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Brown S, Tezanos KM, Nugent NR. Childhood Maltreatment, Executive Function, and Suicide Attempts in Adolescents. CHILD MALTREATMENT 2024; 29:672-683. [PMID: 37279026 DOI: 10.1177/10775595231182047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Evidence suggests that child maltreatment is a risk factor for adolescent suicidal behavior. However, the differential influence of distinct forms of child maltreatment on adolescent suicide attempts is understudied and the factors that might exacerbate or ameliorate these associations warrant attention. We examined the associations between two distinct forms of child maltreatment (threat and deprivation) and suicide attempt history, and investigated whether executive function domains moderated these associations. Participants were 119 adolescents (M = 15.24, SD = 1.46, 72.3% female) recruited from an inpatient psychiatric hospital during hospitalization for suicidal thoughts and behaviors. Results indicated that the executive function domains of initiation, shifting, and planning/organization moderated the associations between threat and suicide attempt history. Associations between threat and suicide attempt history were significant only when initiation and shifting T-scores were lower (OR = 1.22, p = .03 and OR = 1.32, p = .01, respectively). The association between threat and suicide attempt history trended toward significance when planning/organization T-scores were lower (OR = 1.15, p = .10). None of the executive function domains moderated the link between deprivation and suicide attempt history. Findings highlight the need for research investigating whether initiation, shifting, and planning/organization might be amendable to intervention in the context of threat-related child maltreatment.
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Affiliation(s)
- Shaquanna Brown
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Katherine M Tezanos
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Nicole R Nugent
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
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2
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Liu RT, Bettis AH, Lawrence HR, Walsh RFL, Sheehan AE, Pollak OH, Stephenson AR, Kautz MM, Marlowe RM. Measures of Suicidal Thoughts and Behaviors in Children and Adolescents: A Systematic Review and Recommendations for Use in Clinical and Research Settings. Assessment 2024:10731911241249438. [PMID: 38742801 DOI: 10.1177/10731911241249438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Empirically supported measures of suicidal thoughts and behaviors (STBs) are needed to serve as reference outcomes for suicide risk screening tools and to monitor severity and treatment progress in children and adolescents with STBs. The present paper systematically reviewed existing measures of STBs in youth and studies evaluating their psychometric properties and clinical utility. Measures were then evaluated on reliability, validity, and clinical utility. Sixteen articles (20 independent samples) were found with psychometric data with youth samples for eight measures. Interview-based measures were found to have the strongest psychometric support and clinical utility. Significant limitations exist for all self-report measures due to inherent characteristics of these measures that cannot be remedied through additional psychometric study. There is an urgent need for the development and validation of new self-report measures of STBs, particularly for preadolescent children, sexual and gender minority youth, and racial/ethnic minority youth.
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Affiliation(s)
- Richard T Liu
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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3
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Peng B, Wang R, Zuo W, Liu H, Deng C, Jing X, Hu H, Zhao W, Qin P, Dai L, Chen Z, Zhang Y, Liu XA. Distinct correlation network of clinical characteristics in suicide attempters having adolescent major depressive disorder with non-suicidal self-injury. Transl Psychiatry 2024; 14:134. [PMID: 38443348 PMCID: PMC10914800 DOI: 10.1038/s41398-024-02843-w] [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: 07/20/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
Suicidal behavior and non-suicidal self-injury (NSSI) are common in adolescent patients with major depressive disorder (MDD). Thus, delineating the unique characteristics of suicide attempters having adolescent MDD with NSSI is important for suicide prediction in the clinical setting. Here, we performed psychological and biochemical assessments of 130 youths having MDD with NSSI. Participants were divided into two groups according to the presence/absence of suicide attempts (SAs). Our results demonstrated that the age of suicide attempters is lower than that of non-attempters in participants having adolescent MDD with NSSI; suicide attempters had higher Barratt Impulsiveness Scale (BIS-11) impulsivity scores and lower serum CRP and cortisol levels than those having MDD with NSSI alone, suggesting levels of cortisol and CRP were inversely correlated with SAs in patients with adolescent MDD with NSSI. Furthermore, multivariate regression analysis revealed that NSSI frequency in the last month and CRP levels were suicidal ideation predictors in adolescent MDD with NSSI, which may indicate that the increased frequency of NSSI behavior is a potential risk factor for suicide. Additionally, we explored the correlation between psychological and blood biochemical indicators to distinguish suicide attempters among participants having adolescent MDD with NSSI and identified a unique correlation network that could serve as a marker for suicide attempters. Our research data further suggested a complex correlation between the psychological and behavioral indicators of impulsivity and anger. Therefore, our study findings may provide clues to identify good clinical warning signs for SA in patients with adolescent MDD with NSSI.
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Grants
- 32371213 National Natural Science Foundation of China (National Science Foundation of China)
- This work was supported by grants from the National Natural Science Foundation of China (NSFC) (32371213 to X.A.L, 32000710 to Z.X.C, U20A2016 to Z.X.C), the STI2030-Major Projects (2022ZD0207100, Z.X.C), Shenzhen Medical Research Funds (D2301002 to P.W.Q and X.A.L), the Guangdong Basic and Applied Basic Research Foundation (2023A1515011743 to X.A.L, 2019A1515110190 to Z.X.C), the Shenzhen Science and Technology Program (KCXFZ20211020163549011 to X.A.L), Shenzhen Key Basic Research Project (JCYJ20200109115641762 to Z.X.C), Shenzhen governmental grant (ZDSYS20190902093601675 to Z.X.C), and CAS Key Laboratory of Brain Connectome and Manipulation (2019DP173024 to X.A.L and Z.X.C),Supported by Shenzhen Key Medical Discipline Construction Fund(No.SZXK041),Supported by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties(No.SZGSP013).
- Shenzhen Key Medical Discipline Construction Fund (No.SZXK041); the Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties (No. SZGSP013 to B.P)
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Affiliation(s)
- Bo Peng
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Ruoxi Wang
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - Wenlong Zuo
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Haitao Liu
- Shenzhen Longgang District Maternity & Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Chunshan Deng
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - Xiaoyuan Jing
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - Hongtao Hu
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Weitan Zhao
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Peiwu Qin
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, China
| | - Lei Dai
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of the Chinese Academy of Sciences, 100049, Beijing, China
| | - Zuxin Chen
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.
- University of the Chinese Academy of Sciences, 100049, Beijing, China.
| | - Yingli Zhang
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China.
| | - Xin-An Liu
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.
- University of the Chinese Academy of Sciences, 100049, Beijing, China.
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Bettis AH, Burke TA, Scott SR, Bedock C, Ambriano C, Parrish J, Marsh D, Fox KR. Disclosures of self-injurious thoughts and behaviors to parents in the context of adolescent therapy: A qualitative investigation. J Clin Psychol 2024; 80:537-558. [PMID: 38111150 PMCID: PMC10922370 DOI: 10.1002/jclp.23633] [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: 03/15/2023] [Revised: 11/20/2023] [Accepted: 12/02/2023] [Indexed: 12/20/2023]
Abstract
Self-injurious thoughts and behaviors (SITBs), including suicidal thoughts, suicide attempts, and nonsuicidal self-injury, are highly prevalent among adolescents. Identifying adolescents at risk for SITBs relies on their disclosure, and these disclosures commonly occur in therapy context. Moreover, therapists often breach confidentiality to inform adolescents' parent or guardian when they disclose SITBs. Research has explored rates of and barriers to disclosure among adolescents, yet no studies have examined adolescents' experiences of disclosure in the therapy context. Further, no studies have examined adolescents' experiences when their parents are then informed. In this study, we examined qualitative responses from 1495 adolescents who had experienced a SITB disclosure in the therapy context. Qualitative questions included asking adolescents to describe how the SITB disclosure occurred, how their parents were informed, and their parents' reactions. Using open and axial coding, several themes emerged. Adolescents described therapist breaches of confidentiality as collaborative, noncollaborative, or unclear. Adolescents described their parents' affective responses, communication about SITBs, validating and invalidating responses, treatment-oriented responses, and ways that parents restricted their access to people, places, and activities. Findings have implications for the development of clinical guidelines when adolescents disclose SITBs in therapy and highlight areas for future research in adolescent SITB disclosure.
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Affiliation(s)
- Alexandra H Bettis
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Taylor A Burke
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Samantha R Scott
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Cara Bedock
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Caroline Ambriano
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Jordan Parrish
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Destinee Marsh
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Kathryn R Fox
- Department of Psychology, University of Denver, Denver, Colorado, USA
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5
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Kline KM, Jorgensen SL, Lawson WC, Ohashi YGB, Wang SB, Fox KR. Comparing self-harming intentions underlying eating disordered behaviors and nonsuicidal self-injury: Replication and extension in adolescents. Int J Eat Disord 2023; 56:2200-2209. [PMID: 37638551 DOI: 10.1002/eat.24043] [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: 05/19/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Eating disorder (ED) behaviors are often characterized as indirect forms of self-harm. However, recent research has found less clear demarcations between direct self-harming behaviors (e.g., nonsuicidal self-injury [NSSI], suicidal behaviors) than previously assumed. The aim of this study was to replicate findings of this prior research on adult populations in adolescents with a history of restrictive eating. METHOD A total of 117 adolescents between ages 12-14 were included in the study. Participants reported the presence and frequency of binge eating, compensatory, restrictive eating, and NSSI. Participants also reported thoughts of and intentions to hurt and kill themselves when engaging in each behavior on average. The t-tests and linear effects models were conducted to compare self-harming thoughts and intentions across behaviors. RESULTS Participants reported at least some intent to hurt themselves physically in the moment and in the long-term when engaging in all ED behaviors and NSSI, and reported engaging in these behaviors while thinking about suicide. Direct self-harming knowledge and intentions were most frequently reported with NSSI and longer-term knowledge and intentions via NSSI and restrictive eating. Additionally, participants reported some suicidal thoughts and intentions across behaviors. DISCUSSION This study replicates prior research, suggesting that adolescents engage in ED behaviors and NSSI with non-zero self-harming and suicidal thoughts and intentions. ED behaviors and NSSI may better be explained on a continuum. Implications include the recommendation of safety planning during ED treatment. PUBLIC SIGNIFICANCE STATEMENT This study highlights the overlap between eating disorder (ED) behaviors, nonsuicidal self-injury (NSSI), and suicide. Though clear distinctions typically exist for motives of self-harming behavior between ED behaviors (i.e., indirect, in the long run) and NSSI (i.e., direct, in the moment), this research suggests that intentions for self-harming and suicide may exist on a continuum. Clinical ED treatment should consider safety planning as part of routine interventions.
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Affiliation(s)
- Kiki M Kline
- College of Social Work, University of Tennessee, Knoxville, Tennessee, USA
| | - Saskia L Jorgensen
- Department of Psychology, University of Denver, Denver, Colorado, USA
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | - W Cole Lawson
- Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | | | - Shirley B Wang
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Kathryn R Fox
- Department of Psychology, University of Denver, Denver, Colorado, USA
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6
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Beaton MA, Gratch I, Cha CB. Specificity, frequency, and intent: Multiple characteristics of adolescents' suicide plan correlate with their history of suicidal behavior. Suicide Life Threat Behav 2023; 53:1025-1037. [PMID: 37720928 DOI: 10.1111/sltb.13002] [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: 04/08/2023] [Revised: 08/12/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Suicide plans (SP) can be a common precipitant to suicidal behavior (SB) during adolescence, and SPs can vary in how specific they are, how frequently they are thought about, and how strongly they are intended to be enacted. To date, we have limited understanding of how discrete SP characteristics (i.e., specificity, frequency, and intent to act) present among adolescents, and whether they relate to SB. In the current study, we investigated SP characteristics and their association with SB history among adolescents who had previously considered suicide. METHODS Participants were 142 community-based adolescents (14-19 years; M = 17.6, SD = 1.4) who reported a history of suicidal ideation. Adolescents provided responses pertaining to their SP history, SP characteristics, and SB history, via the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R). RESULTS Greater specificity, frequency, and intent were each associated with modestly increased odds of reporting an SB history. The associations between plan specificity and SB history, as well as between frequency of thinking about one's SP and SB history, were mediated by adolescents' intent to act on their SP. CONCLUSIONS It may not only be whether, but how, adolescents plan for suicide that relates to their tendency to engage in SB.
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Affiliation(s)
- Maura A Beaton
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
| | - Ilana Gratch
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
| | - Christine B Cha
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
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7
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Shin KE, Spears AP, Zhang R, Cha CB. Suicide-related disclosure patterns among culturally minoritized youth: Examining differences across race, ethnicity, gender identity, and sexual orientation. Suicide Life Threat Behav 2023. [PMID: 38032047 DOI: 10.1111/sltb.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE Sharing one's suicidal thoughts and behaviors, or suicide-related disclosure, allows adolescents to recruit help from others. Despite elevated risk among culturally minoritized youth, their suicide-related disclosure remains understudied. METHODS 191 adolescents (M = 15.98, SD = 1.04, range = 13-17), including minoritized youth (38% racially, 19% ethnically, 40% gender, and 77% sexually), were recruited via social media ads and completed an anonymous online survey on suicide-related disclosure to informal support sources (e.g., family, friends). Disclosure rates, targets, and reasons for disclosure and nondisclosure were compared based on race, ethnicity, gender identity, and sexual orientation. RESULTS Racially minoritized adolescents less often disclosed suicidal ideation and more strongly endorsed fear of negative reactions and resistance to intervention as reasons for nondisclosure, and reciprocity as reasons for disclosure, than White adolescents. Cisgender adolescents less often disclosed suicidal ideation and more strongly endorsed dismissal of suicide risk as reasons for nondisclosure than gender minoritized adolescents. Non-Hispanic adolescents more strongly endorsed help-seeking as reasons for disclosure than Hispanic adolescents. While adolescents overall disclosed most often to friends, heterosexual adolescents disclosed more to family than sexually minoritized adolescents. CONCLUSION Racial and gender disparities in suicide-related disclosure may occur for distinct reasons among adolescents. Uncovering patterns of disclosure may facilitate detection of suicide risk among minoritized youth.
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Affiliation(s)
- Ki Eun Shin
- Department of Behavioral Sciences, Long Island University Post, Brookville, New York, USA
| | - Angela Page Spears
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Renjie Zhang
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
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8
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Gallyer AJ, Burani K, Mulligan EM, Santopetro N, Dougherty SP, Jeon ME, Nelson BD, Joiner TE, Hajcak G. Examining Blunted Initial Response to Reward and Recent Suicidal Ideation in Children and Adolescents Using Event-Related Potentials: Failure to Conceptually Replicate Across Two Independent Samples. Clin Psychol Sci 2023; 11:1011-1025. [PMID: 38098687 PMCID: PMC10720695 DOI: 10.1177/21677026221120426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
A recent study by Tsypes and colleagues (2019) found that children with recent suicidal ideation had blunted neural reward processing, as measured by the reward positivity (RewP), compared to matched controls, and that this difference was driven by reduced neural responses to monetary loss, rather than to reward. Here, we aimed to conceptually replicate and extend these findings in two samples (n = 264, 27 with suicidal ideation; and n = 314, 49 with suicidal ideation at baseline) of children and adolescents (11 to 15 years and 8 to 15 years, respectively). Results from both samples showed no evidence that children and adolescents with suicidal ideation have abnormal reward or loss processing, nor that reward processing predicts suicidal ideation two years later. The results highlight the need for greater statistical power, as well as continued research examining the neural underpinnings of suicidal thoughts and behaviors.
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Affiliation(s)
| | | | | | | | | | - Min Eun Jeon
- Department of Psychology, Florida State University
| | | | | | - Greg Hajcak
- Department of Psychology, Florida State University
- Department of Biomedical Sciences, Florida State University
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9
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Stanley IH, Marx BP, Fina BA, Young-McCaughan S, Tyler HC, Sloan DM, Blankenship AE, Dondanville KA, Walker JL, Boffa JW, Bryan CJ, Brown LA, Straud CL, Mintz J, Abdallah CG, Back SE, Blount TH, DeBeer BB, Flanagan J, Foa EB, Fox PT, Fredman SJ, Krystal J, McDevitt-Murphy ME, McGeary DD, Pruiksma KE, Resick PA, Roache JD, Shiroma P, Taylor DJ, Wachen JS, Kaplan AM, López-Roca AL, Nicholson KL, Schobitz RP, Schrader CC, Sharrieff AFM, Yarvis JS, Litz BT, Keane TM, Peterson AL. Psychometric Properties of the Self-Injurious Thoughts and Behaviors Interview-Short Form Among U.S. Active Duty Military Service Members and Veterans. Assessment 2023; 30:2332-2346. [PMID: 36644835 DOI: 10.1177/10731911221143979] [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: 01/17/2023]
Abstract
We assessed the interrater reliability, convergent validity, and discriminant validity of the Self-Injurious Thoughts and Behaviors Interview-Short Form (SITBI-SF) in a sample of 1,944 active duty service members and veterans seeking services for posttraumatic stress disorder (PTSD) and related conditions. The SITBI-SF demonstrated high interrater reliability and good convergent and discriminant validity. The measurement properties of the SITBI-SF were comparable across service members and veterans. Approximately 8% of participants who denied a history of suicidal ideation on the SITBI-SF reported suicidal ideation on a separate self-report questionnaire (i.e., discordant responders). Discordant responders reported significantly higher levels of PTSD symptoms than those who denied suicidal ideation on both response formats. Findings suggest that the SITBI-SF is a reliable and valid interview-based measure of suicide-related thoughts and behaviors for use with military service members and veterans. Suicide risk assessment might be optimized if the SITBI-SF interview is combined with a self-report measure of related constructs.
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Affiliation(s)
- Ian H Stanley
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
- University of Colorado, School of Medicine, Aurora, USA
| | - Brian P Marx
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
| | - Brooke A Fina
- University of Texas Health Science Center at San Antonio, USA
| | - Stacey Young-McCaughan
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | - Hannah C Tyler
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | - Denise M Sloan
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
| | | | | | - James L Walker
- University of Texas Health Science Center at San Antonio, USA
| | - Joseph W Boffa
- Southeast Louisiana Veterans Health Care System, New Orleans, USA
- South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Craig J Bryan
- The Ohio State University Wexner Medical Center, Columbus, USA
| | | | - Casey L Straud
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
- University of Texas at San Antonio, USA
| | - Jim Mintz
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | - Chadi G Abdallah
- Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Sudie E Back
- Medical University of South Carolina, Charleston, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | | | - Bryann B DeBeer
- University of Colorado, School of Medicine, Aurora, USA
- Rocky Mountain Regional VA Medical Center, Aurora, CO, USA
| | - Julianne Flanagan
- Medical University of South Carolina, Charleston, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Edna B Foa
- University of Pennsylvania, Philadelphia, USA
| | - Peter T Fox
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | | | - John Krystal
- VA Connecticut Healthcare System, West Haven, USA
- Yale University, New Haven, CT, USA
| | | | - Donald D McGeary
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
- University of Texas at San Antonio, USA
| | - Kristi E Pruiksma
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | | | - John D Roache
- University of Texas Health Science Center at San Antonio, USA
| | - Paulo Shiroma
- Minneapolis VA Medical Center, MN, USA
- University of Minnesota, Minneapolis, USA
| | | | | | | | | | - Karin L Nicholson
- Carl R. Darnall Army Medical Center, Fort Hood, TX, USA
- Kaiser Permanente Woodland Hills Medical Center, Woodland Hills, CA, USA
| | | | | | - Allah-Fard M Sharrieff
- Carl R. Darnall Army Medical Center, Fort Hood, TX, USA
- U.S. Department of Homeland Security, Miami, FL, USA
| | - Jeffrey S Yarvis
- Tulane University School of Medicine, New Orleans, LA, USA
- Carl R. Darnall Army Medical Center, Fort Hood, TX, USA
| | - Brett T Litz
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
- Boston University, MA, USA
| | - Terence M Keane
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
| | - Alan L Peterson
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
- University of Texas at San Antonio, USA
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10
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Shen JE, Huang YH, Huang HC, Liu HC, Lee TH, Sun FJ, Huang CR, Liu SI. Psychometric properties of the Chinese Mandarin version of the Borderline Symptom List, short form (BSL-23) in suicidal adolescents. Borderline Personal Disord Emot Dysregul 2023; 10:23. [PMID: 37553717 PMCID: PMC10411024 DOI: 10.1186/s40479-023-00230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND The short form of the Borderline Symptom List (BSL-23) is a self-rated instrument developed from the initial 95-item German version of the Borderline Symptom List (BSL-95). It is widely used among Chinese adults, but its applicability, factor structure and validity remain uncertain in adolescents. This study aimed to evaluate the psychometric properties of the Chinese Mandarin version of the BSL-23 in a sample of suicidal adolescents. METHODS The Chinese Mandarin BSL-23 was given to 279 outpatient adolescents with self-injurious thoughts or behaviors. The factor structure, reliability, convergent validity, criterion-related validity and cut-off value were investigated. RESULTS The Chinese Mandarin version of the BSL-23 demonstrated a one-factor structure and replicated the original version. The scale had high reliability and good test-retest stability. The Chinese Mandarin BSL-23 was correlated with depression, hopelessness, impulsivity, emotional dysregulation, self-esteem, loneliness, childhood trauma and parental bonding patterns evaluated with a variety of scales. The measure showed good criterion-related validity and predictive accuracy (AUC = 0.87) for self-injurious and suicidal adolescents with borderline personality disorder (BPD) at a cut-off point of 60/61 (mean score 2.60/2.65), with a sensitivity of 0.76 and specificity of 0.83. CONCLUSIONS The Chinese Mandarin version of the BSL-23 is a reliable and valid self-reported instrument to assess BPD symptomatology among suicidal adolescents.
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Affiliation(s)
- Jui-En Shen
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yu-Hsin Huang
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Hui-Chun Huang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Hui-Ching Liu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tsung-Han Lee
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Chiu-Ron Huang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shen-Ing Liu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan.
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
- MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
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11
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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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12
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Ammerman BA, Jacobucci R. The impact of social connection on near-term suicidal ideation. Psychiatry Res 2023; 326:115338. [PMID: 37453309 DOI: 10.1016/j.psychres.2023.115338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
While predominant suicide theories emphasize the role of social connectedness in suicidal thinking, there is a need to better understand (a) how specific aspects of social connection relate to suicidal ideation and (b) the timeframe over which these relationships persist. The current study examined ecological momentary assessment data over a 30-day period from 35 participants with past-year suicidal thoughts or behaviors (mean age = 25.88; 62.9% women; 68.6% White) to address these questions. Results demonstrated that absence of social contact was associated with next timepoint suicidal ideation, even after considering the suicidal ideation autoregressive effect (i.e., concurrent), with effects strongest in the short-term. Findings provide preliminary evidence of the need to assess for the presence of social contact, and for assessments to occur in close proximity (i.e., a few hours), to capture the true dynamics of risk for suicidal ideation. Although needing replication, results suggest importance of just-in-time interventions targeting suicidal ideation.
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Affiliation(s)
- Brooke A Ammerman
- Department of Psychology, University of Notre Dame, 390 Corbett Family Hall, Notre Dame, IN 46656, United States.
| | - Ross Jacobucci
- Department of Psychology, University of Notre Dame, 390 Corbett Family Hall, Notre Dame, IN 46656, United States
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13
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Spears AP, Gratch I, Nam RJ, Goger P, Cha CB. Future Directions in Understanding and Interpreting Discrepant Reports of Suicidal Thoughts and Behaviors Among Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:134-146. [PMID: 36473063 PMCID: PMC9898197 DOI: 10.1080/15374416.2022.2145567] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Both the quality and utility of youth suicide research depend on how we assess our outcomes of interest: suicidal thoughts and behaviors (STBs). We now have access to more STB assessments than ever before, with measures for youth that vary in what exact experiences are asked about, how such measures elicit information, when and how frequently measures are administered, and who the informants are. This growing armamentarium of assessments has the potential to improve the study and treatment of STBs among youth, but it hinges on meaningful interpretation of assessment responses. Interpretation can be especially challenging when different STB assessments yield conflicting information. Determining how to manage discrepant reports of STBs is a pivotal step toward achieving meaningfully comprehensive STB assessment batteries. Here, we outline several discrepant reporting patterns that have been detected, discuss the potential significance of these observed discrepancies, and present initial steps to formally investigate discrepant reports of STBs among youth. Developing coherent, interpretable, and comprehensive batteries assessing STBs among youth would address a fundamental step to uncovering etiology, improving clinical decision-making and case management, informing intervention development, and tracking prognosis.
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Affiliation(s)
- Angela Page Spears
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Ilana Gratch
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Rachel J Nam
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Pauline Goger
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
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14
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Bell KA, Gratch I, Ebo T, Cha CB. Examining Discrepant Reports of Adolescents' Self-Injurious Thoughts and Behaviors: A Focus on Racial and Ethnic Minority Families. Arch Suicide Res 2022; 26:1505-1519. [PMID: 34019780 DOI: 10.1080/13811118.2021.1925607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Adolescents and their parents do not always see eye to eye. This principle applies to multi-informant reports of adolescents' self-injurious thoughts and behaviors. Although prior work has revealed the presence of parent-adolescent discrepant reports, we have little insight into exactly who is most likely to display such discrepancies. To address this knowledge gap, the present investigation examines demographic correlates of parent-adolescent reports of adolescents' self-injurious thoughts and behaviors, with a focus on race and ethnicity. METHOD The sample included 45 dyads of adolescents (M = 15.79 years, SD = 1.42) and their parents reporting on adolescents' history of suicide ideation, suicide plan, suicide gesture, suicide attempt, and nonsuicidal self-injury (NSSI). RESULTS Greater discrepancies in reports of adolescents' suicide ideation and NSSI were observed among racial minority parent-adolescent dyads (Black, Asian, Multiracial, Other) relative to White dyads. Racial minority parents tended to report less suicide ideation and NSSI observed in their adolescents compared to adolescents' self-report. Moreover, Hispanic parents tended to report less NSSI relative to adolescents' self-report. Parent-adolescent discrepancies did not consistently correspond with other characteristics such as age and sexual orientation. CONCLUSION Racial minority parent-adolescent dyads, relative to White parent-adolescent dyads, are less likely to see eye to eye on adolescents' suicidal and nonsuicidal self-harming tendencies.
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15
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Oppenheimer CW, Glenn CR, Miller AB. Future Directions in Suicide and Self-Injury Revisited: Integrating a Developmental Psychopathology Perspective. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:242-260. [PMID: 35380885 PMCID: PMC9840868 DOI: 10.1080/15374416.2022.2051526] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The recent rise in suicide rates among children and adolescents has made suicide prevention in youth a major focus of government agencies and mental health organizations. In 2012, Nock presented future directions in the study of self-injurious thoughts and behavior (SITBs), highlighting the need to better examine which risk factors are associated with "each part of the pathway" to suicidal and non-suicidal self-injury in order to inform prevention and intervention efforts. Over the past decade, we have made important advances in understanding the development of SITBs and effective interventions. However, there are still major gaps of knowledge in our understanding of how to prevent suicide. Researchers have recently called for more studies focusing particularly on the pathway from suicidal ideation to suicidal behavior. However, we caution against prioritizing only a part of the suicide risk continuum (e.g., the transition from suicidal ideation to suicidal behavior) while minimizing research focusing on earlier developmental points of the pathway to suicide (e.g., the first development of suicidal ideation). We emphasize that childhood and adolescence represent a critical opportunity to intervene and prevent SITBs by altering developmental trajectories toward persistent and escalating SITBs over time. We advocate for integrating a developmental psychopathology perspective into future youth suicide research that focuses on how and when risk for SITBs first emerges and develops across childhood into emerging adulthood. This research is critical for informing interventions aimed at bending developmental pathways away from all SITBs. Here, we describe the need for future research that integrates key developmental psychopathology principles on 1) the identification of the continuum from developmentally typical to atypical as SITBs first emerge and develop, particularly among young children in early to middle childhood, 2) the way in which expressions of and risk for SITBs change across development, 3) how SITBs dynamically move along a continuum from typical to atypical over time, and 4) suicide prevention efforts. We also offer recommendations for future directions that focus on identifying disparities in SITBs occurring among minoritized youth within a developmental psychopathology perspective.
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Affiliation(s)
- Caroline W Oppenheimer
- RTI International, Mental Health Risk and Resilience Program, Research Triangle Park, North Carolina, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Catherine R Glenn
- Department of Psychology, Virginia Consortium Program in Clinical Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Adam Bryant Miller
- RTI International, Mental Health Risk and Resilience Program, Research Triangle Park, North Carolina, USA
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, North Carolina, USA
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16
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Pollak OH, Guzmán EM, Shin KE, Cha CB. Defeat, Entrapment, and Positive Future Thinking: Examining Key Theoretical Predictors of Suicidal Ideation Among Adolescents. Front Psychol 2021; 12:590388. [PMID: 33746823 PMCID: PMC7969632 DOI: 10.3389/fpsyg.2021.590388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 01/29/2021] [Indexed: 12/30/2022] Open
Abstract
Adult-based suicide theories have determined much of what we know about suicidal ideation. Here, we investigate the extent to which elements of the Integrated Motivational-Volitional (IMV) model generalize to adolescence, a period when rates of suicidal ideation increase dramatically. In a sample of community-based adolescents (n = 74), we tested whether defeat and entrapment related to suicidal ideation, and whether poor positive future thinking abilities exacerbated this association. Consistent with the IMV model, we found that defeat/entrapment was associated specifically with history of suicidal ideation, and not with history of suicide attempt. Defeat/entrapment was related to baseline suicidal ideation severity above and beyond depressive symptoms. While defeat/entrapment predicted future suicidal ideation controlling for history of ideation, it did not do so controlling for depressive symptoms. Counter to the IMV model, we initially found that the association between defeat/entrapment and suicidal ideation was strongest among adolescents with greater positive future thinking abilities. This was driven by the tendency to imagine more positive future events, particularly those that are less realistic and achievable. These findings call for a more nuanced understanding of defeat/entrapment and positive future thinking among adolescents, particularly in how they interact to predict recurrent suicidal ideation.
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Affiliation(s)
- Olivia H Pollak
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Eleonora M Guzmán
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Ki Eun Shin
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Christine B Cha
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, New York, NY, United States
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