girls and the co-occurrence of emotional dysregulation and depressiveness in boys.
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Affiliation(s)
- Sabrina Mittermeier
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany.
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany.
| | - Alexandra Seidel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany
| | - Christin Scheiner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany
| | - Nikolaus Kleindienst
- Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health Mannheim, Heidelberg University, Heidelberg, Germany
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany
| | - Arne Buerger
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany
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13
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Zheng Y, Wang J, Jiang Q, Liao M, Huang F. Non-suicidal self-injury and suicidal ideation among adolescents: the chain-mediating role of rumination and decentering. Front Psychiatry 2023; 14:1179518. [PMID: 37779633 PMCID: PMC10540194 DOI: 10.3389/fpsyt.2023.1179518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/25/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To explore the relationship between non-suicidal self-injury and suicidal ideation in adolescents and examine the roles of rumination and decentering in that relationship. Method By means of a questionnaire, 175 adolescent patients in a psychiatric hospital in Fujian Province were given the Functional Assessment of Self-Mutilation: Chinese Version, Positive and Negative Suicide Ideation, Ruminative Response Scale: Chinese Version, and Experiences Questionnaire: Decentering Scale. Results (1) Adolescent non-suicidal self-injury was significantly positively related to suicidal ideation and rumination and significantly negatively related to decentering. Suicidal ideation was significantly positively related to rumination and significantly negatively related to decentering. Rumination was significantly negatively related to decentering. (2) Rumination and decentering played a complete chain-mediating role between non-suicidal self-injury and suicidal ideation. Non-suicidal self-injury was found to indirectly affect suicidal ideation along three pathways: the independent mediating role of rumination (the mediating effect accounted for 40.166%), independent mediating role of decentering (the mediating effect accounted for 41.274%), and chain-mediating role of rumination and decentering (the mediating effect accounted for 14.958%). Conclusion Adolescent non-suicidal self-injury can indirectly affect suicidal ideation through rumination and decentering. In the future, mindfulness and other methods should be used to improve individuals' levels of decentering and cultivate emotional regulation abilities, so as to reduce the incidence of non-suicidal self-injury and suicide in adolescents.
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Affiliation(s)
| | | | | | - Meiling Liao
- School of Health, Fujian Medical University, Fuzhou, China
| | - Fajie Huang
- School of Health, Fujian Medical University, Fuzhou, China
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Predescu E, Sipos R. Self-Harm Behaviors, Suicide Attempts, and Suicidal Ideation in a Clinical Sample of Children and Adolescents with Psychiatric Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040725. [PMID: 37189974 DOI: 10.3390/children10040725] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
Suicidal ideation and self-harm behaviors have been found to be important risk factors for suicide. The aim of this study was to explore the rates of psychiatric disorders among different groups of patients with suicidal ideation, suicide attempts, and non-suicidal self-harm behaviors and to identify the associated socio-demographic and clinical variables. We conducted a cross-sectional study with emergency-admitted patients presenting with non-suicidal self-harm behaviors, suicide attempts, or suicidal ideation to the emergency room of the Child and Adolescent Psychiatry Clinic in Cluj-Napoca, Romania. Data were collected from the patients' charts using a questionnaire that contained socio-demographic and clinical variables. A total of 95 patients aged between 6 and 18 years were included in the study. Ingesting medication and cutting were the most frequently used methods to attempt suicide. Depression and mixed affective and conduct disorders were the diagnoses most commonly associated with suicidal behavior. Girls with depressive symptoms were more probable to have suicide attempts than boys, and girls with depressive symptoms and behavioral problems registered more self-harm behaviors. Further research should systematically examine the relationship between self-harm behaviors and suicide attempts and the profile of patients at risk of future suicide attempts.
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Affiliation(s)
- Elena Predescu
- Department of Neuroscience, Psychiatry and Pediatric Psychiatry, "IuliuHatieganu" University of Medicine and Pharmacy, 400460 Cluj-Napoca, Romania
| | - Roxana Sipos
- Department of Neuroscience, Psychiatry and Pediatric Psychiatry, "IuliuHatieganu" University of Medicine and Pharmacy, 400460 Cluj-Napoca, Romania
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15
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Alqueza KL, Pagliaccio D, Durham K, Srinivasan A, Stewart JG, Auerbach RP. Suicidal Thoughts and Behaviors Among Adolescent Psychiatric Inpatients. Arch Suicide Res 2023; 27:353-366. [PMID: 34761728 PMCID: PMC9675401 DOI: 10.1080/13811118.2021.1999874] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Given low base rates of suicidal thoughts and behaviors (STBs) in national samples of adolescents, clarifying the sociodemographic and clinical correlates among psychiatric inpatients may afford insights into potential risk factors that predict STBs onset. METHOD Adolescents (N = 970; ages 12-19 years) admitted for acute, psychiatric inpatient care completed baseline clinical interviews and self-report measures assessing demographics and early life adversity. Lifetime and 12-month STBs prevalence were obtained, allowing for the estimate of STBs persistence (i.e., rates of those with both current and past STBs) and transition rates (i.e., proportion of ideators that transition to plans or attempts). Univariate and multivariate logistic regression tested sociodemographic and clinical correlates of STBs. RESULTS Age-of-onset for STBs occurred in early adolescence. Most patients reported suicide ideation with nearly half of patients making a plan and one-third a suicide attempt. Although relatively modest, the strongest correlates of lifetime attempts were depressive disorders, physical abuse, and non-suicidal self-injury. Knowing a peer that had attempted suicide also increased the likelihood of a suicide attempt, especially among attempters who transitioned from ideation to planned attempts. CONCLUSION STBs are highly prevalent among adolescents admitted for acute psychiatric inpatient treatment. The modest effects suggest that correlates, particularly those related to suicide attempts, are widely distributed. As a history of physical abuse and knowing a peer with a suicide attempt history are related to transitioning from ideation to action, these may be critical factors to target in the deployment of future suicide prevention and treatment programs. HIGHLIGHTSOne-third of adolescent inpatients report a lifetime history of suicide attempts.Approximately 65% of adolescent inpatients with a lifetime plan attempt suicide.Knowing peers who attempt suicide may facilitate the transition from ideation to action.
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Affiliation(s)
- Kira L. Alqueza
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Katherine Durham
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Apoorva Srinivasan
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Jeremy G. Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA
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16
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Rivers AS, Winston-Lindeboom P, Atte T, Rosen P, Wintersteen M, Watkins NK, Tien A, Diamond G. Differentiating Between Youth with a History of Suicidal Thoughts, Plans, and Attempts. SCHOOL MENTAL HEALTH 2023; 15:1-10. [PMID: 36855560 PMCID: PMC9951160 DOI: 10.1007/s12310-023-09575-0] [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] [Accepted: 02/13/2023] [Indexed: 03/02/2023]
Abstract
Limited research has examined factors distinguishing between patterns of adolescent suicidal thoughts and behaviors. The current study examined demographic, school, family, and mental health differences across patterns identified by Romanelli and colleagues (2022): history of thoughts only, plans with thoughts, attempt with thoughts and/or plans, and attempt without thoughts. The current study includes 4,233 students (M age = 14.65 years, SD = 2.06) with a history of suicide risk referred to school Student Assistance Program teams. The sample was approximately 60.7% female, 59.8% White (16.0% Black, 15.4% multiracial, 8.8% other), and 14.4% Hispanic. Results indicated that the "attempt without thoughts" group was small with no differentiating characteristics. However, membership in the other three groups was predicted by demographic, school, family, and mental health factors. These results support the importance of examining suicidal thoughts, plans, and attempts as distinct indicators and assessing key biopsychosocial factors. Further research could improve how behavioral health systems identify at risk youth.
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Affiliation(s)
- Alannah Shelby Rivers
- Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University, Philadelphia, PA USA
- Social Work, Psychology, and Philosophy, Texas Woman’s University, Denton, TX USA
| | - Payne Winston-Lindeboom
- Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University, Philadelphia, PA USA
| | - Tita Atte
- Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University, Philadelphia, PA USA
| | - Perri Rosen
- Pennsylvania Garrett Lee Smith Youth Suicide Prevention Grant, Harrisburg, PA USA
| | - Matt Wintersteen
- Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA USA
| | - Nicole Kathleen Watkins
- Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University, Philadelphia, PA USA
| | - Allen Tien
- Medical Decision Logic, Inc, Baltimore, MD USA
| | - Guy Diamond
- Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University, Philadelphia, PA USA
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Park Y, Ammerman BA. For Better or Worse?: The role of cognitive flexibility in the association between nonsuicidal self-injury and suicide attempt. J Psychiatr Res 2023; 158:157-164. [PMID: 36586214 DOI: 10.1016/j.jpsychires.2022.12.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/25/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
Nonsuicidal self-injury (NSSI) has been repeatedly associated with increased suicide risk. However, the transition from NSSI to suicidal thoughts and behaviors still remains as an enigma. One possible construct that may influence this relationship is cognitive flexibility, which refers to the ability to adapt responses/strategies based on environmental feedback. It may be that greater cognitive flexibility increases one's cognitive accessibility to suicide, making it a more viable option upon distress especially for those with a prior history of NSSI. Conversely, it may be that less cognitive flexibility creates a negative bias that exacerbates the effects of NSSI on suicide. Thus, in this study, we examined how NSSI characteristics (i.e., frequency and methods) interact with cognitive flexibility to predict lifetime suicide attempt (SA) history. Participants were 505 individuals with a lifetime history of NSSI who completed a survey assessing for their NSSI experiences, cognitive flexibility, and SA history. Moderation analyses were conducted while controlling for sexual orientation, which significantly predicted SA history. Results indicated a significant interaction between number of NSSI methods endorsed and cognitive flexibility. In particular, individuals were more likely to have had a history of SA if they scored higher on the alternative subscale of cognitive flexibility. The results suggest that the adaptive value of cognitive flexibility may be context dependent, and highlight the importance of personalized care among those who engage in self-harm.
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Affiliation(s)
- Yeonsoo Park
- University of Notre Dame, Department of Psychology, USA.
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18
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Yu L, Zhao J, Zhao T, Xiao Y, Ou Q, He J, Luo J, Zhong Y, Cen Y, Luo W, Yang J, Deng Y, Zhang J, Luo J. Multicenter analysis on the non-suicidal self-injury behaviors and related influencing factors-A case study of left-behind children in northeastern Sichuan. J Affect Disord 2023; 320:161-168. [PMID: 36162662 DOI: 10.1016/j.jad.2022.09.081] [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: 12/12/2021] [Revised: 08/29/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Few studies have been conducted focusing on the non-suicidal self-injury (NSSI) incidence rate and influencing factors among left-behind children in northeastern Sichuan, China. In this study, we investigated the incidence rate of the NSSI behaviors, levels of anxiety and depression in left-behind children in northeastern Sichuan, and relevant sociodemographic factors. METHODS The NSSI behaviors were identified using the Ottawa Self-injury Inventory (Chinese version). Its incidence rate and related influencing factors were evaluated by Cluster sampling; the Depression Anxiety Stress Scale-21 Items (DASS-21) was adopted to assess the levels of anxiety, depression, and stress. RESULTS A total of 9450 adolescents met the inclusion criteria, including 543 with NSSI behaviors, and the prevalence of NSSI was 5.7 %. There were 3596 left-behind children, and 243 of them had NSSI behaviors, the NSSI incidence in left-behind children was 6.8 %. There were 5854 non-left-behind children, and the NSSI incidence in non-left-behind children was 5.1 %. Left-behind children's NSSI behaviors were remarkably correlated with five risk factors: being female (OR = 2.411, 95%CI = 1.773-3.279), parents' divorce (OR = 1.742, 95%CI = 1.262-2.404), elder age (OR = 1.120, 95%CI = 1.028-1.219), severe depression (OR = 1.212, 95%CI = 1.148-1.281), and high anxiety (OR = 1.170, 95%CI = 1.093-1.251). LIMITATIONS This is a cross-sectional study, we cannot probe into the causality between NSSI behaviors and corresponding risk factors. Reporting and recalling biases may be unavoidable as questionnaires are performed by self-rating scales and retrospective reports. CONCLUSION The NSSI behaviors are common in left-behind children in northeastern Sichuan. This study proposes that prevention and intervention measures are necessary for the healthy growth of such children.
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Affiliation(s)
- Ling Yu
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; School of Psychiatry, North Sichuan Medical College, Nanchong, China; Department of Psychiatry, Nanchong Psychosomatic Hospital, Nanchong, China
| | - Jiayu Zhao
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ting Zhao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yun Xiao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Qin Ou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - JinLong He
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jing Luo
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yunling Zhong
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yu Cen
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Wenxiu Luo
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - JiaMing Yang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ya Deng
- Department of Basic Medicine, Dazhou Vocational College of Chinese Medicine, Dazhou, China
| | - Jiazhu Zhang
- Nanyang Centre for Public Administration, Nanyang Technological University, Singapore
| | - Jiaming Luo
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; School of Psychiatry, North Sichuan Medical College, Nanchong, China.
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Stewart JG, Meddaoui B, Kaufman EA, Björgvinsson T, Beard C. Changes in suicide capability during short-term partial hospital treatment. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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20
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Wu CZ, Zong ZY, Huang TT, Yu LX, Sun QW. Childhood maltreatment influences suicidal behavior: Rumination mediates and regulatory emotional self-efficacy moderates. DEATH STUDIES 2023; 47:784-791. [PMID: 36240232 DOI: 10.1080/07481187.2022.2132319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
To investigate the mediating role of rumination in the association between childhood maltreatment and suicidal behavior, and the moderating role of regulatory emotional self-efficacy, university students (N = 1,458) from 5 universities in China completed questionnaires in classrooms. Path analyses showed emotional maltreatment had the greatest positive association with suicidal behavior and rumination compared with other types of childhood maltreatment. Rumination partly mediated the relationship between childhood maltreatment and suicidal behavior. High regulatory emotional self-efficacy moderated the relation between ruminating childhood maltreatment and suicidal behavior.
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Affiliation(s)
- Cai-Zhi Wu
- Key Laboratory of Human Development and Mental Health of Hubei Province, Key Laboratory of Adolescent Cyber Psychology and Behavior, Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China
| | - Zhi-Ying Zong
- Key Laboratory of Human Development and Mental Health of Hubei Province, Key Laboratory of Adolescent Cyber Psychology and Behavior, Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China
| | - Ting-Ting Huang
- Key Laboratory of Human Development and Mental Health of Hubei Province, Key Laboratory of Adolescent Cyber Psychology and Behavior, Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China
| | - Li-Xia Yu
- Key Laboratory of Human Development and Mental Health of Hubei Province, Key Laboratory of Adolescent Cyber Psychology and Behavior, Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China
| | - Qi-Wu Sun
- Key Laboratory of Human Development and Mental Health of Hubei Province, Key Laboratory of Adolescent Cyber Psychology and Behavior, Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China
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21
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Basic psychological need frustration and adolescent non-suicidal self-injury: Testing a moderated mediation model of depression and self-compassion. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03758-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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22
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Childhood maltreatment and nonsuicidal self-injury among younger Chinese prisoners: the mediating role of self-esteem. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03647-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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23
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Schwartz-Lifshitz M, Ben-Dor DH, Bustan Y, Zalsman G, Gothelf D, Weizman A, Barzilay R. Phenotypic Characterization of Youth Admitted To Acute Psychiatric Inpatient Unit Following Self-Harm Behavior. Arch Suicide Res 2022; 26:1186-1197. [PMID: 33403931 PMCID: PMC9534345 DOI: 10.1080/13811118.2020.1865223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Deliberate self-harm (DSH) is a major health concern among adolescents, and is often associated with the need for inpatient psychiatric hospitalization. The aim of this study was to identify clinical and demographic characteristics associated with DSH behavior among adolescents admitted to an acute psychiatric inpatient unit. METHOD We retrospectively analyzed data from the electronic medical records of consecutive admittances to a single acute adolescent inpatient unit (n = 703, mean age 15.2). We compared inpatients with DSH to inpatients without DSH and further compared within the DSH group based on the presence of suicidal intent. RESULTS Compared to Non-DSH inpatients (n = 497), youths admitted following DSH (n = 206) were more likely to be female (OR = 2.6, 95%CI 1.7-4), currently in depressive exacerbation (OR = 2.4, 95%CI 1.6-3.6), with concurrent suicidal ideation (OR = 3.9, 95%CI 2.5-5.9), and history of alcohol use (OR = 5.6, 95%CI 3.2-9.5). Within DSH youths, no significant clinical differences were identified between those admitted following a suicide attempt (n = 102) compared to non-suicidal-self-injury (n = 104), who were generally younger. CONCLUSIONS Findings suggest that early detection and intervention of DSH and depressive crisis is warranted, regardless of the self-harm subtype.HIGHLIGHTSDeliberate self-harm is common among adolescent psychiatric inpatients.Adolescent inpatients with deliberate self-harm are predominantly females with concurrent depression and suicidal ideation.We did not detect significant clinical and demographic differences between self-harmers with or without suicidal intent.
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Sparrow-Downes VM, Trincao-Batra S, Cloutier P, Helleman AR, Salamatmanesh M, Gardner W, Baksh A, Kapur R, Sheridan N, Suntharalingam S, Currie L, Carrie LD, Hamilton A, Pajer K. Peripheral and neural correlates of self-harm in children and adolescents: a scoping review. BMC Psychiatry 2022; 22:318. [PMID: 35509053 PMCID: PMC9066835 DOI: 10.1186/s12888-022-03724-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/17/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Self-harm in children and adolescents is difficult to treat. Peripheral and neural correlates of self-harm could lead to biomarkers to guide precision care. We therefore conducted a scoping review of research on peripheral and neural correlates of self-harm in this age group. METHODS PubMed and Embase databases were searched from January 1980-May 2020, seeking English language peer-reviewed studies about peripheral and neural correlates of self-harm, defined as completed suicide, suicide attempts, suicidal ideation, or non-suicidal self-injury (NSSI) in subjects, birth to 19 years of age. Studies were excluded if only investigating self-harm in persons with intellectual or developmental disability syndromes. A blinded multi-stage assessment process by pairs of co-authors selected final studies for review. Risk of bias estimates were done on final studies. RESULTS We screened 5537 unduplicated abstracts, leading to the identification of 79 eligible studies in 76 papers. Of these, 48 investigated peripheral correlates and 31 examined neural correlates. Suicidality was the focus in 2/3 of the studies, with NSSI and any type of self-harm (subjects recruited with suicidality, NSSI, or both) investigated in the remaining studies. All studies used observational designs (primarily case-control), most used convenience samples of adolescent patients which were predominately female and half of which were recruited based on a disorder. Over a quarter of the specific correlates were investigated with only one study. Inter-study agreement on findings from specific correlates with more than one study was often low. Estimates of Good for risk of bias were assigned to 37% of the studies and the majority were rated as Fair. CONCLUSIONS Research on peripheral and neural correlates of self-harm is not sufficiently mature to identify potential biomarkers. Conflicting findings were reported for many of the correlates studied. Methodological problems may have produced biased findings and results are mainly generalizable to patients and girls. We provide recommendations to improve future peripheral and neural correlate research in children and adolescents, ages 3-19 years, with self-harm.
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Affiliation(s)
- Victoria M. Sparrow-Downes
- grid.25055.370000 0000 9130 6822Department of Family Medicine Residency Program, Memorial University of Newfoundland, NL St. John’s, Canada
| | - Sara Trincao-Batra
- grid.25055.370000 0000 9130 6822Department of Pediatrics Residency Program, Memorial University of Newfoundland, NL St. John’s, Canada
| | - Paula Cloutier
- grid.414148.c0000 0000 9402 6172CHEO Research Institute, Ottawa, ON Canada
| | - Amanda R. Helleman
- grid.414148.c0000 0000 9402 6172CHEO Research Institute, Ottawa, ON Canada
| | - Mina Salamatmanesh
- grid.414148.c0000 0000 9402 6172CHEO Research Institute, Ottawa, ON Canada
| | - William Gardner
- grid.414148.c0000 0000 9402 6172CHEO Research Institute, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255Department of Psychiatry, University of Ottawa, ON Ottawa, Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, ON Ottawa, Canada
| | - Anton Baksh
- grid.28046.380000 0001 2182 2255Department of Psychiatry, University of Ottawa, ON Ottawa, Canada
| | - Rishi Kapur
- grid.28046.380000 0001 2182 2255Department of Psychiatry, University of Ottawa, ON Ottawa, Canada
| | - Nicole Sheridan
- grid.414148.c0000 0000 9402 6172CHEO Research Institute, Ottawa, ON Canada
| | - Sinthuja Suntharalingam
- grid.28046.380000 0001 2182 2255Department of Psychiatry, University of Ottawa, ON Ottawa, Canada
| | - Lisa Currie
- grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, ON Ottawa, Canada
| | - Liam D. Carrie
- Research Fellow, Harbourfront Health Group, Grand Falls, NB Canada
| | - Arthur Hamilton
- grid.34428.390000 0004 1936 893XPhD Program, Department of Cognitive Science, Carleton University, Ottawa, ON Canada
| | - Kathleen Pajer
- CHEO Research Institute, Ottawa, ON, Canada. .,Department of Psychiatry, University of Ottawa, ON, Ottawa, Canada.
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Depressive symptoms as a mediator between perceived social support and suicidal ideation among Chinese adolescents. J Affect Disord 2022; 302:234-240. [PMID: 35090945 DOI: 10.1016/j.jad.2022.01.061] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/09/2021] [Accepted: 01/11/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Little is known about the association between perceived social support (PSS) and suicidal ideation in Chinese adolescents. This study was to examine the association of perceived social support and suicidal ideation (SI) and the mediating role of depressive symptoms in a large sample of adolescents in China. METHOD A total of 11,831 adolescents who participated in the baseline Shandong Adolescent Behavior & Health Cohort were included for analysis. Perceived social support, depressive symptoms, and other variables were assessed by a self-administrated questionnaire. Path analysis was used to estimate the association between PSS, depressive symptoms, and suicidal ideation. RESULTS The prevalence rate of SI in the past year was 12.5%. Suicidal ideation and depressive symptoms were significantly associated with low PSS from family, friends, and significant others. Path analysis revealed that depressive symptoms partially mediated the relationship between PSS from family, friends, and significant others and suicidal ideation. After controlling for covariates, the mediation effect proportion of depressive symptoms on the associations between perceived social support from family, friends, and significant others and SI ranged from 19.20% to 62.12%. LIMITATIONS As this is a cross-sectional study, no causal relationship could be made. CONCLUSIONS Depressive symptoms partially mediated the association between perceived social support and suicidal ideation. Longitudinal research is needed to better understand the association between social support and suicidal ideation in adolescents.
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Poyraz Fındık OT, Erdoğdu AB, Fadıloğlu E, Rodopman Arman A. Emergency Department Visits for Non-suicidal Self-harm, Suicidal Ideation, and Suicide Attempts in Children and Adolescents. Child Psychiatry Hum Dev 2022; 53:289-299. [PMID: 33523341 DOI: 10.1007/s10578-021-01125-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/26/2022]
Abstract
Self-harm presentations to emergency departments (ED) have become a growing concern, yet little is known about self-harm visits in pediatric EDs. This study aimed to investigate the clinical and demographic characteristics of patients who presented to the pediatric ED between 2012 and 2017 with non-suicidal self-harm (NSSH, n = 63, 60.3% female, M = 14.25 years), suicidal ideation (SI, n = 75, 57.3% female, M = 14.83 years), and suicide attempts (SA, n = 461, 82.9% female, M = 15.41 years). Also, predictors of SA were investigated. Of the patients, 79.4% had at least a psychiatric disorder. Depression was the most common diagnosis in the SI and SA groups, and autism spectrum disorder and intellectual disability were the leading diagnoses in the NSSH group. Self-poisoning was the most common method, and older age, female sex, having relational problems, and prior or current psychiatric admissions were the most important predictive factors of SA. NSSH, SI, and SA exhibit different features in early life. EDs provide an important opportunity for initiating developmentally appropriate interventions to reduce future risks.
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Affiliation(s)
- Onur Tuğçe Poyraz Fındık
- Department of Child and Adolescent Psychiatry, Marmara University, School of Medicine, Pendik Research and Training Hospital, Istanbul, Turkey.
| | - Ayşe Burcu Erdoğdu
- Department of Child and Adolescent Psychiatry, Marmara University, School of Medicine, Istanbul, Turkey
| | - Eray Fadıloğlu
- Child and Psychiatry Clinic, University of Health Sciences, Van Research and Training Hospital, Van, Turkey
| | - Ayşe Rodopman Arman
- Department of Child and Adolescent Psychiatry, Marmara University, School of Medicine, Istanbul, Turkey
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Gouveia-Pereira M, Duarte E, Gomes HS, da Silva CT, Santos N. Exploring the suicidal continuum: Deliberate self-harm diversity and severity as predictors of suicidal ideation and suicide attempts. Psychiatry Res 2022; 309:114400. [PMID: 35078007 DOI: 10.1016/j.psychres.2022.114400] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 11/17/2022]
Abstract
Deliberate self-harm (DSH) in adolescence is a predictor of suicidal thoughts and behaviors (STBs). However, there is still a lack of research systematizing the association between DSH and STBs. Therefore, our main goal was to analyze if DSH diversity and severity predicted suicidal ideation and suicide attempts. Our sample comprised 237 Portuguese adolescents and young adults with a history of DSH, from community (80.2%, n = 190) and clinical (19.8%, n = 47) settings, aged between 14 and 23 years (M = 17.31, SD=1.36). Results showed that DSH diversity and severity were significant predictors of suicidal ideation and suicide attempts. These results were further discussed, underlining the impact that DSH has for suicide risk and highlighting the need to address further variables to understand these suicidality trajectories.
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Affiliation(s)
- Maria Gouveia-Pereira
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI), ISPA - Instituto Universitário, Lisbon, Portugal.
| | - Eva Duarte
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI), ISPA - Instituto Universitário, Lisbon, Portugal.
| | - Hugo S Gomes
- Psychology Research Centre (CIPsi/UM), School of Psychology, University of Minho, Braga, Portugal
| | | | - Nazaré Santos
- Núcleo de Estudos de Suicídio (NES), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE., Lisbon, Portugal
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28
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Sheridan DC, Lin A. Emergency Department Adolescent Suicidality: A Pilot Study to Determine How Common Actual Attempts Are. Pediatr Emerg Care 2022; 38:e458-e461. [PMID: 35100750 DOI: 10.1097/pec.0000000000002629] [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] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Adolescent mental health is a rapidly escalating presentation to emergency departments in the United States with depression and suicidal thoughts being the most prevalent condition. Much of the research and focus has been on preventing future attempts. However, one outcome that may be very important in addition to focus on is the impact of presentations for thoughts without self-injury. The aim was to evaluate outcomes of interest for a larger prospective observational adolescent suicidal trial including frequency of suicide attempts versus thoughts and factors associated with each outcome. METHODS This is a prospective pilot study of adolescents at a single pediatric emergency department between December 2016 and September 2017 with acute suicidality. We used descriptive statistics to compare chief complaint, medical history, Patient Health Questionnaire-9 (PHQ-9), and outcomes including final disposition and total emergency department length of stay (LOS). We used t tests for continuous outcomes, χ2 test for categorical data, and Fisher exact tests for categorical and sparse data (20% of cell sizes of <5). RESULTS Forty-one patients were enrolled, with 43.9% having an attempt; 72.2% of attempts were the result of an ingestion, and approximately 54% were over-the-counter medications. The average (SD) LOS was 30.8 (31.2) hours, and 63% were discharged home to outpatient services. There were no significant differences in age, chief complaint (except overdose), medical history, final disposition, total LOS in the ED, and the PHQ-9. Scores of the PHQ-9 were, on average (SD), 18.51 (4.7) across the entire cohort, 18.06 (5.75) in patients with an attempt, and 18.87 (3.77) in patients without an attempt (P = 0.59). CONCLUSIONS Adolescent mental health is a growing issue for pediatric emergency departments nationally. Prospective research to identify factors associated with worsening outcomes is important to identify and potentially modify if possible. This study did not find any specific factors associated with a suicide attempt, but found that less than half of patients presenting with suicidality actual made an attempt. Future research should focus on not only limiting suicide attempts but also using decreased emergency department visits for worsening thoughts as an outcome of interest.
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Affiliation(s)
| | - Amber Lin
- From the Departments of Emergency Medicine
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29
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Wang Y, Zhou X, Cao B, Chen L, Wang R, Qi L, Meng L, Zeng L, Liu X, Wang W, Li C, Yang J, Gu X, Li Z, Zhou Y. The psychological characteristics and risk factors of suicidal attempt among mood disorders adolescents accompany with non-suicidal self-injury: A multi-center study. J Affect Disord 2022; 298:301-307. [PMID: 34728289 DOI: 10.1016/j.jad.2021.10.130] [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: 07/04/2021] [Revised: 09/11/2021] [Accepted: 10/23/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Identifying the risk factors of suicide attempts(SA) in adolescents with mood disorders(MD) who engage in non-suicidal self-injury(NSSI) is of great significance for suicide prevention. The aim of the present study was to explore the psychological characteristics and risk factors of SA among MD adolescents engaged in NSSI. METHODS We recruited MD outpatients accompany with NSSI aged 12-18 years. SA, NSSI methods and function, suicidal ideation(SI), psychological distress(PD), self-esteem, stress mindset and perceived social support were assessed by valid scales. Classification and regression tree analysis (CART) was employed to explore the characteristics and risk factors of SA among MD adolescent with NSSI. RESULTS We included 658 participants in this study. Of 58.1% participants reported SA during the past 12 months. Compared with the adolescents without SA, the attempters used more different NSSI methods and reported more frequent NSSI. SA, SI, PD, self-esteem and amount of thinking time before engaging in self-injury were risk factors of SA among MD adolescents. Interactions between the four risk factors resulted in varying degrees of risk of SA. Compared to adolescents with the characteristics of low level of SI - little consideration before self-injury, adolescents who having multiple characteristics of the high level of SI -high level of PD - low self-esteem were associated with a 15.1-fold increased risk of SA(P < 0.001), and those with the characteristics of high SI - deliberated before engaging in self-injury were associated with a 28.1-fold increased risk of attempted suicide(P < 0.001). CONCLUSIONS Our findings identify multiple correlates for SA in MD adolescents accompany with NSSI, including SI, PD, self-esteem and deliberate time they thought before self-injury, which may contribute to the development of suicidal behaviors in an interactive manner.
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Affiliation(s)
- Yanni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xin Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Lijuan Chen
- School of Literature, Journalism & Communication, South-Central University for Nationalities, Wuhan, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | | | | | - Xia Liu
- Shenzhen Kangning Hospital, Shenzhen, China
| | - Wenjia Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Chuanxiao Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jiezhi Yang
- Shenzhen Health Development Research Center, Shenzhen, China
| | - Xueyan Gu
- Department of Toxicology, School of Public Health, Lanzhou University, Lanzhou, China
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China.
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30
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Berny LM, Tanner-Smith EE. Differential Predictors of Suicidal Ideation and Suicide Attempts: Internalizing Disorders and Substance Use in a Clinical Sample of Adolescents. J Dual Diagn 2022; 18:59-69. [PMID: 34982653 PMCID: PMC8960344 DOI: 10.1080/15504263.2021.2016343] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: Dually diagnosed adolescents are a high-risk population for experiencing suicidal thoughts and behavior. Given that research suggests risk factors for suicidal ideation and suicide attempts may be different, this study examined whether internalizing disorder severity, frequency of substance use, and the interaction between them differentiated adolescents who attempted suicide from those who ideated. Methods: Baseline data from 287 adolescents who received formal substance use disorder (SUD) treatment were used in this analysis. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) severity as well as past-3 month use of alcohol, cannabis, and other illicit drugs were considered. The outcome of interest was a three-category measure of suicide risk: no reported suicidal ideation or attempts, suicidal ideation only, and suicide attempts. Results: Over half of the sample disclosed prior suicidal ideation (30.0%) or attempts (27.9%). Multinomial logistic regression models indicated more severe MDD and GAD symptomology differentiated ideators from non-suicidal adolescents, but internalizing disorder severity did not differ between ideators and attempters. Substance use frequency did not differ between suicide risk groups. MDD severity and frequency of alcohol use interacted to increase the risk of attempts, yet the effects were minimal. Instead, prior weapon violence victimization and sexual abuse were the largest differentiators between attempters and ideators. Conclusions: Findings suggest that internalizing disorder severity and prior traumatic experiences put adolescents with SUD histories at higher risk of suicidal thoughts and behaviors. Thus, integrating evidence-based suicide prevention and intervention efforts into SUD treatment is critical, particularly for dually diagnosed adolescents who meet these risk profiles. Psychotherapy and medication may help curtail the development of ideation by reducing symptoms of MDD and GAD, whereas adolescents with prior traumatic experiences may benefit from additional treatments shown to lower risk of suicide attempts.
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Affiliation(s)
- Lauren M Berny
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - Emily E Tanner-Smith
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA.,Prevention Science Institute, University of Oregon, Eugene, OR, USA
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31
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Abstract
Suicide is a leading cause of death, and presently, there is no definitive clinical indicator of future suicide behaviors. Anhedonia, a transdiagnostic symptom reflecting diminished ability to experience pleasure, has recently emerged as a risk factor for suicidal thoughts and behaviors (STBs). This overview, therefore, has the following aims. First, prior research relating anhedonia to STBs will be reviewed, with a particular focus on clarifying whether anhedonia is more closely associated with suicidal thoughts versus behaviors. Second, the National Institute of Mental Health's Research Domain Criteria Positive Valence Systems provide a useful heuristic to probe anhedonia across different units of analysis, including clinical symptoms, behaviors, neural mechanisms, and molecular targets. Accordingly, anhedonia-related constructs linked to STBs will be detailed as well as promising next steps for future research. Third, although anhedonia is not directly addressed in leading suicide theories, this review will provide potential inroads to explore anhedonia within diathesis-stress and interpersonal suicide frameworks. Last, novel approaches to treat anhedonia as a means of reducing STBs will be examined.
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Affiliation(s)
- Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Romanelli M, Sheftall AH, Irsheid SB, Lindsey MA, Grogan TM. Factors Associated with Distinct Patterns of Suicidal Thoughts, Suicide Plans, and Suicide Attempts Among US Adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:73-84. [PMID: 34482517 PMCID: PMC8792183 DOI: 10.1007/s11121-021-01295-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 01/03/2023]
Abstract
The current study examined demographic, psychosocial, and substance use factors associated with distinct patterns of past 12-month suicide thoughts, plans, and attempts among adolescents drawn from a nationally representative sample of high schoolers. Data were from the 2015, 2017, and 2019 National Youth Risk Behavior Survey. Four mutually exclusive 12-month suicidal behavior patterns were identified: suicide thoughts only (pattern 1), suicide thoughts and plans without suicide attempt (pattern 2), suicide attempt with thoughts and/or plans (pattern 3), and suicide attempt without thoughts or plans (pattern 4). Multinomial logistic regression analyses were conducted to examine factors correlated with these distinct patterns. Psychosocial and substance use factors were modeled as independent predictors, controlling for demographic characteristics, as well as simultaneously to represent the potential for co-occurrence. The analytic sample included 7491 respondents. About 24% (n = 1734) of youth endorsed pattern 1, 38% (n = 2779) pattern 2, 35% (n = 2716) pattern 3, and 3% (n = 262) pattern 4. All psychosocial and substance use factors measured were individually associated with greater odds of suicide attempts with thoughts or plans (pattern 3) than patterns 1 or 2. Black and male youth were at greater odds of suicide attempts without thoughts or plans (pattern 4) than all other patterns. When modeled simultaneously, respondents who were bullied online, sad or hopeless, had a history of sexual violence, used cigarettes, and misused prescription opiates retained greater odds of suicide attempts with thoughts or plans (pattern 3) than patterns 1 or 2. Findings suggest screening for suicidal behaviors should include factors that differentiate between varying suicidal expressions and that may cue providers to intervene in the absence of suicide thoughts and plans.
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Affiliation(s)
- Meghan Romanelli
- School of Social Work, University of Washington, 4101 15th Avenue NE, WA, 98105-6250, Seattle, USA.
| | - Arielle H Sheftall
- Department of Pediatrics, Center for Suicide Prevention and Research, The Abigail Wexner Research Institute At Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sireen B Irsheid
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, USA
| | - Michael A Lindsey
- Silver School of Social Work, NYU McSilver Institute for Poverty Policy and Research, New York University, New York, NY, USA
| | - Tracy M Grogan
- NYU McSilver Institute for Poverty Policy and Research, New York, NY, USA
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Simões ÉV, Oliveira AMND, Pinho LBD, Lourenção LG, Oliveira SMD, Farias FLRD. Reasons assigned to suicide attempts: adolescents' perceptions. Rev Bras Enferm 2021; 75Suppl 3:e20210163. [PMID: 34787243 DOI: 10.1590/0034-7167-2021-0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE identify the reasons for attempting suicide from the perspective of adolescents. METHODS qualitative study conducted with ten adolescents who attempted suicide and were attending a Centro de Atenção Psicossocial Infanto-Juvenil located in a city in the south of Brazil. Semi-structured interviews were held in July 2020 using WhatsApp. Data were analyzed according to Minayo's Content Thematic Analysis. RESULTS the adolescents' reports listed the reasons that triggered suicide attempts, such as changes in the adolescents' life cycle and violence, which led them to attempt suicide to solve problems. FINAL CONSIDERATIONS Data analysis revealed the reasons that triggered suicide attempts from the adolescents' perspective and difficulties to cope with problems, probably explained by their lack of experience in dealing with frustrations and disappointments.
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Labuhn M, LaBore K, Ahmed T, Ahmed R. Trends and instigators among young adolescent suicide in the United States. Public Health 2021; 199:51-56. [PMID: 34547557 PMCID: PMC8763572 DOI: 10.1016/j.puhe.2021.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The present investigation examined the role of factors involved in suicide ideation and suicide attempt using a nationally representative sample of US high school students. METHODS Data were collected from students in Grades 9-12 as part of the Youth Behavioral Survey (n = 11,328). Logistic regression models were used to examine factors associated with suicide ideation and suicide attempt. Variables included demographic characteristics (grade, sex, and race), psychosocial factors (physical fighting, sexual violence, sports participation, bullying, and electronic bullying), and substance use (cigarette usage, marijuana usage, and alcohol usage). RESULTS The factor most associated with suicide ideation was bullying (either electronic or physical), whereas the factor most associated with suicide attempt was sexual violence followed closely by physical bullying. CONCLUSIONS The multitude of instigators and commonality among gender, ethnicity, and socio-economic status give an indication of how to prevent suicide and who to target information regarding the hazards of suicide.
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Affiliation(s)
- M Labuhn
- University of North Dakota, Grand Forks, ND, USA
| | - K LaBore
- Doctor of Psychology Program in Counseling Psychology, School of Health and Human Services, Saint Mary's University of Minnesota, Minneapolis, MN, USA
| | - T Ahmed
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - R Ahmed
- Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL, USA.
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35
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Zhao S, Hu J, Li D, Wan Y, Zhao L, Fang J, Zhang S. Associations of being bullied and non-suicidal self-injury with suicidal behaviors among Chinese adolescents. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02166-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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36
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Haliczer LA, Harnedy LE, Oakley M, Dixon-Gordon KL. Clarifying the Role of Multiple Self-Damaging Behaviors in the Association Between Emotion Dysregulation and Suicide Risk Among College Students. J Prim Prev 2021; 42:473-492. [PMID: 34236585 DOI: 10.1007/s10935-021-00639-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/29/2022]
Abstract
Suicidal behaviors are increasingly prevalent among college students. Although emotion dysregulation is theorized to increase suicide risk, research supporting this relationship is mixed. Engagement in self-damaging behaviors may play a role in the relationship between emotion dysregulation and suicide risk, theoretically by increasing one's capability of engaging in suicidal behaviors. Such behaviors may interact with emotion dysregulation to predict suicide risk. Alternatively, engaging in self-damaging behaviors may mediate the emotion dysregulation-suicide risk relationship. We examined the potential moderating and mediating roles of engagement in multiple self-damaging behaviors in the relationship between emotion dysregulation and suicide risk among college students. Participants were 181 undergraduate students who reported a history of self-damaging behaviors (i.e., non-suicidal self-injury, alcohol misuse, drug misuse, disordered eating), overall emotion dysregulation, and suicide risk. Findings revealed an interactive effect of emotion dysregulation and self-damaging behaviors on suicide risk, with engagement in more forms of self-damaging behaviors conferring higher risk for suicide, particularly in the context of greater emotion dysregulation. The model testing self-damaging behaviors as a mediator was also significant, such that greater emotion dysregulation had an indirect effect on elevated suicide risk via number of self-damaging behaviors. These findings help clarify associations among emotion dysregulation, self-damaging behaviors, and suicide risk, and have implications for specific targets of intervention and for the prevention of suicide by college students.
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Affiliation(s)
- Lauren A Haliczer
- University of Massachusetts Amherst, 617 Tobin Hall, 135 Hicks Way, Amherst, MA, 01003, USA
| | - Lauren E Harnedy
- University of Massachusetts Amherst, 617 Tobin Hall, 135 Hicks Way, Amherst, MA, 01003, USA
| | - Marykate Oakley
- University of Massachusetts Amherst, 617 Tobin Hall, 135 Hicks Way, Amherst, MA, 01003, USA
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Lanfredi M, Macis A, Ferrari C, Meloni S, Pedrini L, Ridolfi ME, Zonca V, Cattane N, Cattaneo A, Rossi R. Maladaptive behaviours in adolescence and their associations with personality traits, emotion dysregulation and other clinical features in a sample of Italian students: a cross-sectional study. Borderline Personal Disord Emot Dysregul 2021; 8:14. [PMID: 33941285 PMCID: PMC8094601 DOI: 10.1186/s40479-021-00154-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/08/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Emotion Dysregulation (ED), childhood trauma and personality are linked to the occurrence of maladaptive behaviours in adolescence which, in turn, may be related to increased risk for psychopathology in the life course. We sought to explore the relationship among the occurrence of different clusters of maladaptive behaviours and ED, clinical features (i.e. impulsivity, childhood maltreatment, anxiety, depressive symptoms) and personality traits that have been found to be associated to Borderline Personality Disorder (BPD), in a sample of 179 adolescent students. METHODS Multiple Correspondence Analysis (MCA) was applied to detect clustered types of maladaptive behaviours and groups of students were defined as individuals engaging in these clustered behaviours (non-suicidal self-injury-NSSI, binge eating, binge drinking, cannabis use, and sexual risk behaviours). Logistic models were used to evaluate the association among clinical scales, and student groups. Mediation analysis was used to evaluate whether clinical features affected the association between personality traits and student groups. RESULTS MCA analysis allowed to identify three student groups: NSSI/binge eating (NSSI-BE) behaviours, other maladaptive behaviours and "none". Higher scores in ED, impulsivity, childhood maltreatment, anxiety and depressive symptoms increased the risk of belonging to the cluster of NSSI-BE behaviours compared to the other two groups. ED, depression and anxiety symptoms were found to be mediators of the relationship between specific personality traits, mainly pertaining to the negative affectivity construct, and NSSI/BE. CONCLUSIONS Individuals engaging in NSSI-BE behaviours represent a vulnerable adolescent population. ED, depression and anxiety were mediators of the relationship between a variety of personality traits related to BPD and NSSI and binge eating behaviours. Findings have important clinical implications in terms of prevention and interventions among adolescents engaging in self-damaging behaviours.
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Affiliation(s)
- Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy.
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Serena Meloni
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
| | - Laura Pedrini
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
| | | | - Valentina Zonca
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Anna Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological Biomolecular Sciences, University of Milan, Milano, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
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38
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Geng J, Lei L, Han L, Gao F. Shyness and depressive symptoms: a multiple mediation model involving core self-evaluations and sense of security. J Affect Disord 2021; 286:19-26. [PMID: 33662715 DOI: 10.1016/j.jad.2021.01.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 12/30/2020] [Accepted: 01/10/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Depression is one of the most common mental health disorders among Chinese university students. Some depressed students are observed to be shy. Therefore, the current study aimed to verify the association of shyness and depression symptoms and explore how shyness is positively associated with depressive symptoms. According to Blatt's model of depression, the current study explores the mediating roles of core self-evaluation and sense of security, as an affective factor and a cognitive factor, in the relationship between shyness and depressive symptoms. METHODS The participants (543 Chinese college students) completed the Revised Henderson Undergraduate Shyness Scale, Core Self-Evaluations Scale, Self-Rating Depression Scale, and Security Questionnaire. The bivariate correlations between variables andthe multiple mediation model were tested by correlation analysis and structural equation model respectively. RESULTS Shyness was significantly and positively correlated with depressive symptoms; shyness and depressive symptoms were significantly and negatively correlated with sense of security and core self-evaluations; and sense of security was significantly and positively correlated with core self-evaluations. Core self-evaluations and sense of security played complete mediating effects in the relationship between shyness and depressive symptoms parallelly and sequentially. LIMITATIONS The cross-sectional design we used limited causal interpretations. Besides, the sample was restricted to college students, and the generalizability of the results is thus limited. CONCLUSIONS Shyness increases the risk ofdepression by reducing the sense of security and core self-evaluation, as well as by the sequential mediating effects of sense of security and core self-evaluations.
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Affiliation(s)
- Jingyu Geng
- Department of Psychology, Renmin University of China, No. 59 Zhongguancun Street, Haidian District, Beijing100872, China
| | - Li Lei
- School of Education, Renmin University of China, No. 59 Zhongguancun Street, Haidian District, Beijing100872, China
| | - Lei Han
- School of Psychology, Shandong Normal University, Shandong 250358, China
| | - Fengqiang Gao
- School of Psychology, Shandong Normal University, Shandong 250358, China.
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Atteberry-Ash B, Kattari SK, Harner V, Prince DM, Verdino AP, Kattari L, Park IY. Differential Experiences of Mental Health among Transgender and Gender-Diverse Youth in Colorado. Behav Sci (Basel) 2021; 11:48. [PMID: 33918631 PMCID: PMC8069714 DOI: 10.3390/bs11040048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/26/2021] [Accepted: 04/07/2021] [Indexed: 11/29/2022] Open
Abstract
Young people experience a variety of mental health concerns, including depression, non-suicidal self-injury, and suicidal ideation. These issues are at even higher rates among transgender and gender-diverse (TGD) young people, due to the additional burden of having to navigate a world in which transphobia impacts them at the individual, organizational, and policy levels. However, much of the extant research focuses only on comparing TGD youth to cisgender counterparts. This study explores the nuance within the TDG youth population regarding mental health, examining how gender, race/ethnicity, and sexual orientation change the likelihood of experiencing each of these mental health concerns. Among a sample of over 400 young people, findings indicate that those TGD young people who do not identify themselves within the masculine/feminine binary and those with marginalized sexual orientations were two to three times more likely to experience adverse mental health outcomes, as compared to their peers who are questioning their gender, and who are heterosexual. The implications for mental health professionals and others who work with young people are to recognize that mental health is not a one-size-fits all model for young TGD people, and that the intersection of multiple marginalized identities, must be addressed in order to improve the mental health of this group of young people. Findings can also be used to better understand issues of stigma, discrimination, and victimization in education, health care, and beyond.
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Affiliation(s)
- Brittanie Atteberry-Ash
- School of Social Work, University of Texas Arlington, 211 S Cooper St., Arlington, TX 76019, USA
| | - Shanna K. Kattari
- School of Social Work and College of Literature, Science, and the Arts Department of Women’s and Gender Studies, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Vern Harner
- School of Social Work, University of Washington, Seattle, WA 98105, USA;
| | - Dana M. Prince
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Anthony P. Verdino
- School of Social Service Administration, University of Chicago, Chicago, IL 60637, USA;
| | - Leonardo Kattari
- School of Social Work, Michigan State University, East Lansing, MI 48824, USA;
| | - In Young Park
- Graduate School of Social Work, University of Denver, Denver, CO 80208, USA;
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40
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Boduszek D, Debowska A, Ochen EA, Fray C, Nanfuka EK, Powell-Booth K, Turyomurugyendo F, Nelson K, Harvey R, Willmott D, Mason SJ. Prevalence and correlates of non-suicidal self-injury, suicidal ideation, and suicide attempt among children and adolescents: Findings from Uganda and Jamaica. J Affect Disord 2021; 283:172-178. [PMID: 33556751 DOI: 10.1016/j.jad.2021.01.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/08/2021] [Accepted: 01/30/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Youth non-suicidal self-injury (NSSI) and suicide are major public health concerns, but limited data are available on the prevalence and correlates of these problems in developing countries. The aim of this study is to describe experiences of three suicidal phenomena (NSSI, suicidal ideation [SI], and suicide attempt [SA]) among children and adolescents from two developing countries. We also examine how depression, anxiety, sleep problems, child maltreatment, and other socio-demographic variables associate with the risk of NSSI only, SI only, SA only, and co-occurring NSSI/SI/SA. METHODS We conducted a population-based cross-sectional study of school-based Ugandan and Jamaican children and adolescents. Participants were 11,518 (52.4% female) Ugandan and 7,182 (60.8% female) Jamaican youths aged 9-17 years. RESULTS The estimated lifetime prevalence of NSSI, SI, and SA was 25.5%, 25.6%, and 12.8% respectively among Ugandan boys and 23.2%, 32.5%, and 15.3% respectively among Ugandan girls. As for the Jamaican sample, the estimated lifetime prevalence of NSSI, SI, and SA was 21%, 27.7%, and 11.9% respectively among boys and 32.6%, 48.6%, and 24.7% respectively among girls. The odds of experiencing SI only, SA only, and co-occurring NSSI/SI/SA were significantly elevated among participants with mild, moderate, and severe depression in both countries. LIMITATIONS The current study relied on retrospective data. CONCLUSIONS This study found that suicidal phenomena are common among youths from Uganda and Jamaica, with rates substantially higher than among youths from high-income countries. The risk of suicidal phenomena was especially high among youths with severe depression.
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Affiliation(s)
- Daniel Boduszek
- University of Huddersfield, Huddersfield, UK; SWPS University of Social Sciences and Humanities, Katowice, Poland.
| | - Agata Debowska
- The University of Sheffield, Sheffield, UK; SWPS University of Social Sciences and Humanities, Poznan, Poland.
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Robinson K, Garisch JA, Wilson MS. Nonsuicidal self-injury thoughts and behavioural characteristics: Associations with suicidal thoughts and behaviours among community adolescents. J Affect Disord 2021; 282:1247-1254. [PMID: 33601703 DOI: 10.1016/j.jad.2020.12.201] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/15/2020] [Accepted: 12/31/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND We consider whether nonsuicidal self-injury (NSSI) thoughts - in the absence of any NSSI behaviour - are associated with suicidal thoughts and behaviours among adolescents, before examining whether characteristics of NSSI behaviour are associated with greater suicidal thoughts and behaviours. METHODS Adolescents (n = 2,057, M age =15.56) recruited from secondary schools reported their lifetime history of NSSI, suicidal thoughts and behaviours, NSSI characteristics, and NSSI functions. Receiver Operating Characteristic analysis test whether NSSI status and characteristics of NSSI behaviour are diagnostic of clinically elevated suicidal thoughts and behaviours (a score of 7 or higher on the Suicide Behaviours Questionnaire-Revised). Regression models test whether NSSI functions predict greater suicidality. RESULTS Adolescents with NSSI thoughts and those with NSSI behaviour were more likely to report lifetime suicidal ideation and past-year suicide plan(s) than adolescents with no history of NSSI. In addition, adolescents with a history of NSSI were more likely to report a lifetime history of suicide attempt(s) as well as past-year suicide attempt(s) than adolescents with no history of NSSI. A greater number of NSSI methods, requiring medical assistance for NSSI injuries, and engaging in NSSI for self-punishment, anti-suicide, and sensation-seeking functions were associated with greater severity of suicidal thoughts and behaviours. LIMITATIONS Data are cross-sectional, limiting inferences about causality. CONCLUSIONS Findings emphasize the importance of NSSI thoughts and characteristics of NSSI behaviour in understanding the complex relationship between NSSI and suicidal thoughts and behaviours among adolescents.
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Affiliation(s)
- Kealagh Robinson
- School of Psychology, Victoria University of Wellington, New Zealand
| | - Jessica A Garisch
- School of Psychology, Victoria University of Wellington, New Zealand; Child and Adolescent Mental Health Service, Capital and Coast District Health Board, New Zealand
| | - Marc S Wilson
- School of Psychology, Victoria University of Wellington, New Zealand
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42
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Cama SF, Fosbenner S. Nonsuicidal Self-Injury in Youth: A Primer for Pediatricians. Pediatr Ann 2021; 50:e72-e76. [PMID: 33576832 DOI: 10.3928/19382359-20210121-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a relatively common occurrence in youth, and pediatricians must be prepared to address this behavior in their patients in an open and nonjudgmental way. Although NSSI is done without suicidal intent, its occurrence does increase the risk for suicide and is often found with other diagnosable psychiatric conditions. Screening for NSSI should be accompanied by screening for suicidal ideation and comorbid psychiatric disorders to ensure that the patient's current risk is properly assessed and that they have access to the right resources and treatments. This article is a primer for primary care pediatricians for how to talk about and address NSSI in their patients. [Pediatr Ann. 2021;50(2):e72-e76.].
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43
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Fan YY, Liu J, Zeng YY, Conrad R, Tang YL. Factors Associated With Non-suicidal Self-Injury in Chinese Adolescents: A Meta-Analysis. Front Psychiatry 2021; 12:747031. [PMID: 34916971 PMCID: PMC8669619 DOI: 10.3389/fpsyt.2021.747031] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 11/04/2021] [Indexed: 02/05/2023] Open
Abstract
Non-suicidal self-injury (NSSI) in adolescents is an increasing public health problem in China. We conducted a meta-analysis of studies on NSSI in Chinese adolescents (between 10 and 19 years) to examine factors associated with NSSI. Twenty-five papers including 30 separate studies with 186,447 participants were included for analysis. The results from a random-effects model showed a weak, but significant overall prediction of NSSI (OR = 1.734). There were significant associations between the following seven factors and NSSI (ranking by the effect sizes, in descending order): adverse life events (OR = 2.284), negative coping style (OR = 2.040), problematic internet use (OR = 2.023), sleep disturbance (OR = 1.734), traumatic experiences (OR = 1.728), problematic parent-child relationship (OR = 1.585), mental health problems (OR = 1.578). Additionally, NSSI sample type moderated these effects. These findings highlight factors significantly associated with NSSI in Chinese adolescents. Parent-child relationship and mental health of the only children and left-behind children in China deserve more attention. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019123508.
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Affiliation(s)
- Yang-yang Fan
- Department of Public Administration, School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Liu
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- *Correspondence: Jing Liu
| | - Yan-yan Zeng
- Department of Clinical Psychology, Shenzhen Kangning Hospital, Shenzhen, China
| | - Rachel Conrad
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, United States
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Howe SJ, Hewitt K, Baraskewich J, Cassidy S, McMorris CA. Suicidality Among Children and Youth With and Without Autism Spectrum Disorder: A Systematic Review of Existing Risk Assessment Tools. J Autism Dev Disord 2020; 50:3462-3476. [PMID: 32100237 DOI: 10.1007/s10803-020-04394-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Individuals with autism are at heightened risk for experiencing suicidality compared to those without autism. Despite this, it is unknown what tools are used to assess suicide risk in research and clinical practice among children and youth with autism. This systematic review examined tools commonly used to measure suicidality in children and youth with and without autism spectrum disorder. Four databases were searched. We identified five tools (C-SSRS, PSS, SITBI, SIQ-JR, BSS) commonly used with youth in the general population; however, we did not identify any tools that were commonly used autistic children and youth. Results highlight the lack of available tools utilized to measure suicidality in autistic children and youth. We propose a framework to facilitate research to fill this gap.
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Affiliation(s)
- Stephanie J Howe
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Katie Hewitt
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Jessica Baraskewich
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Carly A McMorris
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada. .,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
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45
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May AM, Czyz EK, West BT. Differentiating Adolescent Suicide Attempters and Ideators: A Classification Tree Analysis of Risk Behaviors. J Adolesc Health 2020; 67:837-850. [PMID: 32576482 PMCID: PMC7959206 DOI: 10.1016/j.jadohealth.2020.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/06/2020] [Accepted: 04/20/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Although many youth consider suicide, only a subset act on suicidal thoughts and attempt suicide. The objective of this study was to identify patterns of risk factors that differentiate adolescents who experienced suicidal thoughts from those who attempted suicide. METHODS This study analyzed data from the 2013, 2015, and 2017 National Youth Risk Behavior Surveys. Classification tree analysis was used to identify combinations of health risk behaviors and demographic factors that improved the identification of past-year suicide attempts among adolescents with past-year suicide ideation or planning (overall n = 7,493). RESULTS Forty percent of the past-year ideators attempted suicide in the same period. The best-performing tree included three variables and defined four subgroups. Youth characterized by heroin use and past-year physical fights were at a strikingly high risk of being attempters (78%). Youth who had experienced rape were also likely to be attempters (58%), whereas those who had endorsed none of these three variables were relatively less likely to be attempters (29%). Overall, the tree's classification accuracy was modest (area under the curve = .65). CONCLUSIONS This study advances previous research by identifying notable constellations of risk behaviors that accounted for adolescents' transition from suicidal ideation to behavior. However, even with many health risk behavior variables, a large sample, and a multidimensional analytic approach, the overall classification of suicide attempters among ideators was limited. Implications for future research are discussed.
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Affiliation(s)
- Alexis M May
- Department of Psychology, Wesleyan University, Middletown, Connecticut.
| | - Ewa K Czyz
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Brady T West
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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46
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Stewart JG, Shields GS, Esposito EC, Cosby EA, Allen NB, Slavich GM, Auerbach RP. Life Stress and Suicide in Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:1707-1722. [PMID: 31028559 DOI: 10.1007/s10802-019-00534-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Stress exposure is central to theories of suicide. To advance understanding of the relation between stress and suicide, we examined whether specific, theoretically-pertinent life stressors were differentially related to suicidal thinking versus suicidal behaviors among hospitalized adolescents. Participants were 197 (144 female) adolescents aged 13 to 19 years old (M = 15.61, SD = 1.48) recruited from an acute residential psychiatric treatment program. Participants were categorized into mutually exclusive groups: psychiatric controls (n = 38) with no lifetime history of suicide ideation or suicide attempts, suicide ideators (n = 99) with current ideation and no lifetime attempts, and suicide attempters (n = 60) with a lifetime history of suicide ideation and at least one attempt in the past month. Adolescents completed the Stress and Adversity Inventory for Adolescents (Adolescent STRAIN), which assessed life events and chronic difficulties occurring in five social-psychological categories: Interpersonal Loss, Physical Danger, Humiliation, Entrapment, and Role Change/Disruption. Additionally, they completed a structured interview and symptom questionnaires to capture concurrent psychopathology. Controlling for demographic and clinical covariates, only Interpersonal Loss events distinguished attempters from psychiatric controls (OR = 2.27) and ideators (OR = 1.49); no events or difficulties differentiated ideators from controls. These effects persisted when analyses were restricted to single attempters and when events following the most recent attempt were excluded. The findings elucidate potential social-environmental triggers of suicide. Ultimately, this may improve the identification of ideators most likely to make an attempt, enabling the deployment of targeted early interventions.
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Affiliation(s)
- Jeremy G Stewart
- Department of Psychology, Queen's University, 62 Arch Street, Kingston, Ontario, K7L 3N6, Canada.
| | - Grant S Shields
- Department of Psychology, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA
| | - Erika C Esposito
- Department of Clinical and Social Sciences in Psychology, University of Rochester, P.O. Box 270266, Rochester, NY, 14627-0266, USA
| | - Elizabeth A Cosby
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA.,McLean Hospital, 115 Mill Street, Belmont, MA, 02478-9106, USA
| | - Nicholas B Allen
- Department of Psychology, University of Oregon, 1227 University Street, Eugene, OR, 97403, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, UCLA Medical Plaza 300, Room 3156, Los Angeles, CA, 90095-7076, USA
| | - Randy P Auerbach
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA.,Division of Clinical Developmental Neuroscience, Sackler Institute, 1051 Riverside Drive, New York, NY, 10032, USA
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47
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Kim KL, Galione J, Schettini E, DeYoung LLA, Gilbert AC, Jenkins GA, Barthelemy CM, MacPherson HA, Radoeva PD, Kudinova AY, Dickstein DP. Do styles of emotion dysregulation differentiate adolescents engaging in non-suicidal self-injury from those attempting suicide? Psychiatry Res 2020; 291:113240. [PMID: 32603928 DOI: 10.1016/j.psychres.2020.113240] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 06/14/2020] [Accepted: 06/14/2020] [Indexed: 12/28/2022]
Abstract
Emotion dysregulation is implicated in both suicide attempts (SA) and non-suicidal self-injury (NSSI). However, little is known about how emotion dysregulation may differ between adolescents who have made an SA from those engaged in NSSI. We sought to address this gap by comparing emotion dysregulation profiles across three homogenous groups of adolescents (1) SA-only (2) NSSI-only (3) and typically developing controls (TDCs). Mean comparisons suggest that adolescents with a history of NSSI reported significantly lower distress tolerance and higher emotional reactivity when compared to adolescents who made an SA. After controlling for shared variance across emotion dysregulation measures, parent report of affective lability was the only scale to uniquely distinguish between NSSI and SA groups. Accurately distinguishing emotion dysregulation patterns across self-injurious groups has practical implications towards assessment, treatment, course of illness, and prevention.
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Affiliation(s)
- Kerri L Kim
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States.
| | - Janine Galione
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
| | - Elana Schettini
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
| | - Lena L A DeYoung
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
| | - Anna C Gilbert
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
| | - Gracie A Jenkins
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
| | - Christine M Barthelemy
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
| | - Heather A MacPherson
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
| | - Petya D Radoeva
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
| | - Anastacia Y Kudinova
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
| | - Daniel P Dickstein
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI, United States; Department of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, Providence, RI, United States
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48
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Angelakis I, Austin JL, Gooding P. Association of Childhood Maltreatment With Suicide Behaviors Among Young People: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2012563. [PMID: 32756929 PMCID: PMC7407092 DOI: 10.1001/jamanetworkopen.2020.12563] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/22/2020] [Indexed: 12/17/2022] Open
Abstract
Importance Children and young people's reports of experiences of adverse childhood events have increased in recent years, and this trend has been associated with an elevated risk for suicide behaviors. However, a systematic review and meta-analysis is needed to confirm the significance of this association in young people. Objective To quantify the association between core types of childhood maltreatment, including sexual, physical, and emotional abuse and/or neglect and suicide behaviors in children and young adults. Data Sources Medline, PsychInfo, Embase, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health) databases were searched from January 1, 1980, until December 31, 2019. The reference lists of all the included studies were also checked. Study Selection Quantitative studies that focused on the association between core types of childhood abuse and/or neglect and suicide ideation, plans, and attempts. Data Extraction and Synthesis Data were extracted by 2 independent raters. Publication bias and risk of bias across studies were assessed. Meta-analyses using random-effect models were applied, and heterogeneity was quantified using the I2 statistic. Data were analyzed from January to May 2020 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines. Main Outcomes and Measures The association between core types of childhood maltreatment and suicide behaviors. Results Seventy-nine studies with 337 185 young individuals (mean [SD] age, 15.67 [2.11] years; 63.19% female) were included. The findings demonstrated that sexual abuse (odds ratio [OR], 3.41; 95% CI, 2.90-4.00), physical abuse (OR, 2.18; 95% CI, 1.75-2.71), emotional abuse (OR, 2.21; 95% CI, 1.37-3.57), emotional neglect (OR, 1.93; 95% CI, 1.36-2.74), physical neglect (OR, 1.79; 95% CI, 1.27-2.53), and combined abuse (OR, 3.38; 95% CI, 2.09-5.47) were significantly associated with higher rates of suicide attempts. Core types of childhood maltreatment were also associated with as much as 2.5-fold greater odds for suicide ideation, and sexual abuse with a 4.0-fold increase for suicide plans. Studies based on community samples (β [SE] = -1.68 [0.79]; P = .04) or with lower methodological quality (β [SE] = -2.86 [1.30]; P = .03) were associated more strongly with suicide attempts in those reporting experiences of sexual abuse, whereas young age was associated with both suicide attempts (β [SE] = -0.59 [0.27]; P = .03) and ideation (β [SE] = -0.41 [0.18]; P = .03). Conclusions and Relevance These findings suggest that policy actions should focus on raising public awareness and offering proactive suicide prevention therapies for children and young adults who have experienced abuse and/or neglect.
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Affiliation(s)
- Ioannis Angelakis
- School of Psychology, University of South Wales, Pontypridd, United Kingdom
| | - Jennifer L. Austin
- School of Psychology, University of South Wales, Pontypridd, United Kingdom
| | - Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
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49
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Krysinska K, Curtis S, Lamblin M, Stefanac N, Gibson K, Byrne S, Thorn P, Rice SM, McRoberts A, Ferrey A, Perry Y, Lin A, Hetrick S, Hawton K, Robinson J. Parents' Experience and Psychoeducation Needs When Supporting a Young Person Who Self-Harms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3662. [PMID: 32456022 PMCID: PMC7277421 DOI: 10.3390/ijerph17103662] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Self-harm in young people can have a substantial negative impact on the well-being and functioning of parents and other carers. The "Coping with Self-Harm" booklet was originally developed in the UK as a resource for parents and carers of young people who self-harm, and an adaptation study of this resource was conducted in Australia. This paper presents qualitative analysis of interviews with parents about their experiences and psychoeducational needs when supporting a young person who engages in self harm. METHODS The qualitative study drew on semi-structured individual and group interviews with parents (n = 19 participants) of young people who self-harm. Data were analysed using Thematic Analysis. RESULTS The analysis identified six themes: (1) the discovery of self-harm, (2) challenges in the parent-young person relationship, (3) parents' need to understand self-harm, (4) parents' emotional reactions to self-harm, (5) the importance of self-care and help-seeking among parents, and (6) the need for psychoeducational resources. CONCLUSION The study highlights the need for support for parents and carers of young people who engage in self-harm, including development and adaptation of resources, such as the "Coping with Self-Harm" booklet, of which an Australian version has now been developed.
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Affiliation(s)
- Karolina Krysinska
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Sophie Curtis
- North Western Mental Health, Parkville, VIC 3050, Australia
| | - Michelle Lamblin
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nina Stefanac
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Kerry Gibson
- School of Psychology, The University of Auckland, Auckland 1142, New Zealand
| | - Sadhbh Byrne
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Pinar Thorn
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Simon M Rice
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | | | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Sarah Hetrick
- Orygen, Parkville, VIC 3052, Australia
- Department of Psychological Medicine, The University of Auckland, Auckland 1142, New Zealand
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Jo Robinson
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
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50
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Baer MM, Tull MT, Forbes CN, Richmond JR, Gratz KL. Methods Matter: Nonsuicidal Self-Injury in the Form of Cutting is Uniquely Associated with Suicide Attempt Severity in Patients with Substance Use Disorders. Suicide Life Threat Behav 2020; 50:397-407. [PMID: 31621951 PMCID: PMC7148192 DOI: 10.1111/sltb.12596] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/30/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Despite the robust relation between nonsuicidal self-injury (NSSI) and suicidal behaviors, there is considerable heterogeneity in NSSI characteristics that may have implications for the strength of the NSSI-suicide attempt relation. Past research highlights the relevance of both more severe NSSI methods and NSSI in the form of cutting in particular to suicide attempts. To further explore the relations of specific NSSI methods to suicide attempts, this study examined relations between different NSSI methods (i.e., those involving cutting, burning, blunt force, or resulting in minor tissue damage) and both overall suicide attempts and two indicators of suicide attempt severity (attempts requiring medical attention and nonambivalent attempts) in 203 substance-dependent patients in residential treatment. METHOD Participants were administered questionnaires and semistructured interviews assessing the variables of interest. RESULTS Cutting was the only NSSI method to demonstrate significant relations with overall suicide attempts, nonambivalent suicide attempts, and suicide attempts requiring medical attention. Results remained when considering relevant covariates. CONCLUSION Results highlight an important link between NSSI methods involving cutting and suicide attempts among patients with substance use disorders. Findings also highlight the importance of more fine-grained characterizations of NSSI subgroups.
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Affiliation(s)
| | - Matthew T. Tull
- Department of Psychology, University of Toledo, Toledo, OH, USA,Address correspondence to: Matthew T. Tull, Ph.D., Department of Psychology, Mail Stop 948, University of Toledo, 2801 West Bancroft Street, Toledo, Ohio 43606; Telephone: 419-530-4392; Fax: 419-530-8479;
| | | | | | - Kim L. Gratz
- Department of Psychology, University of Toledo, Toledo, OH, USA
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