Influence of stressors and possible pathways of onset of seventh graders' suicidal ideation in urban and rural areas in Taiwan

Parent-child attachment mediates the association between parental conflict perceptions and suicide intention: a cross-sectional survey among middle school students in China

Introduction

Adolescent suicide is a prevalent issue globally, with various factors contributing to this phenomenon. This study aimed to investigate these factors and their interrelationships to better understand the causes of adolescent suicide and provide evidence for its prevention.

Methods

This study conducted among middle school students in Liaoning Province, China, from April to May 2016, A cross-sectional survey was administered to 1,028 students aged 10-19, using instruments such as the Behavior Questionnaire-Revised (SBQ-R), Children's Perception of Interparental Conflict Scale (CPIC), and revised version of Inventory of Parent Attachment (IPPA-R).

Result

Binary logistic regression analysis revealed that adolescents aged 15-19, adolescents with strong perceptions of parental conflict were at high risk of suicide intention. Adolescents living in rural areas, adolescents with high mother-child attachment, adolescents with high father-child attachment were at low risk of suicide intention. Furthermore, parent-child attachment played a mediating role between two dimensions of parental conflict perception (resolved situations and response effect) and suicide intention.

Discussion

The study concludes that adolescents living in urban areas, older adolescents, adolescents with a high level of parental conflict intensity, and those with low levels of parent-child attachment are at high risk of suicide intention. parent-child attachment played a mediating role between two dimensions of parental conflict perception (resolved situations and response effect) and suicide intention. Interventions aimed at reducing family conflicts and improving parent-child relationships are recommended to decrease the incidence of adolescent suicide.

Prevalence and Correlates of Suicide and Nonsuicidal Self-injury in Children: A Systematic Review and Meta-analysis

IMPORTANCE

Considerably less is known about self-injurious thoughts and behaviors (SITBs) in preadolescence than older age groups, owing partly to the common view that young children are incapable of suicidal thoughts. Yet, preadolescent suicide has increased in recent years and is now the fifth leading cause of death in this age group, leading the National Institute of Mental Health to identify it as a priority for research and intervention.

OBJECTIVE

To assess prevalence estimates of preadolescent SITBs, identify correlates of these outcomes, and conduct head-to-head comparisons of preadolescent and adolescent SITBs in terms of associated characteristics.

DATA SOURCES

MEDLINE, PsycINFO, and Embase were systematically searched from inception through December 23, 2021, for studies on the prevalence and correlates of preadolescent SITBs. The search was restricted to English language publications and peer-reviewed journals.

STUDY SELECTION

Two reviewers independently identified studies providing data on prevalence and correlates of preadolescent SITBs.

DATA EXTRACTION AND SYNTHESIS

Two reviewers independently extracted data from each study, and the Joanna Briggs Institute Checklist for Prevalence Studies was used to assess study quality. Pooled prevalence and Cohen d were derived from random-effects meta-analyses. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed.

MAIN OUTCOMES AND MEASURES

Prevalence and correlates of suicidal ideation, suicide attempts, suicide deaths, and nonsuicidal self-injury among preadolescents.

RESULTS

Fifty-eight studies with 626 486 590 individuals were included. Lifetime prevalence of suicide in the general population was 0.79 per 1 million children. Prevalence for lifetime suicidal thoughts, suicide attempts, and nonsuicidal self-injury among preadolescents were 15.1%, 2.6%, and 6.2%, respectively, in community samples. These data suggest that approximately 17.0% of preadolescents with suicidal ideation transition to attempting suicide. Across several analyses, male individuals appear more likely to have SITBs in preadolescence than adolescence. Correlate data were modest for SITBs other than suicidal ideation, but among specific disorders, attention-deficit/hyperactivity disorder (suicidal ideation: d = 0.54 [95% CI, 0.34-0.75]) and depression (suicidal ideation: d = 0.90 [95% CI, 0.71-1.09]; suicide attempts: d = 0.47 [95% CI, 0.26-0.68]) emerged as the strongest correlates. Among interpersonal factors, child maltreatment (suicidal ideation: d = 2.62 [95% CI, 1.56-3.67]) and parental support (suicidal ideation: d = -0.34 [95% CI, -0.46 to -0.22]) yielded the largest effect sizes.

CONCLUSIONS AND RELEVANCE

In this systematic review anda meta-analysis, although preadolescent suicide deaths were rare, other SITB types occur with concerning frequency. Male individuals were at greater risk for SITBs in preadolescence relative to adolescence. Attention-deficit/hyperactivity disorder, child maltreatment, and parental support were especially relevant to suicidal ideation, as well as depression for suicidal thoughts and behaviors, in this age group. Further study, especially of SITBs other than suicidal ideation, is needed.

Influence of humor expression on suicidal ideation among adolescents: mediating effects of depressive emotion and positive emotion

BACKGROUND

The occurrence and degree of suicidal ideation during the past month in adolescents should be regarded seriously. Several studies have noted that humor expression style and depressive emotion may influence adolescents' suicidal ideation. However, there is insufficient evidence concerning whether positive emotion reduces such suicidal ideation in adolescents. In addition, the relationships among humor expression, depressive emotion, positive emotion and suicidal ideation remain to be confirmed. Therefore, in this study, we aimed to test the mediating roles of depressive emotion and positive emotion in the relationship between humor expression and recent adolescent's suicidal ideation.

METHODS

A total of 1551 students in junior high school completed questionnaires. The collected data were analyzed using structural equation modeling (SEM) with LISREL 8.80 and Monte Carlo resampling with R.

RESULTS

The results indicate that suicidal ideation in adolescents during the past month was related not only to humor expression but also to depressive emotion and positive emotion. The stronger the depressive emotion felt, the stronger the suicidal ideation; in contrast, the stronger the positive emotion, the weaker the suicidal ideation. Moreover, depressive emotion and positive emotion were found to mediate the relationship between humor expression and suicidal ideation; additionally, positive emotion was found to mediate the relationship between depressive emotion and suicidal ideation.

CONCLUSION

These results highlight that depressive emotion and positive emotion may mediate the influence of humor expression on suicidal ideation among adolescents, and positive emotion may mediate the influence of depressive emotion on suicidal ideation. More attention should be paid to decreasing adolescents' self-deprecating humor expression and depressive emotion, whereas more witty response humor expression and positive emotion should be encouraged to prevent their suicidal ideation.

Translation and Psychometric Analysis of the Chinese Version of the Dutch Eating Behavior Questionnaire for Children (DEBQ-C) in Taiwanese Preadolescents

PURPOSE

This study aimed to translate and evaluate the psychometric properties of a Chinese version of the (DEBQ-C) among Taiwanese preadolescents.

DESIGN AND METHODS

The DEBQ-C was translated into Mandarin Chinese (CDEBQ-C) using established translation and back-translation methods and reviewed by an expert panel for cultural equivalence. A convenience sample of 349 preadolescents was randomly split to conduct exploratory factor analysis (EFA) on the first half and confirmatory factor analysis (CFA) on the second. Internal consistency estimates for subscales were evaluated using Cronbach's alpha. Construct validation with academic stress, a theoretically related construct, was also examined.

RESULTS

The theoretical dimensions of the original DEBQ-C were supported with an EFA that revealed the presence of three factors with 41.23% variance explained, and model fit was confirmed by CFA. Construct validation was supported by positive correlations with academic stress. Each subscale of the CDEBQ-C demonstrated satisfactory internal consistency (Cronbach's alpha = 0.72-0.86). Overweight/obese preadolescents scored significantly higher on restrained eating compared to other weight groups.

CONCLUSIONS

The findings suggest that the CDEBQ-C is a psychometrically valid and reliable instrument for assessing overeating tendencies with Taiwanese preadolescents. Replication studies with greater diversity in age, ethnicity, and weight are needed to provide further evidence of construct validity for the CDEBQ-C.

PRACTICE IMPLICATIONS

Clinicians and researchers can use the CDEBQ-C to assess or expand the knowledge of children's overeating. At-risk preadolescents can be identified at an early stage and effective and individualized intervention programs may be designed and facilitated.

Disentangling the effects of depression on trajectories of sleep problems from adolescence through young adulthood

BACKGROUND

Little is known about the differential influences of between- and within-person effects of depression as well as its long-term impacts on sleep problems in adolescents. This study aims to disentangle these differences by estimating three effects of depression (i.e., long-term, immediate, and fluctuating).

METHODS

The sample included 1345 males and 1283 females in Taiwan. In multilevel models, the between- (i.e., long-term and immediate) and within-person (i.e., fluctuating) effects were estimated by using the average and time-varying scores of depression, respectively. The interactions between long-term and the other effects were also tested to determine the moderating effects of long-term influences.

RESULTS

Significant immediate and long-term effects of depression were found for both sexes, indicating that adolescents with higher levels of depression were at increased risks for future sleep problems. For females only, the long-term effects further exacerbated the negative influences of immediate effects of depression on sleep problems. Moreover, the fluctuating effects were found to change over time in females and the influences were more pronounced in young adulthood.

LIMITATIONS

The self-reported measures of both depression and sleep problems may produce common method variance and bias the results. Our measurements were adapted from various existing scales to increase their applicability; therefore, the internal consistency was not high.

CONCLUSIONS

Our findings provide insight regarding who is at risk for sleep problems and when this risk would occur based on the effects of depression. They also highlight the importance of both immediate and long-term effects of depression on development of sleep problems.

Coping strategies of Taiwanese children with autism spectrum disorders

AIMS AND OBJECTIVES

To explore and describe the coping experiences of children with autism spectrum disorders in Taiwan.

BACKGROUND

Children with autism spectrum disorders are faced with daily social and living challenges, which can cause stress. Chinese culture emphasises discipline and obedience, which may influence coping strategies of children with autism spectrum disorders in Taiwan.

DESIGN

This qualitative study employed an exploratory descriptive design.

METHOD

Data were collected from in-depth, face-to-face structured interviews. Interviews explored coping strategies of Taiwanese school-aged children (aged 6-19) with autism spectrum disorders. Children (N = 17) and their caregivers were recruited by purposive sampling. Transcribed interview data were thematically analysed using the procedure of Miles and Huberman.

RESULT

Five themes emerged from the analysis of the data, which described the coping strategies of the children: (1) problem-solving, (2) acting-out, (3) avoidance, (4) seeking help and (5) self-regulation. These themes included multiple coping strategies, which employed the concepts of engagement and disengagement.

CONCLUSIONS

The children with autism spectrum disorder used many strategies to cope with the stresses resulting from behaviours and symptoms associated with the disorder. Most of the Taiwanese children use both problem-solving and emotional-focused coping strategies.

RELEVANCE TO CLINICAL PRACTICE

Understanding coping strategies of children with autism spectrum disorder could help caregivers (parents, teachers) and medical professionals develop interventions to reduce these challenges, which could alleviate stress and improve social functioning for these children.