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Meza JI, Folk J, Hoskins D, Kemp K, Tolou-Shams M. Risk and Protective Factors Associated with Self-Cutting Behavior Among Adolescents at First Contact with the Juvenile Court. J Youth Adolesc 2023; 52:2494-2508. [PMID: 37592194 PMCID: PMC10522515 DOI: 10.1007/s10964-023-01839-x] [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] [Received: 03/20/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023]
Abstract
Adolescents involved in juvenile legal system are at increased risk for self-cutting behavior, however, correlates associated with elevated risk remain underresearched, particularly among youth with first involvement with the court. This study utilized an epidemiological two-year longitudinal study involving 401 adolescents at first contact with the court (Mage = 14.47; SDage = 1.94 years; 43% female; 42% Latinx/Hispanic) and an involved caregiver. Study aims examined key prospective psychosocial correlates of self-cutting behavior. Baseline assessments captured individual and family level risk and protective factors; self-cutting behavior was assessed longitudinally every four months post-baseline for 24 months. Psychosocial correlates of self-cutting behavior included adolescent affect dysregulation, post-traumatic stress disorder symptoms, impulsive decision making, anxiety and depression symptoms. Significant protective factors included positive communication with caregiver and family, higher self-esteem, and having a caring and supportive family. These findings suggest that internalizing symptoms as well as difficulties with emotion regulation and impulsive decision making are correlated with heightened risk for self-cutting behavior among adolescents involved in the juvenile legal system. The findings also suggest that individual and family level protective factors, like positive communication and a supportive family, are associated with decreased risk for self-cutting behavior among adolescents at first contact with the court.
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Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
| | - Johanna Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - David Hoskins
- Pediatric Psychology Program, UCSF Benioff Children's Hospital, San Francisco, USA
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, Brown University, Warren Alpert Medical School, Providence, USA
- Department of Child and Adolescent Psychiatry and Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
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Trivedi MH, Minhajuddin A, Slater H, Baronia R, Blader JC, Blood J, Brown R, Claassen C, DeFilippis M, Farmer D, Garza C, Hughes JL, Kennard BD, Liberzon I, Martin S, Mayes TL, Soares JC, Soutullo CA, Storch EA, Wakefield SM. Texas Youth Depression and Suicide Research Network (TX-YDSRN) research registry and learning healthcare network: Rationale, design, and baseline characteristics. J Affect Disord 2023; 340:88-99. [PMID: 37459975 DOI: 10.1016/j.jad.2023.07.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/13/2023] [Accepted: 07/08/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND American youth are seriously impacted by depression and suicide. The Texas Youth Depression and Suicide Research Network (TX-YDSRN) Participant Registry Study was initiated in 2020 to develop predictive models for treatment outcomes in youth with depression and/or suicidality. This report presents the study rationale, design and baseline characteristics of the first 1000 participants. METHODS TX-YDSRN consists of the Network Hub (coordinating center), 12 medical school "Nodes" (manage/implement study), each with 1-5 primary care, inpatient, and/or outpatient Sub-Sites (recruitment, data collection). Participants are 8-20-year-olds who receive treatment or screen positive for depression and/or suicidality. Baseline data include mood and suicidality symptoms, associated comorbidities, treatment history, services used, and social determinants of health. Subsequent assessments occur every two months for 24 months. RESULTS Among 1000 participants, 68.7 % were 12-17 years, 24.6 % were ≥ 18 years, and 6.7 % were < 12. Overall, 36.8 % were non-Hispanic Caucasian, 73.4 % were female, and 79.9 % had a primary depressive disorder. Nearly half of the sample reported ≥1 suicide attempt, with rates similar in youth 12-17 years old (49.9 %) and those 18 years and older (45.5 %); 29.9 % of children <12 reported at least one suicide attempt. Depression and anxiety scores were in the moderate-severe range for all age groups (Patient Health Questionnaire for Adolescents [PHQ-A]: 12.9 ± 6.4; Generalized Anxiety Disorder [GAD-7]: 11.3 ± 5.9). LIMITATIONS The sample includes youth who are receiving depression care at enrollment and may not be representative of non-diagnosed, non-treatment seeking youth. CONCLUSIONS The TX-YDSRN is one of the largest prospective longitudinal cohort registries designed to develop predictive models for outcome trajectories based on disorder heterogeneity, social determinants of health, and treatment availability.
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Affiliation(s)
- Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Abu Minhajuddin
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Holli Slater
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Regina Baronia
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Joseph C Blader
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jamon Blood
- University of Texas Health Science Center, Tyler, TX, USA
| | - Ryan Brown
- University of Texas at Austin Dell Medical School, Austin, TX, USA
| | | | | | - David Farmer
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Cynthia Garza
- Department of Psychiatry, University of Texas Rio Grande Valley, School of Medicine, Edinburg, TX, USA
| | - Jennifer L Hughes
- Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - Beth D Kennard
- Department of Psychiatry, University of Texas Southwestern Medical Center in Dallas, TX, USA
| | | | - Sarah Martin
- Texas Tech University Health Science Center, El Paso, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jair C Soares
- University of Texas Health Science Center, Houston, TX, USA
| | | | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Sarah M Wakefield
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
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Ko JA, Kim JY. [Adolescents' Experiences of Non-Suicidal Self-Injury: An Interpretative Phenomenological Analysis Stud]. J Korean Acad Nurs 2023; 53:538-555. [PMID: 37977564 DOI: 10.4040/jkan.23075] [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: 05/18/2023] [Revised: 07/30/2023] [Accepted: 09/22/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE This qualitative study used interpretative phenomenological analysis and photovoice methods to explore the meaning of non-suicidal self-injury experienced by adolescents. METHODS Participants were adolescents enrolled in middle and high schools in Gyeonggi-do and Jeollabuk-do who were selected through snowball sampling. Six participants had repeatedly engaged in self-injurious behavior for over a year. Data were collected through in-depth interviews and the photovoice method between November 2020 and July 2021. The collected data were analyzed using six steps of interpretative phenomenological analysis. RESULTS The results yielded 5 main themes and 18 subthemes. The main themes were 'a silent cry to an indifferent world', 'a heartache that one endures with scars', 'an inescapable cycle', 'filling the space in one's heart', and 'healing the wounds'. The study findings revealed that the self-injurious behavior of adolescents began as a consequence of feeling lost and struggling with conflicts at home and school, which helped them relieve tension and pain. Nonetheless, inflicting self-injury only left signs of regret and remorse, which became a trace that the participants wanted to hide. However, the wounds healed after receiving attention and support from others. They were determined to stop engaging in repeated self-injurious behaviors and made efforts to do so. CONCLUSION This study can be used as a basis for the development of educational programs to prevent non-suicidal self-injury in adolescents. Additionally, it can inform nursing interventions that focus on building support systems to help adolescents who attempt self-injury.
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Affiliation(s)
- Jung A Ko
- Department of Nursing, Hwasung Medi-Science University, Hwasung, Korea
| | - Ji Young Kim
- College of Nursing, Jeonbuk Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea.
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Molock SD, Boyd RC, Alvarez K, Cha C, Denton EG, Glenn CR, Katz CC, Mueller AS, Meca A, Meza JI, Miranda R, Ortin-Peralta A, Polanco-Roman L, Singer JB, Zullo L, Miller AB. Culturally responsive assessment of suicidal thoughts and behaviors in youth of color. AMERICAN PSYCHOLOGIST 2023; 78:842-855. [PMID: 36913280 PMCID: PMC10497725 DOI: 10.1037/amp0001140] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
The significance of youth suicide as a public health concern is underscored by the fact that it is the second-leading cause of death for youth globally. While suicide rates for White groups have declined, there has been a precipitous rise in suicide deaths and suicide-related phenomena in Black youth; rates remain high among Native American/Indigenous youth. Despite these alarming trends, there are very few culturally tailored suicide risk assessment measures or procedures for youth from communities of color. This article attempts to address this gap in the literature by examining the cultural relevancy of currently widely used suicide risk assessment instruments, research on suicide risk factors, and approaches to risk assessment for youth from communities of color. It also notes that researchers and clinicians should consider other, nontraditional but important factors in suicide risk assessment, including stigma, acculturation, and racial socialization, as well as environmental factors like health care infrastructure and exposure to racism and community violence. The article concludes with recommendations for factors that should be considered in suicide risk assessment for youth from communities of color. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Sherry D Molock
- Department of Psychological and Brain Sciences, George Washington University
| | - Rhonda C Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
| | - Kiara Alvarez
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health
| | - Christine Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Ellen-Ge Denton
- Department of Psychology, College of Staten Island, City University of New York
| | | | - Colleen C Katz
- Silberman School of Social Work, Hunter College, City University of New York
| | | | - Alan Meca
- Department of Psychology, University of Texas at San Antonio
| | - Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Regina Miranda
- Department of Psychology, Hunter College, City University of New York
| | - Ana Ortin-Peralta
- Department of Psychology, Hunter College, City University of New York
| | | | | | - Lucas Zullo
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Li L, Yang H. Heterogeneity in Adolescents' Non-Suicidal Self-Injury Behaviour Trajectories Based on the Group-Based Trajectory Model and a Decision Tree Analysis of Family-Related Determinants. Psychol Res Behav Manag 2023; 16:3359-3371. [PMID: 37654969 PMCID: PMC10465360 DOI: 10.2147/prbm.s427090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/19/2023] [Indexed: 09/02/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) is a global public health problem. While some studies have noted the importance of behavioural development patterns in NSSI, most NSSI research is based on cross-sectional survey data. Few studies explore the time-series heterogeneity of trajectories of NSSI symptoms and family-related influencing factors of NSSI. Aim The purpose of the study was to identify the heterogeneity in trajectories of adolescents' NSSI behaviour and their family-related influencing factors. Methods The group-based trajectory model (GBTM) was used to identify the heterogeneity in the NSSI behaviour trajectories of 208 adolescents in China. Next, the decision tree model (DTM) was used to analyse which family related factors influence the trajectory type. Results The GBTM revealed two heterogeneous trajectories of NSSI behaviour: the high-risk and low-risk NSSI behaviour groups. Next, DTM's average accuracy was 83.2%. A total of seven independent variables were used for the DTM: gender, number of NSSIs in the past month, and family economic, family structure, family conflict, parental psychological control, parental behavior control and family intimacy risks. Family conflict risk was located at the root node and was the most important factor. Conclusion Heterogeneity within the population should be considered in the management of adolescents' NSSI behaviours. Further, from the perspective of family system theory and cumulative risk, focusing on the adverse effect of multiple risk factors on adolescents' NSSI addiction is more meaningful rather than the impact of single risk factors. Studies that use time series data should focus on the trend of dynamic changes in NSSI addiction characteristics over time.
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Affiliation(s)
- Linbo Li
- College of Nursing, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Hui Yang
- College of Nursing, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
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Polanco-Roman L, Ebrahimi CT, Mafnas KSW, Hausmann-Stabile C, Meca A, Mazzula SL, Duarte CS, Lewis-Fernández R. Acculturation and suicide-related risk in ethnoracially minoritized youth in the US: a scoping review and content analysis of the empirical evidence. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1121-1137. [PMID: 37270726 PMCID: PMC10366293 DOI: 10.1007/s00127-023-02494-0] [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: 08/30/2022] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE Among Asian-American/Pacific Islander, Hispanic/Latinx, and Black youth, the US born have higher risk of suicidal thoughts and behaviors (attempts and death-by-suicide) than first-generation migrants. Research has focused on the role of acculturation, defined as the sociocultural and psychological adaptations from navigating multiple cultural environments. METHODS Using content analysis, we conducted a scoping review on acculturation-related experiences and suicide-related risk in Asian-American/Pacific Islander, Hispanic/Latinx, and Black youth (henceforth described as "ethnoracially minoritized adolescents"), identifying 27 empirical articles in 2005-2022. RESULTS Findings were mixed: 19 articles found a positive association between acculturation and higher risk for suicide ideation and attempts, namely when assessed as acculturative stress; 3 articles a negative association; and 5 articles no association. Most of the research, however, was cross-sectional, largely focused on Hispanic/Latinx youth, relied on demographic variables or acculturation-related constructs as proxies for acculturation, used single-item assessments for suicide risk, and employed non-random sampling strategies. Although few articles discussed the role of gender, none discussed the intersections of race, sexual orientation, or other social identities on acculturation. CONCLUSION Without a more developmental approach and systematic application of an intersectional research framework that accounts for racialized experiences, the mechanisms by which acculturation may influence the risk of suicidal thoughts and behavior remain unclear, resulting in a dearth of culturally responsive suicide-prevention strategies among migrant and ethnoracially minoritized youth.
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Affiliation(s)
- Lillian Polanco-Roman
- The New School, Department of Psychology, 80 Fifth Avenue, Room 617, New York, NY, 10011, USA.
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA.
| | - Chantel T Ebrahimi
- The New School, Department of Psychology, 80 Fifth Avenue, Room 617, New York, NY, 10011, USA
| | - Katherine S W Mafnas
- The New School, Department of Psychology, 80 Fifth Avenue, Room 617, New York, NY, 10011, USA
| | | | - Alan Meca
- Department of Psychology, University of Texas at San Antonio, San Antonio, USA
| | - Silvia L Mazzula
- Department of Psychology, John Jay College for Criminal Justice, CUNY, New York, NY, USA
| | - Cristiane S Duarte
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Roberto Lewis-Fernández
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
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Aghatabay R, Vaezi A, Mazloomy Mahmoodabad SS, Rahimi M, Fallahzadeh H, Alizade S. Investigating identity‐related weak developmental assets and their barriers in Iranian female adolescents: Self‐worth, self‐efficacy, and personal power. PSYCHOLOGY IN THE SCHOOLS 2023. [DOI: 10.1002/pits.22910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Affiliation(s)
- Rabea Aghatabay
- Department of Health Education & Promotion, School of Public Health Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Aliakbar Vaezi
- Department of Nursing, School of Nursing & Midwifery, Research Center for Nursing & Midwifery Care in Family Health Shahid Sadoughi University of Medical Science Yazd Iran
| | - Seyed Saeed Mazloomy Mahmoodabad
- Department of Health Education & Promotion, Social Determinants of Health Research Center, School of Public Health Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Mehdi Rahimi
- Department of Psychology and Education, School of Developmental Science Yazd University Yazd Iran
| | - Hosein Fallahzadeh
- Department of Epidemiology and Biostatistics, School of Public Health Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Somaye Alizade
- Department of Health Education & Promotion, School of Public Health Kerman University of Medical Sciences Kerman Iran
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Xiao Q, Song X, Huang L, Hou D, Huang X. Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis. Front Psychiatry 2022; 13:912441. [PMID: 36032224 PMCID: PMC9399519 DOI: 10.3389/fpsyt.2022.912441] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adolescents with immature mind and unstable emotional control are high-risk groups of non-suicidal self-injury (NSSI) behavior. We meta-analyzed the global prevalence of NSSI and prevalence of NSSI characteristics in a non-clinical sample of adolescents between 2010 and 2021. Methods A systematic search for relevant articles published from January 1, 2010 to June 30, 2021 was performed within the scholarly database search engines of CBM, CNKI, VIP, Wanfang, PubMed, Web of Science, PsycINFO, and Embase. Eligibility criteria were as follows: provided cross-sectional data on the prevalence of NSSI; the subjects were non-clinical sample adolescents; and a clear definition of NSSI was reported. We used the following definiton of NSSI as our standard: the deliberate, self-inflicted destruction of body tissue, such as cutting, burning, and biting, without attempted suicide. The quality evaluation tool for cross-sectional studies recommended by the JBI was used. The global prevalence of NSSI was calculated based on the random-effects model by Comprehensive Meta-analysis version 3.0. Subgroup analyses were performed to compare the prevalence according to sex, living place, smoking or drinking history, and family structure. Results Sixty-two studies involving 264,638 adolescents were included. The aggregate prevalence of NSSI among a non-clinical sample of adolescents was similar between over a lifetime (22.0%, 95% CI 17.9-26.6) and during a 12-month period (23.2%, 95% CI 20.2-26.5). Repetitive NSSI was more common than episodic NSSI (20.3% vs. 8.3%) but the frequency of mild injury (12.6%) was similar to that of moderate injury (11.6%). Multiple-method NSSI occurred slightly more often compared than one-method NSSI (16.0% vs. 11.1%). The top three types of NSSI in adolescents were banging/hitting (12.0%, 95% CI 8.9-15.9), pinching (10.0%, 95% CI 6.7-14.8), and pulling hair (9.8%, 95% CI 8.3-11.5), and the least common type was swallowing drugs/toxic substances/chemicals (1.0%, 95% CI 0.5-2.2). Subgroup analyses showed that being female, smoking, drinking, having siblings, and belonging to a single-parent family may be linked to higher prevalence of NSSI. Conclusion This meta-analysis found a high prevalence of NSSI in non-clinical sample of adolescents, but there are some changes in severity, methods, and reasons. Based on the current evidence, adolescents in modern society are more inclined to implement NSSI behavior by a variety of ways, which usually are repetitive, and moderate and severe injuries are gradually increasing. It is also worth noting that adolescents with siblings or in single-parent families are relatively more likely to implement NSSI behavior due to maladjustment to the new family model. Future research needs to continue to elucidate the features and risk factors of NSSI so as to intervene in a targeted way. Limitation The limitation of this study is that the heterogeneity among the included studies is not low, and it is mainly related to Chinese and English studies. The results of this study should be used with caution. Systematic review registration [www.crd.york.ac.uk/prospero/], identifier [CRD42022283217].
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Affiliation(s)
- Qingqing Xiao
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaozhen Song
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Lijuan Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Dandan Hou
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xuehua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
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Marraccini ME, Pittleman C, Griffard M, Tow AC, Vanderburg JL, Cruz CM. Adolescent, parent, and provider perspectives on school-related influences of mental health in adolescents with suicide-related thoughts and behaviors. J Sch Psychol 2022; 93:98-118. [PMID: 35934453 PMCID: PMC9516717 DOI: 10.1016/j.jsp.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/04/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
Previous research supports a link between school-related factors, such as bullying and school connectedness, and suicidal thoughts and behaviors. To deepen understanding of how school experiences may function as both protective and risk factors for youth struggling with suicidal thoughts and behaviors, this qualitative study explored multiple perspectives. Specifically, in-depth interviews were conducted with adolescents previously hospitalized for a suicidal crisis (n = 19), their parents (n = 19), and the professionals they may interact with in schools and hospitals (i.e., school professionals [n = 19] and hospital providers [n = 7]). Data were analyzed using applied thematic analysis revealing three main themes related to perceptions of how school experiences can positively or negatively impact mental health, including (a) school activities, (b) school social experiences, and (c) school interventions. An emergent theme related to the complexity of suicide-related risk identified the ways in which school experiences may intersect with other environmental, biological, and psychological factors. Findings underscore the need for school-based approaches to address the unique academic, social, and emotional needs of students with suicide-related risk that complement the supports and services provided in their home and community.
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Samways B, Heslop P, Dowling S. Self-reported explanations for self-injury by people with intellectual disabilities: a systematic review of qualitative studies. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:382-396. [PMID: 38699488 PMCID: PMC11062260 DOI: 10.1080/20473869.2022.2098665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 07/01/2022] [Indexed: 05/05/2024]
Abstract
Background Emotional distress has received less attention as an explanatory factor for self-injury in people with intellectual disabilities, with research and practice primarily focusing on biobehavioural factors. This systematic review examines the self-reported explanations for self-injury by people with mild or moderate intellectual disabilities, and discusses how the findings contrast with those from self-reported studies of people within the general population who self-harm. Methods Five databases (PsychINFO, IBSS, CINAHL, Web of Science and Medline) were systematically searched to find qualitative, empirical research since 2000 about self-reported reasons for self-injury. Results Four studies were found which conducted research with people with intellectual disabilities. Three primary themes are discussed: relief from overwhelming emotions; trauma and loss; and difficulty in articulating emotions. Conclusion This review found a paucity of research asking people with intellectual disabilities about their own self-injury. However, the research available suggests that explanatory factors for self-injury typically reported in the general population should be considered for those with mild or moderate intellectual disabilities.
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Affiliation(s)
| | - Pauline Heslop
- Professor of Intellectual Disabilities Studies, University of Bristol, Bristol, UK
| | - Sandra Dowling
- Senior Lecturer, School, for Policy Studies, University of Bristol, Bristol, UK
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Abstract
Co-occurrence of nonsuicidal self-injury (NSSI) and suicide attempts (SA) might occur because they share common risk factors, or alternatively because one leads to the other. Using search terms salient to NSSI and SA, we screened 555 studies to identify 17 that presented temporal data about NSSI and SA. Much of the evidence indicates that NSSI predates SA, especially among females and individuals with depressive symptoms, or diagnosed with borderline personality disorder or mood disorders. However, in some studies, associated risk factors likely accounted for the effect. Greater NSSI frequency to a threshold increases risk for later SA. Findings suggest that the behaviors have common predisposing factors, but that there is also a potent gateway effect whereby NSSI precedes SA.
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12
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Ye Z, Xiong F, Li W. A meta-analysis of co-occurrence of non-suicidal self-injury and suicide attempt: Implications for clinical intervention and future diagnosis. Front Psychiatry 2022; 13:976217. [PMID: 36032240 PMCID: PMC9411747 DOI: 10.3389/fpsyt.2022.976217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicide attempt (SA) are risk behaviors that lead to physical injury and even death in individuals, and are a very powerful risk factor when both occur together, with individuals presenting with more severe psychological and behavioral problems. Due to the different demographic characteristics of different study subjects, an overall understanding of the incidence and occurrence of this co-occurrence is lacking to clarify the focus of clinical interventions and future research directions. METHODS A systematic search was conducted for relevant studies in English and Chinese that reported data on co-occurring non-suicidal self-injury and suicide attempts as of May 2022. The incidence of co-occurrence of non-suicidal self-injury and suicide attempt (NSSI + SA) was calculated using Stata version 16.0 software based on a random-effects model, and the differences in incidence in different populations were compared by subgroups of age group, comorbidity, and time of occurrence. The study was written in strict accordance with PRISMA norms and registration was completed on the PROSPERO platform (CRD42022329095). RESULTS A total of 37 studies (139,573 individuals) were included for meta-analysis, and the combined incidence of non-suicidal self-injury and suicide attempt co-occurrence was 9.6%. Among different groups, the prevalence of NSSI + SA was 10, 11, 6, and 26% in adolescents and young adults, adults, the general population, and people with mental illness, respectively, and the co-occurrence of NSSI + SA within 12 months was 17%. CONCLUSION There is a significant group with a history of both non-suicidal self-injury and suicide attempts and presenting with more severe symptoms clinically. Targeted prevention and intervention are urgently needed, but the direction of intervention needs further research on the occurrence trajectory of this co-occurrence. SYSTEMATIC REVIEW REGISTRATION http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42022329095, identifier: CRD42022329095.
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Affiliation(s)
- Zhiyu Ye
- School of Education Research, China University of Geosciences, Wuhan, China.,Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Fang Xiong
- School of Education Research, China University of Geosciences, Wuhan, China.,Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Wentian Li
- Wuhan Mental Health Centre, Wuhan, China
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Pinheiro TDP, Warmling D, Coelho EBS. Characterization of suicide attempts and self-harm by adolescents and adults notified in Santa Catarina, Brazil, 2014-2018. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e2021337. [PMID: 34878004 DOI: 10.1590/s1679-49742021000400026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/05/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To characterize adolescent and adult suicide attempts and self-harm reported in Santa Catarina, Brazil, from 2014 to 2018. METHODS This was a cross-sectional descriptive study with data from the Notifiable Health Conditions Information System. The sociodemographic, clinical and type of self-inflicted violence characteristics among adolescents and adults were compared. RESULTS Among the 8,859 notifications analyzed, suicide attempts predominated in relation to self-mutilation; self-inflected violence was more frequent in females, those of white skin color and with mental disorders; it occurred more at home, in both age groups. Among adolescents, repeated self-mutilation (83.3%) stood out, while among adults, repeated suicide attempts (50.6%) and suspected alcohol use (18.3%) at the time of violence stood out. CONCLUSION We identified high prevalence of attempted suicide among adolescents and adults; the characteristics of violence were similar between the age groups analyzed.
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Affiliation(s)
| | - Deise Warmling
- Secretaria de Estado da Saúde de Santa Catarina, Florianópolis, SC, Brasil
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Querdasi FR, Bacio GA. Suicidal behaviors among Latina adolescents: An ecodevelopmental approach and narrative review. J Adolesc 2021; 93:161-176. [PMID: 34785380 DOI: 10.1016/j.adolescence.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 08/10/2021] [Accepted: 10/31/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION For the past several decades, Latina adolescents have consistently shown high rates of suicidal behaviors (i.e., suicidal ideation, planning, and attempts), higher than Latino adolescents and adolescents of most other ethnic groups. Yet, progress toward establishing evidence-based intervention efforts to address this urgent public health issue has been slow. The purpose of this narrative review is to summarize empirical findings on etiological factors associated with Latina adolescent suicidal behaviors using an ecodevelopmental, gender-specific framework that contextualizes Latina adolescent development. METHODS To be included, peer reviewed empirical manuscripts had to focus on suicidal behaviors (i.e., suicide attempts, suicide plan, and/or suicidal ideation) of adolescents (ages 11-19 or in grades 7-12) who self-identified as either Latina or Hispanic and a girl in the United States. RESULTS A total of 19 studies met review criteria and focused on microsystemic and intrapersonal predictors. Microsystemic predictors included family (i.e., family-adolescent discrepancies in acculturation, family functioning, family-daughter interactions), peer (i.e., victimization, friendships), and school (i.e., functioning, achievement) factors, while intrapersonal predictors were emotional vulnerability, psychosocial functioning, and substance use. CONCLUSIONS Family-related phenomena were the most widely studied. Research on school and peer microsystems was comparatively sparse, and several promising intrapersonal development factors have been underexplored. A notable limitation of existing studies is that samples consisted primarily of U.S.-born adolescents living in urban areas. Additional research is needed to characterize factors on other ecodevelopmental levels, identify resilience processes, and examine within-group diversity among Latina adolescents. Implications for intervention and future directions are discussed.
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Affiliation(s)
- Francesca R Querdasi
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA.
| | - Guadalupe A Bacio
- Departments of Psychological Science and Intercollegiate Chicana/o-Latina/o Studies, Pomona College, 647 N College Way, Claremont, CA, 91711, USA.
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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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16
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Manzo G, Piña-Watson B, Gonzalez IM, Garcia A, Meza JI. Disentangling acculturation and enculturation intergenerational gaps: Examining mother-youth value discrepancies and mental health among Mexican-descent college students. J Clin Psychol 2021; 78:298-320. [PMID: 34414572 DOI: 10.1002/jclp.23229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/14/2021] [Accepted: 06/28/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To test the acculturation gap hypothesis by examining mother-youth value discrepancies (both acculturative and enculturative) and their association with mother-youth acculturative conflict and youth mental health outcomes. METHOD Participants were 273 Mexican descent college students attending a large, public, Hispanic Serving Institution (HSI) in West Texas (72% women). The participants' ages ranged 18-25 years (M = 19.33 years; SD = 1.54 years). RESULTS Three models assessed the relationship between mother-youth value discrepancies and mental health outcomes (suicidal ideation, non-suicidal self-injury, and depressive symptoms) as mediated by mother-youth acculturative conflict. Consistently, Mexican heritage cultural values were related to mental health outcomes while American cultural values were not. CONCLUSIONS The study found that increased mother-youth discrepancies on Mexican cultural values were associated with increased negative mental health outcomes. Our findings suggest that adopting or learning new mainstream American values does not substitute for the Mexican cultural values that protect against negative outcomes.
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Laestadius LI, Craig KA, Campos-Castillo C. Perceptions of Alerts Issued by Social Media Platforms in Response to Self-injury Posts Among Latinx Adolescents: Qualitative Analysis. J Med Internet Res 2021; 23:e28931. [PMID: 34383683 PMCID: PMC8386397 DOI: 10.2196/28931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/22/2021] [Accepted: 07/05/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is growing interest in using social media data to detect and address nonsuicidal self-injury (NSSI) among adolescents. Adolescents often do not seek clinical help for NSSI and may adopt strategies to obscure detection; therefore, social media platforms may be able to facilitate early detection and treatment by using machine learning models to screen posts for harmful content and subsequently alert adults. However, such efforts have raised privacy and ethical concerns among health researchers. Little is currently known about how adolescents perceive these efforts. OBJECTIVE The aim of this study is to examine perceptions of automated alerts for NSSI posts on social media among Latinx adolescents, who are at risk for NSSI yet are underrepresented in both NSSI and health informatics research. In addition, we considered their perspectives on preferred recipients of automated alerts. METHODS We conducted semistructured, qualitative interviews with 42 Latinx adolescents between the ages of 13 and 17 years who were recruited from a nonprofit organization serving the Latinx community in Milwaukee, Wisconsin. The Latinx population in Milwaukee is largely of Mexican descent. All interviews were conducted between June and July 2019. Transcripts were analyzed using framework analysis to discern their perceptions of automated alerts sent by social media platforms and potential alert recipients. RESULTS Participants felt that automated alerts would make adolescents safer and expedite aid before the situation escalated. However, some worried that hyperbolic statements would generate false alerts and instigate conflicts. Interviews revealed strong opinions about ideal alert recipients. Parents were most commonly endorsed, but support was conditional on perceptions that the parent would respond appropriately. Emergency services were judged as safer but inappropriate for situations considered lower risk. Alerts sent to school staff generated the strongest privacy concerns. Altogether, the preferred alert recipients varied by individual adolescents and perceived risks in the situation. None raised ethical concerns about the collection, analysis, or storage of personal information regarding their mental health status. CONCLUSIONS Overall, Latinx adolescents expressed broad support for automated alerts for NSSI on social media, which indicates opportunities to address NSSI. However, these efforts should be co-constructed with adolescents to ensure that preferences and needs are met, as well as embedded within broader approaches for addressing structural and cultural barriers to care.
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Affiliation(s)
- Linnea I Laestadius
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Katherine A Craig
- Department of Sociology, University of Colorado Boulder, Boulder, CO, United States
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Goodwill JR. Black Youth's Experiences With Feelings of Worthlessness, Parent Relationships, and Suicide: Findings From a National Probability Survey. J Adolesc Health 2021; 69:294-301. [PMID: 33602614 DOI: 10.1016/j.jadohealth.2020.12.141] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Suicide has been a leading cause of death for Black youth in the U.S. since the 1980s. Yet, empirical investigations that examine correlates of suicidality and assess within-group differences among Black boys and girls are scant. The current study therefore sought to rectify this gap by assessing whether feelings of worthlessness and parent relationships were associated with suicidality for Black adolescents, while also examining whether youth's experiences are consistent across gender groups. METHODS Data from the 2004-2018 National Survey on Drug Use and Health (NSDUH) were analyzed using multivariate logistic regression. The NSDUH is a nationally representative probability sample of households in the U.S. Predicted probabilities were plotted to aid interpretation of odds ratios. RESULTS Black girls reported more suicide ideation and attempt. Black girls also reported more feelings of worthlessness, while boys reported fewer fights with their parents. Results from the gender-stratified logistic regression analyses revealed that feelings of worthlessness were associated with significantly greater odds of suicide ideation, planning, and attempt both for Black girls and boys. The frequency of fighting with parents was associated with greater odds of all three suicide outcomes for girls and ideation only for boys. Receiving verbal affirmation from parents was associated with significantly lower odds of suicide ideation among girls only. CONCLUSIONS Findings indicate that some intrapersonal and interpersonal factors are differentially associated with suicide in boys and girls. As such, affirming Black youth of their self-worth and promoting positive relationships with their parents will be imperative in working to prevent suicide among this population.
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Affiliation(s)
- Janelle R Goodwill
- University of Chicago, Crown Family School of Social Work, Policy, and Practice, Chicago, Illinois.
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19
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Mueller AS, Abrutyn S, Pescosolido B, Diefendorf S. The Social Roots of Suicide: Theorizing How the External Social World Matters to Suicide and Suicide Prevention. Front Psychol 2021; 12:621569. [PMID: 33868089 PMCID: PMC8044307 DOI: 10.3389/fpsyg.2021.621569] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/22/2021] [Indexed: 01/03/2023] Open
Abstract
The past 20 years have seen dramatic rises in suicide rates in the United States and other countries around the world. These trends have been identified as a public health crisis in urgent need of new solutions and have spurred significant research efforts to improve our understanding of suicide and strategies to prevent it. Unfortunately, despite making significant contributions to the founding of suicidology - through Emile Durkheim's classic Suicide (1897/1951) - sociology's role has been less prominent in contemporary efforts to address these tragic trends, though as we will show, sociological theories offer great promise for advancing our understanding of suicide and improving the efficacy of suicide prevention. Here, we review sociological theory and empirical research on suicide. We begin where all sociologists must: with Durkheim. However, we offer a more comprehensive understanding of Durkheim's insights into suicide than the prior reviews provided by those in other disciplines. In so doing, we reveal the nuance and richness of Durkheim's insights that have been largely lost in modern suicidology, despite being foundational to all sociological theories of suicide - even those that have moved beyond his model. We proceed to discuss broadly acknowledged limitations to Durkheim's theory of suicide and review how more recent theoretical efforts have not only addressed those concerns, but have done so by bringing a larger swatch of sociology's theoretical and empirical toolkit to bare on suicide. Specifically, we review how recent sociological theories of suicide have incorporated insights from social network theories, cultural sociology, sociology of emotions, and sociological social psychology to better theorize how the external social world matters to individual psychological pain and suffering. We conclude by making explicit bridges between sociological and psychological theories of suicide; by noting important limitations in knowledge about suicide - particularly regarding the roles of organizations, inequality, and intersectionality in suicide - that sociology is well situated to help address.
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Affiliation(s)
- Anna S. Mueller
- Department of Sociology, Indiana University Bloomington, Bloomington, IN, United States
| | - Seth Abrutyn
- Department of Sociology, The University of British Columbia, Vancouver, BC, Canada
| | - Bernice Pescosolido
- Department of Sociology, Indiana University Bloomington, Bloomington, IN, United States
| | - Sarah Diefendorf
- Department of Political Science, The University of Utah, Salt Lake City, UT, United States
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Nonsuicidal Self-Injury Among African American and Hispanic Adolescents and Young Adults: a Systematic Review. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 22:367-377. [PMID: 32671672 DOI: 10.1007/s11121-020-01147-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
While African American and Hispanic adolescents and young adults living in the USA are exposed to myriad stressors that may increase their risk for mental health difficulties, few studies have examined nonsuicidal self-injury (NSSI) among these youth. The purpose of this systematic review was to critically examine and synthesize current literature on NSSI among these understudied youth. Using multiple search terms related to NSSI, race/ethnicity, and developmental stage, electronic literature searches of PubMed, PsychINFO, and Google Scholar databases retrieved 3036 relevant articles published in the English language between 2000 and 2018; manual reference checks yielded an additional 17 articles. Ultimately, a total of 52 full-text studies were assessed for eligibility, and 15 articles were included in the present review. Although the majority of studies reported higher prevalence of NSSI among non-Hispanic White youth, evidence suggests that African American males are also at high risk of engaging in self-harm. Emotional dysregulation emerged as a common risk factor, while social support and feelings of connection were protective for some African American and Hispanic youth. Although racism and discrimination were not linked to NSSI in the reviewed studies, this remains an important area of future research for prevention and intervention efforts.
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Szlyk HS, Gulbas L, Zayas L. "I Just Kept It to Myself": The Shaping of Latina Suicidality Through Gendered Oppression, Silence, and Violence. FAMILY PROCESS 2019; 58:778-790. [PMID: 30117539 PMCID: PMC6378134 DOI: 10.1111/famp.12384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Suicide is a critical issue among Latina youth. In this study, we use family case analysis to explore how gendered oppression, silencing, and violence shape suicidal behaviors among a sample of Latina daughters (n = 10), and their parents. For comparison, we include family narratives from Latina adolescents with no histories of suicide attempts (n = 10). Results suggest how secrets and silence, as indicative of gendered oppression, may catalyze a suicide attempt. The risks are particularly salient when daughter and mother both have experienced violence that conflicts with gendered cultural scripts. Findings highlight the importance of parental engagement and exploration of histories of violence in the treatment of Latina suicide attempters. Future research should incorporate the risk factors of gendered oppression and violence to better understand the development of suicidality among Latina women.
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Affiliation(s)
- Hannah S Szlyk
- The Brown School, Washington University at St. Louis, St. Louis, MO
| | - Lauren Gulbas
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX
| | - Luis Zayas
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX
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A qualitative systematic review of experiences and perceptions of youth suicide. PLoS One 2019; 14:e0217568. [PMID: 31188855 PMCID: PMC6561633 DOI: 10.1371/journal.pone.0217568] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/14/2019] [Indexed: 11/26/2022] Open
Abstract
Background Suicide remains a global issue with over 800,000 people dying from suicide every year. Youth suicide is especially serious due to the years of life lost when a young person takes their own life. Social interactions, perceived support, genetic predisposition and mental illnesses are factors associated with suicide ideation. Objectives To review and synthesize qualitative studies that explored the experiences and perceptions of suicide in people 25 years old and younger. Design Qualitative systematic review. Data sources PubMed, PsycINFO, Scopus and CINAHL were searched alongside hand-searching reference lists up to October 2018. Methods Methodological quality was assessed using the qualitative Critical Appraisal Skills Programme checklist. The 27 studies included in the review centered around youth suicide and included interviews with young people and members of the wider community. Thematic synthesis focused on factors leading to suicide attempts, elements important to recovery, beliefs within the community, and treatment/prevention strategies. Results Thematic analysis of the articles revealed four categories: i) triggers and risks leading to suicidality; ii) factors involved in recovery; iii) need for institutional treatment/prevention strategies; and iv) beliefs about suicide at a community level. The first category was further subdivided into: i) behaviours; ii) feelings/emotions; iii) family influences; iv) peer influences; and v) other. The second category was split into: i) interpersonal; ii) cultural; and iii) individual influences, while the third category was divided into i) education; and ii) treatment. Conclusion Youth suicide is a complex issue with many causes and risks factors which interact with one another. For successful treatment and prevention, procedural reform is needed, along with a shift in societal attitudes toward emotional expression and suicide.
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Sellers CM, Iriarte ADV, Battalen AW, O’Brien KHM. Alcohol and marijuana use as daily predictors of suicide ideation and attempts among adolescents prior to psychiatric hospitalization. Psychiatry Res 2019; 273:672-677. [PMID: 31207851 PMCID: PMC9262037 DOI: 10.1016/j.psychres.2019.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Little research has been conducted on alcohol use, marijuana use, and suicide ideation and attempts on a daily level, and specifically among adolescents prior to inpatient hospitalization. The purpose of this study was to examine the within (over time) and between (between adolescents) effects of alcohol use and marijuana use on suicide ideation and attempts. METHODS Participants included 50 adolescents (80% female; Mage = 15.8). All participants reported drinking alcohol in the prior three months and were receiving treatment in an inpatient psychiatric hospital. Random and mixed-effect models were used to test study hypotheses. RESULTS Results from the random effect model indicated that alcohol use, marijuana use, hospitalization and sexual orientation were significant predictors of suicide attempts. Results from the mixed-effect model indicated that marijuana use, hospitalization, and sexual orientation were significant predictors of suicide ideation. CONCLUSIONS Study findings extend current knowledge about the longitudinal and day-to-day relationship between alcohol and marijuana use and suicide ideation and attempts. Results underscore the importance of addressing alcohol and marijuana use in interventions with suicidal adolescents, recognizing that sexual minority youth may be at elevated risk for suicide ideation.
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Affiliation(s)
- Christina M. Sellers
- Boston Children’s Hospital, Department of Psychiatry, 300 Longwood Ave Boston, MA 02115, USA,Corresponding author at: Boston Children’s Hospital, 300 Longwood Ave, Boston, MA, USA. (C.M. Sellers)
| | - Antonia Diaz-Valdes Iriarte
- Boston College, School of Social Work, 140 Commonwealth Ave Chestnut Hill, MA 02467, USA,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Oficina 1305, Las Condes, Santiago 750000 Chile
| | - Adeline Wyman Battalen
- Boston Children’s Hospital, Department of Psychiatry, 300 Longwood Ave Boston, MA 02115, USA
| | - Kimberly H. McManama O’Brien
- Boston Children’s Hospital, Department of Psychiatry, 300 Longwood Ave Boston, MA 02115, USA,Education Development Center, Department of Innovation in Practice and Technology, 43 Foundry Ave Waltham, MA 02453, USA,Harvard Medical School, Department of Psychiatry, 25 Shattuck St Boston, MA 02115, USA
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Liu W, Sun H, Zhang X, Chen Q, Xu Y, Chen X, Ding Z. Air pollution associated with non-suicidal self-injury in Chinese adolescent students: A cross-sectional study. CHEMOSPHERE 2018; 209:944-949. [PMID: 30114744 PMCID: PMC6100799 DOI: 10.1016/j.chemosphere.2018.06.168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/12/2018] [Accepted: 06/27/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a frequent phenomenon in adolescents and is closely related to eventual suicide. Although the effect of air pollution on various diseases has been extensively investigated, no studies examined its effect on NSSI in young students. OBJECTIVES We investigated the effect of air pollution on NSSI in Chinese students. METHODS We investigated the incidence of NSSI in the past 12 months in 54 923 Chinese students with an anonymous questionnaire. We assessed the air pollution exposure of each student by the air quality matched with their schools, which were calculated by the inverse distance weighting method from the environmental monitoring data. We discussed the association between ambient air pollutants and the incidence of NSSI using generalized additive mixed models. RESULTS A 10 μg/m3 increase in the annual moving average concentration of particulate matter with diameters less than 2.5 μm (PM2.5) and ozone (O3) was associated with a 13.9 percent and a 10.5 percent increase in the odds ratio (OR) of NSSI, respectively. In addition, a 0.1 mg/m3 increase in the annual moving average concentration of carbon monoxide (CO) was associated with a 4.8 percent increase in the OR of NSSI. NO2 and SO2 were not related to NSSI. CO and O3 show non-linear effects on NSSI. Male students in high school are the most s to the effects of PM2.5 on NSSI. CONCLUSIONS Our study suggests that increases in PM2.5, O3 and CO may increase the incidence of NSSI among adolescent students.
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Affiliation(s)
- Weina Liu
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China
| | - Hong Sun
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China.
| | - Xin Zhang
- School of Statistics, Beijing Normal University, 19 XinJieKouWai Street, 100875 Beijing, China
| | - Qi Chen
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China
| | - Yan Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China
| | - Xi Chen
- Department of Health Policy and Management, Department of Economics, Yale University, 60 College St., New Haven, CT 06520, USA
| | - Zhen Ding
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China.
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Abstract
In this article, we examine the treatment narratives of Latina adolescent suicide attempters to understand their experiences undergoing care. For this study, we conducted content and thematic analysis of 68 interviews with Latina adolescent suicide attempters. Most teens who described positive experiences undergoing treatment (n = 39, 44.1%) did so when discussing outpatient mental health services (n = 30, 72.9%). Latinas felt that the providers who fostered their autonomy and connectedness helped them become active agents in their recovery. Clinicians serving suicidal Latinas must allow them to exercise agency while feeling emotionally connected to providers. To help Latinas manage their suicidality, treatments need to address the teens' developmental needs.
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Humensky JL, Coronel B, Gil R, Mazzula S, Lewis-Fernández R. Life is Precious: A Community-Based Program to Reduce Suicidal Behavior in Latina Adolescents. Arch Suicide Res 2017; 21:659-671. [PMID: 27700862 PMCID: PMC5626659 DOI: 10.1080/13811118.2016.1242442] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Latina adolescents have high rates of suicidal behavior. Life is Precious (LIP), a community-based program in New York City, helps adolescents and families address risk factors facing Latinas. Participants are assessed for suicidal ideation, depressive and other psychiatric symptoms, and family functioning, at program entry and every 4 months during participation. Demographic characteristics and suicide attempts are also tracked. In the study period, there were no attempted or completed suicides in this high-risk population. Suicidal ideation, depressive symptoms, anger, and posttraumatic stress symptoms decreased significantly during participation. The LIP model shows promise for helping to address suicidal risk factors facing Latinas. However, in the absence of a comparison group, participants' improvement may be due to their engagement in mental health treatment more generally, or to the passage of time, rather than specifically to LIP. Nevertheless, as very little is known about how to address risk factors unique to Latina adolescents, these early findings may be of interest to the community serving Latina adolescents and the lessons may be of interest to programs serving adolescents from other racial/ethnic groups. Future research should develop comparison groups and test LIP implementation in other settings.
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Humensky JL, Gil RM, Mazzula S, Diaz S, Lewis-Fernández R. Life Is Precious: Views of Adolescents and Their Mothers on Methods to Reduce Suicidal Behavior in Latinas. J Sch Nurs 2017; 33:426-433. [PMID: 28750573 DOI: 10.1177/1059840517722590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Life is Precious (LIP) was developed to help reduce suicidal behavior in Latina adolescents. As part of an external evaluation of the LIP program, we conducted focus groups with adolescent participants and mothers to learn whether participants and families believe that the activities of LIP address risks for suicidal behavior. Four focus groups were conducted: three with Latina adolescent LIP participants ( n = 31) and one with mothers ( n = 8). Transcripts were analyzed using ATLAS.ti. A grounded theory approach was used to identify themes and subthemes. The following themes emerged: (1) challenges contributing to suicidal behavior and self-harm among Latina adolescents, (2) how respondents believe that LIP is helping to reduce suicidal behavior, and 3) ongoing challenges. Participants say that the LIP program helps adolescents feel better and improve social relationships, academic performance, and relationships with their family. School nurses may wish to identify community-based programs offering similar services.
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Affiliation(s)
- Jennifer L Humensky
- 1 Columbia University, New York, NY, USA.,2 New York State Psychiatric Institute, New York, NY, USA
| | | | - Silvia Mazzula
- 4 John Jay College, City University of New York, New York, NY, USA
| | - Samantha Diaz
- 2 New York State Psychiatric Institute, New York, NY, USA
| | - Roberto Lewis-Fernández
- 1 Columbia University, New York, NY, USA.,2 New York State Psychiatric Institute, New York, NY, USA
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Abstract
UNLABELLED The current paper reviews extant quantitative and qualitative literature into how Non-Suicidal Self-Injury cessation occurs, and individuals' experiences of stopping. Specific search criteria utilizing a PRISMA format were used across 5 databases, which resulted in 454 papers being identified. After utilizing exclusion criteria and then review, nine of the 454 papers identified were retained for extensive synthesis and critique. RESULTS Results from 8 of the identified papers indicated that both intra and inter personal factors can influence self-injury cessation. These include: family support, self-esteem, emotional regulation, and professional help. Only 1 paper articulated a cessation process, describing it as a procedural event of developing interpersonal strength, then implementing alternative coping strategies. Limitations and implications of the studies are reported, concluding that further research is warranted to inform effective prevention and treatment strategies to ameliorate this growing public health concern.
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Young CC, Simonton AJ, Key S, Barczyk AN, Lawson KA. Closing in on Crisis: Informing Clinical Practice Regarding Nonsuicidal Self-Injury in Youth. J Pediatr Health Care 2017; 31:334-341. [PMID: 27816254 DOI: 10.1016/j.pedhc.2016.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/05/2016] [Accepted: 10/07/2016] [Indexed: 10/20/2022]
Abstract
Nonsuicidal self-injury (NSSI) in youth is a major public health concern. A retrospective chart review was conducted within a hospital system to examine (a) youth self-reports of reasons for engaging in NSSI and (b) additional contextual circumstances that may contribute to youth NSSI. Detailed history, physical examination, and treatment/discharge data were extracted by thoroughly reviewing all electronic documents in each medical record. The final sample (N = 135) were predominantly female (71.1%), and well over half (63.8%) reported Medicaid or uninsured status. Qualitative content analysis of youth self-reports and hospital progress notes showed that NSSI served as an emotional and functional coping mechanism. Five primary themes characterized the contextual influences on youth engaging in NSSI: (1) Personal Emotions, (2) Trauma, (3) Relationship Quality, (4) Sense of Loss, and (5) Risk Behaviors. Practical clinical practice suggestions for working with youth are discussed using these themes as a template for assessing risk and protective factors.
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