1
|
Haroz EE, Sarapik LM, Adams LB, Nestadt PS, Athey A, Alvarez K, Slade EP, Cwik M, Berman AL, Wilcox HC. A Cascade of Care Model for Suicide Prevention. Am J Prev Med 2023; 64:599-603. [PMID: 36402646 PMCID: PMC10166000 DOI: 10.1016/j.amepre.2022.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/31/2022] [Accepted: 09/21/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Emily E Haroz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Liina M Sarapik
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Leslie B Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Paul S Nestadt
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Alison Athey
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kiara Alvarez
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eric P Slade
- Johns Hopkins School of Nursing, Baltimore, Maryland; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mary Cwik
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Alan L Berman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| |
Collapse
|
2
|
Kemp K, Poindexter B, Ng MY, Correia V, Marshall BDL, Koinis-Mitchell D, Tolou-Shams M. EARLY IDENTIFICATION OF SUICIDE RISK FACTORS AMONG JUSTICE-INVOLVED YOUTH. CRIMINAL JUSTICE AND BEHAVIOR 2022; 49:730-744. [PMID: 35754948 PMCID: PMC9221642 DOI: 10.1177/00938548211059504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Suicidal thoughts and behaviors among juvenile justice populations are elevated. However, the characteristics of justice-involved youth who consider and attempt suicide are not well understood. This study examined suicidal ideation and attempt with first-time, preadjudicated diverted youth, and the relationship with commonly associated risk factors. The sample included 135 youth (50% male, M age = 14.48) that provided complete responses to self-reported lifetime suicidal ideation and attempt items. Analyses examined relationships between suicidal ideation/attempt and mental health, child welfare involvement, delinquency, self-cutting, and substance use. First time, preadjudicated diverted youth reported high rates of lifetime suicidal ideation (27%) and attempt (17%). Suicidal ideation and attempt were associated with sexually minoritized status and self-cutting, while child welfare involvement was only associated with suicidal ideation. This high-risk population would benefit from refined suicide screening and prevention services not always available to justice-involved youth living in the community.
Collapse
|
3
|
Kemp K, Yurasek AM, Poindexter B, Webb M, Tolou-Shams M. Suicide Screening Among Youth at First Court Contact. Arch Suicide Res 2022; 26:748-760. [PMID: 33076766 PMCID: PMC8053719 DOI: 10.1080/13811118.2020.1833795] [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: 12/28/2022]
Abstract
Youth involved in the juvenile justice system are at elevated risk for suicide and co-occurring mental health symptoms. This study aims to examine the suicide risk and treatment needs of court-involved, non-incarcerated (CINI) youth, and to understand the acceptability and effectiveness of implementing a mental health screening procedure at time of first court contact. By embedding a forensic mental health screening tool into the intake process of a family court diversionary program, a total of 891 youth (aged 12-18) were assessed using the Massachusetts Youth Screening Instrument-2 (MAYSI-2). Analysis of screening responses revealed 12.5% of youth indicated risk for suicide with risk levels differentiated by youth sex, race and ethnicity. Suicide ideation was also significantly associated with flagging, an indication of clinical risk, on all other scales of the MAYSI-2, as well as subsequent referrals to treatment. Screening for suicide at first point of court contact within an existing diversionary program may serve as a critical and effective point of intervention for youth in need.
Collapse
|
4
|
Meza JI, Snyder S, Shanholtz C. Equitable suicide prevention for youth impacted by the juvenile legal system. Front Psychiatry 2022; 13:994514. [PMID: 36387003 PMCID: PMC9640731 DOI: 10.3389/fpsyt.2022.994514] [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] [Received: 07/14/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
Suicide is the second leading cause of death for adolescents in the United States. Despite the already alarmingly high rates of suicide attempts among adolescents, youth involved in the juvenile legal system (JLS) are up to three times more likely to have suicide attempts than their peers not impacted by the JLS. This public health crisis is also a matter of health equity, knowing that ethnoracially minoritized youth, mainly Black and Latinx youth, have disproportionate contact with the JLS. In order to disrupt the current elevated rates of suicide among Black and Latinx youth involved in the JLS, there needs to be more concerted efforts to improve assessment and suicide prevention efforts in the JLS. There are various potential touch points of care for suicide prevention and the Sequential Intercept Model (SIM), which outlines community-based responses to the involvement of people with mental and substance use disorders in the criminal justice system, can be used as a strategic planning tool to outline possible equitable interventions across these various touch points. Our purpose is to provide a comprehensive picture of gaps and equitable opportunities for suicide prevention across each intercept of the SIM. We provide recommendations of priorities to promote health equity in suicide prevention for ethnoracially minoritized youth impacted by the JLS.
Collapse
Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, United States
| | - Sean Snyder
- Department of Psychiatry, Pennsylvania Hospital, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Caroline Shanholtz
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
5
|
Kemp K, Pederson CA, Webb M, Williamson S, Elwy AR, Spirito A. Feasibility and acceptability of a brief suicide intervention for youth involved with the family court. BEHAVIORAL SCIENCES & THE LAW 2021; 39:26-43. [PMID: 33569818 DOI: 10.1002/bsl.2498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/30/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
As efforts to develop models for suicide prevention and intervention in the juvenile justice (JJ) system continue to grow, research to understand the feasibility and acceptability of implementing these models is critical. Examining organizational readiness for implementation, ensuring leadership and staff buy-in for delivering the intervention, and planning for sustainability of staff participation in implementation efforts is essential. The current study involved semi-structured formative evaluation interviews with key JJ stakeholders (n = 10) to determine perspectives on the acceptability (perceived need and fit of the intervention) and feasibility (organizational readiness for change) of a proposed brief safety planning intervention for youth with suicidal ideation delivered by nonclinical staff and integrated into the existing system. Qualitative data revealed stakeholders' perceived need for the intervention in the family court context and their agreement that the aims of the intervention were congruent with the goals of the family court. Some barriers to successful implementation were noted, which, addressed through selection of appropriate implementation strategies, can be overcome in a future test of the safety intervention.
Collapse
Affiliation(s)
- Kathleen Kemp
- Rhode Island Hospital Bradley Hasbro Children's Research Center, Providence, Rhode Island, USA
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Casey A Pederson
- Department of Pediatrics Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Margaret Webb
- Rhode Island Hospital Bradley Hasbro Children's Research Center, Providence, Rhode Island, USA
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Shannon Williamson
- Rhode Island Hospital Bradley Hasbro Children's Research Center, Providence, Rhode Island, USA
| | - A Rani Elwy
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Anthony Spirito
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
| |
Collapse
|
6
|
Kemp K, Webb M, Wolff J, Affleck K, Casamassima J, Weinstock L, Spirito A. Screening and Brief Intervention for Psychiatric and Suicide Risk in the Juvenile Justice System: Findings from an Open Trial. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2021; 6:410-419. [PMID: 34693005 PMCID: PMC8528172 DOI: 10.1080/23794925.2021.1908190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Court-involved non-incarcerated (CINI) youth endorse higher rates of lifetime suicide ideation (SI) and attempts than youth in the community. Brief intervention programs to address SI and related psychiatric symptoms upon entry into the juvenile justice system are rare. The current study reports the results of a pilot trial on a brief, coping intervention for CINI youth. Fifteen CINI youth (and caregivers) were eligible for participation based on youth report of SI or endorsing symptoms on a mental health screening tool. Youth completed a Coping Plan intervention with a master's-level counselor and received a 1-week follow-up call. Follow-up assessments were conducted at 1 and 3-months post-intervention. Participants were also interviewed about intervention acceptability. About half of the sample screened into the study based on SI and half screened in based on psychiatric symptoms on the Anxious/Depressed and Angry/Irritable subscales of the MAYSI-2. A reduction in SI and psychiatric symptoms was observed at 3-months post-intervention. Youth and caregivers reported the brief coping intervention was useful. This study highlights that intervening with youth with SI and psychiatric symptoms upon entry into the juvenile justice system can be successfully conducted with a population who historically has difficulty accessing mental health resources.
Collapse
Affiliation(s)
- Kathleen Kemp
- Rhode Island Hospital, 1 Hoppin St., Coro Building West, Suite 204, Providence, RI 02903
- Alpert Medical School of Brown University, 345 Blackstone Blvd., Duncan Building, Providence, RI 02906
| | - Margaret Webb
- Rhode Island Hospital, 1 Hoppin St., Coro Building West, Suite 204, Providence, RI 02903
- Alpert Medical School of Brown University, 345 Blackstone Blvd., Duncan Building, Providence, RI 02906
| | - Jennifer Wolff
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Pkwy, Riverside, RI 02915
- Alpert Medical School of Brown University, 345 Blackstone Blvd., Duncan Building, Providence, RI 02906
| | - Katelyn Affleck
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Pkwy, Riverside, RI 02915
- Alpert Medical School of Brown University, 345 Blackstone Blvd., Duncan Building, Providence, RI 02906
| | - Joseph Casamassima
- Alpert Medical School of Brown University, 345 Blackstone Blvd., Duncan Building, Providence, RI 02906
| | - Lauren Weinstock
- Alpert Medical School of Brown University, 345 Blackstone Blvd., Duncan Building, Providence, RI 02906
| | - Anthony Spirito
- Alpert Medical School of Brown University, 345 Blackstone Blvd., Duncan Building, Providence, RI 02906
| |
Collapse
|
7
|
Borschmann R, Janca E, Carter A, Willoughby M, Hughes N, Snow K, Stockings E, Hill NTM, Hocking J, Love A, Patton GC, Sawyer SM, Fazel S, Puljević C, Robinson J, Kinner SA. The health of adolescents in detention: a global scoping review. LANCET PUBLIC HEALTH 2020; 5:e114-e126. [PMID: 31954434 PMCID: PMC7025881 DOI: 10.1016/s2468-2667(19)30217-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/12/2022]
Abstract
Adolescents detained within the criminal justice system are affected by complex health problems, health-risk behaviours, and high rates of premature death. We did a global synthesis of the evidence regarding the health of this population. We searched Embase, PsycINFO, Education Resources Information Center, PubMed, Web of Science, CINCH, Global Health, the Cochrane Database of Systematic Reviews, the Campbell Library, the National Criminal Justice Reference System Abstract Database, and Google Scholar for peer-reviewed journal articles, including reviews, that reported the prevalence of at least one health outcome (physical, mental, sexual, infectious, and neurocognitive) in adolescents (aged <20 years) in detention, and were published between Jan 1, 1980, and June 30, 2018. The reference lists of published review articles were scrutinised for additional relevant publications. Two reviewers independently screened titles and abstracts, and three reviewed full texts of relevant articles. The protocol for this Review was registered with PROSPERO (CRD42016041392). 245 articles (204 primary research articles and 41 reviews) were included, with most primary research (183 [90%]) done in high-income countries. A high lifetime prevalence of health problems, risks, and conditions was reported in detained adolescents, including mental disorders (0–95%), substance use disorders (22–96%), self-harm (12–65%), neurodevelopmental disabilities (2–47%), infectious diseases (0–34%), and sexual and reproductive conditions (pregnant by age 19 years 20–37%; abnormal cervical screening test result 16%). Various physical and mental health problems and health-risk behaviours are more common among adolescents in detention than among their peers who have not been detained. As the social and structural drivers of poor health overlap somewhat with factors associated with exposure to the criminal justice system, strategies to address these factors could help to reduce both rates of adolescent detention and adolescent health inequalities. Improving the detection of mental and physical disorders, providing appropriate interventions during detention, and optimising transitional health care after release from detention could improve the health outcomes of these vulnerable young people.
Collapse
Affiliation(s)
- Rohan Borschmann
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Emilia Janca
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Annie Carter
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Melissa Willoughby
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Nathan Hughes
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Kathryn Snow
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | | | - Jane Hocking
- Sexual Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alexander Love
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - George C Patton
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia
| | - Susan M Sawyer
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Cheneal Puljević
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Jo Robinson
- Orygen Youth Health, Melbourne, VIC, Australia
| | - Stuart A Kinner
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Mater Research Institute-UQ, University of Queensland, Brisbane, QLD, Australia; Griffith Criminology Institute, Griffith University, Brisbane, QLD, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
8
|
Ruch DA, Sheftall AH, Schlagbaum P, Fontanella CA, Campo JV, Bridge JA. Characteristics and Precipitating Circumstances of Suicide Among Incarcerated Youth. J Am Acad Child Adolesc Psychiatry 2019; 58:514-524.e1. [PMID: 30768395 PMCID: PMC9721273 DOI: 10.1016/j.jaac.2018.07.911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/25/2018] [Accepted: 08/15/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Studies show incarcerated youth are at increased risk for suicidal behavior, yet little is known about factors associated with suicide for this population. Using a nationally representative sample, this study examined characteristics and precipitating circumstances of suicide in incarcerated youth decedents compared with youth suicide decedents in the general population. METHOD Data were analyzed for suicide decedents 10- to 24-years-old (N = 10,126) in the United States from 2003 through 2012 from the National Violent Death Reporting System. Logistic regression compared precipitating circumstances of suicide for incarcerated youth decedents and those not in custody. Details on suicide deaths in detained youth were captured from coroner/medical examiner and law enforcement reports associated with each incident. RESULTS Most youth suicide decedents were older, white, and male regardless of incarceration status. Incarcerated youth suicide decedents were more likely to die by hanging, strangulation, or suffocation and less likely to disclose suicide intent, leave a suicide note, or exhibit depressive symptoms compared with those not in custody. Additional risk factors for suicide were not significantly different between youth decedents in custody and those not in custody, suggesting that unique aspects of the incarceration environment could be associated with an increased risk of suicide. CONCLUSION Study findings highlight the need for early suicide risk detection and developmentally relevant interventions tailored for youth in correctional settings. Future efforts should include evaluation studies to support suicide prevention programs designed for incarcerated youth and research that examines distinctive factors associated with suicidal behavior in youth in custody.
Collapse
Affiliation(s)
- Donna A. Ruch
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
| | - Arielle H. Sheftall
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
| | - Paige Schlagbaum
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
| | - Cynthia A. Fontanella
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
| | - John V. Campo
- Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown
| | - Jeffrey A. Bridge
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
| |
Collapse
|
9
|
Keeshin BR, Gray D, Zhang C, Presson AP, Coon H. Youth Suicide Deaths: Investigation of Clinical Predictors in a Statewide Sample. Suicide Life Threat Behav 2018; 48:601-612. [PMID: 28833472 DOI: 10.1111/sltb.12386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 05/17/2017] [Indexed: 11/29/2022]
Abstract
Death by suicide is a significant cause of mortality among youth. However, there is limited information on the demographic and clinical factors associated with youth suicide deaths. The objective of this study was to link large statewide databases to describe demographic, clinical, and cause of death characteristics among youth who died by suicide. We examined 1,218 decedents under age 26 who died by suicie between 2000 and 2014. Eighteen died before age 12, 53 died between ages 12 and 14, 292 died between ages 15 and 18, and 855 died between ages 19 and 25. Most were male (83%), and firearm was most common cause of death; 28% previously attempted suicide, 31% had a mental health diagnosis, and 17% were prescribed psychotropic medication. Younger children died by hanging/smothering (89% of all 7- to 11-year olds), and overdose/poisoning increased progressively with age. Adolescents had a higher proportion of females than young adults (23% vs. 14%, p = .002). Combining data from the medical examiner and large hospital systems allows examination of youth suicide from a developmental perspective. Differences between age groups included gender, method, diagnosed mental illness, and diagnosis of attention deficit hyperactivity disorder. These data point to missed opportunities for effective interventions for specific developmental stages.
Collapse
Affiliation(s)
- Brooks R Keeshin
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Doug Gray
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA.,Mental Illness Research, Education and Clinical Center, Veterans Integrated Service Network 19, George E. Whalen Department of Veteran Affairs Medical Center, Salt Lake City, UT, USA
| | - Chong Zhang
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Angela P Presson
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Hilary Coon
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
10
|
Bernanke J, Galfalvy HC, Mortali MG, Hoffman LA, Moutier C, Nemeroff CB, Stanley BH, Clayton P, Harkavy-Friedman J, Oquendo MA. Suicidal ideation and behavior in institutions of higher learning: A latent class analysis. J Psychiatr Res 2017; 95:253-259. [PMID: 28923719 PMCID: PMC5826724 DOI: 10.1016/j.jpsychires.2017.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/08/2017] [Accepted: 09/01/2017] [Indexed: 11/29/2022]
Abstract
Suicide is the second leading cause of death among undergraduate students, with an annual rate of 7.5 per 100,000. Suicidal behavior (SB) is complex and heterogeneous, which might be explained by there being multiple etiologies of SB. Data-driven identification of distinct at-risk subgroups among undergraduates would bolster this argument. We conducted a latent class analysis (LCA) on survey data from a large convenience sample of undergraduates to identify subgroups, and validated the resulting latent class model on a sample of graduate students. Data were collected through the Interactive Screening Program deployed by the American Foundation for Suicide Prevention. LCA identified 6 subgroups from the undergraduate sample (N = 5654). In the group with the most students reporting current suicidal thoughts (N = 623, 66% suicidal), 22.5% reported a prior suicide attempt, and 97.6% endorsed moderately severe or worse depressive symptoms. Notably, LCA identified a second at-risk group (N = 662, 27% suicidal), in which only 1.5% of respondents noted moderately severe or worse depressive symptoms. When graduate students (N = 1138) were classified using the model, a similar frequency distribution of groups was found. Finding multiple replicable groups at-risk for suicidal behavior, each with a distinct prevalence of risk factors, including a group of students who would not be classified as high risk with depression-based screening, is consistent with previous studies that identified multiple potential etiologies of SB.
Collapse
Affiliation(s)
- Joel Bernanke
- Department of Psychiatry, Columbia University, NY, USA; New York State Psychiatric Institute, NY, USA
| | - Hanga C Galfalvy
- Department of Psychiatry, Columbia University, NY, USA; Department of Biostatistics, Columbia University, NY, USA.
| | | | | | | | | | - Barbara H Stanley
- Department of Psychiatry, Columbia University, NY, USA; New York State Psychiatric Institute, NY, USA
| | | | | | - Maria A Oquendo
- Department of Psychiatry, Columbia University, NY, USA; New York State Psychiatric Institute, NY, USA
| |
Collapse
|
11
|
Santos MSPD, Silva TDPSD, Pires CMDC, Ramos PGX, Sougey EB. Identificação de aspectos associados à tentativa de suicídio por envenenamento. JORNAL BRASILEIRO DE PSIQUIATRIA 2017. [DOI: 10.1590/0047-2085000000171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
RESUMO Objetivo Identificar as condições psiquiátricas e aspectos sociobiodemográficos associados à tentativa de suicídio. Métodos A amostra foi constituída por 240 pacientes de ambos os sexos, com idade entre 18 a 68 anos, dos quais 120 pacientes compuseram o grupo controle e 120 o grupo experimental. Os instrumentos utilizados foram um questionário sociobiodemográfico e o Mini International Neuropsychiatric Interview (MINI). Resultados Observou-se maior presença de estressores no grupo experimental, sendo os principais a vivência de uma separação afetiva e a existência de conflitos familiares, e a condição psiquiátrica mais frequente na população estudada foi o transtorno de ansiedade generalizada e a mais associada ao comportamento suicida foi a depressão maior. Conclusões Os resultados acrescentam a importância de investigar a presença do transtorno de ansiedade generalizada como mais um fator de vulnerabilidade ao suicídio.
Collapse
|
12
|
Biopsychosocial Causes of Suicide and Suicide Prevention Outcome Studies in Juvenile Detention Facilities: A Review. Psychiatr Q 2017; 88:141-153. [PMID: 27169893 DOI: 10.1007/s11126-016-9434-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To identify various biopsychosocial risk factors associated with suicidality in juvenile detention facilities and the effectiveness of suicide prevention protocols currently in use. Medical literature searches were conducted using databases like Pub Med, Ovid, and Google Scholar to identify studies conducted in and outside of United States. The prevalence of suicide among youth imprisoned at detention facilities has risen. Psychiatric disorders are common among such population, making them vulnerable to suicidal tendencies. Suicide risk screening within first 24 h of admission to the detention facility has shown to lower the risk of suicide. Identification of high risk individuals and their further psychiatric assessment is advocated. Much of work with regards to screening tools and instruments is underway and further study is required to get a better understanding.
Collapse
|
13
|
Stokes ML, McCoy KP, Abram KM, Byck GR, Teplin LA. Suicidal Ideation and Behavior in Youth in the Juvenile Justice System: A Review of the Literature. JOURNAL OF CORRECTIONAL HEALTH CARE 2016; 21:222-42. [PMID: 26084946 DOI: 10.1177/1078345815587001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Suicide is prevalent among youth, especially those involved in the juvenile justice system. Although many studies have examined suicidal ideation and behavior in delinquent youth, prevalence rates vary widely. This article reviews studies of suicidal ideation and behavior in youth in the juvenile justice system, focusing on the point of contact: incarceration status and stage of judicial processing. Suicidal ideation and behavior are prevalent and increase with greater involvement in the juvenile justice system. Depression, sexual abuse, and trauma were the most commonly identified predictors of suicidal ideation and behavior. Prevalence rates of suicidal ideation and behavior vary by gender and race/ethnicity, indicating the need for gender-specific and culturally relevant interventions.
Collapse
Affiliation(s)
- Marquita L Stokes
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kathleen P McCoy
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Karen M Abram
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gayle R Byck
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Linda A Teplin
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
14
|
Mallett CA, Boitel C. From Juvenile Offender Institutions to Residential Treatment Centers: Evidence of the Shifting Paradigm to Improved Youth and Community Outcomes. JOURNAL OF EVIDENCE-INFORMED SOCIAL WORK 2015; 13:155-164. [PMID: 25975808 DOI: 10.1080/23761407.2015.1013367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Hundreds of thousands of youth are held every year in U.S. juvenile justice detention centers and incarceration facilities. Increasingly it is known that these facility placements are at best ineffective and at worst lead to additional youth recidivism outcomes. What is most concerning, though, is that a majority of these incarcerated youth have one or more mental health/substance abuse disorders, special education disabilities, or maltreatment victimization histories-comorbid situations that negatively impact their involvement with the juvenile courts. In this article the authors summarize the epidemiology of these youth problems within the juvenile justice system. The authors then compare the outcome evidence for the youth placed in juvenile justice facilities with those placed in residential treatment centers, finding significant advantages to addressing the problems through rehabilitative efforts. Recognizing that there are a small number of serious youthful offenders who will need placement, their analysis finds that the juvenile courts must continue (or in many instances begin) reshaping their detention and incarceration facilities reliance on punishment toward a rehabilitative residential model.
Collapse
Affiliation(s)
| | - Craig Boitel
- a School of Social Work, Cleveland State University , Cleveland , Ohio , USA
| |
Collapse
|
15
|
Cook TB. Recent criminal offending and suicide attempts: a national sample. Soc Psychiatry Psychiatr Epidemiol 2013; 48:767-74. [PMID: 22918292 DOI: 10.1007/s00127-012-0567-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Accepted: 08/03/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Few studies have assessed the risk of suicide and suicidal behavior among the community-residing population with recent criminal justice involvement despite evidence of high rates of suicide in jails and prisons. This study assessed the association between recent arrest history and a suicide attempt in the previous year including multiple arrests and specific offense categories using a national representative sample of adults. METHODS Data were derived from 2 years of the National Survey on Drug Use and Health (2008 and 2010), a nationally representative cross-sectional survey of non-institutionalized US adults. Suicide attempts in the previous year based on self-report were assessed in relation to recent arrest history while accounting for socio-demographic factors, mental and physical health status and substance use. RESULTS Suicide attempts in the previous year are relatively common among those with recent arrests (2.3 %) compared to the general US population (0.4 %), with much higher prevalence among those with multiple recent arrests or charges (4.5 %). The prevalence of recent suicide attempts among those with multiple recent arrests was highest among adults aged 25-34 (5.7 %), with similar risks between men and women, and across racial and ethnic subgroups. There was no association between arrests prior to the most recent year and recent suicide attempts. CONCLUSIONS Suicide attempts are common among the non-institutionalized population of US adults with recent criminal justice involvement. Suicide prevention efforts in the criminal justice system should extend to clients who remain in the community both during and immediately following periods of court-processing. Future research is needed to better identify case and client characteristics indicating the highest suicide risk.
Collapse
Affiliation(s)
- Thomas Bradley Cook
- Center for Health Disparities Research and Education, Baldwin Wallace University, 275 Eastland Road, Berea, OH 44017, USA.
| |
Collapse
|
16
|
Service Referral for Juvenile Justice Youths: Associations with Psychiatric Disorder and Recidivism. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2013; 41:379-89. [DOI: 10.1007/s10488-013-0472-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
17
|
Abstract
Relatively little is known about legal entanglements and suicide risk. This matched case-control study estimated the risk of suicide associated with legal strains using online court archives, a novel source of exposure data. Court records linked to suicide deaths (N = 315), controls (N = 630), and unintentional injury and poisoning deaths (N = 630) for an urban county from 2000 to 2005 revealed that nearly a third of suicide victims had recent court involvement, twice the proportion among controls. Misdemeanors, car accidents, and foreclosures were each associated with a threefold risk of suicide. Implications for suicide prevention and research are discussed.
Collapse
Affiliation(s)
- Thomas Bradley Cook
- Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, OH, USA.
| | | |
Collapse
|
18
|
Conner KR, Beautrais AL, Brent DA, Conwell Y, Phillips MR, Schneider B. The next generation of psychological autopsy studies: part 2. Interview procedures. Suicide Life Threat Behav 2012; 42:86-103. [PMID: 22288728 DOI: 10.1111/j.1943-278x.2011.00073.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The psychological autopsy (PA) is a systematic method of assessing the psychological and contextual circumstances preceding suicide. The method requires interviews with one or more proxy respondents (i.e., informants) of suicide decedents. Procedural challenges that need to be addressed to conduct PA interviews are described in this article and recommendations for meeting these challenges in future PA investigations are made. Procedures addressed include determining the timing of PA interviews after suicide, designing the structure and flow of interviews, selection of proxy respondents, integrating interview data with information gathered from records, and selecting and training interviewers. This methodological article is the second in a two-part series-the first article focused on interview content.
Collapse
Affiliation(s)
- Kenneth R Conner
- Kenneth R. Conner, Yeates Conwell, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Kenneth R. Conner, VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, USA; Annette L. Beautrais, Yale University School of Medicine, New Haven, CT, USA; David A. Brent, Western Psychiatric Institute and Clinic, Pittsburgh, PA, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Michael R. Phillips, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hua Long Guan Hospital, Beijing, China; Barbara Schneider, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| | - Annette L Beautrais
- Kenneth R. Conner, Yeates Conwell, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Kenneth R. Conner, VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, USA; Annette L. Beautrais, Yale University School of Medicine, New Haven, CT, USA; David A. Brent, Western Psychiatric Institute and Clinic, Pittsburgh, PA, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Michael R. Phillips, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hua Long Guan Hospital, Beijing, China; Barbara Schneider, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| | - David A Brent
- Kenneth R. Conner, Yeates Conwell, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Kenneth R. Conner, VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, USA; Annette L. Beautrais, Yale University School of Medicine, New Haven, CT, USA; David A. Brent, Western Psychiatric Institute and Clinic, Pittsburgh, PA, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Michael R. Phillips, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hua Long Guan Hospital, Beijing, China; Barbara Schneider, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| | - Yeates Conwell
- Kenneth R. Conner, Yeates Conwell, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Kenneth R. Conner, VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, USA; Annette L. Beautrais, Yale University School of Medicine, New Haven, CT, USA; David A. Brent, Western Psychiatric Institute and Clinic, Pittsburgh, PA, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Michael R. Phillips, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hua Long Guan Hospital, Beijing, China; Barbara Schneider, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| | - Michael R Phillips
- Kenneth R. Conner, Yeates Conwell, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Kenneth R. Conner, VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, USA; Annette L. Beautrais, Yale University School of Medicine, New Haven, CT, USA; David A. Brent, Western Psychiatric Institute and Clinic, Pittsburgh, PA, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Michael R. Phillips, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hua Long Guan Hospital, Beijing, China; Barbara Schneider, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| | - Barbara Schneider
- Kenneth R. Conner, Yeates Conwell, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Kenneth R. Conner, VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, USA; Annette L. Beautrais, Yale University School of Medicine, New Haven, CT, USA; David A. Brent, Western Psychiatric Institute and Clinic, Pittsburgh, PA, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Michael R. Phillips, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hua Long Guan Hospital, Beijing, China; Barbara Schneider, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| |
Collapse
|
19
|
Mallett C, De Rigne LA, Quinn L, Stoddard-Dare P. Discerning reported suicide attempts within a youthful offender population. Suicide Life Threat Behav 2012; 42:67-77. [PMID: 22276846 DOI: 10.1111/j.1943-278x.2011.00071.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
With suicide being the third leading cause of death among young people, early identification of risk is critical, particularly for those involved with the juvenile courts. In this study of court-involved youth (N = 433) in two Midwest counties, logistic regression analysis identified some expected and unexpected findings of important demographic, educational, mental health, child welfare, and juvenile court-related variables that were linked to reported suicide attempts. Some of the expected suicide attempt risk factors for these youth included prior psychiatric hospitalization and related mental health services, residential placement, and diagnoses of depression and alcohol dependence. However, the most unexpected finding was that a court disposition to shelter care (group home) was related to a nearly tenfold increased risk in reported suicide attempt. These findings are of importance to families, mental health professionals, and juvenile court personnel to identify those youth who are most at risk and subsequently provide appropriate interventions to prevent such outcomes.
Collapse
Affiliation(s)
- Christopher Mallett
- Christopher Mallett and Patricia Stoddard-Dare, School of Social Work, Cleveland State University, Cleveland, OH, USA; Lea A. Derigne, Department of Social Work, Florida Atlantic University, Fort Lauderdale, FL, USA; and Linda Quinn, Department of Mathematics, Cleveland State University, Cleveland, OH, USA
| | - Lea A De Rigne
- Christopher Mallett and Patricia Stoddard-Dare, School of Social Work, Cleveland State University, Cleveland, OH, USA; Lea A. Derigne, Department of Social Work, Florida Atlantic University, Fort Lauderdale, FL, USA; and Linda Quinn, Department of Mathematics, Cleveland State University, Cleveland, OH, USA
| | - Linda Quinn
- Christopher Mallett and Patricia Stoddard-Dare, School of Social Work, Cleveland State University, Cleveland, OH, USA; Lea A. Derigne, Department of Social Work, Florida Atlantic University, Fort Lauderdale, FL, USA; and Linda Quinn, Department of Mathematics, Cleveland State University, Cleveland, OH, USA
| | - Patricia Stoddard-Dare
- Christopher Mallett and Patricia Stoddard-Dare, School of Social Work, Cleveland State University, Cleveland, OH, USA; Lea A. Derigne, Department of Social Work, Florida Atlantic University, Fort Lauderdale, FL, USA; and Linda Quinn, Department of Mathematics, Cleveland State University, Cleveland, OH, USA
| |
Collapse
|
20
|
Kutcher S, McDougall A. Problems with access to adolescent mental health care can lead to dealings with the criminal justice system. Paediatr Child Health 2011; 14:15-8. [PMID: 19436458 DOI: 10.1093/pch/14.1.15] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2008] [Indexed: 11/14/2022] Open
Abstract
Mental disorders collectively constitute the largest burden of disease in young people. They have substantial negative short- and long-term outcomes across many domains, yet early identification and effective intervention can improve outcomes and can often lead to recovery. Unfortunately, many young people do not receive the mental health care they require and may consequently enter the justice system. Studies of incarcerated youths show that up to 70% of them have mental disorders. Many of these youth receive primarily custodial care. A variety of social, legal and medical interventions can and should be implemented to ensure that young people suffering from mental disorders do not inappropriately enter the justice system due to lack of access to health care and other services.
Collapse
Affiliation(s)
- Stanley Kutcher
- Sun Life Financial Chair in Adolescent Mental Health, Halifax, Nova Scotia
| | | |
Collapse
|
21
|
Wasserman GA, McReynolds LS, Musabegovic H, Whited AL, Keating JM, Huo Y. Evaluating Project Connect: improving juvenile probationers' mental health and substance use service access. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2009; 36:393-405. [PMID: 19582568 DOI: 10.1007/s10488-009-0229-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 06/17/2009] [Indexed: 10/20/2022]
Abstract
Project Connect is a multilayered county-specific program aimed at linking juvenile probationers to needed mental health and substance use services. In four NY counties, the intervention included cooperative agreements between probation and mental health authorities, program materials to facilitate referral, in-service training for probation officers, and systematic screening for mental health needs. Charts for 583 Baseline youths were reviewed and compared with 594 youths undergoing intake under Project Connect. Compared to Baseline, under Project Connect, referred youths were 2.7 times as likely to access services, regardless of youth or county characteristics, service availability, or when the intervention took place.
Collapse
Affiliation(s)
- Gail A Wasserman
- Center for the Promotion of Mental Health in Juvenile Justice, NY State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
| | | | | | | | | | | |
Collapse
|
22
|
Garlow SJ, Rosenberg J, Moore JD, Haas AP, Koestner B, Hendin H, Nemeroff CB. Depression, desperation, and suicidal ideation in college students: results from the American Foundation for Suicide Prevention College Screening Project at Emory University. Depress Anxiety 2008; 25:482-8. [PMID: 17559087 DOI: 10.1002/da.20321] [Citation(s) in RCA: 416] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The objective of this investigation was to examine suicidal ideation and depression in undergraduate college students who participated in the American Foundation for Suicide Prevention-sponsored College Screening Project at Emory University. The principal measure of depressive symptoms was the nine-item depression module from the Patient Health Questionnaire (PHQ-9). Additional questions were focused on current suicidal ideation, past suicide attempts, and episodes of deliberate self-harm and on symptoms of anxiety and distress. Seven hundred and twenty-nine students participated over a 3-school-year interval (2002-2005). Most notably, 11.1% of the students endorsed current (past 4 weeks) suicidal ideation and 16.5% had a lifetime suicide attempt or self-injurious episode. Students with current suicidal ideation had significantly higher depression symptom severity than those without suicidal ideation (t = -9.34, df = 706, P<.0001, d = 1.9), and 28.5% of the students with PHQ-9 scores of 15 or higher reported suicidal ideation compared to 5.7% of those with lower scores (chi(2) = 56.29, df = 1, P<.0001, two-tailed). Suicidal ideation was prominently associated with symptoms of desperation (odds ratio 2.6, 95% CI 1.5-4.6, P<.001). The vast majority of students with moderately severe to severe depression (85%) or current suicidal ideation (84%) were not receiving any psychiatric treatment at the time of assessment. These results suggest that there is a strong relationship between severity of depressive symptoms and suicidal ideation in college students, and that suicidal feelings and actions are relatively common in this group. This underscores the need to provide effective mental health outreach and treatment services to this vulnerable population. As this analysis was based on data collected at a single institution, the results may not be representative of all college students or young adults.
Collapse
Affiliation(s)
- Steven J Garlow
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
| | | | | | | | | | | | | |
Collapse
|
23
|
Walsh E, Eggert LL. Preventing youth suicide: issues for law enforcement personnel. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2008; 31:347-358. [PMID: 18644625 PMCID: PMC2579764 DOI: 10.1016/j.ijlp.2008.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Suicide is a leading cause of death for adolescents. A number of problem behaviors associated with youth suicide fall into the purview of law enforcement personnel, and they are therefore in a position to detect risk and prevent suicidal behaviors. Eight hundred one youth identified as having school difficulty, a group at increased risk for both suicide and legal problems, participated in a paper and pencil survey followed by an interview focusing on suicide risk and protective factors. Linear regression was used to examine the ability of factors within each risk and protective factor dimension to predict current suicide risk. The study goal was to determine the most relevant factors influencing suicide risk in each domain examined. Findings are discussed in terms of implications for assessment and policy for law enforcement personnel.
Collapse
Affiliation(s)
- Elaine Walsh
- Reconnecting Youth Prevention Research Program, University of Washington School of Nursing, United States.
| | | |
Collapse
|
24
|
Abstract
To describe suicide risk in youth seen at a Juvenile Assessment Center (JAC), we examined relationships among self-reported lifetime attempts and demographic, justice, and psychiatric data via logistic regression. Similar to other settings, youth reporting lifetime attempts were more likely to be older, female, not living with both parents and currently arrested for a violent or felony crime. Mood, substance use, and behavior disorder each increased prediction substantially. Anxiety Disorder was associated with elevated attempt rates for boys only. JACs need to develop protocols for identifying suicide risk; further, since suicide history predicts future attempts, Anxiety Disordered boys may be at particular risk.
Collapse
|
25
|
Abstract
Youth who experience difficulty in school are at risk for suicide, yet there is little published information specific to risk and protective factors among this group. The purpose of this study was to conduct an in-depth examination of risk and protective factors associated with suicidal behaviour among youth who were experiencing problems in school and to compare these factors between suicide risk and non-suicide risk subgroups. Participants were 730 high school students in the Northwest and Southwest regions of the United States, aged 14-21 years. All participants were known to be experiencing difficulty with grades and/or attendance. Students completed a paper-and-pencil questionnaire and a one-on-one interview, which assessed suicidal behaviours as well as risk factors (e.g. drug involvement, emotional distress, stress), and protective factors (e.g. self-esteem, coping, support). Analysis of covariance tests, controlling for age and sex, were conducted to examine differences between the suicide risk and non-suicide risk groups on each risk and protective factor. The suicide risk subgroup reported higher levels of all risk factors, except alcohol and marijuana use, and lower levels of protective factors. While the groups did not differ on frequency of alcohol or marijuana use, they did differ on other illicit drug use and consequences of alcohol and other illicit drug use. Recommendations for nurses practising in school settings are discussed.
Collapse
Affiliation(s)
- Elaine Walsh
- Reconnecting Youth Prevention Research Program, University of Washington School of Nursing, Seattle, Washington 98195, USA.
| | | |
Collapse
|
26
|
Garlow SJ, Purselle DC, Heninger M. Cocaine and alcohol use preceding suicide in African American and white adolescents. J Psychiatr Res 2007; 41:530-6. [PMID: 16203014 DOI: 10.1016/j.jpsychires.2005.08.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2005] [Revised: 08/15/2005] [Accepted: 08/17/2005] [Indexed: 11/20/2022]
Abstract
The goal of this investigation was to determine whether cocaine and ethanol use was a differentiating factor between African American and white teenage suicide victims. This is a retrospective analysis of medical examiner's records of all completed suicides in Fulton County, GA from 01/1989 to 12/2003, and included 1296 cases. There were 79 suicide victims aged 19 and younger during the study interval, and of this group, 49 (62%) were African American, 26 (33%) were white, and 4 (5%) other race, compared to adults (20 years) where 28.5% were African American, 68.6% white and 2.9% other race (chi(2)=42.678, d.f.=2, p<0.0001). Of the black teenaged victims, 82.2% had no cocaine or alcohol detected at autopsy, while 41.7% of the white victims were positive for one or both substance (chi(2)=4.633, d.f.=1, p=0.04). Only 8.9% of the black teenage suicide victims had used cocaine prior to death compared to 28% of the whites (chi(2)=4.432; d.f.=1; p<0.04). The suicide rate (suicide/100,000/year) for black teens was 5.48 compared to 4.16 for whites, but the rate of cocaine positive teen suicides was 1.12 for whites and 0.45 for blacks. The pattern of cocaine use changes dramatically in the adult group, with 27% of African American suicide victims compared to 7.7% of whites being positive (chi(2)=73.272; d.f.=1; p<0.001). Use of intoxicating substances does differentiate teenage suicide victims, as only a small proportion of black teenagers had used cocaine or alcohol prior to death compared to almost half of all whites.
Collapse
Affiliation(s)
- Steven J Garlow
- Mood and Anxiety Disorders Program, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1841 Clifton Road, 4th floor, Atlanta, GA 30322, USA.
| | | | | |
Collapse
|
27
|
Brent DA, Bridge JA. Delinquent accounts: does delinquency account for suicidal behavior? J Adolesc Health 2007; 40:204-5. [PMID: 17321419 DOI: 10.1016/j.jadohealth.2006.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Indexed: 11/16/2022]
|
28
|
Emslie G, Kratochvil C, Vitiello B, Silva S, Mayes T, McNulty S, Weller E, Waslick B, Casat C, Walkup J, Pathak S, Rohde P, Posner K, March J. Treatment for Adolescents with Depression Study (TADS): safety results. J Am Acad Child Adolesc Psychiatry 2006; 45:1440-55. [PMID: 17135989 PMCID: PMC3285253 DOI: 10.1097/01.chi.0000240840.63737.1d] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the rates of physical, psychiatric, and suicide-related events in adolescents with MDD treated with fluoxetine alone (FLX), cognitive-behavioral therapy (CBT), combination treatment (COMB), or placebo (PBO). METHOD Safety assessments included adverse events (AEs) collected by spontaneous report, as well as systematic measures for specific physical and psychiatric symptoms. Suicidal ideation and suicidal behavior were systematically assessed by self- and clinician reports. Suicidal events were also reanalyzed by the Columbia Group and expert raters using the Columbia-Classification Algorithm for Suicidal Assessment used in the U.S. Food and Drug Administration reclassification effort. RESULTS Depressed adolescents reported high rates of physical symptoms at baseline, which improved as depression improved. Sedation, insomnia, vomiting, and upper abdominal pain occurred in at least 2% of those treated with FLX and/or COMB and at twice the rate of placebo. The rate of psychiatric AEs was 11% in FLX, 5.6% in COMB, 4.5% in PBO, and 0.9% in CBT. Suicidal ideation improved overall, with greatest improvement in COMB. Twenty-four suicide-related events occurred during the 12-week period: 5 patients (4.7%) in COMB, 10 (9.2%) in FLX, 5 (4.5%) in CBT, and 3 (2.7%) in placebo. Statistically, only FLX had more suicide-related events than PBO (p =.0402, odds ratio (OR) = 3.7, 95% CI 1.00-63.7). Only five actual attempts occurred (2 COMB, 2 FLX, 1 CBT, 0 PBO). There were no suicide completions. CONCLUSIONS Different methods for eliciting AEs produce different results. In general, as depression improves, physical complaints and suicidal ideation decrease in proportion to treatment benefit. In this study, psychiatric AEs and suicide-related events are more common in FLX-treated patients. COMB treatment may offer a more favorable safety profile than medication alone in adolescent depression.
Collapse
Affiliation(s)
- Graham Emslie
- UT Southwestern Medical Centre at Dallas, TX 75390-8589, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Shen X, Hackworth J, McCabe H, Lovett L, Aumage J, O'Neil J, Bull M. Characteristics of suicide from 1998-2001 in metropolitan area. DEATH STUDIES 2006; 30:859-71. [PMID: 17004369 DOI: 10.1080/07481180600853074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
In order to establish effective suicide preventive programs, it is important to know the etiologic factors and causal relationships between suicide and behavior. Coroner data was analyzed for the 468 suicides that occurred in Indianapolis, Indiana during 1998-2001. The age-adjusted suicide rate was 14.08 per 100,000. Almost one-half of the victims had a mental illness and 26% had a history of alcohol/substance abuse. The leading risk factors for suicide were age, impaired health, psychosocial stressors, and access to firearms. This information can be used by health departments and mental health professionals to help reduce suicide.
Collapse
Affiliation(s)
- Xun Shen
- Indiana Partnership to Prevent Violent Injury and Death, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA
| | | | | | | | | | | | | |
Collapse
|
30
|
McKeown RE, Cuffe SP, Schulz RM. US suicide rates by age group, 1970-2002: an examination of recent trends. Am J Public Health 2006; 96:1744-51. [PMID: 17008567 PMCID: PMC1586156 DOI: 10.2105/ajph.2005.066951] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2005] [Indexed: 01/24/2023]
Abstract
US suicide rates have declined in recent years, reversing earlier trends. We examined suicide rates among 4 age groups from 1970 to 2002 and the factors that may have contributed to the decline. We paid particular attention to newer anti-depressants because of recent concerns and controversy about a possible association with suicidal behaviors. These trends warrant more extensive analysis of suicide rates among specific subgroups, including consideration of additional variables that may influence rates differentially. The relative contributions of depression diagnosis and treatment, postsuicide attempt care, and other contextual factors (e.g., overall economic conditions) also deserve attention. If the decline is associated with contextual factors, clarifying these associations will better inform public policy decisions and contribute to more effective interventions for preventing suicide.
Collapse
Affiliation(s)
- Robert E McKeown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia 29208, USA.
| | | | | |
Collapse
|
31
|
Shields LBE, Hunsaker DM, Hunsaker JC. Adolescent and Young Adult Suicide: A 10-Year Retrospective Review of Kentucky Medical Examiner Cases. J Forensic Sci 2006; 51:874-9. [PMID: 16882232 DOI: 10.1111/j.1556-4029.2006.00164.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The compilation of all suicidal causes of death attained the third highest ranking of mortality between the ages of 15 and 24 following unintentional deaths and homicide in the United States, accounting for approximately 4000 deaths in 2002. A variety of biopsychosocial factors may contribute to adolescent suicidal behavior, including psychiatric disorders, risk-taking behaviors, and lack of a cohesive family unit. The authors conducted a 10-year (1993-2002) retrospective review of 108 Medical Examiner cases of suicide ages 11-17 and 358 cases ages 18-24 in Kentucky, which represents two thirds of the Coroner cases in the state. The majority of victims were male and Caucasian. The major causes of death were the same for the two age groups, specifically, firearm injury (72.2% and 70.7%), hanging (22.2% and 18.7%), and drug intoxication (2.8% and 5.3%). An integrated Coroner-Medical Examiner system profits in the public health arena by providing collaborative research data for policy decisions. The prevalence of youth suicide by firearm should prompt further discussion regarding ways to better identify high-risk adolescents and young adults and restrict pediatric access to unsecured household firearms.
Collapse
Affiliation(s)
- Lisa B E Shields
- Office of the Chief Medical Examiner, Urban Government Center, Louisville, KY 40204, USA
| | | | | |
Collapse
|
32
|
Callor WB, Petersen E, Gray D, Grey T, Lamoreaux T, Bennett PJ. Preliminary findings of noncompliance with psychotropic medication and prevalence of methamphetamine intoxication associated with suicide completion. CRISIS 2006; 26:78-84. [PMID: 16138744 DOI: 10.1027/0227-5910.26.2.78] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE A study of medical examiner records from suicide completers was designed to identify potential precipitating factors in the decision to commit suicide. METHODS Forensic data has been collected for a subset of suicide victims in Utah who completed suicide between 1996 and 2002. RESULTS Youth suicide completers appear to be undiagnosed for mental illness, or to be noncompliant with psychotropic medications. Along with treatment issues, alcohol and methamphetamine were the most common substances found in the blood and/or urine of suicide completers. CONCLUSIONS Accurate diagnosis of mental illness, and improved compliance with psychotropic medications may play a critical role in suicide prevention. The prevalence of methamphetamine in suicide completers is unexpectedly high and requires further investigation.
Collapse
Affiliation(s)
- William B Callor
- Department of Psychiatry, University of Utah, Salt Lake City 84132, USA
| | | | | | | | | | | |
Collapse
|
33
|
Abstract
Many risks for suicidal behavior, identified in population samples, are elevated in justice youth. We examined whether risks operate similarly in a justice sample. We measured suicidal behavior and disorder on the Diagnostic Interview Schedule for Children in 991 randomly selected youths, and examined associations between demographic, offense, and disorder characteristics and past attempts. Recent attempts were more common in girls, in those with depression or substance disorder, and in violent offenders. While more girls reported recent attempts regardless of depression, depressed boys' attempt risk was as high as girls'. Depression contributed more to attempt history than did substance disorder.
Collapse
Affiliation(s)
- Gail A Wasserman
- Center for Promotion of Mental Health in Juvenile Justice, Division of Child Psychiatry, Columbia University/New York State Psychiatric Institute, NY 10032, USA.
| | | |
Collapse
|
34
|
Abstract
This review examines the descriptive epidemiology, and risk and protective factors for youth suicide and suicidal behavior. A model of youth suicidal behavior is articulated, whereby suicidal behavior ensues as a result of an interaction of socio-cultural, developmental, psychiatric, psychological, and family-environmental factors. On the basis of this review, clinical and public health approaches to the reduction in youth suicide and recommendations for further research will be discussed.
Collapse
Affiliation(s)
- Jeffrey A Bridge
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | | |
Collapse
|
35
|
Abstract
We conducted a psychological autopsy study to further understand youth suicide in Utah. While traditional psychological autopsy studies primarily focus on the administration of psychometric measures to identify any underlying diagnosis of mental illness for the suicide decedent, we focused our interviews to identify which contacts in the decedent's life recognized risk factors for suicidal behavior, symptoms of mental illness, as well as barriers to mental health treatment for the decedent. Parents and friends recognized most symptoms universally, although friends better recognized symptoms of substance abuse than any other contact. The study results suggest that parents and friends are the most appropriate individuals for gatekeeper training and, in conjunction with other innovative screening programs, may be an effective strategy in reducing adolescent suicide.
Collapse
Affiliation(s)
- Michelle Moskos
- Department of Pediatrics at the University of Utah School of Medicine, USA.
| | | | | | | | | |
Collapse
|
36
|
Gallagher CA, Dobrin A. The association between suicide screening practices and attempts requiring emergency care in juvenile justice facilities. J Am Acad Child Adolesc Psychiatry 2005; 44:485-93. [PMID: 15843771 DOI: 10.1097/01.chi.0000156281.07858.52] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To provide a national description of suicide screening practices in juvenile residential facilities and to examine their association with whether facilities experience a suicide attempt. METHOD Multivariate modeling with data from the 2000 Juvenile Residential Facility Census (n = 3690 facilities). RESULTS Controlling for facility characteristics, screening the entire facility population within the first 24 hours after arrival is significantly linked to lower odds of serious suicide attempts (odds ratio 0.23-0.65). Facilities screening just some of their population in a 2- to 7-day window after arrival exhibited significantly higher odds of serious suicide attempts (odds ratio 1.30-4.73). CONCLUSIONS Results suggest that facility-level risks of serious suicide attempts may be reduced by screening every child and adolescent entering a juvenile justice facility within the 24-hour window directly following arrival, regardless of the facility size and whether the youths came directly from another facility within the system.
Collapse
Affiliation(s)
- Catherine A Gallagher
- Department of Public and International Affairs, Justice, Law and Crime Policy Program, George Mason University, Fairfax, VA 22030, USA.
| | | |
Collapse
|
37
|
Abstract
Depression occurs in children and adolescents, although it may appear differently in younger patients. Research suggests juvenile depression may respond to psychotherapy and to pharmacologic agents, and that antidepressants remain a valuable treatment for juveniles with depression. Diagnostic considerations in juveniles with mood symptoms are discussed. A brief overview is provided of the evidence supporting psychotherapy for juveniles with depression. Controlled antidepressant trials in juveniles with depression provide some support for the use of some selective serotonin reuptake inhibitors and little support for atypical antidepressants, tricyclic antidepressants, or monoamine oxidase inhibitors. Evidence from suicide rates over time, autopsy findings among juvenile suicides, and impacts of antidepressant prescribing trends are related to the current controversy over suicidality and antidepressant use in juvenile patients. Based on this evidence, practical guidelines for treatment of juvenile depression are provided.
Collapse
Affiliation(s)
- Jeff Q Bostic
- Harvard Medical School, Massachusetts General Hospital Boston, MA 02114, USA
| | | | | | | |
Collapse
|
38
|
Putnins AL. Correlates and predictors of self-reported suicide attempts among incarcerated youths. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2005; 49:143-157. [PMID: 15746266 DOI: 10.1177/0306624x04269412] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The correlates and predictors of suicidal behaviors among 900 young offenders in detention centers in South Australia are investigated. That young offenders are a high-risk population is confirmed, with a quarter of the youths reporting recent suicidal ideation and more than a quarter reporting having made a suicide attempt. Past suicide attempts are significantly predictive of future suicide attempts. Other variables both concurrently and prospectively associated with suicidal behaviors (even after controlling for prior suicide attempt status) are substance use, prolonged dysphoric mood, attention deficit hyperactivity disorder signs, and having a bad temper. These variables not only have predictive value but should also be considered as appropriate targets when intervening to reduce suicide risk. It is suggested that impulsiveness is an underlying common factor.
Collapse
Affiliation(s)
- Aldis L Putnins
- Department for Families and Communities-South Australia, and University of South Australia, 2 Norton Summit Rd., Magill, SA 5072, Australia.
| |
Collapse
|
39
|
Abstract
Abstract: In the United States, teen suicide rates tripled over several decades, but have declined slightly since the mid-1990s. Suicide, by its nature, is a complex problem. Many myths have developed about individuals who complete suicide, suicide risk factors, current prevention programs, and the treatment of at-risk youth. The purpose of this article is to address these myths, to separate fact from fiction, and offer recommendations for future suicide prevention programs. Myth #1: Suicide attempters and completers are similar. Myth #2: Current prevention programs work. Myth #3: Teenagers have the highest suicide rate. Myth #4: Suicide is caused by family and social stress. Myth #5: Suicide is not inherited genetically. Myth #6: Teen suicide represents treatment failure. Psychiatric illnesses are often viewed differently from other medical problems. Research should precede any public health effort, so that suicide prevention programs can be designed, implemented, and evaluated appropriately. Too often suicide prevention programs do not use evidence-based research or practice methodologies. More funding is warranted to continue evidence-based studies. We propose that suicide be studied like any medical illness, and that future prevention efforts are evidence-based, with appropriate outcome measures.
Collapse
Affiliation(s)
- Michelle Ann Moskos
- Univ. of Utah School of Medicine, Department of Pediatrics, Intermountain Injury Control Research Center, Salt Lake City, UT, USA.
| | | | | |
Collapse
|
40
|
Sanislow CA, Grilo CM, Fehon DC, Axelrod SR, McGlashan TH. Correlates of suicide risk in juvenile detainees and adolescent inpatients. J Am Acad Child Adolesc Psychiatry 2003; 42:234-40. [PMID: 12544184 DOI: 10.1097/00004583-200302000-00018] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare correlates of risk for suicidal behavior in juvenile detainees with those in another high-risk group, adolescent psychiatric inpatients. METHOD Eighty-one adolescents in a short-term juvenile detention center were contrasted with a matched group of 81 adolescent psychiatric inpatients on a clinical assessment battery of established instruments including a measure for risk of suicidal behavior. RESULTS Juvenile detainees and adolescent psychiatric inpatients reported similar levels of distress on measures of suicide risk, depression, impulsivity, and drug abuse. After controlling for depression, impulsivity and drug abuse remained significantly associated with suicide risk scores in the juvenile detention group, but did not in the psychiatric contrast group. For depressed female inpatients, hopelessness added significantly to the prediction of suicide risk scores. CONCLUSIONS Correlates of risk for suicidal behavior in juvenile detainees may differ from those in other high-risk groups. Results suggest that it may be helpful to examine impulsivity and history of drug abuse when assessing suicide risk for detained adolescents. Further study of juvenile detainees as a separate high-risk group is warranted to better determine the nature and extent of risk.
Collapse
Affiliation(s)
- Charles A Sanislow
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA.
| | | | | | | | | |
Collapse
|