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Pears KC, Tiberio SS, Kim HK. Reducing Suicidal Ideation in Preadolescents With a History of Foster Care by Promoting School Readiness in Early Childhood. CHILD MALTREATMENT 2024; 29:165-175. [PMID: 35835729 DOI: 10.1177/10775595221115209] [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: 06/15/2023]
Abstract
Preadolescents with a history of foster care placement report suicidal ideation (SI) at higher rates than their peers, which increases their risk for suicide attempts in adolescence. Despite these increased risks, few interventions have been shown to reduce SI in these youth. This study examined the main and mediated long-term effects of a program to increase school readiness in children in foster care at age 5 years on SI when the children were ages 9-11 years, 4-6 years after the intervention ended. Children who received the intervention were less likely to report SI, although the difference did not reach statistical significance. The intervention reduced SI indirectly through its positive effect on children's self-esteem at age 9 years. Implications for programming to reduce SI and subsequent suicide attempts in youth with a history of foster care are discussed.
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Affiliation(s)
- Katherine C Pears
- Oregon Social Learning Center, Eugene, OR, USA
- OSLC Developments, Inc, Eugene, OR, USA
| | | | - Hyoun K Kim
- Department of Child & Family Studies, Yonsei University, Seodaemun-gu, Korea
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Connell AM, Seidman S, Ha T, Stormshak E, Westling E, Wilson M, Shaw D. Long-term Effects of the Family Check-Up on Suicidality in Childhood and Adolescence: Integrative Data Analysis of Three Randomized Trials. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1558-1568. [PMID: 35476247 PMCID: PMC9606146 DOI: 10.1007/s11121-022-01370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
This study employed integrative data analysis techniques to examine the long-term effects of the family check-up (FCU) on changes in youth suicide risk using three randomized prevention trials, including one trial initiated in early childhood and two initiated in early adolescence. Data were harmonized across studies using moderated nonlinear factor analysis, and intervention effects were tested using an autoregressive latent trajectory model examining changes in suicide risk across long-term follow-up. Across trials, significant long-term effects of the FCU on reductions in suicide risk were observed, although differences between intervention and control group trajectories declined over time. No moderation of intervention effects was observed by youth gender or race/ethnicity or across samples. While results offer further support for the benefits of the FCU for suicide risk reduction, they also suggest that such effects may wane over time, underscoring the need for continued development of the FCU to enhance longer-term durability of effects on suicide-related behaviors.
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Affiliation(s)
| | | | - Thao Ha
- Arizona State University, Tempe, USA
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3
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Duprey EB, Handley ED, Wyman PA, Ross AJ, Cerulli C, Oshri A. Child maltreatment and youth suicide risk: A developmental conceptual model and implications for suicide prevention. Dev Psychopathol 2023; 35:1732-1755. [PMID: 36097812 PMCID: PMC10008764 DOI: 10.1017/s0954579422000414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Experiences of child abuse and neglect are risk factors for youth suicidal thoughts and behaviors. Accordingly, suicide risk may emerge as a developmental process that is heavily influenced by the rearing environment. We argue that a developmental, theoretical framework is needed to guide future research on child maltreatment and youth (i.e., adolescent and emerging adult) suicide, and to subsequently inform suicide prevention efforts. We propose a developmental model that integrates principles of developmental psychopathology and current theories of suicide to explain the association between child maltreatment and youth suicide risk. This model bears significant implications for future research on child maltreatment and youth suicide risk, and for suicide prevention efforts that target youth with child maltreatment experiences.
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Affiliation(s)
- Erinn B. Duprey
- Children’s Institute, University of Rochester, Rochester, NY, USA
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Elizabeth D. Handley
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Peter A. Wyman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Andrew J. Ross
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Catherine Cerulli
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- The Susan B. Anthony Center, University of Rochester, Rochester, NY, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
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Zhang N, Sandler I, Tein JY, Wolchik S. Reducing suicide risk in parentally bereaved youth through promoting effective parenting: testing a developmental cascade model. Dev Psychopathol 2023; 35:433-446. [PMID: 34872628 PMCID: PMC9170840 DOI: 10.1017/s0954579421001474] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Children who experience parental death are at increased risk for suicide. The Family Bereavement Program (FBP) is an upstream preventive intervention for parentally bereaved families that was found to reduce suicide risk in parentally bereaved youth up to 6 and 15 years later. We tested whether FBP-induced improvements in effective parenting led to changes in multiple proximal factors that prior theory and research implicated in the cascading pathway to suicide risk, namely, aversive self-views, caregiver connectedness, peer connectedness, complicated grief, depressive symptoms, and emotion suppression. The sample was 244 bereaved youth and their surviving caregiver from 156 families. Families were randomized into the FBP (12 group-based sessions for parents, youth, and two joint sessions) or a literature control condition. Multimethod and multiinformant data were collected at baseline, posttest, 6-year and 15-year follow-up assessments. Results showed that program-induced improvements in effective parenting at posttest were associated with reduced aversive self-views and increased caregiver connectedness at the 6-year follow-up, and each mediator was in turn associated with reduced suicide risk at the 6- and 15-year follow-up. The mediated pathways via aversive self-views remained significant while controlling for caregiver connectedness. Self-related concepts may be important targets in upstream suicide prevention for at-risk youth.
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Affiliation(s)
- Na Zhang
- Department of Human Development and Family Sciences, University of Connecticut, Stamford, CT, USA
| | - Irwin Sandler
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Jenn-Yun Tein
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Sharlene Wolchik
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
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Preventing Youth Suicide: Potential "Crossover Effects" of Existing School-Based Programs. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:382-392. [PMID: 36484887 PMCID: PMC9734872 DOI: 10.1007/s11121-022-01473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
Notable increases in youth mental health problems combined with strains on the already stretched mental health workforce raise concerns that there will be an ensuing increase in youth suicide thoughts, behaviors, and even deaths. Schools are recognized as crucial settings for youth mental health support and suicide prevention activities, yet schools also face staff shortages and ever-increasing responsibilities for student well-being. Evidence is emerging that prevention programs originally designed to improve problem-solving skills and social-emotional functioning in youth have demonstrated downstream, "crossover effects," that is, unanticipated benefits, on youth suicidal behavior. Relatively little research on crossover effects has been conducted within school settings, despite the strong potential for commonly administered programs to have an impact on later suicide risk. We review key suicide risk factors and their proposed mechanisms of action; we also discuss factors that may protect against suicide risk. We then identify upstream prevention programs targeting the same factors and mechanisms; these programs may hold promise for downstream, crossover effects on youth suicide risk. This paper is intended to provide a framework to help researchers, practitioners, and policymakers as they consider how to prevent youth suicide using existing school-based resources. Rigorous investigation of upstream prevention programs is urgently needed to determine ideal approaches schools and communities can deploy to prevent youth suicide.
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Trenoska Basile V, Newton-John T, Wootton BM. Internet videoconferencing delivered cognitive behavior therapy for generalized anxiety disorder: protocol for a randomized controlled trial. Trials 2022; 23:592. [PMID: 35871088 PMCID: PMC9308270 DOI: 10.1186/s13063-022-06520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 07/06/2022] [Indexed: 11/23/2022] Open
Abstract
Background Generalized anxiety disorder (GAD) is a chronic mental health condition that results in a significant individual and societal burden. While cognitive behavioral therapy (CBT) is well established as an efficacious treatment for GAD, many patients experience logistical barriers when accessing face-to-face CBT. Remotely delivered treatments remove many of these barriers. Despite emerging evidence demonstrating the efficacy of remotely delivered CBT for GAD, studies examining the efficacy of remote methods for GAD that are analogous to standard face-to-face treatment, in particular synchronous treatments such as CBT delivered via online videoconferencing (VCBT), are needed. Methods The authors propose a two-group randomized controlled trial comparing the efficacy of VCBT for GAD against a waitlist control group. The recruitment target will be 78 adults with primary GAD of at least moderate severity. The manualized high-intensity VCBT intervention will be delivered weekly over a 10-week period. After treatment completion, waitlist participants will receive the same VCBT delivered in a brief format (i.e., weekly over a 5-week period). Treatment for both groups will be delivered in real time via an online teleconferencing platform. Outcome measures will be administered at baseline, mid-treatment, post-treatment, and 3-month follow-up. Discussion This trial will report findings on the efficacy of a remote synchronous high-intensity VCBT intervention for GAD. The results have the potential to contribute towards advancing our knowledge on the evidence base for GAD, as well as increase the dissemination of VCBT for GAD. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12621000786897. Registered on 22 June 2021
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Ayer L, Pane JD, Godley MD, McCaffrey DF, Burgette L, Cefalu M, Vegetabile B, Griffin BA. Comparative effectiveness of individual versus family-based substance use treatment on adolescent self-injurious thoughts and behaviors. J Subst Abuse Treat 2022; 139:108782. [PMID: 35461747 PMCID: PMC9674085 DOI: 10.1016/j.jsat.2022.108782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/07/2022] [Accepted: 04/09/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Self-injurious thoughts and behaviors (SITB) are of increasing concern among adolescents, especially those who use substances. Some evidence suggests that existing evidence-based substance use treatments (EBTs) could impact not only their intended substance use targets but also SITB. However, which types of substance use treatments may have the greatest impact on youth SITB is not yet clear. Based on prior literature showing that family support and connection may buffer youth from SITB, we initially hypothesized that family-based EBTs would show greater improvement in SITB compared to those receiving individually focused EBTs and that the size of the effects would be small given the comparison between two active, evidence-based interventions, and base rates of SITB. METHODS In a sample of 2893 youth in substance use treatment, we compared the effectiveness of individually and family-based EBTs in reducing SITBs. The study used entropy balancing and regression modeling to balance the groups on pre-treatment characteristics and examine change in outcomes over a one-year follow-up period. RESULTS Both groups improved in self-injury and suicide attempts over the one-year study period, but only youth in individual treatment improved in suicidal ideation. However, the study found no significant difference between the changes over time in the two groups for any outcome. As expected, effect sizes were small and power was constrained in this study given the rarity of the outcomes, but effect sizes are similar to those observed with substance use outcomes. CONCLUSIONS The results provide important exploratory evidence on the potential relative effectiveness of these two treatments for SITBs. This study supports prior findings that EBTs for youth substance use may help to improve SITB and suggests that different treatment formats (individual or family-based) could result in different benefits for SITB outcomes.
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Reiss D, Ganiban JM, Leve LD, Neiderhiser JM, Shaw DS, Natsuaki MN. Parenting in the Context of the Child: Genetic and Social Processes. Monogr Soc Res Child Dev 2022; 87:7-188. [PMID: 37070594 PMCID: PMC10329459 DOI: 10.1111/mono.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 04/19/2023]
Abstract
The focus on the role of parenting in child development has a long-standing history. When measures of parenting precede changes in child development, researchers typically infer a causal role of parenting practices and attitudes on child development. However, this research is usually conducted with parents raising their own biological offspring. Such research designs cannot account for the effects of genes that are common to parents and children, nor for genetically influenced traits in children that influence how they are parented and how parenting affects them. The aim of this monograph is to provide a clearer view of parenting by synthesizing findings from the Early Growth and Development Study (EGDS). EGDS is a longitudinal study of adopted children, their birth parents, and their rearing parents studied across infancy and childhood. Families (N = 561) were recruited in the United States through adoption agencies between 2000 and 2010. Data collection began when adoptees were 9 months old (males = 57.2%; White 54.5%, Black 13.2%, Hispanic/Latinx 13.4%, Multiracial 17.8%, other 1.1%). The median child age at adoption placement was 2 days (M = 5.58, SD = 11.32). Adoptive parents were predominantly in their 30s, White, and coming from upper-middle- or upper-class backgrounds with high educational attainment (a mode at 4-year college or graduate degree). Most adoptive parents were heterosexual couples, and were married at the beginning of the project. The birth parent sample was more racially and ethnically diverse, but the majority (70%) were White. At the beginning of the study, most birth mothers and fathers were in their 20s, with a mode of educational attainment at high school degree, and few of them were married. We have been following these family members over time, assessing their genetic influences, prenatal environment, rearing environment, and child development. Controlling for effects of genes common to parents and children, we confirmed some previously reported associations between parenting, parent psychopathology, and marital adjustment in relation to child problematic and prosocial behavior. We also observed effects of children's heritable characteristics, characteristics thought to be transmitted from parent to child by genetic means, on their parents and how those effects contributed to subsequent child development. For example, we found that genetically influenced child impulsivity and social withdrawal both elicited harsh parenting, whereas a genetically influenced sunny disposition elicited parental warmth. We found numerous instances of children's genetically influenced characteristics that enhanced positive parental influences on child development or that protected them from harsh parenting. Integrating our findings, we propose a new, genetically informed process model of parenting. We posit that parents implicitly or explicitly detect genetically influenced liabilities and assets in their children. We also suggest future research into factors such as marital adjustment, that favor parents responding with appropriate protection or enhancement. Our findings illustrate a productive use of genetic information in prevention research: helping parents respond effectively to a profile of child strengths and challenges rather than using genetic information simply to identify some children unresponsive to current preventive interventions.
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Affiliation(s)
- David Reiss
- Yale Child Study Center, Yale University School of Medicine
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9
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Gijzen MWM, Rasing SPA, Creemers DHM, Engels RCME, Smit F. Effectiveness of school-based preventive programs in suicidal thoughts and behaviors: A meta-analysis. J Affect Disord 2022; 298:408-420. [PMID: 34728296 DOI: 10.1016/j.jad.2021.10.062] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 10/01/2021] [Accepted: 10/23/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Suicidal thoughts and behaviors (STBs) among adolescents have hardly decreased despite preventative efforts. School-based prevention programs could have a great reach, yet suicide prevention is not an easy topic to address. To increase acceptability of school-based suicide prevention, it is important to evaluate whether programs that target known risk factors of STBs, such as depression, could be equally effective. METHODS We conducted a systematic literature search in major electronic databases. Outcomes were suicidal ideation and behaviors. Multivariate random effects meta-regression-analyses were conducted. RESULTS Eleven primary studies met the inclusion criteria, totalling 23,230 participants. The post-test effect size was small for both suicidal ideation (g = 0.15) and suicidal behaviors (g = 0.30). Meta-regression indicated that targeting known risk factors of STBs was not a significant modifier of effect size for ideation, indicating equal effectiveness. However, it was significant modifier of effect for behaviors, but only one intervention targeted know risk factors. Effects at follow-up (3-12 months) were also significant but small for both outcomes. LIMITATIONS Substantial heterogeneity between studies was noted. Only few and small sample size studies could be included that targeted known risk factors of STBs. Therefore, these results should be interpreted with caution. CONCLUSIONS School-based prevention of STBs shows some promise within three months post-test assessments, and potentially also have effects that are sustained over time. More studies are needed to make conclusions regarding school-based interventions that target risk factors of STBs.
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Affiliation(s)
- Mandy W M Gijzen
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, Utrecht 3500 AS, the Netherlands; Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, P.O. Box 1738, Rotterdam 3000 DR, the Netherlands; GGZ Oost Brabant, P.O. Box 3, Boekel 5427 ZG, the Netherlands.
| | - Sanne P A Rasing
- GGZ Oost Brabant, P.O. Box 3, Boekel 5427 ZG, the Netherlands; Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, Nijmegen 6500 HE, the Netherlands
| | - Daan H M Creemers
- GGZ Oost Brabant, P.O. Box 3, Boekel 5427 ZG, the Netherlands; Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, Nijmegen 6500 HE, the Netherlands
| | - Rutger C M E Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, P.O. Box 1738, Rotterdam 3000 DR, the Netherlands
| | - Filip Smit
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, Utrecht 3500 AS, the Netherlands; Department of Clinical, Neuro and Developmental Psychology and Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, P.O. Box 7057, Amsterdam 1007 MB, the Netherlands
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A Population-Based Examination of Suicide and Child Protection System Involvement. J Adolesc Health 2021; 69:465-469. [PMID: 33814278 DOI: 10.1016/j.jadohealth.2021.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/26/2021] [Accepted: 02/10/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this study was to provide a population-based analysis of child protection system (CPS) involvement among children and adolescents who died by suicide. METHODS We performed a case-control study of child and adolescent suicide and CPS involvement. Using linked birth, death, and CPS records, we longitudinally followed all children born in California in 1999 and 2000 (N = 1,052,333) in CPS and death records through 2017. Cases were defined as children who died in California and had a manner of death coded as suicide using the International Classification of Diseases, 10th revision (n = 170). Each suicide case was matched to four living controls, and children were classified based on CPS exposure: no history, reported for alleged child maltreatment, substantiated for child maltreatment, and placed in foster care. Crude suicide rates were documented, and conditional logistic regression models were used to estimate the adjusted odds of suicide. RESULTS Among children and adolescents who died by suicide, 56.5% had a history of past allegations of abuse or neglect. Children with any CPS history had three times the odds of suicide compared to children with no history. No additional risk was found for children substantiated or placed in foster care compared to children with only an allegation. CONCLUSIONS Suicide risk is not isolated to the relatively small group of children and youth placed in foster care. Findings reinforce the importance of increased attention to the experiences of the larger universe of children who remain at home after alleged or substantiated maltreatment.
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Griffin BA, Ayer L, Pane J, Vegetabile B, Burgette L, McCaffrey D, Coffman DL, Cefalu M, Funk R, Godley MD. Expanding outcomes when considering the relative effectiveness of two evidence-based outpatient treatment programs for adolescents. J Subst Abuse Treat 2020; 118:108075. [PMID: 32972649 PMCID: PMC7519172 DOI: 10.1016/j.jsat.2020.108075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/08/2020] [Accepted: 06/28/2020] [Indexed: 11/27/2022]
Abstract
The current study seeks to advance understanding about how to address substance use and co-occurring mental health problems in adolescents. Specifically, we compared the effectiveness of two evidence-based treatment programs (Motivational Enhancement Treatment/Cognitive Behavior Therapy, 5 Sessions [MET/CBT5] and Adolescent Community Reinforcement Approach [A-CRA]) for both substance use and mental health outcomes (i.e., crossover effects). We used statistical methods designed to approximate randomized controlled trials when comparing nonequivalent groups using observational study data. Our methods also included an assessment of the potential impact of omitted variables. We found that after applying balancing weighting to ensure similarity of the baseline samples (given the nonrandomized study design), both groups significantly improved on the two substance use outcomes (days abstinent and percent of youth in recovery) and on the two mental health outcomes (post-traumatic stress disorder (PTSD) symptoms and general emotional problems). Youth in A-CRA were significantly more likely to be in recovery at the 3-month follow-up compared to youth in MET/CBT5, but the size of this effect was very small. Youth receiving MET/CBT5 appeared to show significantly more improvement in the two mental health measures compared to youth in A-CRA, though these effect sizes were also very small. The findings indicate that adolescents with co-occurring substance use and mental health problems improve on both substance use and mental health outcomes with both treatments even though they are not specifically targeting mental health problems.
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Affiliation(s)
| | - Lynsay Ayer
- RAND Corporation, 1200 South Hayes Street, Arlington, VA, USA.
| | - Joseph Pane
- RAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA 15213, USA.
| | | | - Lane Burgette
- RAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA 15213, USA.
| | | | - Donna L Coffman
- Temple University, 1301 Cecil B. Moore Ave, Ritter Annex, 9th floor, Philadelphia, PA 19122, USA.
| | - Matthew Cefalu
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA.
| | - Rod Funk
- Chestnut Health Systems, 448 Wylie Dr, Normal, IL 61761, USA.
| | - Mark D Godley
- Chestnut Health Systems, 448 Wylie Dr, Normal, IL 61761, USA.
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Indirect effects of the early childhood Family Check-Up on adolescent suicide risk: The mediating role of inhibitory control. Dev Psychopathol 2020; 31:1901-1910. [PMID: 31370914 DOI: 10.1017/s0954579419000877] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study investigates suicide risk in late childhood and early adolescence in relation to a family-centered intervention, the Family Check-Up, for problem behavior delivered in early childhood. At age 2, 731 low-income families receiving nutritional services from Women, Infants, and Children programs were randomized to the Family Check-Up intervention or to a control group. Trend-level main effects were observed on endorsement of suicide risk by parents or teachers from ages 7.5 to 14, with higher rates of suicide risk endorsement in youth in the control versus intervention condition. A significant indirect effect of intervention was also observed, with treatment-related improvements in inhibitory control across childhood predicting reductions in suicide-related risk both at age 10.5, assessed via diagnostic interviews with parents and youth, and at age 14, assessed via parent and teacher reports. Results add to the emerging body of work demonstrating long-term reductions in suicide risk related to family-focused preventive interventions, and highlight improvements in youth self-regulatory skills as an important mechanism of such reductions in risk.
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Abstract
Suicide rates among youths in foster care are among the highest in the United States. Despite this fact, many foster-care agencies do not perform universal suicide-risk assessments as part of routine care. This commentary includes an argument for the importance of implementing universal suicide-risk assessments for youths in foster care. Important contextual information that prevents behavioral-health clinicians from implementing universal suicide screenings of youths in foster care is discussed. Several possible strategies for implementing universal suicide-risk assessments are offered; the pros and cons of each strategy are discussed. The perspectives of multiple stakeholders should be included in the consideration of universal suicide screening for youths in foster care, including behavioral-health providers, primary-care doctors, supervisors, directors of agencies, foster parents, and case managers. Although each of these stakeholders can improve suicide prevention, youths in foster care may not have regular access to each stakeholder. Case managers may be the optimal stakeholders for implementing universal suicide screening because of their frequent access to youths in foster care; therefore, case managers should receive training in suicide-risk assessment and prevention strategies.
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Affiliation(s)
- Lily A Brown
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
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Abstract
Justice-involved youth are at exceedingly high risk of trauma exposure, multisystem involvement, and mental health distress, including depression. Justice-involved youth carry with them both a high symptom burden and a high cost to society. Both could be reduced through evidence-based prevention and treatment strategies. Effective treatment of mental disorders may reduce future justice involvement, whereas lack of treatment increases likelihood of justice involvement into adulthood. Multiple effective programs exist to improve the lives of justice-involved youth and subsequently decrease the cost to society of detaining and adjudicating these youth within the juvenile justice system.
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Franz DJ, Griffin AM, Saldana L, Leve LD. A Longitudinal Examination of Service Utilization and Trauma Symptoms among Young Women with Prior Foster Care and Juvenile Justice System Involvement. CHILD WELFARE 2019; 97:199-215. [PMID: 32308211 PMCID: PMC7167304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We investigated the prediction of young adult service utilization and trauma symptoms from adverse childhood experiences (ACEs) and adolescent mental health symptoms in young women with dual child welfare and juvenile justice system involvement. A sample of 166 females (ages 13 to 17) was followed to examine the transition to young adulthood. Path models indicated that more ACEs were associated with poorer adolescent mental health. Adolescent mental health symptoms were associated with more young adult trauma symptoms and service utilization. Implications for service providers and policy-makers are discussed.
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Baiden P, Fallon B. Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada. CHILD ABUSE & NEGLECT 2018; 79:115-124. [PMID: 29428879 DOI: 10.1016/j.chiabu.2018.01.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 01/25/2018] [Accepted: 01/30/2018] [Indexed: 06/08/2023]
Abstract
Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper Street, Box 19129, Arlington, TX, 76019, U.S.A.
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON,M5S 1V4, Canada
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Feingold A. Meta-analysis with standardized effect sizes from multilevel and latent growth models. J Consult Clin Psychol 2017; 85:262-266. [PMID: 28068118 DOI: 10.1037/ccp0000162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Findings from multilevel and latent growth modeling analysis (GMA) need to be included in literature reviews, and this article explicates 4 rarely discussed approaches for using GMA studies in meta-analysis. METHOD Extant and new equations are presented for calculating the effect size (d) and its variance (v) from reported statistics from GMA studies with each method, and a fixed effects meta-analysis of results from 5 randomized clinical trials was conducted to demonstrate their applications. RESULTS Two common problematic practices--one that introduces bias in effect sizes because of attrition, measurement errors, and probable violations of assumptions for classical analysis, and the other that confounds the treatment effect with the intraclass correlation--were both found to yield smaller effect sizes from retrieved studies than were obtained with a newer model-based framework and its associated GMA d statistic. CONCLUSIONS The optimal strategy for including a GMA study in a meta-analysis is to use GMA d and its v calculated with the standard error of the unstandardized coefficient for the treatment effect. When that standard error is unknown, the use of GMA d and its v estimated with an alternative equation that requires only GMA d and sample size is recommended. (PsycINFO Database Record
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18
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Abstract
Despite the commonly held belief that there is a high degree of intergenerational continuity in maltreatment, studies to date suggest a mixed pattern of findings. One reason for the variance in findings may be related to the measurement approach used, which includes a range of self-report and official indicators of maltreatment and both cross-sectional and longitudinal designs. This study attempted to shed light on the phenomenon of intergenerational continuity of maltreatment by examining multiple indicators of perpetration of maltreatment in young adults and multiple risk factors across different levels within an individual's social ecology. The sample included 166 women who had been placed in out-of-home care as adolescents (>85% had a substantiated maltreatment incident) and followed into young adulthood, and included three waves of adolescent data and six waves of young adult data collected across 10 years. The participants were originally recruited during adolescence as part of a randomized controlled trial examining the efficacy of the Treatment Foster Care Oregon intervention. Analyses revealed weak to modest associations among the three indicators of perpetration of maltreatment in young adulthood, that is, official child welfare records, self-reported child welfare system involvement, and self-reported maltreatment (r = .03-.51). Further, different patterns of prediction emerged as a function of the measurement approach. Adolescent delinquency was a significant predictor of subsequent self-reported child welfare contact, and young adult partner risk was a significant predictor of perpetration of maltreatment as indexed by both official child welfare records and self-reported child welfare contact. In addition, women who were originally assigned to the intervention condition reported perpetrating less maltreatment during young adulthood. Implications for measurement and interventions related to reducing the risk for intergenerational transmission of risk are discussed.
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Farmer EM, Lippold MA. The need to do it all: Exploring the ways in which Treatment Foster Parents enact their complex role. CHILDREN AND YOUTH SERVICES REVIEW 2016; 64:91-99. [PMID: 27134324 PMCID: PMC4845756 DOI: 10.1016/j.childyouth.2016.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Elizabeth M.Z. Farmer
- Professor and Associate Dean for Research, School of Social Work, Virginia Commonwealth University
| | - Melissa A. Lippold
- Assistant Professor, School of Social Work, University of North Carolina, Chapel Hill
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Connell AM, McKillop HN, Dishion TJ. Long-Term Effects of the Family Check-Up in Early Adolescence on Risk of Suicide in Early Adulthood. Suicide Life Threat Behav 2016; 46 Suppl 1:S15-22. [PMID: 27094106 PMCID: PMC4889021 DOI: 10.1111/sltb.12254] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The impact of the Family Check-Up (FCU), a school-based prevention program, as delivered in public secondary schools on suicide risk across adolescence, was examined. Students were randomly assigned to a family-centered intervention (N = 998) in the sixth grade and offered a multilevel intervention that included (1) a universal classroom-based intervention, (2) the FCU (Dishion, Stormshak, & Kavanagh, 2011), and (3) family management treatment. Engagement with the FCU predicted significant reductions in suicide risk across adolescence and early adulthood.
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Affiliation(s)
| | | | - Thomas J. Dishion
- Arizona State University, REACH Institute & Oregon Research Institute
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21
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Gewirtz AH, DeGarmo DS, Zamir O. Effects of a Military Parenting Program on Parental Distress and Suicidal Ideation: After Deployment Adaptive Parenting Tools. Suicide Life Threat Behav 2016; 46 Suppl 1:S23-31. [PMID: 27094107 PMCID: PMC5113712 DOI: 10.1111/sltb.12255] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Few studies have examined whether parenting prevention programs might mitigate risk for suicidality in parents, yet parent suicidality is a strong risk factor for offspring suicidality. We report results from a randomized controlled trial of a parenting program for deployed National Guard and Reserve families with a school-aged child. Intent-to-treat analyses showed that random assignment to the parenting program (ADAPT) was associated with improved parenting locus of control (LOC). Improved parenting LOC was concurrently associated with strengthened emotion regulation which predicted reductions in psychological distress and suicidal ideation at 12 months postbaseline. Results are discussed in the context of ongoing efforts to reduce suicide rates in military populations.
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Affiliation(s)
- Abigail H. Gewirtz
- Department of Family Social Science & Institute of Child Development, & Institute for Translational Research in Children’s Mental Health, University of Minnesota
| | - David S. DeGarmo
- Prevention Science Institute, Department of Educational Methodology, Policy, and Leadership, University of Oregon
| | - Osnat Zamir
- Institute for Translational Research in Children’s Mental Health, University of Minnesota
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Sandler I, Tein JY, Wolchik S, Ayers TS. The Effects of the Family Bereavement Program to Reduce Suicide Ideation and/or Attempts of Parentally Bereaved Children Six and Fifteen Years Later. Suicide Life Threat Behav 2016; 46 Suppl 1:S32-8. [PMID: 27094109 PMCID: PMC6108320 DOI: 10.1111/sltb.12256] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Findings concerning the long-term effects of the Family Bereavement Program (FBP) to reduce suicide ideation and/or attempts of parentally bereaved children and adolescents are presented. Parental death is a significant risk factor for suicide among offspring (Guldin et al., 2015). This study is a long-term follow-up of 244 children and adolescents who had participated in a randomized trial of the FBP, examining the intervention effects on suicide ideation and/or attempts as assessed through multiple sources. Results indicate a significant effect of the FBP to reduce suicide ideation and/or attempts at the 6- and 15-year follow-up evaluation. The findings support the potential benefits of further research on "upstream" suicide prevention.
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Affiliation(s)
- Irwin Sandler
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Jenn-Yun Tein
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Sharlene Wolchik
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Tim S Ayers
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
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Reider EE, Sims BE. Family-Based Preventive Interventions: Can the Onset of Suicidal Ideation and Behavior Be Prevented? Suicide Life Threat Behav 2016; 46 Suppl 1:S3-7. [PMID: 27094108 PMCID: PMC4839188 DOI: 10.1111/sltb.12252] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Suicide is the second leading cause of death for youth aged 10-24. Research informed prevention efforts have the opportunity to decrease risk for suicidal ideation and behavior before it is manifested. Indeed, there is a small body of research findings demonstrating both proximal and distal effects of preventive interventions delivered in childhood and adolescence on suicidal ideation and/or behavior. These efforts build off of other secondary analyses of prevention research that has demonstrated benefits for multiple types of youth outcomes. This supplement provides "proof of concept" that family-based preventive interventions aimed at reducing a number of risk factors for suicide (e.g., substance use, externalizing, and internalizing behavior) can prevent suicidal ideation and behaviors.
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Affiliation(s)
- Eve E Reider
- National Center for Complementary and Integrative Health (NCCIH), Bethesda, MD, USA
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Zajac K, Sheidow AJ, Davis M. Juvenile Justice, Mental Health, and the Transition to Adulthood: A Review of Service System Involvement and Unmet Needs in the U.S. CHILDREN AND YOUTH SERVICES REVIEW 2015; 56:139-148. [PMID: 26273119 PMCID: PMC4530519 DOI: 10.1016/j.childyouth.2015.07.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Although adolescents are the primary focus of juvenile justice, a significant number of young people involved with this system are considered transition age youth (i.e., 16-25 years of age). The aim of this review is to summarize the specific needs of transition age youth with mental health conditions involved with the juvenile justice system, identify the multiple service systems relevant to this group, and offer recommendations for policies and practice. A comprehensive search strategy was used to identify and synthesize the literature. Findings highlight the paucity of research specific to transition age youth. Thus, we also summarized relevant research on justice-involved adolescents, with a focus evaluating its potential relevance in the context of the unique milestones of the transition age, including finishing one's education, setting and working towards vocational goals, and transitioning from ones' family of origin to more independent living situations. Existing programs and initiatives relevant to transition age youth with mental health conditions are highlighted, and nine specific recommendations for policy and practice are offered.
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Affiliation(s)
- Kristyn Zajac
- Family Services Research Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | | | - Maryann Davis
- Transitions Research and Training Center, Systems and Psychosocial Advances Research Center, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
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Rabinovitch SM, Kerr DCR, Leve LD, Chamberlain P. Suicidal Behavior Outcomes of Childhood Sexual Abuse: Longitudinal Study of Adjudicated Girls. Suicide Life Threat Behav 2015; 45:431-47. [PMID: 25370436 PMCID: PMC4420727 DOI: 10.1111/sltb.12141] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 09/01/2014] [Indexed: 11/28/2022]
Abstract
Childhood sexual abuse (CSA) histories are prevalent among adolescent girls in the juvenile justice system (JJS) and may contribute to their high rates of suicidal behavior. Among 166 JJS girls who participated in an intervention trial, baseline CSA and covariates were examined as predictors of suicide attempt and nonsuicidal self-injury (NSSI) reported at long-term follow-up (7-12 years later). Early forced CSA was related to lifetime suicide attempt and NSSI history and (marginally) to postbaseline attempt; effects were not mediated by anxiety or depressive symptoms. Findings suggest that earlier victimization and younger entry into JJS are linked with suicide attempt and NSSI.
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26
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Feingold A. Confidence interval estimation for standardized effect sizes in multilevel and latent growth modeling. J Consult Clin Psychol 2014; 83:157-68. [PMID: 25181028 DOI: 10.1037/a0037721] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Multilevel and latent growth models are frequently used interchangeably to examine differences between groups in trajectories of outcomes from controlled clinical trials. The unstandardized coefficient for the effect from group to slope (the treatment effect) from such models can be converted to a standardized mean difference (Cohen's d) between the treatment and control groups at end of study. This article addresses the confidence interval (CI) for this effect size. METHOD Two sets of equations for estimating the CI for the treatment effect size in multilevel models were derived, and the usage of each was illustrated with data from the National Youth Study (Elliott, Huizinga, & Menard, 1989). Validity of the CIs was examined with a Monte Carlo simulation study that manipulated effect potency and sample size. RESULTS The equivalence of the 2 new CI estimation methods was demonstrated, and the Monte Carlo study found that bias in the CI for the effect size was not appreciably larger than bias in the CI for the widely used unstandardized coefficient. CONCLUSIONS Investigators reporting this increasingly popular effect size can estimate its CI with equations presented in this article.
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27
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Kerr DCR, Gibson B, Leve LD, Degarmo DS. Young adult follow-up of adolescent girls in juvenile justice using the Columbia suicide severity rating scale. Suicide Life Threat Behav 2014; 44:113-29. [PMID: 24446880 PMCID: PMC3989504 DOI: 10.1111/sltb.12072] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 05/22/2013] [Indexed: 12/01/2022]
Abstract
This study focused on the reliability and validity of the Columbia Suicide Severity Scale (C-SSRS). Severely delinquent adolescent girls (n = 166) participated in a treatment trial and repeated assessments over time. Lifetime suicide attempt history was measured using the C-SSRS in early adulthood (n = 144; 7-12 years postbaseline). Nonclinician raters showed strong interrater reliability using the C-SSRS. Self-reports, caseworker reports, and caregiver reports of girls' suicide attempt histories collected at baseline correlated with adult participants' recollections of their baseline attempt histories. Suicidal ideation measured prospectively across a 7- to -12-year period was associated with retrospectively reported suicide attempt across the same period.
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Affiliation(s)
- David C R Kerr
- Oregon Social Learning Center, Oregon State University, Corvallis, OR, USA
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