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Thompson RJ, Whalen DJ, Gilbert K, Tillman R, Hennefield L, Donohue MR, Hoyniak CP, Barch DM, Luby JL. Preadolescent Suicidal Thoughts and Behaviors: An Intensive Longitudinal Study of Risk Factors. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00184-9. [PMID: 38604472 DOI: 10.1016/j.jaac.2024.03.018] [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: 09/05/2023] [Revised: 03/06/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Dramatic increases in rates of suicidal thoughts and behaviors (STBs) among youth highlight the need to pinpoint early risk factors. This study used intensive longitudinal sampling to assess what the concurrent associations were between risk factors and STB status, how proximal changes in risk factors were related to STB status, and how risk factors prospectively predicted changes in STB status in a preadolescent sample enriched for early childhood psychopathology. METHOD A total of 192 participants were included from the Parent-Child Interaction Therapy-Emotional Development (PCIT-ED) Study, a longitudinal study of children with and without preschool depression. Participants 7 to 12 years of age completed a diagnostic interview, followed by 12 months of intensive longitudinal sampling, assessing experiences of suicidal ideation and 11 psychosocial variables with known links to STBs in adolescents and adults. Preadolescents with STB history (high-risk) received surveys weekly, and those without STB history (lower-risk) received surveys monthly. RESULTS Female sex, elevated depressive symptoms, greater use of expressive suppression and rumination, emotional clarity, and perceived burdensomeness were uniquely concurrently associated with the likelihood of STB endorsement. Within the high-risk group, (1) increases in depression, expressive suppression, rumination, and perceived burdensomeness, and decreases in positive affect from weekt to weekt+1 were associated with a higher likelihood of a positive STB status at weekt+1; and (2) higher expressive suppression, perceived burdensomeness, and caregiver criticism and conflict at weekt compared to participants' mean levels prospectively predicted increases in the likelihood of a positive STB report from weekt to weekt+1. CONCLUSION Psychosocial factors influencing STBs in adolescents and adults also affect preadolescents in day-to-day life. Expressive suppression and perceived burdensomeness consistently emerged as novel risk indicators and potential targets for treatment. In addition, increases in depression, rumination, and caregiver criticism and conflict, as well as decreases in positive affect, might prompt heightened STB screening and assessments for preadolescents with a history of STBs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Joan L Luby
- Washington University in St. Louis, St. Louis, Missouri
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Mota MSSD, Ulguim HB, Jansen K, Cardoso TDA, Souza LDDM. Are big five personality traits associated to suicidal behaviour in adolescents? A systematic review and meta-analysis. J Affect Disord 2024; 347:115-123. [PMID: 37956831 DOI: 10.1016/j.jad.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/05/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Suicidal behaviour is one of the main causes of death worldwide, especially among teenagers, and its development is potentially associated with the development of personality. The aim of this systematic review and meta-analysis is to describe the association between the Big Five Personality Traits and suicidal behaviour in adolescents. METHODS Seven databases were systematically searched between June 2022 and July 2022 with no language or year restrictions. We searched for a combination of the following search items (suicid* OR suicidal behaviour OR suicidal ideation OR suicide attempts OR self injury OR self-destructive behaviour OR self-harm OR suicidal risk) AND (personality OR personality traits OR temperament OR neuroticism OR extraversion OR agreeableness OR openness to experience OR conscientiousness) AND (adolescents OR youth OR teenagers OR young adults). Meta-analysis procedures were performed using the R software. A random-effect-model was performed for the models through the incorporation of τ2, based on the DerSimonion Lard method. RESULTS Seven studies met all inclusion criteria and were included in this systematic review. Our meta-analysis showed that higher neuroticism are both associated and a risk factor for suicidal behaviour. Higher levels of openness to experience and agreeableness, and lower levels of extraversion and conscientiousness, were linked to suicidal behaviour, especially self-harm. LIMITATIONS Due to the heterogeneity of the studies, we were only able to perform meta-analysis regarding neuroticism. CONCLUSION The present study may help professionals to identify adolescents in higher risk for suicidal behaviour, enabling the development of early interventions to prevent suicidality in this population.
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Affiliation(s)
- Manuela Silva Silveira da Mota
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Chronobiology and Sleep Laboratory, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Helena Bohm Ulguim
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Karen Jansen
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
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Cossu G, Vecchio A, Orlandi M, Casini E, Borgatti R, Mensi MM. Multiphasic Personality Assessment in a Case Series of Adolescent Patients with Suicidal Ideation and/or Attempts. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1794. [PMID: 38002885 PMCID: PMC10670834 DOI: 10.3390/children10111794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023]
Abstract
Suicide is an important public health issue. To examine the differences in personality characteristics between a group of adolescents with suicidal ideation (SI) and a group with a history of suicidal attempts (SA), we conducted a cross-sectional study. We enrolled 55 adolescents (51 females; 12-18 y.o.) who presented SI and/or SA. Using the Columbia Suicide Severity Rating Scale, we divided the sample into two groups: adolescents with SI and adolescents with SA. All participants filled in the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A). Adolescents in the SA group had greater difficulties in social relations, risky behaviors, and more intense suicidal ideation compared to those in the SI group. Adolescents in the SA group scored higher in Omission, in the Lie Scale, the Conduct Problem Scale, the Less Aspirations Scale, the Repression Scale in the MMPI-A, and item 283 of the MAST compared to the other group. The results suggest that using the MMPI-A to assess certain features (e.g., tendency to lie, repression) may be helpful in identifying young people who are at high risk of suicide. However, further research is required to determine the effectiveness of using this instrument.
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Affiliation(s)
- Giulia Cossu
- Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy
| | - Arianna Vecchio
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Marika Orlandi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Erica Casini
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Renato Borgatti
- Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Martina Maria Mensi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
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Brown SA, Moeketsi TD, Musekiwa A, Moodley SV. Readmission of adolescent psychiatric patients to a specialised unit in Gauteng, South Africa. S Afr J Psychiatr 2023; 29:2018. [PMID: 38860147 PMCID: PMC11163387 DOI: 10.4102/sajpsychiatry.v29i0.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 06/02/2023] [Indexed: 06/12/2024] Open
Abstract
Background Readmission rates to child and adolescent psychiatric units among the youth have been reported to be increasing. Aim The study aimed to determine the readmission rate and factors associated with readmission of adolescent psychiatric patients at a child and adolescent psychiatric unit. Setting A specialised psychiatric hospital in Gauteng province, South Africa. Methods This retrospective cohort study utilised data from the records of patients admitted to the adolescent inpatient unit over a period of five years. The cumulative incidence and incidence rate of readmission within one year of discharge from the index admission was calculated using survival analysis methods. Characteristics significantly associated with readmission were determined by applying the multivariable Cox proportional hazards regression model. Results Among the 189 patients included in the analysis, the cumulative incidence of readmission within one year of discharge was 17.5%. The incidence rate was 5.31 readmissions per 10 000 person-days. The final multivariable model showed that a diagnosis of schizophrenia (p = 0.015), a diagnosis of attention deficit hyperactivity disorder (p = 0.039), and coming from a child and youth care centre or temporary safe care (p = 0.018) increased the risk of readmission while having a medical condition (p = 0.008) reduced the risk. Conclusion Psychiatric diagnosis and residential care could be potential risk markers for readmission. Improving the collaboration between health and social services in residential care would be beneficial. Contribution Identifying factors that predispose adolescent psychiatric patients to readmission can inform and improve management and risk assessments.
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Affiliation(s)
- Sarah-Anne Brown
- Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Tshepiso D. Moeketsi
- Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Alfred Musekiwa
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Saiendhra V. Moodley
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Bendezú JJ, Handley ED, Manly JT, Toth SL, Cicchetti D. Psychobiological foundations of coping and emotion regulation: Links to maltreatment and depression in a racially diverse, economically disadvantaged sample of adolescent girls. Psychoneuroendocrinology 2022; 143:105826. [PMID: 35700563 PMCID: PMC9357119 DOI: 10.1016/j.psyneuen.2022.105826] [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: 02/10/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
Abstract
Adolescent risk for depression and passive or active suicidal ideation (PASI) involves disturbance across multiple systems (e.g., arousal regulatory, affective valence, neurocognitive). Exposure to maltreatment while growing up as a child or teenager may potentiate this risk by noxiously impacting these systems. However, research exploring how coordinated disturbance across these systems (i.e., profiles) might be uniquely linked to depressogenic function, and how past maltreatment contributes to such disturbance, is lacking. Utilizing a racially diverse, economically disadvantaged sample of adolescent girls, this person-centered study identified psychobiological profiles and linked them to maltreatment histories, as well as current depressive symptoms and PASI. Girls (N = 237, Mage=13.98, SD=0.85) who were non-depressed/non-maltreated (15.1%), depressed/non-maltreated (40.5%), or depressed/maltreated (44.4%) provided morning saliva samples, completed questionnaires, a clinical interview, and a neurocognitive battery. Latent profile analysis of girls' morning cortisol:C-reactive protein ratio, positive and negative affect levels, and attentional set-shifting ability revealed four profiles. Relative to Normative (66.6%), girls exhibiting a Pro-inflammatory Affective Disturbance (13.1%), Severe Affective Disturbance (10.1%), or Hypercortisol Affective Neurocognitive Disturbance (n = 24, 10.1%) profile reported exposure to a greater number of maltreatment subtypes while growing up. Girls exhibiting these dysregulated profiles were also more likely (relative to Normative) to report current depressive symptoms (all three profiles) and PASI (only Pro-inflammatory Affective Disturbance and Hypercortisol Affective Neurocognitive Disturbance). Of note, girls' cognitive reappraisal utilization moderated profile membership-depression linkages (depressive symptoms, but not PASI). A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.
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Affiliation(s)
- Jason José Bendezú
- The Institute of Child Development, University of Minnesota, USA; Department of Psychology, University of Minnesota, USA.
| | | | - Jody T Manly
- Mt. Hope Family Center, University of Rochester, USA
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, USA
| | - Dante Cicchetti
- The Institute of Child Development, University of Minnesota, USA
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McCallum SM, Batterham PJ, Christensen H, Werner-Seidler A, Nicolopoulos A, Newton N, Teesson M, Calear AL. Personality factors associated with suicidal ideation, plans and attempts in adolescents. J Affect Disord 2022; 310:135-141. [PMID: 35537543 DOI: 10.1016/j.jad.2022.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 04/07/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suicide is the leading cause of death among young Australians, therefore identifying factors that increase risk is important. The aims of this study was to investigate the association between personality domains and suicidal ideation, plans and attempts in a community-based sample of adolescents. METHODS 1428 students from thirteen secondary schools in Australia completed a survey consisting of demographic information (gender and age), personality risk across four domains (Hopelessness, Impulsivity, Sensation Seeking and Anxiety Sensitivity) as measured by the Substance Use Risk Profile Scale, and psychological distress measured by the Distress Questionnaire 5 scale. Outcome measures included suicidal ideation, plans and attempts measured by the Youth Risk Behavior Survey. RESULTS Students were aged between 11 and 17 years old (mean: 13.3, SD = 1.2) with 59% identifying as female. Proportions of participants reporting suicidal ideation, plans and at least one attempt were 14%, 9% and 7% respectively. Hopelessness was associated with twice the odds (OR = 3.1 and 2.9) of suicidal thoughts and plans respectively. Hopelessness also had 45% increased odds for suicide attempt (OR = 2.1), however this was not significant in the suicidal ideation sub-group. Impulsivity and sensation seeking were associated with suicidal ideation (OR = 1.3), while only impulsivity was associated with attempt (OR = 1.5). LIMITATIONS The study was cross-sectional, considered suicidal thoughts and behaviors in past 12 months only and used one measure of personality. CONCLUSIONS Personality traits may be important for determining suicide risk in adolescents. Developing screening and interventions targeting personality may have implications for the detection and prevention of suicide.
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Affiliation(s)
- Sonia M McCallum
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | | | - Ally Nicolopoulos
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre, University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre, University of Sydney, Sydney, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia.
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Bendezú JJ, Thai M, Wiglesworth A, Cullen KR, Klimes-Dougan B. Adolescent stress experience-expression-physiology correspondence: Links to depression, self-injurious thoughts and behaviors, and frontolimbic neural circuity. J Affect Disord 2022; 300:269-279. [PMID: 34954334 PMCID: PMC9062769 DOI: 10.1016/j.jad.2021.12.098] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Dysregulated stress responsivity is implicated in adolescent risk for depression and self-injurious thoughts and behaviors (STBs). However, studies often examine levels of the stress response in isolation, precluding understanding of how coordinated disturbance across systems confers risk. The current study utilized a novel person-centered approach to identify stress correspondence profiles and linked them to depressive symptoms, STBs, and neural indices of self-regulatory capacity. METHOD Adolescents with and without a major depressive disorder diagnosis (N = 162, Mage = 16.54, SD = 1.96, 72.8% White, 66.5% female) completed the Trier Social Stress Test (TSST), questionnaires, and clinical interviews. Stress experience (self-report), expression (observed), and physiology (salivary cortisol) were assessed during the experimental protocol. Adolescents also underwent a magnetic resonance imaging scan. RESULTS Multitrajectory modeling revealed four profiles. High Experience-High Expression-Low Physiology (i.e., lower stress correspondence) adolescents were more likely to report depressive symptoms, lifetime nonsuicidal self-injury, and suicidal ideation relative to all other subgroups reflecting higher stress correspondence: Low Experience-Low Expression-Low Physiology, Moderate Experience-Moderate Expression-Moderate Physiology, High Experience-High Expression-High Physiology. High Experience-High Expression-Low Physiology adolescents also exhibited less positive amygdala-ventromedial prefrontal cortex resting state functional connectivity relative to Moderate Experience-Moderate Expression-Moderate Physiology. LIMITATIONS Data were cross-sectional, precluding inference about our profiles as etiological risk factors or mechanisms of risk. CONCLUSIONS Findings illustrate meaningful heterogeneity in adolescent stress correspondence with implications for multimodal, multilevel assessment and outcome monitoring in depression prevention and intervention efforts.
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Affiliation(s)
- Jason José Bendezú
- The Institute of Child Development, University of Minnesota, Minneapolis, MN 55455, United States; Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States.
| | - Michelle Thai
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States
| | - Andrea Wiglesworth
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States
| | - Kathryn R Cullen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, United States
| | - Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States
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Lawson KM, Kellerman JK, Kleiman EM, Bleidorn W, Hopwood CJ, Robins RW. The role of temperament in the onset of suicidal ideation and behaviors across adolescence: Findings from a 10-year longitudinal study of Mexican-origin youth. J Pers Soc Psychol 2022; 122:171-186. [PMID: 33539152 PMCID: PMC8333186 DOI: 10.1037/pspp0000382] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Suicide among young people is an increasingly prevalent and devastating public health crisis around the world. To reduce the rate of suicide, it is important to identify factors that can help us better predict suicidal ideation and behaviors. Adolescent temperament (effortful control, negative emotionality, positive emotionality) may be a source of risk and resilience for the onset of suicidal ideation, plans, and attempts. The present study uses longitudinal data from a large, community sample of Mexican-origin youth (N = 674), assessed annually from age 12 to 21, to examine how temperament is associated with the onset of suicidal ideation and behaviors during adolescence and young adulthood. Results indicate that higher levels of effortful control (activation control, inhibitory control, attention) are associated with decreased probability of experiencing the onset of suicidal ideation, plans, and attempts, whereas higher levels of negative emotionality (particularly aggression, frustration, and depressed mood) are associated with increased probability of experiencing the onset of suicidal ideation and behaviors. Positive emotionality (surgency, affiliation) was not associated with the onset of suicidal ideation and behaviors. Supplemental analyses showed conceptually similar findings for the Big Five, with Conscientiousness associated with decreased risk, Neuroticism associated with increased risk, and the other three dimensions showing largely null results. The findings did not vary significantly for boys and girls or for youth born in the U.S. versus Mexico. Overall, these findings suggest that adolescent temperament serves as both a protective factor (via effortful control/Conscientiousness) and a risk factor (via negative emotionality/Neuroticism) for suicidal ideation and behaviors in Mexican-origin youth. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Yan H, Ding Y, Guo W. Suicidality in patients with premenstrual dysphoric disorder-A systematic review and meta-analysis. J Affect Disord 2021; 295:339-346. [PMID: 34488087 DOI: 10.1016/j.jad.2021.08.082] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 07/03/2021] [Accepted: 08/25/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Whether premenstrual dysphoric disorder (PMDD) is correlated with the risk of suicidality and the extent of its effect on suicidality are unclear. The present study was conducted to elucidate the association between PMDD and suicidality from relevant studies. METHODS Four electronic databases, namely, Scopus, Embase, PubMed, and Web of Science, were searched from inception to November 15, 2020. Quality assessment, data synthesis, and sensitivity analysis were performed on the included studies. RESULTS Six studies with 8 532 participants were included in this meta-analysis. PMDD was associated with an increased risk of suicidal ideation (odds ratio [OR]=2.34, 95% confidence interval [CI]=1.50-3.18, I2=0.0%, p=0.99, k=4). Patients with PMDD had a greater risk of experiencing suicide attempt (OR=2.13, 95% CI=1.05-3.21, I2=0.0%, p=0.81, k=5). PMDD was associated with an increased risk of suicidal plan (OR=2.24, 95% CI=1.03-3.45, I2=0.0%, p=0.96, k=2). LIMITATIONS The diagnosis of PMDD should be considered "provisional" in all the included studies. CONCLUSIONS Among PMDD sufferers there would be a group of particularly suicidal women. Clinicians who treat patients with PMDD should be vigilant for signs of suicidal ideation and behavior to implement better treatment and preventive measures.
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Affiliation(s)
- Haohao Yan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yudan Ding
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Department of Psychiatry, The Third People's Hospital of Foshan, Foshan 528000, Guangdong, China.
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O'Neill C, Pratt D, Kilshaw M, Ward K, Kelly J, Haddock G. The relationship between self-criticism and suicide probability. Clin Psychol Psychother 2021; 28:1445-1456. [PMID: 33847028 DOI: 10.1002/cpp.2593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 03/25/2021] [Indexed: 11/07/2022]
Abstract
The relationship of self-to-self relating and suicide has received attention in explanatory models of suicide. However, exploration of specific types of self-relationships, namely feelings of inadequacy (associated with perfectionism), self-attacking and the ability to be kind and nurturing towards the self has received limited attention in a suicidal population. The present study assessed the relative contribution of self-criticism to suicide probability, alongside established predictors of suicidal ideation; hopelessness, depression, defeat and entrapment. Participants completed measures of inadequacy, self-attacking, self-reassurance, defeat, entrapment, depression and hopelessness (N = 101). A correlation, regression and mediation analysis was undertaken. Results demonstrated that self-attacking has a direct relationship with suicide probability, alongside established predictors; entrapment and hopelessness. Depressive symptomology was not found to be a significant predictor of suicide probability in this population. Addressing particularly hostile forms of self-criticism may be a promising area in terms of future research and clinical practice. Entrapment continues to be a significant predictor of suicide risk and interventions that target this experience should be explored.
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Affiliation(s)
- Catherine O'Neill
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
| | - Daniel Pratt
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
| | - Meryl Kilshaw
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
| | - Kate Ward
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
| | - James Kelly
- Early Intervention in Psychosis Team, Lancashire Care NHS Trust, Preston, UK
| | - Gillian Haddock
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
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Anxiety, Suicidal Risk and Personal Characteristics of Medical Students. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. The prevalence of anxiety, depression, personality traits and poor quality of life among medical students contributes to the formation of suicidal behaviorAims. To reveal the relationship between the severity of anxiety, hopelessness, personality traits and suicidal risk in students of Irkutsk State Medical University.Material and methods. The study included third-year students of the medical faculty of Irkutsk State Medical University (n = 61), average age – 19.7 ± 2.2 years. We used Spielberger – Khanin and Sheehan scales of self-assessment of the anxiety level, the personality questionnaire of Smisek – Mueller “Accent 2-90”, and Beck’s hopelessness scale.Results. According to the results of testing on the Spielberger – Khanin scale, the severity of reactive anxiety reached moderate values in 57.3 % of students, severe anxiety was found in 32.8 %, the absence of anxiety – in 9.8 %. Personal anxiety on the Spielberger – Khanin scale was characterized by moderate values in 52.5 % of cases, severe anxiety was found in 45.9 %, the absence of anxiety – in 1.6 %. Moderate and high values of reactive and personal anxiety were significantly more common compared to the students with no anxiety. According to the psychometric assessment of students using Sheehan scale, clinically expressed anxiety was observed in 47.5 % of cases, severe anxiety disorder – in 4.9 %, lack of anxiety – in 47.5 %. The personality traits of students with anxiety include hyperthymia, excitability, dysthymia, cyclothymia, introversion and exaltation.Нopelessness in students was detected in 27.9 % of cases (mild – in 16.4 %, moderate – in 9.8 %, severe – in 1.6 %). Тhe criterion of hopelessness was detected with pronounced situational and personal anxiety in comparison with moderately pronounced anxiety using Spielberger – Khanin scale (50 % and 39.3 % respectively); expressed and severe anxiety was detected in 51.7 % and 66.7 % of cases on the Sheehan scale.The personality traits of students with hopelessness included stuckness, pedantry (standard level and level above average); cyclothymia in the form of unstable mood; demonstrativeness; excitability (normative level); dysthymia in the form of attempts to deny difficulties; exaltation (average level); introverted personality direction.Conclusion. Determination of factors of suicidal risk is important in the prevention of suicidal behavior among medical students.
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Adolescent girls' stress responses as prospective predictors of self-injurious thoughts and behaviors: A person-centered, multilevel study. Dev Psychopathol 2021; 34:1447-1467. [PMID: 33762041 DOI: 10.1017/s0954579420002229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Adolescent risk for self-injurious thoughts and behaviors (STBs) involves disturbance across multiple systems (e.g., affective valence, arousal regulatory, cognitive and social processes). However, research integrating information across these systems is lacking. Utilizing a multiple-levels-of-analysis approach, this person-centered study identified psychobiological stress response profiles and linked them to cognitive processes, interpersonal behaviors, and STBs. At baseline, adolescent girls (N = 241, Mage = 14.68 years, Range = 12-17) at risk for STBs completed the Trier Social Stress Test (TSST), questionnaires, and STB interviews. Positive affect (PA), negative affect (NA), and salivary cortisol (SC) were assessed before and after the TSST. STBs were assessed again during 3, 6, and 9 month follow-up interviews. Multitrajectory modeling of girls' PA, NA, and SC revealed four profiles, which were compared on cognitive and behavioral correlates as well as STB outcomes. Relative to normative, girls in the affective distress, hyperresponsive, and hyporesponsive subgroups were more likely to report negative cognitive style (all three groups) and excessive reassurance seeking (hyporesponsive only) at baseline, as well as nonsuicidal self-injury (all three groups) and suicidal ideation and attempt (hyporesponsive only) at follow-up. Girls' close friendship characteristics moderated several profile-STB links. A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.
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Investigating how individual differences influence responses to the COVID-19 crisis: The role of maladaptive and five-factor personality traits. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021; 176:110786. [PMID: 33642660 PMCID: PMC7901380 DOI: 10.1016/j.paid.2021.110786] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 01/03/2023]
Abstract
Introduction Coronavirus disease (COVID-19) pandemic impacted both the physical and psychological aspects of people's lives. Personality traits are one of the factors that explain the diverse responses to stressful situations. This study aimed to investigate whether five-factor and maladaptive personality traits are associated with depressive and anxiety symptoms, suicide risk, self-reported COVID-19 symptoms, and preventive behaviors during the COVID-19 pandemic, comprehensively. Methods We conducted an online survey among a representative sample of 1000 Koreans between May 8 to 13, 2020. Participants' five-factor and maladaptive personality traits were measured using the multidimensional personality inventory, the Bright and Dark Personality Inventory. COVID-19 symptoms, depressive and anxiety symptoms, suicide risk, and preventive behaviors were also measured. Results The results revealed that maladaptive personality traits (e.g., negative affectivity, detachment) had positive correlations with depressive and anxiety symptoms, suicide risk, and COVID-19 symptoms, and the five-factor personality traits (e.g., agreeableness, conscientiousness) had positive correlations with preventive behaviors. Conclusion Our findings extend the current understanding of the relationship between five-factor and maladaptive personality traits and responses to the COVID-19 pandemic. Longitudinal follow-up should further investigate the influence of personality traits on an individual's response to the COVID-19 pandemic.
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Predicting Psychiatric Rehospitalization in Adolescents. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:807-820. [PMID: 31584109 DOI: 10.1007/s10488-019-00982-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Adolescent psychiatric rehospitalizations are common, cause patients and their families severe psychological distress, and use tremendous healthcare resources. This study sought to identify predictors of rehospitalization in 783 adolescents in the 2 year period following psychiatric hospitalization at a major treatment facility in a large urban area. A current diagnosis of posttraumatic stress disorder, greater severity of lifetime suicidal ideation (SI) and stronger treatment alliance prior to hospitalization were associated with a greater likelihood of rehospitalization. Overall, severe lifetime SI was the strongest predictor of rehospitalization; although, within the first 4 months post-discharge, moderate lifetime SI was the strongest predictor. Future research should continue to identify additional factors that may influence rehospitalization, such as the intensity of post-discharge services.
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Kuang L, Wang W, Huang Y, Chen X, Lv Z, Cao J, Ai M, Chen J. Relationship between Internet addiction, susceptible personality traits, and suicidal and self-harm ideation in Chinese adolescent students. J Behav Addict 2020; 9:676-685. [PMID: 32750031 PMCID: PMC8943662 DOI: 10.1556/2006.2020.00032] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 02/28/2020] [Accepted: 05/04/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIMS Internet addiction (IA) is common among young students. This study aimed to examine the influence and mechanisms of IA and susceptible personality traits on the impact of suicidal ideation in adolescent students in China. METHODS This cross-sectional study (09/2012-09/2015) used stratified cluster sampling with "school type" for stratification; 136,266 students from 63 schools completed the questionnaire. Logistic regression analysis was performed to estimate the effect of IA (Young's Internet Addiction Test) and susceptible personality (Barratt impulsiveness scale, Buss & Perry Aggression Questionnaire; and Eysenck Personality Questionnaire-R Short Scale) on suicidal ideation (Scale of Suicidal Ideation). RESULTS Suicidal ideation was observed in 20,218 (14.77%) of the students, and IA was detected in 28,836 (21.16%) subjects. Compared with those without IA, students with IA had a higher prevalence of suicidal ideation (P < 0.0001). No planning impulsiveness had a predictive effect on suicidal ideation in the impulsive personality trait, while in the aggressive personality trait, hostility and self-aggression had a predictive effect on suicidal ideation (all P < 0.0001). High psychoticism and neuroticism were impact factors for suicidal ideation, but extroversion was a protective factor (all P < 0.0001). DISCUSSION These results highlight the importance of assessing personality traits and reducing IA as a possible means of lessening suicidal ideation. Susceptible personality (such as high psychoticism, high neuroticism, and low extroversion) play a prominent role in influencing the probability of having suicidal behavior among those recently exposed to IA. CONCLUSIONS IA and susceptible personality traits were significantly correlated with suicidal and self-harm ideation among adolescent students.
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Affiliation(s)
- Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,Corresponding author. E-mail:
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Huang
- GCP Office, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Xiaorong Chen
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Zhen Lv
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianmei Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Edgcomb JB, Sorter M, Lorberg B, Zima BT. Psychiatric Readmission of Children and Adolescents: A Systematic Review and Meta-Analysis. Psychiatr Serv 2020; 71:269-279. [PMID: 31822241 DOI: 10.1176/appi.ps.201900234] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate predictors of psychiatric hospital readmission of children and adolescents, a systematic review and meta-analysis was conducted. METHODS Following PRISMA statement guidelines, a systematic literature search of articles published between 1997 and 2018 was conducted in PubMed/MEDLINE, Google Scholar, and PsycINFO for original peer-reviewed articles investigating predictors of psychiatric hospital readmission among youths (<18 years old). Effect sizes were extracted and combined by using random-effects meta-analysis. Covariates were investigated with meta-regression and subgroup analyses. RESULTS Thirty-three studies met inclusion criteria, containing information on 83,361 children and adolescents, of which raw counts of readmitted vs. non-readmitted youths were available for 76,219. Of these youths, 13.2% (N=10,076) were readmitted. The mean±SD study follow-up was 15.9±15.0 months, and time to readmission was 13.1±12.8 months. Readmission was associated with, but not limited to, suicidal ideation at index hospitalization (pooled odds ratio [ORpooled]=2.35, 95% confidence interval [CI]=1.64-3.37), psychotic disorders (ORpooled=1.87, 95% CI=1.53-2.28), prior hospitalization (ORpooled=2.51, 95% CI=1.76-3.57), and discharge to residential treatment (ORpooled=1.84, 95% CI=1.07-3.16). There was evidence of moderate study bias. Prior investigations were methodologically and substantively heterogeneous, particularly for measurement of family-level factors. CONCLUSIONS Interventions to reduce child psychiatric readmissions should place priority on youths with indicators of high clinical severity, particularly with a history of suicidality, psychiatric comorbidity, prior hospitalization, and discharge to residential treatment. Standardization of methods to determine prevalence rates of readmissions and their predictors is needed to mitigate potential biases and inform a national strategy to reduce repeated child psychiatric hospital readmissions.
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Affiliation(s)
- Juliet Beni Edgcomb
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Edgcomb, Zima); Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati (Sorter); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lorberg)
| | - Michael Sorter
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Edgcomb, Zima); Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati (Sorter); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lorberg)
| | - Boris Lorberg
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Edgcomb, Zima); Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati (Sorter); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lorberg)
| | - Bonnie T Zima
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Edgcomb, Zima); Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati (Sorter); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lorberg)
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Carballo JJ, Llorente C, Kehrmann L, Flamarique I, Zuddas A, Purper-Ouakil D, Hoekstra PJ, Coghill D, Schulze UME, Dittmann RW, Buitelaar JK, Castro-Fornieles J, Lievesley K, Santosh P, Arango C. Psychosocial risk factors for suicidality in children and adolescents. Eur Child Adolesc Psychiatry 2020; 29:759-776. [PMID: 30684089 PMCID: PMC7305074 DOI: 10.1007/s00787-018-01270-9] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/20/2018] [Indexed: 12/28/2022]
Abstract
Suicidality in childhood and adolescence is of increasing concern. The aim of this paper was to review the published literature identifying key psychosocial risk factors for suicidality in the paediatric population. A systematic two-step search was carried out following the PRISMA statement guidelines, using the terms 'suicidality, suicide, and self-harm' combined with terms 'infant, child, adolescent' according to the US National Library of Medicine and the National Institutes of Health classification of ages. Forty-four studies were included in the qualitative synthesis. The review identified three main factors that appear to increase the risk of suicidality: psychological factors (depression, anxiety, previous suicide attempt, drug and alcohol use, and other comorbid psychiatric disorders); stressful life events (family problems and peer conflicts); and personality traits (such as neuroticism and impulsivity). The evidence highlights the complexity of suicidality and points towards an interaction of factors contributing to suicidal behaviour. More information is needed to understand the complex relationship between risk factors for suicidality. Prospective studies with adequate sample sizes are needed to investigate these multiple variables of risk concurrently and over time.
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Affiliation(s)
- J. J. Carballo
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - C. Llorente
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - L. Kehrmann
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - I. Flamarique
- grid.410458.c0000 0000 9635 9413Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain
| | - A. Zuddas
- grid.7763.50000 0004 1755 3242Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, and “A. Cao” Paediatric Hospital, “G. Brotzu” Hospital Trust, Cagliari University Hospital, Cagliari, Italy
| | - D. Purper-Ouakil
- grid.414352.5CHRU Montpellier, Hôpital Saint Eloi, Médecine Psychologique de l’Enfant et de l’Adolescent, Montpellier, France
| | - P. J. Hoekstra
- grid.4494.d0000 0000 9558 4598Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - D. Coghill
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Psychiatry, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Melbourne, Australia ,grid.8241.f0000 0004 0397 2876Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - U. M. E. Schulze
- grid.6582.90000 0004 1936 9748Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - R. W. Dittmann
- grid.7700.00000 0001 2190 4373Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - J. K. Buitelaar
- grid.10417.330000 0004 0444 9382Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - J. Castro-Fornieles
- grid.410458.c0000 0000 9635 9413Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain ,grid.418264.d0000 0004 1762 4012Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain
| | - K. Lievesley
- grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK ,HealthTracker Ltd, Gillingham, Kent UK
| | - Paramala Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK. .,Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK. .,HealthTracker Ltd, Gillingham, Kent, UK.
| | - C. Arango
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
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Stewart SL, Celebre A, Hirdes JP, Poss JW. Risk of Suicide and Self-harm in Kids: The Development of an Algorithm to Identify High-Risk Individuals Within the Children's Mental Health System. Child Psychiatry Hum Dev 2020; 51:913-924. [PMID: 32076912 PMCID: PMC7554002 DOI: 10.1007/s10578-020-00968-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Suicide is the second leading cause of death in adolescents within Canada. While several risk factors have been found to be associated with increased risk, appropriate decision-support tools are needed to identify children who are at highest risk for suicide and self-harm. The aim of the present study was to develop and validate a methodology for identifying children at heightened risk for self-harm and suicide. Ontario data based on the interRAI Child and Youth Mental Health Screener (ChYMH-S) were analyzed to develop a decision-support algorithm to identify young persons at risk for suicide or self-harm. The algorithm was validated with additional data from 59 agencies and found to be a strong predictor of suicidal ideation and self-harm. The RiSsK algorithm provides a psychometrically sound decision-support tool that may be used to identify children and youth who exhibit signs and symptoms noted to increase the likelihood of suicide and self-harm.
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Affiliation(s)
| | - Angela Celebre
- Faculty of Education, Western University, London, ON, Canada.
| | - John P Hirdes
- Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jeffrey W Poss
- Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Xi W, Banerjee S, Penfold RB, Simon GE, Alexopoulos GS, Pathak J. Healthcare utilization among patients with psychiatric hospitalization admitted through the emergency department (ED): A claims-based study. Gen Hosp Psychiatry 2020; 67:92-99. [PMID: 33068850 PMCID: PMC7722047 DOI: 10.1016/j.genhosppsych.2020.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To characterize the US national level healthcare utilization patterns of patients with commercial insurance plans before and after a psychiatric hospitalization admitted through the emergency department (ED) using insurance claims data. METHOD We identified 34,250 patients from multiple commercial health insurance providers across the US who meet our eligibility criteria. We summarized their healthcare encounters and used logistic regression models to study the patterns of healthcare utilization including prior visits, outpatient follow-ups, and hospital- or ED-readmissions. RESULTS Suicidal ideation was highly prevalent at the time of the index event (29.88%). Almost half of the patients (48.28%) had healthcare encounters with the same primary diagnosis one year before admission, about 5% had outpatient follow-ups or were readmitted to the hospital or ED 7 days post discharge. The post 30-day follow-ups and readmission rates were slightly higher. In general, older patients were less likely to have prior visits, follow-ups, or readmissions, and patients with SUDs, specifically alcohol dependence, opioid dependence/abuse, and stimulant dependence, were more likely to have outpatient follow-ups. CONCLUSION Patterns of patients' prior visits, follow-ups, and readmissions varied by demographics and psychiatric comorbidity. Additional studies are needed to further explain the spatial variations of utilization patterns.
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Affiliation(s)
- Wenna Xi
- Department of Population Health Sciences, Weill Cornell Medicine, DV-306A, 425 E 61st St, New York, NY 10065, USA.
| | - Samprit Banerjee
- Department of Population Health Sciences, Weill Cornell Medicine, LA-233, 402 E 67th St, New York, NY 10065, USA.
| | - Robert B. Penfold
- Kaiser Permanente Washington Health Research Institute; 1730 Minor Avenue, Suite 1600, Seattle, WA, USA 98101
| | - Gregory E. Simon
- Kaiser Permanente Washington Health Research Institute; 1730 Minor Avenue, Suite 1600, Seattle, WA, USA 98101
| | - George S. Alexopoulos
- Department of Psychiatry, Weill Cornell Medicine; 21 Bloomingdale Road, White Plains, NY 10605
| | - Jyotishman Pathak
- Departments of Population Health Sciences and Psychiatry, Weill Cornell Medicine, 425 E 61st St, New York, NY 10065, USA.
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20
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Kane FA, Bornstein RF. Does interpersonal dependency affect therapeutic outcome? A meta-analytic review. Personal Ment Health 2019; 13:215-229. [PMID: 31364815 DOI: 10.1002/pmh.1463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/14/2019] [Accepted: 06/21/2019] [Indexed: 11/07/2022]
Abstract
This study examined whether interpersonal dependency affects therapeutic outcome, using meta-analytic techniques to synthesize results from 31 studies (49 effect sizes; overall N = 3807). High levels of dependency were associated with more positive outcome in psychodynamic therapy (r = 0.11, p < 0.05), but not cognitive-behavioural therapy (r = -0.05, ns), and were associated with a less positive outcome in pharmacological treatment (r = -0.15, p < 0.001). Other predictors of outcome included patient diagnosis (high levels of dependency were linked with more positive outcome for patients with anxiety disorders but not those with depression), outcome measure (high levels of dependency were associated with significantly greater improvement in global functioning but not symptom reduction) and dependency measure (cognitive and cognitive-behavioural dependency scales yielded less positive results than other types of measures). These results contribute to a growing body of literature examining effects of personality on treatment process and outcome. © 2019 John Wiley & Sons, Ltd.
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Affiliation(s)
- Fallon A Kane
- Derner School of Psychology, Adelphi University Garden City, New York, USA
| | - Robert F Bornstein
- Derner School of Psychology, Adelphi University Garden City, New York, USA
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21
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Clarke S, Allerhand LA, Berk MS. Recent advances in understanding and managing self-harm in adolescents. F1000Res 2019; 8:F1000 Faculty Rev-1794. [PMID: 31681470 PMCID: PMC6816451 DOI: 10.12688/f1000research.19868.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2019] [Indexed: 12/28/2022] Open
Abstract
Adolescent suicide is a serious public health problem, and non-suicidal self-injury (NSSI) is both highly comorbid with suicidality among adolescents and a significant predictor of suicide attempts (SAs) in adolescents. We will clarify extant definitions related to suicidality and NSSI and the important similarities and differences between these constructs. We will also review several significant risk factors for suicidality, evidence-based and evidence-informed safety management strategies, and evidence-based treatment for adolescent self-harming behaviors. Currently, dialectical behavior therapy (DBT) for adolescents is the first and only treatment meeting the threshold of a well-established treatment for self-harming adolescents at high risk for suicide. Areas in need of future study include processes underlying the association between NSSI and SAs, clarification of warning signs and risk factors that are both sensitive and specific enough to accurately predict who is at imminent risk for suicide, and further efforts to sustain the effects of DBT post-treatment. DBT is a time- and labor-intensive treatment that requires extensive training for therapists and a significant time commitment for families (generally 6 months). It will therefore be helpful to assess whether other less-intensive treatment options can be established as evidence-based treatment for suicidal adolescents.
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Affiliation(s)
- Stephanie Clarke
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
| | - Lauren A. Allerhand
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
| | - Michele S. Berk
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
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22
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Gong T, Ren Y, Wu J, Jiang Y, Hu W, You J. The associations among self-criticism, hopelessness, rumination, and NSSI in adolescents: A moderated mediation model. J Adolesc 2019; 72:1-9. [DOI: 10.1016/j.adolescence.2019.01.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 09/25/2018] [Accepted: 01/24/2019] [Indexed: 11/15/2022]
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Huang Y, Kuang L, Wang W, Cao J, Xu L. Association between personality traits and risk of suicidal ideation in Chinese university students: Analysis of the correlation among five personalities. Psychiatry Res 2019; 272:93-99. [PMID: 30579188 DOI: 10.1016/j.psychres.2018.12.076] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
Abstract
The purpose of our study was to determine the incidence of suicidal ideation among Chinese college students and to explore the risk factors for suicidal ideation. A large-sample epidemiological survey was conducted in 13 colleges in Chongqing, China (n = 69,790). Suicidal ideation was reported by 13.03% of the college students who were surveyed. The participants with suicidal ideation were more likely to be female, to come from rural areas, and to have poor life quality and psychological disorder compared to those without suicidal ideation. Moreover, this study revealed that neuroticism, psychoticism, impulsivity, and aggression are risk factors for suicidal ideation, while extroversion has a protective effect on suicidal ideation. We found that four personality traits of students with suicidal ideation, including impulsivity, aggression, psychoticism, and neuroticism, are positively correlated. However, there is a negative correlation between extroversion and the other four traits. These findings highlight the need for further exploration of personality traits in the risk of suicidal ideation.
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Affiliation(s)
- Yan Huang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China; GCP Office, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing 400016, China.
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Lu Xu
- Chongqing Medical and Pharmaceutical College, Chongqing, China
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Zhou H, Roberts PA, Dhaliwal SS, Della PR. Risk factors associated with paediatric unplanned hospital readmissions: a systematic review. BMJ Open 2019; 9:e020554. [PMID: 30696664 PMCID: PMC6352831 DOI: 10.1136/bmjopen-2017-020554] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 09/21/2018] [Accepted: 10/23/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To synthesise evidence on risk factors associated with paediatric unplanned hospital readmissions (UHRs). DESIGN Systematic review. DATA SOURCE CINAHL, EMBASE (Ovid) and MEDLINE from 2000 to 2017. ELIGIBILITY CRITERIA Studies published in English with full-text access and focused on paediatric All-cause, Surgical procedure and General medical condition related UHRs were included. DATA EXTRACTION AND SYNTHESIS Characteristics of the included studies, examined variables and the statistically significant risk factors were extracted. Two reviewers independently assessed study quality based on six domains of potential bias. Pooling of extracted risk factors was not permitted due to heterogeneity of the included studies. Data were synthesised using content analysis and presented in narrative form. RESULTS Thirty-six significant risk factors were extracted from the 44 included studies and presented under three health condition groupings. For All-cause UHRs, ethnicity, comorbidity and type of health insurance were the most frequently cited factors. For Surgical procedure related UHRs, specific surgical procedures, comorbidity, length of stay (LOS), age, the American Society of Anaesthesiologists class, postoperative complications, duration of procedure, type of health insurance and illness severity were cited more frequently. The four most cited risk factors associated with General medical condition related UHRs were comorbidity, age, health service usage prior to the index admission and LOS. CONCLUSIONS This systematic review acknowledges the complexity of readmission risk prediction in paediatric populations. This review identified four risk factors across all three health condition groupings, namely comorbidity; public health insurance; longer LOS and patients<12 months or between 13-18 years. The identification of risk factors, however, depended on the variables examined by each of the included studies. Consideration should be taken into account when generalising reported risk factors to other institutions. This review highlights the need to develop a standardised set of measures to capture key hospital discharge variables that predict unplanned readmission among paediatric patients.
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Affiliation(s)
- Huaqiong Zhou
- General Surgical Ward, Princess Margret Hospital for Children, Perth, Western Australia, Australia
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Pam A Roberts
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | | | - Phillip R Della
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
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Vandenkerckhove B, Brenning K, Vansteenkiste M, Luyten P, Soenens B. The Explanatory Role of Basic Psychological Need Experiences in the Relation between Dependency, Self-Criticism and Psychopathology in Adolescence. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019. [DOI: 10.1007/s10862-019-09719-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Shahar G, Rogers ML, Shalev H, Joiner TE. Self-criticism, interpersonal conditions, and biosystemic inflammation in suicidal thoughts and behaviors within mood disorders: A bio-cognitive-interpersonal hypothesis. J Pers 2018; 88:133-145. [PMID: 30447120 DOI: 10.1111/jopy.12446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 12/27/2022]
Abstract
We review the theoretical and empirical literature on the role of self-concept in suicidal behavior in the context of mood disorders (i.e., unipolar depression and bipolar spectrum disorders). The main themes emanating from this review are then juxtaposed against (a) the Interpersonal-Psychological Theory of Suicide and (b) biological research on the role of inflammatory processes in suicidality. Such a juxtaposition paves the way for a bio-cognitive-interpersonal hypothesis. Pathologies of the self-concept-primarily self-criticism-propel mood disorder sufferers to generate interpersonal stress that culminates in two proximal causes of suicidality: thwarted belongingness and perceived burdensomeness. In turn, these two interpersonal conditions set in motion systemic biosystemic inflammation, serving as a proximal cause for suicidality in mood disorders. We conclude by describing a research project aimed at testing this hypothesis, and by outlining pertinent implications for assessment, treatment, and prevention.
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Affiliation(s)
- Golan Shahar
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassie, Florida
| | - Hadar Shalev
- Department of Psychiatry, Soroka Medical Center, Beer Sheva, Israel
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassie, Florida
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Role of adolescent exposure to rockets in the links between personality vulnerability and psychopathology. Dev Psychopathol 2018; 31:1367-1380. [DOI: 10.1017/s0954579418000792] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThe aim of this study is to examine the role of repeated exposure to rocket attacks in the links between personality vulnerability (dependency and self-criticism) and internalizing/externalizing psychopathology. A main-effect vulnerability model (personality leads to psychopathology) was compared with a main-effect scarring model (psychopathology leads to personality vulnerability). Also, a stress-diathesis pattern (personality vulnerability is activated under stress) was compared to a dual-vulnerability pattern (either personality vulnerability or stress, but not both, lead to psychopathology). Israeli adolescents (N = 362) repeatedly exposed to rocket attacks were assessed annually over 3 years. In 2008 and 2010, personality and psychopathology were assessed. Cumulative exposure was measured as the sums of exposure across the three assessment waves. Theoretical models were tested via Autoregressive Cross-Lagged Structural Equation Modeling analyses. Baseline dependency and self-criticism were associated with an increase in anxiety, whereas baseline depression was associated with an increase in dependency. Under low, not high, levels of rocket exposure, self-criticism and depression were longitudinally associated. Violence commission was associated with an increase in dependency under high, not low, cumulative exposure. Results are consistent with both scarring and vulnerability models, and with both stress-diathesis and dual-vulnerability patterns of adolescent risk and resilience.
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Hartley EL, Stritzke WGK, Page AC, Blades CA, Parentich KT. Neuroticism confers vulnerability in response to experimentally induced feelings of thwarted belongingness and perceived burdensomeness: Implications for suicide risk. J Pers 2018; 87:566-578. [PMID: 29999525 DOI: 10.1111/jopy.12415] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 05/09/2018] [Accepted: 06/28/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study investigated the role of individual differences in neuroticism in conferring increased reactivity to the interpersonal antecedents for suicide proposed by the interpersonal theory of suicide. METHOD Undergraduate students (N = 113) were screened and selected to form high (n = 58) and low (n = 55) neuroticism groups, and an experimental computer task was used to manipulate participants' experience of thwarted belongingness and perceived burdensomeness. Participants' self-reported desire to persist in the face of this induced interpersonal adversity was measured. RESULTS Results indicate that high neuroticism confers increased reactivity to the experimental induction of the interpersonal antecedents of suicidal ideation: Thwarted belongingness and perceived burdensomeness. Furthermore, this vulnerability corresponds to a diminished desire to persist with the task in the face of interpersonal adversity. CONCLUSIONS Neuroticism confers vulnerability for suicidal desire via an increased reactivity to the proximal, causal risk factors proposed by the interpersonal theory of suicide. This has implications for considering how personality risk factors such as neuroticism may interact with proximal interpersonal risk factors to increase suicidal ideation.
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Affiliation(s)
- Elise L Hartley
- School of Psychological Science, University of Western Australia
| | | | - Andrew C Page
- School of Psychological Science, University of Western Australia
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Biering P, Jensen VH. The concept of patient satisfaction in adolescent psychiatric care: A qualitative study. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2018; 30:162-169. [DOI: 10.1111/jcap.12189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Páll Biering
- Associate Professor; Faculty of Nursing; School of Health Science; University of Iceland; Iceland
| | - Valgerdur H. Jensen
- Psychiatric Nurse; Department of Child and Adolescent Psychiatry; Icelandic State and University Hospital; Iceland
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Pennel L, Quesada JL, Dematteis M. Neuroticism and anxious attachment as potential vulnerability factors of repeat suicide attempts. Psychiatry Res 2018; 264:46-53. [PMID: 29626831 DOI: 10.1016/j.psychres.2018.03.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 03/14/2018] [Accepted: 03/22/2018] [Indexed: 11/30/2022]
Abstract
The recurrence risk of suicide attempts can reach 50% in the first year, each attempt increasing suicide-risk by 32%. No screening tool efficiently identifies potential repeat suicide attempters who are too often regarded as borderline personality. Our aim was to identify individual and interpersonal psychopathological dimensions that could represent a vulnerability to repeat suicide attempts. Sixty first-time and repeat suicide attempters consecutively admitted in emergency rooms were compared for fundamental dimensions of personality, patterns of attachment, personality and mental disorders using standardized questionnaires. Confounding and significantly different factors were evaluated using univariate and multivariate logistic regressions. Repeat suicide attempters differed from first-attempters by higher neuroticism and anxious attachment. Combined in an 11-item measure, these two parameters identified a 3.99 times higher risk of repeat suicide attempt. These traits associated with the other two best predictors (non-suicidal self-injury history, current psychotropic drugs) provide a vulnerability model with better screening performance compared to each factor individually. Repeat suicide attempters have more psychological features impairing emotional stability and social interactions than first attempters. Cross-sectional study design, sample size, lack of independent sample and of fearful-avoidant attachment evaluation are the main limitations. The model needs to be validated in a prospective and controlled study.
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Affiliation(s)
- Lucie Pennel
- Univ. Grenoble Alpes, F-38042 Grenoble, France; CHU Grenoble Alpes, Department of Addiction Medicine, F-38043 Grenoble, France
| | - Jean-Louis Quesada
- CHU Grenoble Alpes, Clinical Investigation Center 1406, F-38043 Grenoble, France
| | - Maurice Dematteis
- Univ. Grenoble Alpes, F-38042 Grenoble, France; CHU Grenoble Alpes, Department of Addiction Medicine, F-38043 Grenoble, France.
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31
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Bleys D, Soenens B, Claes S, Vliegen N, Luyten P. Parental psychological control, adolescent self-criticism, and adolescent depressive symptoms: A latent change modeling approach in Belgian adolescents. J Clin Psychol 2018; 74:1833-1853. [DOI: 10.1002/jclp.22632] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/26/2018] [Accepted: 02/01/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Dries Bleys
- Faculty of Psychology and Educational Sciences; KU Leuven; Belgium
| | - Bart Soenens
- Department of Developmental; Personality and Social Psychology; Ghent University; Belgium
| | | | - Nicole Vliegen
- Faculty of Psychology and Educational Sciences; KU Leuven; Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences; KU Leuven; Belgium
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Similä N, Hakko H, Riipinen P, Riala K. Gender Specific Characteristics of Revolving Door Adolescents in Acute Psychiatric Inpatient Care. Child Psychiatry Hum Dev 2018; 49:225-233. [PMID: 28752267 DOI: 10.1007/s10578-017-0744-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study examined the impact of clinical and family related factors on adolescent revolving door (RD) phenomenon, defined as having three or more psychiatric hospitalizations before the age of 18. A clinical sample of adolescents (N = 508) aged 13-17 years, admitted to psychiatric inpatient care between April 2001 through March 2006, were interviewed using the k-SADS-PL and the EuropASI instruments. The national Finnish Care Register for Health Care provided life-time data on child and adolescent psychiatric inpatient hospitalizations. RD boys were shown to be significantly more likely than non-RD boys to be admitted to psychiatric inpatient care from child welfare placements and have previous self-mutilative behavior (SMB) and suicide attempts. RD girls were more likely to come from child welfare placements, have unemployed mothers and a history of SMB. Mortality in RD boys was significantly higher compared to non-RD boys. Frequent use of psychiatric inpatient care warrants comprehensive assessment of suicidal behavior in adolescents.
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Affiliation(s)
- Noora Similä
- Research Unit of Clinical Neurosciences, Department of Psychiatry, University of Oulu, Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, P. O. Box 26, 90029 OYS, Oulu, Finland
| | - Pirkko Riipinen
- Research Unit of Clinical Neurosciences, Department of Psychiatry, University of Oulu, Oulu, Finland
| | - Kaisa Riala
- Department of Psychiatry, Oulu University Hospital, P. O. Box 26, 90029 OYS, Oulu, Finland.
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Cha CB, Franz PJ, Guzmán EM, Glenn CR, Kleiman EM, Nock MK. Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment. J Child Psychol Psychiatry 2018; 59:460-482. [PMID: 29090457 PMCID: PMC5867204 DOI: 10.1111/jcpp.12831] [Citation(s) in RCA: 285] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Suicide is a leading cause of death and a complex clinical outcome. Here, we summarize the current state of research pertaining to suicidal thoughts and behaviors in youth. We review their definitions/measurement and phenomenology, epidemiology, potential etiological mechanisms, and psychological treatment and prevention efforts. RESULTS We identify key patterns and gaps in knowledge that should guide future work. Regarding epidemiology, the prevalence of suicidal thoughts and behaviors among youth varies across countries and sociodemographic populations. Despite this, studies are rarely conducted cross-nationally and do not uniformly account for high-risk populations. Regarding etiology, the majority of risk factors have been identified within the realm of environmental and psychological factors (notably negative affect-related processes), and most frequently using self-report measures. Little research has spanned across additional units of analyses including behavior, physiology, molecules, cells, and genes. Finally, there has been growing evidence in support of select psychotherapeutic treatment and prevention strategies, and preliminary evidence for technology-based interventions. CONCLUSIONS There is much work to be done to better understand suicidal thoughts and behaviors among youth. We strongly encourage future research to: (1) continue improving the conceptualization and operationalization of suicidal thoughts and behaviors; (2) improve etiological understanding by focusing on individual (preferably malleable) mechanisms; (3) improve etiological understanding also by integrating findings across multiple units of analyses and developing short-term prediction models; (4) demonstrate greater developmental sensitivity overall; and (5) account for diverse high-risk populations via sampling and reporting of sample characteristics. These serve as initial steps to improve the scientific approach, knowledge base, and ultimately prevention of suicidal thoughts and behaviors among youth.
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Affiliation(s)
- Christine B. Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia
University
| | | | - Eleonora M. Guzmán
- Department of Counseling and Clinical Psychology, Teachers College, Columbia
University
| | - Catherine R. Glenn
- Department of Clinical and Social Sciences in Psychology, University of
Rochester
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34
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Peters EM, John A, Bowen R, Baetz M, Balbuena L. Neuroticism and suicide in a general population cohort: results from the UK Biobank Project. BJPsych Open 2018; 4:62-68. [PMID: 29971148 PMCID: PMC6020311 DOI: 10.1192/bjo.2017.12] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/12/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Neuroticism has often been linked to suicidal thoughts and behaviour. AIMS To examine whether neuroticism is associated with suicide deaths after adjusting for known risks. METHOD UK Biobank participants (n = 389 365) were assessed for neuroticism as well as social, demographic and health-related variables at study entry and followed for up to 10 years. Suicide risk was modelled using Cox regression stratified by gender. RESULTS Neuroticism increased the risk of suicide in both men (hazard ratio (HR) = 1.15, 95% CI 1.09-1.22) and women (HR = 1.16, 95% CI 1.06-1.27). In a subsample who were assessed for mood disorders, neuroticism remained a significant predictor for women (HR 1.25, 95% CI 1.03-1.51) but not for men. CONCLUSIONS Screening and therapeutic interventions for neuroticism may be important for early suicide prevention. DECLARATION OF INTEREST None.
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Affiliation(s)
- Evyn M. Peters
- Department of Psychiatry, University of
Saskatchewan, Saskatoon, SK,
Canada
| | - Ann John
- Swansea University Medical School and the Farr
Institute, Swansea, Wales,
UK
| | - Rudy Bowen
- Department of Psychiatry, University of
Saskatchewan, Saskatoon, SK,
Canada
| | - Marilyn Baetz
- Department of Psychiatry, University of
Saskatchewan, Saskatoon, SK,
Canada
| | - Lloyd Balbuena
- Department of Psychiatry, University of
Saskatchewan, Saskatoon, SK,
Canada
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35
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Taylor EP, Couper R, Butler CM. Adolescent perfectionism: Structural features of the Frost Multidimensional Perfectionism Scale and correlates with attachment and psychopathology. Psychol Psychother 2017; 90:686-704. [PMID: 28585772 DOI: 10.1111/papt.12133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 04/19/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Perfectionism is recognized as a significant risk factor for psychopathology. Emerging research links attachment to perfectionism in adult and college-age samples. The Frost Multidimensional Perfectionism Scale (FMPS) has been used in adults and adolescents with a variety of factor structures found. This study sought to establish the factor structure in a general adolescent sample prior to testing for associations between perfectionism, attachment, and psychopathology in the same sample. DESIGN A cross-sectional survey design was used. Confirmatory factor analysis, and correlational and regression analyses were employed. METHODS A total of 290 adolescents, aged 12-18 years, were recruited from a state secondary school. All completed the FMPS along with brief measures of attachment and psychopathology. RESULT Exploratory and confirmatory factor analyses failed to replicate previously published models, and a new six-item, 1-factor model representing perfectionism was found instead. This new variable was then used to establish a role for perfectionism and attachment anxiety in predicting internalizing problems. Perfectionism also correlated with conduct problems and hyperactivity. CONCLUSION This study established a novel factor structure for the FMPS, allowing proof of principle of the role of perfectionism in a relationship with attachment and psychopathology, which after replication, may inform new interventions for perfectionism. Caution is noted about the use of extant perfectionism measures that are not properly developmentally informed and which do not capture the dynamic nature of adolescence and adolescent perfectionism. PRACTITIONER POINTS Perfectionism is a feature of adolescent psychopathology, including internalizing and externalizing problems. Perfectionism is associated with attachment anxiety and together contributes to internalizing problems. Current conceptualizations of perfectionism may not capture the specific developmental and dynamic aspects of adolescence and should not be regarded as a stable personality trait.
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Affiliation(s)
- Emily P Taylor
- Department of Clinical Psychology, University of Edinburgh, UK
| | - Rachel Couper
- Department of Clinical Psychology, University of Edinburgh, UK
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A Test of the Perfectionism Social Disconnection Model among Ethnic Minority Youth. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 45:1181-1193. [DOI: 10.1007/s10802-016-0240-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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37
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Layne JA, Porcerelli JH, Shahar G. Psychotherapy of Self-Criticism in a Case of Mixed Anaclitic-Introjective Depression. Clin Case Stud 2016. [DOI: 10.1177/1534650106290370] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this case study, the year-long psychotherapy of a depressed and self-critical 34-year-old women is described. Her depression was conceptualized as a “mixed” anaclitic and introjective type according to the model of Sidney Blatt. Anaclitic depression involves a preoccupation with the integrity of interpersonal relatedness (e.g., issues of dependency and abandonment), whereas introjective depression involves a preoccupation with autonomy and self-esteem (e.g., self-criticism and feelings of worthlessness). Given the potentially destructive nature of self-criticism, the therapist systematically confronted the patient’s use of this trait in a supportive manner. Changes in the patient’s functioning were assessed at the beginning and at the end of treatment using the Shedler-Westen Assessment Procedure and the Diagnostic and Statistical Manual of Mental Disorders (4th edition) Global Assessment of Functioning Scale. After 1 year of psychotherapy combining both cognitive and psychodynamic interventions, the patient evidenced significant changes in both anaclitic and introjective personality dimensions and showed significant improvements in adaptive functioning.
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Smith MM, Sherry SB, Rnic K, Saklofske DH, Enns M, Gralnick T. Are Perfectionism Dimensions Vulnerability Factors for Depressive Symptoms after Controlling for Neuroticism? A Meta–analysis of 10 Longitudinal Studies. EUROPEAN JOURNAL OF PERSONALITY 2016. [DOI: 10.1002/per.2053] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Extensive evidence suggests neuroticism is a higher–order personality trait that overlaps substantially with perfectionism dimensions and depressive symptoms. Such evidence raises an important question: Which perfectionism dimensions are vulnerability factors for depressive symptoms after controlling for neuroticism? To address this, a meta–analysis of research testing whether socially prescribed perfectionism, concern over mistakes, doubts about actions, personal standards, perfectionistic attitudes, self–criticism and self–oriented perfectionism predict change in depressive symptoms, after controlling for baseline depression and neuroticism, was conducted. A literature search yielded 10 relevant studies (N = 1,758). Meta–analysis using random–effects models revealed that all seven perfectionism dimensions had small positive relationships with follow–up depressive symptoms beyond baseline depression and neuroticism. Perfectionism dimensions appear neither redundant with nor captured by neuroticism. Results lend credence and coherence to theoretical accounts and empirical studies suggesting perfectionism dimensions are part of the premorbid personality of people vulnerable to depressive symptoms. Copyright © 2016 European Association of Personality Psychology
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Affiliation(s)
- Martin M. Smith
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Simon B. Sherry
- Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Katerina Rnic
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Donald H. Saklofske
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Murray Enns
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tara Gralnick
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
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Ayub N. Predicting suicide ideation through intrapersonal and interpersonal factors: The interplay of Big-Five personality traits and social support. Personal Ment Health 2015; 9:308-18. [PMID: 26148708 DOI: 10.1002/pmh.1301] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 05/31/2015] [Accepted: 06/04/2015] [Indexed: 11/09/2022]
Abstract
While a specific personality trait may escalate suicide ideation, contextual factors such as social support, when provided effectively, may alleviate the effects of such personality traits. This study examined the moderating role of social support in the relationship between the Big-Five personality traits and suicide ideation. Significant interactions were found between social support and extraversion and emotional stability. Specifically, the relationship between emotional stability and extraversion to suicide ideation was exacerbated when social support was low. Slope analysis showed openness also interacted with low social support. Results were computed for frequency, duration and attitude dimensions of suicide ideation. Extraversion interacted with social support to predict all three dimensions. Social support moderated emotional stability to predict frequency and duration, moderated conscientiousness towards frequency and attitude, and moderated openness towards attitude. The results imply that whereas personality traits may be difficult to alter, social support may play a significant role in saving a life. Psychologists should include family and friends when treating a suicidal youth, guiding them to awareness of one's personality and being more supportive.
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Affiliation(s)
- Nailah Ayub
- King Abdulaziz University, Jeddah, Saudi Arabia
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40
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Abstract
Although perfectionism has been identified as a factor in many psychiatric disorders across the life span, it is relatively understudied in pediatric anxiety and depressive disorders. Furthermore, there exists little cohesion among previous research, restricting the conclusions that can be made across studies. In this review, research associating perfectionism with pediatric anxiety and depression is examined and a framework is presented synthesizing research to date. We focus on detailing the current understanding of how perfectionism develops and interacts with other developmental features characteristic of anxiety and depression in children and potential pathways that result in anxiety and depressive disorders. This includes: how perfectionism is measured in children, comparisons with relevant adult literature, the development of perfectionism in children and adolescents, mediators and moderators of the link between perfectionism and anxiety and depression, and the role of perfectionism in treatment and prevention of these disorders. We also present research detailing perfectionism across cultures. Findings from these studies are beginning to implicate perfectionism as an underlying process that may contribute broadly to the development of anxiety and depression in a pediatric population. Throughout the review, difficulties, limitations, and gaps in the current understanding are presented while offering suggestions for future research.
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Comas M, Valentino K, Bridgett DJ, Hayden LC. The direct and interactive effects of physical abuse severity and negative affectivity on length of psychiatric hospitalization: evidence of differential reactivity to adverse environments in psychiatrically high-risk youth. Child Psychiatry Hum Dev 2015; 45:220-8. [PMID: 23824554 DOI: 10.1007/s10578-013-0394-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The current study examined the interactive influence of multiple factors (i.e., physical abuse severity and negative affectivity) in predicting youth's inpatient psychiatric length of stay (LOS), extending previous research focused on identification of only single LOS predictors. Elevated physical abuse severity was hypothesized to predict longer youth LOS, and negative affectivity was anticipated to exacerbate this relationship. This study included 42 youth. Clinicians rated youth temperament, whereas physical abuse severity and LOS were coded from youth medical records. Controlling for other previously determined predictors of LOS (i.e., age, gender, and GAF), moderation analyses confirmed hypotheses, revealing a temperament by environment interaction. Specifically, physical abuse severity was positively associated with LOS only in the context of high negative affectivity. Findings highlighted the importance of disentangling the interactive effects of multiple factors in predicting LOS. Moreover, critical clinical implications involving prioritized trauma assessment and treatment for inpatient youth are discussed.
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Affiliation(s)
- Michelle Comas
- Center for Children and Families, Department of Psychology, University of Notre Dame, Notre Dame, IN, 46556, USA,
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42
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Hengartner MP. The Detrimental Impact of Maladaptive Personality on Public Mental Health: A Challenge for Psychiatric Practice. Front Psychiatry 2015; 6:87. [PMID: 26106335 PMCID: PMC4460874 DOI: 10.3389/fpsyt.2015.00087] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 05/27/2015] [Indexed: 11/16/2022] Open
Abstract
Experts in personality psychology and personality disorders have long emphasized the pervasive and persistent detrimental impact of maladaptive personality traits on mental health and functioning. However, in routine psychiatric practice, maladaptive personality is readily ignored and personality traits are seldom incorporated into clinical guidelines. The aim of this narrative review is to outline how pervasively personality influences public mental health and how personality thereby challenges common psychiatric practice. A comprehensive search and synthesis of the scientific literature demonstrates that maladaptive personality traits and personality disorders, in particular high neuroticism and negative affectivity, first, are risk factors for divorce, unemployment, and disability pensioning; second, relate to the prevalence, incidence, and co-occurrence of common mental disorders; third, impair functioning, symptom remission, and recovery in co-occurring common mental disorders; and fourth, predispose to treatment resistance, non-response and poor treatment outcome. In conclusion, maladaptive personality is not only involved in the development and course of mental disorders but also predisposes to chronicity and re-occurrence of psychopathology and reduces the efficacy of psychiatric treatments. The pernicious impact of maladaptive personality on mental health and functioning demands that careful assessment and thorough consideration of personality should be compulsory in psychiatric practice.
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Affiliation(s)
- Michael Pascal Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW) , Zurich , Switzerland
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Flett GL, Hewitt PL, Heisel MJ. The Destructiveness of Perfectionism Revisited: Implications for the Assessment of Suicide Risk and the Prevention of Suicide. REVIEW OF GENERAL PSYCHOLOGY 2014. [DOI: 10.1037/gpr0000011] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although perfectionism is recognized as a factor that is linked with suicide, we maintain that the role of perfectionism as an amplifier of the risk of suicide has been underestimated due to several factors. In the current article, contemporary research on the role of perfectionism in suicide is reviewed and summarized. Several themes are addressed, including: (a) consistent evidence linking suicide ideation with chronic exposure to external pressures to be perfect (i.e., socially prescribed perfectionism); (b) the roles of perfectionistic self-presentation and self-concealment in suicides that occur without warning; and (c) how perfectionism contributes to lethal suicide behaviors. We also summarize data showing consistent links between perfectionism and hopelessness and discuss the need for a person-centered approach that recognizes the heightened risk for perfectionists who also tend to experience hopelessness, psychache, life stress, overgeneralization, and a form of emotional perfectionism that restricts the willingness to disclose suicidal urges and intentions. It is concluded that when formulating clinical guidelines for suicide risk assessment and intervention and public health approaches to suicide prevention, there is an urgent need for an expanded conceptualization of perfectionism as an individual and societal risk factor. We also discuss why it is essential to design preventive programs tailored to key personality features with specific components that should enhance resilience and reduce levels of risk among perfectionists who hide behind a mask of apparent invulnerability.
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Affiliation(s)
- Gordon L. Flett
- Department of Psychology, LaMarsh Centre for Child and Youth Research, York University
| | - Paul L. Hewitt
- Department of Psychology, University of British Columbia
| | - Marnin J. Heisel
- Department of Epidemiology and Biostatistics, Western University
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Perfectionism, Stress, Daily Hassles, Hopelessness, and Suicide Potential in Depressed Psychiatric Adolescents. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2014. [DOI: 10.1007/s10862-014-9427-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ritter K, Moore TM. A Time-Series Study of Depression Using Cognitive-Behavioral Techniques Subsequent to Short-Term Psychodynamic Psychotherapy. Clin Case Stud 2012. [DOI: 10.1177/1534650112461172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined the sequential use of two distinct treatment modalities in the care of a client with depression and comorbid anxiety. The client was initially treated with 16 sessions of short-term psychodynamic psychotherapy (STPP) followed by seven sessions of cognitive-behavioral therapy (CBT). Simulation modeling analysis was used to assess the symptom changes across both treatment phases. Symptoms tracked included level of self-esteem, degree of sadness, and overall distress. Results indicated that the client did not experience any significant changes in response to STPP, but did experience a reduction in distress and sadness, and an increase in self-esteem subsequent to CBT. This study highlights the importance of clinical flexibility in cases in which a particular treatment modality may not be effective. Complicating factors and implications are also discussed.
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Biering P, Jensen VH. The concept of patient satisfaction in adolescent psychiatric care: a qualitative study. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2012; 23:143-50. [PMID: 20796097 DOI: 10.1111/j.1744-6171.2010.00236.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PROBLEM Few studies have asked how adolescents perceive the quality of psychiatric care. Therefore, the aim of the study was to explore adolescents' perception of quality of care and of satisfying treatment outcomes. METHODS Fourteen adolescents participated in this hermeneutic study. FINDINGS Several concepts describing adolescents' perspective of quality of care were found: secure place, tough love, peer solidarity, self-expression, and person not patient. Concepts describing satisfying treatment outcomes fell into four categories: improved mental health, personal development, strengthening of the self, and improved family relations. CONCLUSIONS By casting light on users' perspectives, the study offers guidance for improvement of quality of care and for the development of patient satisfaction instruments.
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Affiliation(s)
- Páll Biering
- Faculty of Nursing, School of Health Science, University of Iceland, Iceland.
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Roxborough HM, Hewitt PL, Kaldas J, Flett GL, Caelian CM, Sherry S, Sherry DL. Perfectionistic self-presentation, socially prescribed perfectionism, and suicide in youth: a test of the perfectionism social disconnection model. Suicide Life Threat Behav 2012; 42:217-33. [PMID: 22380005 DOI: 10.1111/j.1943-278x.2012.00084.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The role of interpersonal components of perfectionism in suicide outcomes among youth was assessed and the Perfectionism Social Disconnection Model (PSDM) was tested by determining whether the links between socially prescribed perfectionism (SPP) and perfectionistic self-presentation (PSP) and suicide outcomes are mediated by experiences of social disconnection, as indicated by social hopelessness and being bullied. PSP, trait perfectionism, suicide outcomes, and experiences of being bullied and social hopelessness were measured in 152 psychiatric outpatient children and adolescents. Correlational tests confirmed that PSP and SPP were associated with suicide outcomes and these interpersonal perfectionism components were associated significantly with bullying and social hopelessness. Support was also obtained for the PSDM. The relationship between the PSP facets, particularly nondisplay of imperfections, and suicide outcomes were mediated by being bullied. Additionally, the relationship between all interpersonal components of perfectionism and suicide risk was mediated by social hopelessness. Theoretical and clinical implications of interpersonal components of perfectionism and social disconnection in suicide outcomes for youth are discussed.
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Hankin BL, Abela JR. Nonsuicidal self-injury in adolescence: prospective rates and risk factors in a 2½ year longitudinal study. Psychiatry Res 2011; 186:65-70. [PMID: 20807667 PMCID: PMC3008214 DOI: 10.1016/j.psychres.2010.07.056] [Citation(s) in RCA: 196] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 06/16/2010] [Accepted: 07/31/2010] [Indexed: 10/19/2022]
Abstract
Little is known about which risk factors longitudinally predict non-suicidal self-injury (NSSI) during adolescence, a period when these self-injurious behaviors become alarmingly prevalent. We prospectively studied the rates, course, and longitudinal prediction of NSSI from early through middle adolescence with a community sample of 103 youth (ages 11-14) who were assessed for NSSI at baseline and 2 ½ years later (94% retention; final N=97). Multiple risk factors (temperament, cognitive and interpersonal vulnerabilities, stressors; youths' and mothers' depression) were examined as prospective predictors of NSSI over the 2½ year follow-up. Analyses showed that 18% of youth engaged in NSSI over the 2½-year follow-up; 14% for the first time. Distal risks (assessed at baseline) that differentiated youth who engaged in NSSI from those who did not included negative cognitive style and mothers' prior depression. Proximal factors (assessed 2 years after baseline) that differentiated NSSI from non-NSSI youth included stressors, depressive symptoms, poor relationship quality, excessive reassurance seeking, and mothers' onset of depression. Several of these factors predicted new engagement of NSSI over 2½ years.
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Affiliation(s)
- Benjamin L. Hankin
- Department of Psychology, University of Denver, Denver, CO, USA,Corresponding author. Department of Psychology, University of Denver, 2155 South Race St., Denver CO 80208. Tel. +1 303-871-7468.
| | - John R.Z. Abela
- Department of Psychology, Rutgers University, New Brunswick, NJ, USA
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Perfectionism, Coping, Social Support, and Depression in Maltreated Adolescents. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2011. [DOI: 10.1007/s10942-011-0132-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Perfectionistic Automatic Thoughts and Psychological Distress in Adolescents: An Analysis of the Perfectionism Cognitions Inventory. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2011. [DOI: 10.1007/s10942-011-0131-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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