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Wang Y, Liu J, Chen S, Zheng C, Zou X, Zhou Y. Exploring risk factors and their differences on suicidal ideation and suicide attempts among depressed adolescents based on decision tree model. J Affect Disord 2024; 352:87-100. [PMID: 38360368 DOI: 10.1016/j.jad.2024.02.035] [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: 08/09/2023] [Revised: 02/04/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Suicide has been recognized as a major global public health issue. Depressed adolescents are more prone to experiencing it. We explore risk factors and their differences on suicidal ideation and suicide attempts to further enhance our understanding of suicidal behavior. METHODS 2343 depressed adolescents aged 12-18 from 9 provinces/cities in China participated in this cross-sectional study. We utilized decision tree model, incorporating 32 factors encompassing participants' suicidal behavior. The feature importance of each factor was measured using Gini coefficients. RESULTS The decision tree model demonstrated a good fit with high accuracy (SI = 0.86, SA = 0.85 and F-Score (SI = 0.85, SA = 0.83). The predictive importance of each factor varied between groups with suicidal ideation and with suicide attempts. The most significant risk factor in both groups was depression (SI = 16.7 %, SA = 19.8 %). However, factors such as academic stress (SI = 7.2 %, SA = 1.6 %), hopelessness (SI = 9.1 %, SA = 5.0 %), and age (SI = 7.1 %, SA = 3.2 %) were more closely associated with suicidal ideation than suicide attempts. Factors related to the schooling status (SI = 3.5 %, SA = 10.1 %), total years of education (SI = 2.6 %, SA = 8.6 %), and loneliness (SI = 2.3 %, SA = 7.4 %) were relatively more important in the suicide attempt stage compared to suicidal ideation. LIMITATIONS The cross-sectional design limited the ability to capture changes in suicidal behavior among depressed adolescents over time. Possible bias may exist in the measurement of suicidal ideation. CONCLUSION The relative importance of each risk factor for suicidal ideation and attempted suicide varies. These findings provide further empirical evidence for understanding suicide behavior. Targeted treatment measures should be taken for different stages of suicide in clinical interventions.
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Affiliation(s)
- Yang Wang
- College of Management, Shenzhen University, Shenzhen, China
| | - Jiayao Liu
- College of Management, Shenzhen University, Shenzhen, China
| | - Siyu Chen
- College of Management, Shenzhen University, Shenzhen, China
| | - Chengyi Zheng
- College of Management, Shenzhen University, Shenzhen, China
| | - Xinwen Zou
- School of Business Informatics and Mathematics, University of Mannheim, Mannheim, Germany
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China.
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Bahali K, Durcan G, Topal M, Önal BS, Bilgiç A, Tanıdır C, Aytemiz T, Yazgan Y. Parental attachment and childhood trauma in adolescents engaged in non-suicidal self-injury. Early Interv Psychiatry 2024; 18:173-180. [PMID: 37438893 DOI: 10.1111/eip.13452] [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: 12/13/2022] [Revised: 06/06/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023]
Abstract
AIM In this study, it was aimed to compare parental attachment and childhood traumas in adolescents with NSSI with healthy peers. METHODS Fifty adolescents aged 14-18 years with lifetime NSSI and 56 healthy peers were included in the study. Inventory of Statements About Self-injury (ISAS), The Parental Bonding Instrument (PBI) and Child Trauma Questionnaire (CTQ-28) scales were used. RESULTS Eighty-two percentage of the NSSI group and 70% of the control group were girls. The mean age was 15.6 ± 1.1 years in the NSSI group and 15.3 ± 0.9 years in the control group. There was no significant difference between the groups in terms of age and gender. The NSSI group had more negative scores than the control group in terms of childhood traumas and attachment characteristics to both mother and father. The analyses showed that mother PBI care/control and sexual abuse score had a relationship with both ISAS Autonomic Functions and ISAS Social Functions scores. CONCLUSIONS These results suggest that secure attachment with the mother may be protective for both the autonomic and social functions of the NSSI. Therefore, interventions for dysfunctional parental attachment may prevent the development of NSSI.
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Affiliation(s)
- Kayhan Bahali
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Gizem Durcan
- Department of Child and Adolescent Psychiatry, Medical Faculty of Cerrahpasa, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Melike Topal
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Basaksehir Cam ve Sakura Research and Training Hospital, Istanbul, Turkey
| | - Bedia Sultan Önal
- Department of Child and Adolescent Psychiatry, Medical Faculty, Giresun University, Giresun, Turkey
| | - Ayhan Bilgiç
- Faculty of Medicine, Izmir University of Economics, İzmir, Turkey
| | - Canan Tanıdır
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Tuğçe Aytemiz
- Child and Adolescent Psychology Laboratory, University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Yankı Yazgan
- Department of Child and Adolescent Psychiatry, Güzel Günler Clinic, Istanbul, Turkey
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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Koh YS, Shahwan S, Jeyagurunathan A, Abdin E, Vaingankar JA, Chow WL, Chong SA, Subramaniam M. Prevalence and correlates of suicide planning and attempt among individuals with suicidal ideation: Results from a nationwide cross-sectional survey. J Affect Disord 2023; 328:87-94. [PMID: 36791970 DOI: 10.1016/j.jad.2023.02.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Suicidality spans from having suicidal ideation to planning and making an attempt. However, not all individuals with suicidal thoughts will proceed to plan or attempt suicide. Our study investigated (i) the prevalence of suicide planning and attempt among those with suicidal ideation and (ii) their associations with sociodemographic characteristics, mental disorders, adverse childhood events and prior suicidal behaviour. METHOD This cross-sectional analysis utilised data from Singapore Mental Health Study 2016. Only respondents with suicidal ideation were included. A total of 411 and 365 individuals were examined to establish the prevalence of suicide planning and attempt respectively. Multivariable logistic regressions were performed to determine associations. RESULTS The prevalence of suicide planning and attempt were 17.7 % and 10.6 % respectively, with >80.0 % occurring within a year of suicidal ideation. Suicide planning was more likely among those who had mood disorders. Suicide attempt was more likely for those were currently married, had lower educational qualifications, history of anxiety disorders, history of emotional neglect and parental separation. LIMITATIONS Recall bias may be present because the age of onset for various mental disorders and suicidal behaviours were self-reported. As suicide was criminalised when the study was conducted, the prevalence of suicidal behaviours may have been underestimated. CONCLUSION Individuals at risk of suicide planning and attempt should be identified early since most of them progressed within a year. Findings suggest the importance of including prior suicide behaviour and history of dysfunctional family and emotional abuse in suicide risk assessment and intervention.
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Affiliation(s)
- Yen Sin Koh
- Research Division, Institute of Mental Health, Singapore, Singapore.
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Han K, Ji L, Chen C, Hou B, Ren D, Yuan F, Liu L, Bi Y, Guo Z, Wu N, Feng M, Su K, Wang C, Yang F, Wu X, Li X, Liu C, Zuo Z, Zhang R, Yi Z, Xu Y, He L, Shi Y, Yu T, He G. College students’ screening early warning factors in identification of suicide risk. Front Genet 2022; 13:977007. [DOI: 10.3389/fgene.2022.977007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
This study aimed to explore the main influencing factors of suicide risk among Chinese students and establish an early warning model to provide interventions for high-risk students. We conducted surveys of students in their first and third years from a cohort study at Jining Medical College. Logistic regression models were used to screen the early warning factors, and four machine learning models were used to establish early warning models. There were 8 factors related to suicide risk that were eventually obtained through screening, including age, having a rough father, and CES-D, OHQ, ASLEC-4, BFI-Neuroticism, BFI-Openness, and MMC-AF-C scores. A random forest model with SMOTE was adopted, and it verified that these 8 early warning signs, for suicide risk can effectively predict suicide risk within 2 years with an AUC score of 0.947. Among the factors, we constructed a model that indicated that different personality traits affected suicide risk by different paths. Moreover, the factors obtained by screening can be used to identify college students in the same year with a high risk of suicide, with an AUC score that reached 0.953. Based on this study, we suggested some interventions to prevent students going high suicide risk.
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Colmenero-Navarrete L, García-Sancho E, Salguero JM. Relationship Between Emotion Regulation and Suicide Ideation and Attempt in Adults and Adolescents: A Systematic Review. Arch Suicide Res 2022; 26:1702-1735. [PMID: 34821201 DOI: 10.1080/13811118.2021.1999872] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Suicide is one of the main causes of death in adults and adolescents, so research focused on identifying risk factors for suicidal behavior is needed. In recent years, emotion regulation, mainly the presence of difficulties regulating one's own negative emotions, has been associated with negative mental health outcomes. OBJECTIVE The purpose of this study was to systematically review the available evidence on the association between emotion regulation and suicide (ideation and attempt) in both adults and adolescents. METHOD A systematic search of scientific articles published in English and Spanish was carried out through the databases PsycINFO, MEDLINE, Scopus, and the Cochrane Library. RESULTS We identified 76 eligible studies, of which 70 reported that people with difficulties in emotion regulation reported higher levels of suicide ideation and more suicide attempts. The results were consistent in adolescents and adults, in clinical and general population samples, and when studies assessed both emotion regulation processes and strategies. However, few studies were longitudinal and most of them were with women. CONCLUSIONS We discuss the theoretical implications of the results, suggesting that actual psychological models might benefit from considering individual differences in ER in understanding why people engage in suicide behavior. Clinical implications are also discussed.HIGHLIGHTSDifficulties regulating one's emotions is associated with suicide behavior (SI and SA).Consistent results at all the ages and in the clinical and general population.Individual differences in ER could help researchers to understand suicide.
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Alvarez-Subiela X, Castellano-Tejedor C, Villar-Cabeza F, Vila-Grifoll M, Palao-Vidal D. Family Factors Related to Suicidal Behavior in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9892. [PMID: 36011528 PMCID: PMC9408664 DOI: 10.3390/ijerph19169892] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
Objective: This research aims to investigate what type of family patterns (specifically attachment, bonding and family functioning) and stressful life events can trigger or protect adolescents from developing suicidal behavior. Methods: For these purposes, a case-control study (adolescents with suicidal behavior vs. paired adolescents with no suicidal behavior) was conducted with one hundred 12 to 17-year-old adolescents (50 controls, 50 cases, 74% females), assessed between 2018 and 2020. Results: Negligent (p < 0.001) or affection-less control bonding (p < 0.001), insecure attachment (p = 0.001) and stressful life events (p < 0.001) revealed to be significant risk factors for suicidal behavior. On the contrary, parents’ care (p < 0.001) and security (p < 0.001) were revealed as protective factors for suicidal behavior. Conclusions: Considering these results, family interventions and improving coping skills seem to be two essential targets for any suicide prevention intervention in adolescents.
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Affiliation(s)
- Xavier Alvarez-Subiela
- Suicide Conduct Unit, Psychiatry and Psychology Department, Sant Joan de Déu Hospital, 08950 Esplugues del Llobregat, Spain
- Doctoral Program in Psychiatry, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Carmina Castellano-Tejedor
- Research Group on Stress and Health (GIES), Department of Basic Psychology, Faculty of Psychology, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain
- RE-FIT Research Group, Parc Sanitari Pere Virgili & Vall d’Hebron Institute of Research, 08023 Barcelona, Spain
| | - Francisco Villar-Cabeza
- Suicide Conduct Unit, Psychiatry and Psychology Department, Sant Joan de Déu Hospital, 08950 Esplugues del Llobregat, Spain
| | - Mar Vila-Grifoll
- Suicide Conduct Unit, Psychiatry and Psychology Department, Sant Joan de Déu Hospital, 08950 Esplugues del Llobregat, Spain
| | - Diego Palao-Vidal
- Doctoral Program in Psychiatry, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain
- Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, 08208 Barcelona, Spain
- Department of Mental Health, University Hospital Parc Taulí, Sabadell, 08208 Barcelona, Spain
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Risk and Protective Factors Associated with Suicidal Thoughts and Behaviors Among Maryland Middle School Students. SCHOOL MENTAL HEALTH 2022; 14:1024-1043. [PMID: 35669255 PMCID: PMC9145114 DOI: 10.1007/s12310-022-09521-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 11/25/2022]
Abstract
The aim of this study was to identify independent risk and protective factors associated with self-reported suicidal thoughts and behaviors (STB) among young adolescents by examining self-report data on mental health, substance abuse, violence involvement, social and economic challenges and supports, physical health and demographics in relation to STB. Data from nearly 27,000 students who completed the 2018-19 Maryland Middle School Youth Risk Behavior Survey/Youth Tobacco Survey (YRBS/YTS) were used to identify independent risk and protective factors associated with STB among middle school students (grades 6–8; ages 11-14). Twenty-three percent of students reported lifetime suicidal ideation and nine percent reported lifetime attempt(s). Independent risk factors associated with STB include depression, substance abuse or misuse, violence involvement, bullying victimization at school or electronically, sexual activity, and sleep deprivation. Protective factors include having an adult outside of school to confide in and feeling that teachers care and provide encouragement. Interactive effects by gender and/or race/ethnicity were observed for some factors in relation to STB. These results suggest that evidence-based programs and policies at the universal and selective/indicated levels in school settings are needed and should be introduced earlier on to address the widespread prevalence of STB in young adolescents. Program planners should take into consideration social, cultural and language needs when implementing and developing intervention strategies.
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Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry 2021; 12:628252. [PMID: 34759846 PMCID: PMC8573252 DOI: 10.3389/fpsyt.2021.628252] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria.,Department of Child and Adolescent Psychiatry and Psychotherapy, Regional Psychiatric Hospital, Mauer, Austria
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Nagamitsu S, Mimaki M, Koyanagi K, Tokita N, Kobayashi Y, Hattori R, Ishii R, Matsuoka M, Yamashita Y, Yamagata Z, Igarashi T, Croarkin PE. Prevalence and associated factors of suicidality in Japanese adolescents: results from a population-based questionnaire survey. BMC Pediatr 2020; 20:467. [PMID: 33023527 PMCID: PMC7542337 DOI: 10.1186/s12887-020-02362-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/28/2020] [Indexed: 11/13/2022] Open
Abstract
Background Suicide is the leading cause of death among Japanese adolescents. However, knowledge gaps regarding contemporary demographics and factors associated with suicidality among Japanese adolescents are a major concern. This study examined the prevalence of suicidality among Japanese adolescents and investigated associated factors. Methods A population-based questionnaire survey investigating general health was administered to 22,419 adolescents aged 13–18 years. The 29-item questionnaire covered emotional status, family function, cyberbullying, suicidality, and stressors (e.g., relationships with parents/friends, school performance, and sexual identity). We conducted multiple logistic regression analysis to identify factors associated with suicidality in this population. Results The prevalence of suicidal ideation was 21.6% in males and 28.5% in females, and that of attempted suicide was 3.5% in males and 6.6% and in females. Bullying and stress related to family relationships had the strongest associations with suicidality. Exposure to cyberbullying had the highest odds ratio for both junior high (3.1, 95% confidence interval [CI] 2.1–4.4) and high school students (3.6, 95% CI 2.5–5.3). Other factors significantly associated with suicidality were sex, emotional status, and stress about relationships with friends, sexual identity, school records, and academic course. Adolescents accessed a variety of resources to cope with stressors, with the Internet being the most common resource consulted. Conclusions Suicidality is commonly experienced among Japanese adolescents. Although there are many associated risk factors, cyberbullying is of particular concern. Recognition of factors associated with adolescent suicidality will inform further research and suicide prevention efforts for healthcare providers and families.
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Affiliation(s)
- Shinichiro Nagamitsu
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi Kurume, Fukuoka, 830-0011, Japan.
| | - Masakazu Mimaki
- Department of Pediatrics, School of Medicine Teikyo University, Tokyo, Japan
| | - Kenshi Koyanagi
- Nagasaki Prefectural Center of Medicine and Welfare for Children, Isahaya, Japan
| | - Natsuko Tokita
- Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan
| | - Yoriko Kobayashi
- Clinic of International University of Health and Welfare, Otawara, Japan
| | - Ritsuko Hattori
- Faculty of Health Science Naragakuen University, Nara, Japan
| | - Ryuta Ishii
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi Kurume, Fukuoka, 830-0011, Japan
| | - Michiko Matsuoka
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi Kurume, Fukuoka, 830-0011, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, School of Medicine, University of Yamanashi, Kofu, Japan
| | | | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, USA
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Janiri D, Doucet GE, Pompili M, Sani G, Luna B, Brent DA, Frangou S. Risk and protective factors for childhood suicidality: a US population-based study. Lancet Psychiatry 2020; 7:317-326. [PMID: 32171431 PMCID: PMC7456815 DOI: 10.1016/s2215-0366(20)30049-3] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/17/2020] [Accepted: 01/30/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Childhood suicidal ideation and behaviours are poorly understood. We examined correlates of suicidality in a US population-based sample of children participating in the Adolescent Brain and Cognitive Development (ABCD) study. The ABCD study aims to examine trajectories of mental health from childhood to adulthood and collects information on multiple domains, including mental and physical wellbeing, brain imaging, behavioural and cognitive characteristics, and social and family environment. We sought to identify and rank risk and protective factors for childhood suicidal thoughts and behaviours across these multiple domains and evaluate their association with self-agreement and caregiver agreement in reporting suicidality. METHODS The ABCD sample comprises a cohort of 11 875 children aged 9-10 years. The sociodemographic factors on which the sample was recruited were age, sex, race, socioeconomic status, and urbanicity. Participants were enrolled at 22 sites, the catchment area of which encompassed over 20% of the entire US population in this age group. Multistage sampling was used to ensure both local randomisation and representativeness of sociodemographic variation of the ABCD sample. The data used in this study were accessed from the ABCD Study Curated Annual Release 2.0. Suicidal thoughts and behaviours (suicidality) in each child were evaluated through independent child and caregiver reports based on the computerized Kiddie Schedule for Affective Disorders and Schizophrenia for DSM-5 (KSADS-5). We used bootstrapped logistic regression to quantify the association between suicidal ideation and behaviours, with measures of mental and physical wellbeing, behaviour, cognition, and social and family environment in participants from the ABCD study. FINDINGS Our study sample comprised 7994 unrelated children (mean age 9·9 years [SD 0·5]; 4234 [53%] male participants) with complete data on child-reported and caregiver-reported suicidal ideas and behaviours. Overall, 673 (8·4%) children reported any past or current suicidal ideation, 75 (0·9%) had any past or current suicidal plans, and 107 (1·3%) had any past or current suicidal attempts. According to caregivers, 650 (8·1%) of the children reported any past or current suicidal ideation, 46 (0·6%) reported any past or current suicidal plans, and 39 (0·5%) reported past or current suicidal attempts. However, inter-informant agreement was low (Cohen's κ range 0·0-0·2). Regardless of informant, child psychopathology (odds ratio [OR] 1·7-4·8, 95% CI 1·5-7·4) and child-reported family conflict (OR 1·4-1·8, 95% CI 1·1-2·5) were the most robust risk factors for suicidality. The risk of child-reported suicidality increased with higher weekend screen use time (OR 1·3, 95% CI 1·2-1·7) and reduced with greater parental supervision and positive school involvement (for both OR 0·8, 95% CI 0·7-0·9). Additionally, caregiver-reported suicidality was positively associated with caregiver educational level (OR 1·3, 95% CI 1·1-1·5) and male sex in children (1·5, 1·1-2·0), and inversely associated with the number of household cohabitants (0·8, 0·7-1·0). INTERPRETATION We identified risk and protective factors that show robust and generalisable associations with childhood suicidality. These factors provide actionable targets for optimising prevention and intervention strategies, support the need to identify and treat psychopathology in school-age children, and underscore the importance of school and family interventions for childhood suicidality. FUNDING National Institutes of Health.
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Affiliation(s)
- Delfina Janiri
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Centro Lucio Bini-Aretæus, Rome, Italy
| | - Gaelle E Doucet
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Gabriele Sani
- Centro Lucio Bini-Aretæus, Rome, Italy; Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Beatriz Luna
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Paediatrics, University of Pittsburgh, Pittsburgh, PA, USA
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
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Zortea TC, Gray CM, O'Connor RC. Perceptions of Past Parenting and Adult Attachment as Vulnerability Factors for Suicidal Ideation in the Context of the Integrated Motivational-Volitional Model of Suicidal Behavior. Suicide Life Threat Behav 2020; 50:515-533. [PMID: 31763711 DOI: 10.1111/sltb.12606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 09/20/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE We aimed to investigate whether perceptions of past parenting and current attachment orientations are associated with key components of the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior. We investigated the relationship between perceptions of past parenting, attachment, suicide ideation, defeat, entrapment, coping, and resilience. METHOD A total of 730 adult participants responded to an online questionnaire comprised of psychological measures. An initial regression analysis indicated that memories of past parenting and attachment were associated with suicide ideation. Four mediation models were tested based on the IMV model, all controlling for depressive symptoms. RESULTS In the first model, attachment orientations mediated the relationships between perceptions of past parenting dimensions and defeat. In the second, defeat mediated the relationships between attachment orientations and entrapment. In the third, entrapment mediated the relationship between defeat and suicidal ideation, but coping did not moderate the defeat-entrapment relationship. In the final model, entrapment mediated the relationship between defeat and suicide ideation, with resilience moderating this relationship. CONCLUSIONS The findings are novel and congruent with the core principles of the IMV model. Clinical implications suggest the protective effect of resilience and strengthening of self-compassion attitudes to reduce the effect of insecure attachment strategies.
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Affiliation(s)
- Tiago C Zortea
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Kovacs M, George CJ. Maladaptive mood repair predicts suicidal behaviors among young adults with depression histories. J Affect Disord 2020; 265:558-566. [PMID: 31787418 PMCID: PMC7042083 DOI: 10.1016/j.jad.2019.11.091] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 09/23/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND As the rates of suicidal behaviors continue to rise, research is needed that can facilitate prevention. The present study therefore examined whether a modifiable process, dysfunctional regulation of sadness (maladaptive mood repair), predicts a range of suicidal behaviors and if its impact is affected by risk and protective factors. METHODS Young adults with histories of childhood-onset mood disorder (COMD) (n = 173) or no histories of major psychiatric illness (controls, n = 96) were followed for approximately 3 years. Self-rated questionnaires and psychiatric evaluations were administered at study entry (T1) and across the follow-up (T2) and clinicians assessed the DSM-range of non-fatal suicidal behaviors. We hypothesized that the impact of depression on suicidal behaviors was mediated by dysfunctional regulation of sadness. RESULTS At T1, 90% of the COMD group had histories of various suicidal behaviors; 63% had past suicide attempts. During follow-up, 40% exhibited suicidal behaviors; 7% reported suicide attempts. Controlling for prior suicidal behaviors, T1 maladaptive mood repair predicted suicidal behavior during the follow-up and differentiated recurrent thoughts of death from other forms of suicidality. Protective and risk factors lost their predictive power in the presence of maladaptive mood repair. LIMITATIONS Few control cases exhibited suicidal behavior during the follow-up and the high inter-correlations among several key variables constrained the models that could be fitted. CONCLUSIONS Programs to prevent suicidal behavior among high-risk individuals should include maladaptive mood repair as an intervention target. Further research is needed on whether recurrent thoughts of death constitute a valid index of suicidality.
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Affiliation(s)
- Maria Kovacs
- Department of Psychiatry, University of Pittsburgh, School of MedicineWPIC, 3811 O'Hara Street, Pittsburgh PA 15213, United States.
| | - Charles J George
- University of Pittsburgh Medical Center, Pittsburgh PA, United States
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Ngwane VE, van der Wath AE. The psychosocial needs of parents of adolescents who attempt suicide. JOURNAL OF PSYCHOLOGY IN AFRICA 2019. [DOI: 10.1080/14330237.2019.1647494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Vangi E. Ngwane
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Anna E. van der Wath
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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14
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Ohtaki Y, Doki S, Kaneko H, Hirai Y, Oi Y, Sasahara S, Matsuzaki I. Relationship between suicidal ideation and family problems among young callers to the Japanese crisis hotline. PLoS One 2019; 14:e0220493. [PMID: 31361766 PMCID: PMC6667271 DOI: 10.1371/journal.pone.0220493] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 07/17/2019] [Indexed: 01/22/2023] Open
Abstract
Previous studies have reported an association between family relationships and suicidal behavior, and found that people with high suicidal ideation are not likely to consult with others about their distress. An effective consulting service is therefore necessary for such individuals. Crisis hotlines are effective for reducing suicide risk, but their associated suicide ideation rate and odds ratio of family problems children remain unclear. The present study investigated the suicidal ideation rate and odds ratio of callers under 20 years of age (N = 24,333) with family problems to the Japanese crisis hotline in 2012. There were 5,242 (21.5%), 18,061 (74.2%), and 1,030 (4.2%) calls related to family problems, other problems, and both, respectively. The suicidal ideation rate and odds ratio of callers with family problems were 2.2% and 0.426, respectively. This result suggested that callers with family problems have a significantly lower rate and odds ratio for suicidal ideation compared with others. However, some associations with a high suicide ideation rate were found for individual items among callers with family problems such as abuse (20.4%), family breakdown (16.1%), and domestic violence (10.6%). Further studies are needed to understand the suicidal ideation of callers with family problems and develop more effective preventive strategies.
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Affiliation(s)
- Yuh Ohtaki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki prefecture, Japan
- * E-mail:
| | - Shotaro Doki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki prefecture, Japan
| | | | - Yasuhito Hirai
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki prefecture, Japan
| | - Yuichi Oi
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki prefecture, Japan
| | - Shinichiro Sasahara
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki prefecture, Japan
| | - Ichiyo Matsuzaki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki prefecture, Japan
- International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Ibaraki prefecture, Japan
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Associations between depression, anxiety, stress, hopelessness, subjective well-being, coping styles and suicide in Chinese university students. PLoS One 2019; 14:e0217372. [PMID: 31260454 PMCID: PMC6602174 DOI: 10.1371/journal.pone.0217372] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/09/2019] [Indexed: 12/13/2022] Open
Abstract
Suicide is a major public health concern worldwide. This study aimed to predict the suicidal behavior of Chinese university students by studying psychological measures such as hopelessness, orientation to happiness, meaning in life, depression, anxiety, stress, and coping styles. In November 2016, a stratified-clustered-random sampling approach was utilized to select subjects from two large public medical-related universities in Shandong province, China. This sample consisted of 2,074 undergraduate students (706 males, 1,368 females; mean age = 19.79±1.39 years). The students’ major risk factors for suicide were depression, anxiety, stress, and hopelessness, and the students’ minor risk factors included orientation to happiness and coping styles (including self-distraction, self-blame and substance use). Notably, the presence of meaning in life had a positive effect on preventing suicide and acted as a protective factor, which suggests that it is important to identify risk factors as well as protective factors relevant to the target population group in order to increase the effectiveness of counseling and suicide prevention programs.
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16
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Yang X, Daches S, George CJ, Kiss E, Kapornai K, Baji I, Kovacs M. Autonomic correlates of lifetime suicidal thoughts and behaviors among adolescents with a history of depression. Psychophysiology 2019; 56:e13378. [PMID: 31002191 DOI: 10.1111/psyp.13378] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 03/27/2019] [Accepted: 03/31/2019] [Indexed: 12/23/2022]
Abstract
Suicidal thoughts and behaviors (STBs) have been associated with emotion dysregulation and atypical responses to affective and stressful stimuli. To investigate the psychophysiology involved, we measured changes in respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP; indexing parasympathetic and sympathetic functioning, respectively) in response to stressful- and sadness-eliciting laboratory probes. Our sample included adolescents with a history of depression and STBs (n = 177), adolescents with a history of depression but no history of STBs (n = 47), and healthy controls (n = 175). The outcome of interest was the most severe form of clinician-rated STBs across the subject's lifetime. In partial support of our hypotheses, during the stressful task, adolescents with a history of depression and STBs did not evidence the RSA decrease that was exhibited by controls and displayed greater PEP shortening compared to ever-depressed adolescents with no lifetime STBs. No group differences were found in either RSA or PEP reactivity to the sadness-eliciting stimulus. As expected, severity of STBs was positively correlated with the extent of PEP shortening during the stressful task. The results suggest that adolescents with a history of depression and STBs experience blunted parasympathetic responses to stress along with compensatory efforts. Our findings contribute to a better understanding of STBs among youths and underscore that future studies should examine physiological risk factors for these psychopathological outcomes.
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Affiliation(s)
- Xiao Yang
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Shimrit Daches
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Charles J George
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Enikő Kiss
- Department of Child and Adolescent Psychiatry, University of Szeged, Szeged, Hungary
| | - Krisztina Kapornai
- Department of Child and Adolescent Psychiatry, University of Szeged, Szeged, Hungary
| | - Ildikó Baji
- Department of Child and Adolescent Psychiatry, University of Szeged, Szeged, Hungary
| | - Maria Kovacs
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Kim HHS. Parental overprotection and youth suicide behavior in low- and middle-income countries: a multilevel analysis of cross-national data. Int J Public Health 2018; 64:173-184. [PMID: 30406419 DOI: 10.1007/s00038-018-1169-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Research on youth suicide behavior has emphasized parent-child relations as a critical protective factor. This study investigates whether "too much" regulation of children, i.e., overprotection, may actually increase the likelihoods of youth suicide intent and plan. METHODS Data are drawn from the subset of the Global School-based Student Health Survey (2000-2012), consisting of children living in 48 low- and middle-income countries. Two-level hierarchical linear models are fitted to examine the potential curvilinear (U-shaped) association between parental monitoring and suicide behavior among youth. RESULTS Adjusting for individual- and country-level covariates, significant support is found for non-monotonicity specifically among boys: Greater parental involvement in male children's lives lowers both suicide ideation and suicide plan to some extent but, after certain thresholds, increases the odds of both outcomes. Results for girls, however, are much less pronounced. CONCLUSIONS In resource-poor countries marked by some of the highest teenage suicide rates in the world, overprotective parenting style is found to have negative and gendered consequences on the mental health of youth. More research is needed to confirm its replicability in economically more developed societies.
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Affiliation(s)
- Harris Hyun-Soo Kim
- Department of Sociology, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 120-750, Republic of Korea.
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18
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Systematic Literature Review of Attempted Suicide and Offspring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050937. [PMID: 29738447 PMCID: PMC5981976 DOI: 10.3390/ijerph15050937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 11/27/2022]
Abstract
Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic literature search. Results: The search resulted in a total of 1275 article titles, of which all abstracts were screened. Out of these, 72 full text papers were read, and a final four articles were included. Three of the included papers described parts of the same study from an emergency department in The Hague, where a protocol was implemented for monitoring and referring children of parents attempting suicide. The fourth article described the association between maternal attempted suicide and risk of abuse or neglect of their children. Conclusions: The lack of research in this particular area is striking. The circumstances surrounding a parent’s suicide attempt call for appropriate familial care.
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19
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Lau P, Hawes DJ, Hunt C, Frankland A, Roberts G, Wright A, Costa DSJ, Mitchell PB. Family environment and psychopathology in offspring of parents with bipolar disorder. J Affect Disord 2018; 226:12-20. [PMID: 28942201 DOI: 10.1016/j.jad.2017.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/09/2017] [Accepted: 09/11/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of this study was to examine the relationship between family environment (cohesion and parental bonding), high-risk status, and psychopathology (internalizing and externalizing problems) among offspring of parents with bipolar disorder (BD), from the perspective of both offspring and their parents. We further tested if family environment mediated the relationship between bipolar risk status and internalizing and externalizing problems. METHOD High-risk (n = 90) BD offspring and control (n = 56) offspring aged 12-21 years old, and their parents, completed questionnaires on family cohesion and offspring internalizing and externalizing problems. Offspring also completed a parental bonding questionnaire. Group differences were examined, followed by multi-level mediation analysis with maximum likelihood and robust standard errors. RESULTS Both offspring and parents in the high-risk group reported higher levels of internalizing and externalizing problems than controls. According to offspring reports, high-risk status, lower maternal and paternal care in parental bonding, was independently associated with internalizing problems. Lower maternal care alone predicted externalizing problems. Family environment did not mediate the relationship between bipolar risk status, and offspring problems. LIMITATIONS Due to rates of missing data from parent reports of offspring psychopathology, mediation analysis was completed using offspring reports. CONCLUSIONS The offspring-report data presented indicate that low parental warmth and connection were associated with internalizing and externalizing problems as an independent risk factor, in addition to bipolar risk status. The parent-child relationship therefore warrants attention as a potential target for prevention strategies with such families.
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Affiliation(s)
- Phoebe Lau
- School of Psychology, University of Sydney, NSW, Australia
| | - David J Hawes
- School of Psychology, University of Sydney, NSW, Australia.
| | - Caroline Hunt
- School of Psychology, University of Sydney, NSW, Australia
| | - Andrew Frankland
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Randwick, NSW, Australia
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Randwick, NSW, Australia
| | - Adam Wright
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Randwick, NSW, Australia
| | - Daniel S J Costa
- Pain Management Research Institute, Royal North Shore Hospital, Australia; Sydney Medical School, University of Sydney, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Randwick, NSW, Australia
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20
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Li D, Zhang R, Liu S, Liu J, Zhang T. The Characteristics of Chinese Adolescents With Suicidal Ideation: A Mixed-Methods Approach. JOURNAL OF ADOLESCENT RESEARCH 2017. [DOI: 10.1177/0743558417723603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We conducted a mixed-methods study to explore the characteristics of Chinese adolescents with suicidal ideation, using both quantitative and qualitative data and analysis. Participants were N = 244 adolescents, who completed self-report assessments of suicidal ideation, as well as indices of psychological functioning and well-being. A subset of n = 6 high and n = 6 low suicidal ideation adolescents participated in the follow-up interviews. Among the quantitative results, as compared with adolescents with low suicidal ideation, adolescents with high suicidal ideation reported significantly higher scores for stressful life events, coping-avoidant strategies, loneliness, and depression, as well as significantly lower scores for coping-approach strategies. Among the qualitative results, adolescents with high suicidal ideation demonstrated the following characteristics: (a) most troubled by academic pressures and relations, (b) negative self-evaluations, (c) maladaptive understanding of life and death, (d) individual-oriented attributions, and (e) negative coping strategies and self-fulfilling prophesy. These findings contribute to the early identification of adolescents who are at higher risk for suicide, further expand the stress and coping model with the distress-to-meaninglessness framework, and suggest that improving positive self-evaluation may be a focus of prevention and intervention.
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Affiliation(s)
- Dan Li
- Shanghai Normal University, Shanghai, China
| | - Rongwei Zhang
- Shanghai Normal University, Shanghai, China
- Fujian Polytechnic of Information Technology, Fuzhou, China
| | | | | | - Ting Zhang
- Zhejiang Industry & Trade Vocational College, Wenzhou, China
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21
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Mackin DM, Perlman G, Davila J, Kotov R, Klein DN. Social support buffers the effect of interpersonal life stress on suicidal ideation and self-injury during adolescence. Psychol Med 2017; 47:1149-1161. [PMID: 27995812 DOI: 10.1017/s0033291716003275] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The effect of life stress on suicidal symptoms during adolescence is well documented. Stressful life events can trigger suicidality, but most adolescents are resilient and it is unclear which factors protect against the deleterious impact of stress. Social support is thought to be one such factor. Therefore, we investigated the buffering effect of specific sources of social support (parental and peer) on life stress (interpersonal and non-interpersonal) in predicting suicidal symptoms during adolescence. In order to test the specificity of this stress buffering, we also examined it with regard to dysphoric mood. METHOD Data come from the Adolescent Development of Emotions and Personality Traits (ADEPT) Project, a cohort of 550 adolescent females aged 13.5-15.5 recruited from Long Island. Self-reported social support, suicidality, and dysphoria were assessed at baseline and suicidality and dysphoria were assessed again at 9-month follow-up. Life stress was assessed by interview at the follow-up. RESULTS High levels of parental support protected adolescent girls from developing suicidal symptoms following a stressor. This effect was less pronounced for peer support. Also, social support did not buffer the pathogenic effects of non-interpersonal stress. Finally, social support did not buffer the effect of life stress on dysphoric symptoms. CONCLUSIONS Altogether, our results highlight a distinct developmental pathway for the development of suicidal symptoms involving parental support that differs from the development of dysphoria, and signifies the importance and specificity of social support in protecting against suicidality in adolescent girls.
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Affiliation(s)
- D M Mackin
- Stony Brook University,Stony Brook, NY,USA
| | - G Perlman
- Stony Brook University,Stony Brook, NY,USA
| | - J Davila
- Stony Brook University,Stony Brook, NY,USA
| | - R Kotov
- Stony Brook University,Stony Brook, NY,USA
| | - D N Klein
- Stony Brook University,Stony Brook, NY,USA
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Abstract
PURPOSE OF REVIEW This article summarizes findings from recent studies (published since 2015) examining differences between suicide attempters and suicide ideators. RECENT FINDINGS Converging evidence suggests that the capability to attempt suicide (e.g., acquired capability, painful and provocative experiences, high tolerance for pain and distress) is higher in suicide attempters than suicide ideators. Other psychosocial and biological differences have also been identified but require replication. SUMMARY Recent literature reviews find that traditional risk factors for suicide - such as depression, hopelessness, most psychiatric disorders, and even impulsivity - robustly predict suicide ideation but poorly predict suicide attempts among ideators. To address this knowledge gap, studies are increasingly employing an ideation-to-action framework. This framework views the development of suicide ideation and the progression from ideation to potentially lethal attempts as distinct processes with distinct explanations and predictors. Converging evidence suggests that factors associated with diminished fear of pain, injury, and death can increase one's capability to attempt suicide and facilitate the progression from suicidal thoughts to suicidal acts. Recent studies have also identified other variables that may differentiate attempters from ideators, but these require replication. Theories of suicide positioned within the ideation-to-action framework provide testable and promising hypotheses about the progression from ideation to attempts. These include the Interpersonal Theory, Integrated Motivational-Volitional Model, and Three-Step Theory.
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23
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Sun L, Zhou C, Xu L, Li S, Kong F, Chu J. Suicidal ideation, plans and attempts among medical college students in china: The effect of their parental characteristics. Psychiatry Res 2017; 247:139-143. [PMID: 27889604 DOI: 10.1016/j.psychres.2016.11.024] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 07/13/2016] [Accepted: 11/17/2016] [Indexed: 11/25/2022]
Abstract
Medical college students are a high-risk population of suicidal ideation, plan and attempt. However, few studies discuss the effect of parental characteristics on suicidal ideation, plans and attempts among medical college students in China. A total of 2198 respondents answered the questionnaires referring social-demographic characteristics, psychological conditions, parental characteristics, suicidal ideation, plan and attempt. The prevalence of suicidal ideation, plan and attempt among the subjects were 17.9%, 5.2% and 4.3%, respectively. The results of multiple logistic regression showed that male, mother's education level, mother's parenting style, relationship in parents and psychological condition were associated with lifetime suicidal ideation. Male, mother's vocation, mother's parenting style, relationship in parents and psychological conditions were associated with suicide plan. Male, relationship in parents and psychological condition were associated with suicide attempt. Those imply that mother may play more roles on suicidal ideation and plan than father among medical college students in China. Psychological condition has a very strong association with suicidal ideation, plan and attempt.
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Affiliation(s)
- Long Sun
- Department of Social Medicine and Health Service Management, School of Public Health, Shandong University, Jinan, China
| | - Chengchao Zhou
- Department of Social Medicine and Health Service Management, School of Public Health, Shandong University, Jinan, China.
| | - Lingzhong Xu
- Department of Social Medicine and Health Service Management, School of Public Health, Shandong University, Jinan, China
| | - Shixue Li
- Department of Social Medicine and Health Service Management, School of Public Health, Shandong University, Jinan, China
| | - Fanlei Kong
- Department of Social Medicine and Health Service Management, School of Public Health, Shandong University, Jinan, China
| | - Jie Chu
- Department for Chronic and Non-communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
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Susukida R, Wilcox HC, Mendelson T. The association of lifetime suicidal ideation with perceived parental love and family structure in childhood in a nationally representative adult sample. Psychiatry Res 2016; 237:246-51. [PMID: 26803361 DOI: 10.1016/j.psychres.2016.01.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/01/2015] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
Abstract
While perceived support from caregivers in the early stages of life is an aspect of family environment that is increasingly recognized as important for understanding lifetime suicidal behaviors, it is not well understood whether the relationship between perceived support from caregivers during childhood and lifetime suicidal behaviors holds regardless of family structure. This study examined the association between perceived love from caregivers in childhood and lifetime suicidal ideation in the National Comorbidity Survey Replication (N=5,692, 2001-2003). Multivariable logistic regression analyses were conducted to examine the association between lifetime suicidal ideation and retrospectively ascertained data on perceived love from caregivers during childhood as well as clinical and sociodemographic characteristics of study participants. Regression analyses were stratified by family structure, namely, whether or not study participants lived with two biological parents during childhood. Regardless of whether or not they lived with two biological parents during childhood, individuals who perceived love from caregivers during childhood had significantly 42-43% lower odds of lifetime suicide ideation as compared with those who did not perceive love from caregivers. Results suggest that perceived support from caregivers during childhood is an important correlate of lifetime suicidal ideation, regardless of family structure.
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Affiliation(s)
- Ryoko Susukida
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Holly C Wilcox
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Tamar Mendelson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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