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Bartkowski JP, Klee K, Xu X. Youth Suicide Prevention Programming among the Mississippi Band of Choctaw Indians: Effects of the Lifelines Student Curriculum. CHILDREN (BASEL, SWITZERLAND) 2024; 11:488. [PMID: 38671705 PMCID: PMC11049181 DOI: 10.3390/children11040488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Abstract
Suicide continues to be a leading cause of mortality for young people. Given persistent intersecting forms of disadvantage, Native American adolescents are especially vulnerable to mental health adversities and other suicide risk factors. The Mississippi Band of Choctaw Indians (MBCI) implemented the Choctaw Youth Resilience Initiative (CYRI), a five-year SAMHSA-funded project that began in 2019. This study uses Choctaw student pre-test/post-test survey data to examine the effectiveness of the Hazelden Lifelines Suicide Prevention Training curriculum for youth. A lagged post-test design was used, whereby post-surveys were administered at least one month after program completion. Several intriguing results were observed. First, the lagged post-test model was subject to some pre-to-post attrition, although such attrition was comparable to a standard pre/post design. Second, analyses of completed surveys using means indicated various beneficial effects associated with the Lifelines curriculum implementation. The greatest benefit of the program was a significant change in student perceptions concerning school readiness in response to a suicidal event. Some opportunities for program improvement were also observed. Our study sheds new light on suicide prevention training programs that can be adapted according to Native American youth culture. Program implementation and evaluation implications are discussed in light of these findings.
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Affiliation(s)
- John P. Bartkowski
- Department of Sociology and Demography, University of Texas at San Antonio, San Antonio, TX 78249, USA;
| | - Katherine Klee
- Bartkowski & Associates Research Team, San Antonio, TX 78258, USA;
| | - Xiaohe Xu
- Department of Sociology and Demography, University of Texas at San Antonio, San Antonio, TX 78249, USA;
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Jankowsky K, Steger D, Schroeders U. Predicting Lifetime Suicide Attempts in a Community Sample of Adolescents Using Machine Learning Algorithms. Assessment 2024; 31:557-573. [PMID: 37092544 PMCID: PMC10903120 DOI: 10.1177/10731911231167490] [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] [Indexed: 04/25/2023]
Abstract
Suicide is a major global health concern and a prominent cause of death in adolescents. Previous research on suicide prediction has mainly focused on clinical or adult samples. To prevent suicides at an early stage, however, it is important to screen for risk factors in a community sample of adolescents. We compared the accuracy of logistic regressions, elastic net regressions, and gradient boosting machines in predicting suicide attempts by 17-year-olds in the Millennium Cohort Study (N = 7,347), combining a large set of self- and other-reported variables from different categories. Both machine learning algorithms outperformed logistic regressions and achieved similar balanced accuracies (.76 when using data 3 years before the self-reported lifetime suicide attempts and .85 when using data from the same measurement wave). We identified essential variables that should be considered when screening for suicidal behavior. Finally, we discuss the usefulness of complex machine learning models in suicide prediction.
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Bete T, Birhanu A, Negash A, Yadeta E, Lemi M, Balcha T, Sertsu A, Birhanu B, Nigussie S, Gemechu K, Meseret F, Mohammed H, Alemu A, Dechasa DB, Asmerom H, Arkew M, Shewangizaw A, Mohamed A, Ahemed F, Wodaje D, Dessie Y, Debella A, Getachew T, Nigussie K, Eyeberu A. Suicidal ideation, attempt and associated factor among secondary school students in Harari regional state, Eastern Ethiopia. A multi-center cross-sectional study. Front Psychiatry 2023; 14:1069910. [PMID: 37215668 PMCID: PMC10196371 DOI: 10.3389/fpsyt.2023.1069910] [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: 12/06/2022] [Accepted: 03/27/2023] [Indexed: 05/24/2023] Open
Abstract
Background Suicide is a major public health issue across the globe. It is the second leading cause of death in adolescents. Even though the rate of suicide has increased, no study has been conducted to investigate the determinants of suicide in the study area. Therefore, this study aimed to assess the magnitude of suicidal ideation, suicide attempts, and its associated factors among secondary school students in the Harari regional state of Eastern Ethiopia. Methods An institutional-based cross-sectional study was conducted among randomly selected 1,666 secondary school students. A structured-self-administered questionnaire was used for data collection. The WHO Composite International Diagnostic Interview (CIDI) was used to assess suicidal ideation and suicide attempts. The Depression Anxiety and Stress Scale (DASS) was also used to assess depression, anxiety, and stress. Data were entered into EpiData version 3.1 and exported to Stata version 14.0 for the analysis. A logistic regression analysis was performed to determine the association between the outcome and independent variables and the statistical significance was declared at a p-value of < 0.05. Result The overall magnitude of suicidal ideation and attempts was 13.82% at 95% confidence interval (CI): 12.16-15.66 and 7.61% at 95% CI: 6.37-9.07, respectively. Suicidal ideations and suicide attempts were significantly associated with undergoing depressive symptoms (adjusted odds ratio [AOR]: 1.54; 95% CI: 1.08-2.19 and AOR: 2.37; 95% CI: 1.46-3.86, respectively), experiencing anxiety symptoms (AOR: 1.80; 95% CI: 1.25-2.59 and AOR: 1.89; 95% CI: 2.14-10.65, respectively), being exposed to sexual violence (AOR: 3.36; 95% CI: 1.65-6.84), and having a family history of suicidal attempts (AOR: 2.12; 95% CI: 1.21-3.69 and AOR: 4.74; 95% CI: 2.14-10.65, respectively), whereas living in a rural residence (AOR: 1.65 95%, CI: 1.08-2.55) was significantly associated only with suicide attempts. Conclusion and recommendations Nearly one in six secondary school students had both suicidal ideation and attempted to take their own life. Suicide is one of the psychiatric emergencies that need immediate action. Therefore, the concerned body from either a governmental or a non-governmental organization should work in setting strategies to minimize sexual violence as well as depressive and anxiety symptoms.
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Affiliation(s)
- Tilahun Bete
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Elias Yadeta
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Magarsa Lemi
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tegenu Balcha
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Sertsu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bekelu Birhanu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Shambel Nigussie
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Gemechu
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fentahun Meseret
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Hanan Mohammed
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Deribe Bekele Dechasa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Haftu Asmerom
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mesay Arkew
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abayneh Shewangizaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Debre Birhan University, Debre Berhan, Ethiopia
| | - Ahmed Mohamed
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fila Ahemed
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawud Wodaje
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Maultsby K, López R, Wolff J, Spirito A, Esposito-Smythers C. Longitudinal Relations Between Parenting Practices and Adolescent Suicidal Ideation in a High-Risk Clinical Sample: A Moderated Mediation Model. Res Child Adolesc Psychopathol 2023; 51:613-623. [PMID: 36652026 DOI: 10.1007/s10802-022-01018-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 01/19/2023]
Abstract
Parenting behaviors are associated with adolescent suicidal ideation (SI), but few studies have examined this relation longitudinally or investigated underlying mechanisms. We investigated a moderated mediation model to evaluate perceived burdensomeness as a mediator in the longitudinal relation between parenting behavior (warmth and verbal hostility) and adolescent SI. We hypothesized that this association would be particularly strong among adolescents with greater functional impairment. The sample included 147 adolescents (Mage = 14.9, Age Range = 12-18 years, 76.2% female) and a primary caregiver (Mage = 43.5, Age Range = 27-60 years, 81.4% female) enrolled in a clinical trial. Caregivers completed measures of warmth and verbal hostility (PCPR) and adolescents completed measures of functional impairment (CDI-2), perceived burdensomeness (INQ), and SI (SIQ-JR) at baseline, 12 and 18 months. Two moderated mediation path analyses, one for each parenting behavior, were conducted. Age, sex, treatment condition, baseline and 12-month SI, baseline perceived burdensomeness, and the alternate baseline parenting behavior were included as covariates. Neither model yielded a significant direct effect between baseline parental verbal hostility or warmth and 18-month SI. However, lower warmth and higher verbal hostility were positively associated with 18-month SI indirectly through greater 12-month perceived burdensomeness among youth with relatively higher levels of functional impairment. Perceptions of burdensomeness are a mechanism by which low parental warmth and high parental verbal hostility contribute to SI, but only among youth with greater functional impairment. Interventions to address youth perceptions of burdensomeness may be beneficial, particularly for the most highly impaired youth.
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Affiliation(s)
| | - Roberto López
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Jennifer Wolff
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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Mori Y, Tiiri E, Khanal P, Khakurel J, Mishina K, Sourander A. Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review. CHILDREN-BASEL 2021; 8:children8030232. [PMID: 33802967 PMCID: PMC8002666 DOI: 10.3390/children8030232] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/16/2022]
Abstract
This study systematically reviewed the literature on perceived school safety. We investigated the prevalence, factors and associated mental health difficulties, as well as cross-cultural findings. Five databases were searched up to 9 February 2021 for peer-reviewed papers published in English. We included quantitative studies that explored the perception of school safety among children and adolescents. The reference lists of the selected papers were also searched. We conducted a narrative synthesis of the included studies. The review included 43 papers. The mean prevalence of the students who felt unsafe at school was 19.4% and ranged from 6.1% to 69.1%. Their perceived safety was associated with a wide range of personal, school, and social factors. Not feeling safe at school was related to being victimized and mental health difficulties, including depressive symptoms and suicidal behavior. Higher perceived school safety was associated with measures such as the presence of a security officer and fair school rule enforcement. The results showed the lack of cross-cultural studies on perceived school safety. Empirical studies are needed that examine the mechanisms of school safety, using valid measures. A clear definition of school safety should be considered a key aspect of future studies.
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Affiliation(s)
- Yuko Mori
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Correspondence:
| | - Elina Tiiri
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Child Psychiatry, University of Turku and Turku University Hospital, 20521 Turku, Finland
| | - Prakash Khanal
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
| | - Jayden Khakurel
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
| | - Kaisa Mishina
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Nursing Science, University of Turku, 20014 Turun Yliopisto, Finland
| | - Andre Sourander
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Child Psychiatry, University of Turku and Turku University Hospital, 20521 Turku, Finland
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Caballero-Domínguez CC, Campo-Arias A. Prevalence and Factors Associated With Suicide Ideation in Colombian Caribbean Adolescent Students. OMEGA-JOURNAL OF DEATH AND DYING 2020; 85:837-849. [DOI: 10.1177/0030222820959929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The study aimed to know the prevalence of and some factors associated with suicide ideation in high school adolescents from a Colombian Caribbean city. A cross-sectional analytical study was designed with probability sampling. An expected prevalence of 50% and an alpha error of 5% were estimated. High-school students from public and private institutions were invited to participate. One thousand four hundred sixty-two adolescents participated in, they were aged between 13 and 17 years, and 33.6% of students reported suicide ideation. Suicide ideation was associated with depression risk (OR = 4.54, 95% CI 2.35–8.77), family dysfunction (OR = 4.54, 95% CI 2.35–8.77), sexual violence (OR = 1.92 CI95% 1.33–2.76) and low academic achievement (OR = 1.97, 95% CI 1.42–2.73). It is concluded that 33.6% of adolescents enrolled in secondary education reported suicide ideation and was associated with depression risk, family dysfunction, sexual abuse, and poor academic achievement.
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