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Sellers CM, Díaz-Valdés A, Porter AC, Glenn CR, Miller AB, Battalen AW, O'Brien KHM. Nonsuicidal Self-injury, Suicide Planning, and Suicide Attempts Among High-risk Adolescents Prior to Psychiatric Hospitalization. Res Child Adolesc Psychopathol 2021; 49:1503-1511. [PMID: 34059987 DOI: 10.1007/s10802-021-00830-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to understand the trajectories of nonsuicidal self-injury (NSSI) and suicide plans (SP) in the 90 days prior to inpatient hospitalization, understand the role of NSSI and SP in predicting suicide attempts (SA) on a given day, and to test the interaction between NSSI and SP in predicting same-day SA. Participants included 69 adolescents (77% female, 65% white, 77% Non-Hispanic/Latinx, Mage = 15.77 SDage = 1.00) from an inpatient psychiatric unit. Past 90 day NSSI, SP, and SA were measured using the Columbia Suicide Severity Rating Scale and Timeline Follow Back. First, mixed effect models were conducted to assess trajectories of NSSI and SP leading up to inpatient hospitalization. The odds of NSSI remained relatively stable prior to hospitalization (OR = 1.01, 95% CI [1.00,1.02]). The odds of SP increased in the 90 days prior to hospitalization (OR = 1.04, 95% CI [1.02,1.05]) with each day associated with a 4% increase in the odds of making a SP. Second, random effect models were conducted to predict the odds of same-day SA from NSSI and SP. When adolescents endorsed either NSSI (OR = 2.99, p < .001) or a SP (OR = 77.13, p < .001) there was elevated odds of same-day SA. However, the presence of both NSSI and SP on a given day did not increase risk of SA on that same day. For this high-risk clinical sample of suicidal adolescents who drink alcohol, odds of SP increased in the days leading up to psychiatric hospitalization, but NSSI remained stable. On days when adolescents reported NSSI or SP, they had an increased odds of same-day SA. These results underscore the importance of frequent monitoring of NSSI and SP among high-risk adolescents who drink alcohol to prevent suicide attempts.
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Affiliation(s)
- Christina M Sellers
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, 02115, US. .,School of Social Work, College of Social Science, Policy, and Practice (CSSPP), Simmons University, Boston, MA, 02115, US.
| | - Antonia Díaz-Valdés
- Faculty of Humanities, Society and Health Research Center, Universidad Mayor, 7750000, Santiago, Chile
| | - Andrew C Porter
- Department of Psychology, University of Rochester, Rochester, NY, 14627, US
| | - Catherine R Glenn
- Department of Psychology, University of Rochester, Rochester, NY, 14627, US.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, 14627, US.,Department of Psychology, Old Dominion University, Norfolk, VA, 23529, US
| | - Adam Bryant Miller
- Department of Psychology and Neurosciences, The University of North Carolina At Chapel Hill, Chapel Hill, NC, 27599, Raleigh, US
| | | | - Kimberly H McManama O'Brien
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, 02115, US.,Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, US
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O'Brien KHM, Nicolopoulos A, Almeida J, Aguinaldo LD, Rosen RK. Why Adolescents Attempt Suicide: A Qualitative Study of the Transition from Ideation to Action. Arch Suicide Res 2021; 25:269-286. [PMID: 31608796 DOI: 10.1080/13811118.2019.1675561] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To ameliorate the public health problem of adolescent suicide, it is imperative to go beyond simply establishing which factors increase risk. Multiple factors often interact in such a way that escalates suicide risk, and some combinations may be particularly perilous. Therefore, it is essential to examine the sequence and interplay of these various contributors to understand how they interact to confer risk. To enhance our understanding of this process, we used qualitative in-depth interviews with 20 psychiatrically hospitalized adolescents who had recently made a suicide attempt to investigate the factors that contributed to their attempts. In this qualitative analysis we 1) identified 16 separate factors that contributed to their suicide attempts, and 2) focused on the sequence and interplay between these factors in order to better understand why adolescents attempt suicide, with specific attention to which factors facilitated the transition from suicide ideation to action. Findings demonstrated that the strain caused by historical, sociocultural, and interpersonal factors alone was not enough to result in adolescents attempting suicide. For all but two participants, it was the interaction of intrapersonal factors that appeared to distort cognitions and/or elevate emotions to the point where they became intolerable and suicide became a viable option. These intrapersonal factors appeared to be the catalyst in the process from suicide ideation to action. Our findings suggest the need for specific strategies that address cognitive distortions, emotion dysregulation, and feelings of invalidation and entrapment as potential targets for interventions and prevention practices with adolescents at risk for suicide.
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Sellers CM, Díaz-Valdés A, Oliver MM, Simon KM, O'Brien KHM. The relationship between alcohol and cannabis use with nonsuicidal self-injury among adolescent inpatients: Examining the 90 days prior to psychiatric hospitalization. Addict Behav 2021; 114:106759. [PMID: 33338906 DOI: 10.1016/j.addbeh.2020.106759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/22/2020] [Accepted: 11/26/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND This study examined the trajectories of alcohol use, cannabis use, suicide planning (SP), and nonsuicidal self-injury (NSSI) prior to hospitalization and examined the role of alcohol and cannabis use, independently and jointly, in predicting NSSI on a daily level and over time. METHODS Participants included 71 adolescents hospitalized for suicide risk (75% female; 25% male; Mage = 15.79). All participants drank alcohol at least once in the prior 90-days. We conducted mixed effect models to assess the trajectories of alcohol use, cannabis use, and NSSI over the 90-days prior hospitalization. To test the effect of SP, alcohol use, and cannabis use on NSSI, we conducted logistic random effect models, while controlling for demographics. RESULTS SP (OR = 4.47, p < 0.001) and suicide ideation (SI) (OR = 10.09, p < 0.001) significantly increased the odds of engaging in NSSI. Neither cannabis nor alcohol use independently predicted the odds of engaging in NSSI, however, the co-occurrence of alcohol and cannabis use increased the odds of engaging in NSSI on a given day (OR = 30.5, p < 0.05). CONCLUSIONS Study findings extend current knowledge about the longitudinal and day-to-day relationships between alcohol and cannabis use and NSSI. Results underscore the importance of developing interventions that address polysubstance use among suicidal adolescents engaging in NSSI.
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McManama O'Brien KH, Almeida J, View L, Schofield M, Hall W, Aguinaldo L, Ryan CA, Maneta E. A Safety and Coping Planning Intervention for Suicidal Adolescents in Acute Psychiatric Care. Cognitive and Behavioral Practice 2021. [DOI: 10.1016/j.cbpra.2019.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Wyman Battalen A, Mereish E, Putney J, Sellers CM, Gushwa M, McManama O'Brien KH. Associations of Discrimination, Suicide Ideation Severity and Attempts, and Depressive Symptoms Among Sexual and Gender Minority Youth. Crisis 2020; 42:301-308. [PMID: 33034519 DOI: 10.1027/0227-5910/a000718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We examined the unique associations among discrimination, suicidal thoughts, suicide attempts, and depressive symptoms in a sample of sexual and gender minority (SGM) youth as well as interpersonal mediators of these associations. Participants included 94 SGM youth (Mage = 18; SD = 2.88) recruited from SGM-specific drop-in centers. We used mediation analyses to test the mediating effects of perceived burdensomeness and thwarted belongingness on the associations between discrimination and suicidal ideation, suicide attempts, and depressive symptoms, accounting for childhood trauma and sociodemographic variables (age, gender identity, race, and sexual orientation). Within our nonclinical community sample of SGM youth, 49% reported a lifetime suicide attempt, 84% reported current suicide ideation, and 82% reported current depressive symptoms. Experiencing discrimination was associated with greater likelihood of suicide attempts and depressive symptoms, and greater perceived burdensomeness and thwarted belongingness, over and above the effects of childhood trauma and sociodemographic variables. Discrimination was indirectly associated with greater depressive symptoms through perceived burdensomeness and thwarted belongingness, and with greater severity of suicidal ideation through perceived burdensomeness. Findings suggest clinicians should assess for discrimination and include a focus on perceived burdensomeness and thwarted belongingness as targets of intervention for suicide and depression.
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Affiliation(s)
- Adeline Wyman Battalen
- Counseling and Mental Health Services, Harvard University Health Services, Cambridge, MA, USA
| | - Ethan Mereish
- Department of Health Studies, American University, Washington, DC, USA
| | | | - Christina M Sellers
- School of Social Work, Simmons University, Boston, MA, USA.,Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
| | - Melinda Gushwa
- School of Social Work, Simmons University, Boston, MA, USA
| | - Kimberly H McManama O'Brien
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA.,Department of Health Promotion, Practice, and Innovation, Education Development Center, Waltham, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Taliaferro LA, Almeida J, Aguinaldo LD, McManama O'Brien KH. Function and progression of non-suicidal self-injury and relationship with suicide attempts: A qualitative investigation with an adolescent clinical sample. Clin Child Psychol Psychiatry 2019; 24:821-830. [PMID: 31315465 DOI: 10.1177/1359104519862340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIM To investigate the function and progression of non-suicidal self-injury (NSSI) and its relationship with suicide attempts. METHOD Qualitative in-depth interviews were conducted with 15 adolescents psychiatrically hospitalized following a suicide attempt who reported NSSI. Applied thematic analysis was used to identify and examine themes from the interview data. RESULTS Thematic analysis revealed that the primary function of NSSI was relief from emotional pain, though the function often changed over time. NSSI was often not directly related to patients' suicide attempts, yet risk of suicidal behavior seemed to increase once NSSI lost its effectiveness, and suicide became the only option. CONCLUSION Clinicians need to understand and monitor the functions of NSSI, and its relationship with suicidality, to prevent suicide attempts among adolescents.
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Affiliation(s)
- Lindsay A Taliaferro
- Department of Population Health Sciences, College of Medicine, University of Central Florida, USA
| | | | | | - Kimberly H McManama O'Brien
- Department of Health Promotion, Practice, and Innovation, Education Development Center, USA.,Department of Psychiatry, Boston Children's Hospital, USA.,Department of Psychiatry, Harvard Medical School, USA
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McManama O'Brien KH, Battalen AW, Sellers CM, Spirito A, Yen S, Maneta E, Ryan CA, Braciszeweski JM. An mHealth approach to extend a brief intervention for adolescent alcohol use and suicidal behavior: Qualitative analyses of adolescent and parent feedback. J Technol Hum Serv 2019; 37:255-285. [PMID: 31814806 PMCID: PMC6897385 DOI: 10.1080/15228835.2018.1561347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/24/2018] [Accepted: 12/18/2018] [Indexed: 06/10/2023]
Abstract
Mobile health (mHealth) tools that supplement inpatient psychiatric care can maintain and enhance intervention effects following hospitalization. Adolescents hospitalized following a suicidal event represent a vulnerable population who could greatly benefit from such an mHealth intervention. In specific, suicidal adolescents who drink alcohol are in need of robust interventions that address the bidirectional relationship between alcohol use and suicidal thoughts and behaviors, because it puts them at especially high risk for suicide upon discharge. The purpose of this study was to conduct qualitative interviews to gather feedback to improve a brief alcohol intervention provided to suicidal adolescents during psychiatric hospitalization, and to develop a mHealth tool to extend care after discharge. Participants, eight adolescents and their parents, identified the need for a smartphone application to deliver intervention content to adolescents and parents during the post-hospitalization period. Adolescents sought support in meeting alcohol- and mood-related goals, while parents desired general resources as well as tips for conversations with their adolescent about mood and alcohol use.
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Affiliation(s)
- Kimberly H McManama O'Brien
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Education Development Center, Department of Innovation in Practice and Technology, Waltham, MA, 02453, US
- Harvard Medical School, Department of Psychiatry, Boston, MA, 02115, US
| | - Adeline Wyman Battalen
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Boston College School of Social Work, Chestnut Hill, MA, 02467, US
| | - Christina M Sellers
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Boston College School of Social Work, Chestnut Hill, MA, 02467, US
| | - Anthony Spirito
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, 02912, US
| | - Shirley Yen
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, 02912, US
| | - Eleni Maneta
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Harvard Medical School, Department of Psychiatry, Boston, MA, 02115, US
| | - Colleen A Ryan
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Harvard Medical School, Department of Psychiatry, Boston, MA, 02115, US
- Children's Specialized Hospital, Department of Medicine, 200 Somerset St., New Brunswick, NJ, 08901, US
| | - Jordan M Braciszeweski
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, 48202, US
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McManama O'Brien KH, Sellers CM, Battalen AW, Ryan CA, Maneta EK, Aguinaldo LD, White E, Spirito A. Feasibility, acceptability, and preliminary effects of a brief alcohol intervention for suicidal adolescents in inpatient psychiatric treatment. J Subst Abuse Treat 2018; 94:105-112. [PMID: 30243410 DOI: 10.1016/j.jsat.2018.08.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 11/25/2022]
Abstract
Alcohol use, both short-term intoxication and longer-term use, is a notable risk factor for suicide. Despite the strong relationship between alcohol use and suicidal thoughts and behaviors, providers typically treat these two problems independently. In particular, acute psychiatric care hospitalizations for adolescents are typically brief, and many only cursorily address alcohol use. Integrating a brief motivational enhancement intervention for alcohol use into an inpatient psychiatric hospitalization treatment protocol has the potential to enhance motivation to stop or reduce drinking if adolescents can more fully understand how it increases risk for suicidal behavior. This study tested the feasibility, acceptability, and preliminary effects of the Alcohol and Suicide Intervention for Suicidal Teens (ASIST), a brief motivational enhancement intervention targeting alcohol use and suicidal thoughts and behaviors for suicidal adolescents receiving inpatient psychiatric treatment. Results from a randomized pilot trial of ASIST (N = 50) revealed that the intervention was both feasible and acceptable, with 92% of those in the ASIST condition reporting that the intervention helped them to understand how their alcohol use is related to their suicidal thoughts and behaviors. Study findings suggest a larger randomized controlled trial may be warranted to test the effectiveness of ASIST with psychiatrically hospitalized adolescents.
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Affiliation(s)
- Kimberly H McManama O'Brien
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America; Harvard Medical School, Department of Psychiatry, 25 Shattuck St., Boston, MA 02115, United States of America; Education Development Center, Department of Innovation in Practice and Technology, 43 Foundry Ave, Waltham, MA 02453, United States of America.
| | - Christina M Sellers
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Adeline Wyman Battalen
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Colleen A Ryan
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America; Children's Specialized Hospital, Department of Medicine, 200 Somerset St., New Brunswick, NJ 08901, United States of America.
| | - Eleni K Maneta
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America; Harvard Medical School, Department of Psychiatry, 25 Shattuck St., Boston, MA 02115, United States of America.
| | - Laika D Aguinaldo
- Brown University, Department of Psychiatry and Human Behavior, 121 South Main St., Providence, RI 02912, United States of America.
| | - Erina White
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America; Harvard Medical School, Department of Psychiatry, 25 Shattuck St., Boston, MA 02115, United States of America; Mightier, Boston, 200 Portland St., MA 02114, United States of America.
| | - Anthony Spirito
- Brown University, Department of Psychiatry and Human Behavior, 121 South Main St., Providence, RI 02912, United States of America.
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Sellers CM, McManama O'Brien KH, Hernandez L, Spirito A. Adolescent Alcohol Use: The Effects of Parental Knowledge, Peer Substance Use, and Peer Tolerance of Use. J Soc Social Work Res 2018; 9:69-87. [PMID: 30250635 PMCID: PMC6150601 DOI: 10.1086/695809] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Parents and peers exert significant influence on a young person's decision to consume alcohol. This study examines the relationship between parental monitoring and adolescent alcohol consumption and tests whether peer substance use and tolerance of use mediates the relationship between monitoring and drinking. METHOD Participants included 116 adolescents (53.5% female; Mage = 15.6). All participants reported drinking alcohol in the past 6 months, and 96 participants had been previously admitted to a hospital emergency department for an alcohol-related event. Mediation analyses were used to test the study hypotheses. RESULTS The total effect of baseline parental monitoring on 6-month alcohol use was -1.15 (p < .01), with higher monitoring related to less use. Controlling for peer use and tolerance of use, the effect of parental monitoring was reduced to .46, leaving an indirect effect of .69 (p < .01). Peer use and tolerance of use had no effect on participant alcohol use when controlling for parental monitoring. CONCLUSIONS Study findings extend current knowledge about the interactive effects of parental supervision and peer influence on the drinking patterns of adolescents. Results underscore the importance of addressing both parental monitoring and peer influence in interventions that target adolescent alcohol use, recognizing peer factors as a potential mechanism of the effect that parental monitoring has on adolescent drinking.
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Titelius EN, Cook E, Spas J, Orchowski L, Kivisto K, O'Brien KHM, Frazier E, Wolff JC, Dickstein DP, Kim KL, Seymour K. Emotion Dysregulation Mediates the Relationship Between Child Maltreatment and Non-Suicidal Self-Injury. J Aggress Maltreat Trauma 2018; 27:323-331. [PMID: 30369785 PMCID: PMC6108548 DOI: 10.1080/10926771.2017.1338814] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
One risk factor for non-suicidal self-injury (NSSI) in adolescents is exposure to traumatic experiences, particularly child maltreatment. However, the mechanisms through which childhood maltreatment predicts NSSI are largely unknown. Emotion dysregulation (ED) is likely an important mechanism in this relationship. Therefore, this study examined the relationship between childhood maltreatment, ED, and NSSI in a sample of adolescent inpatients (n= 53). Results demonstrated that child physical and emotional maltreatment, but not child sexual abuse, was significantly associated with NSSI frequency. More specifically, ED mediated the relationship between child physical and emotional maltreatment and NSSI frequency. Findings support the importance of ED as a mediating factor in the relationship between childhood maltreatment and NSSI behaviors and highlight the need for teaching emotion regulation skills to youth affected by trauma.
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Affiliation(s)
| | - Emily Cook
- Department of Psychology, Rhode Island College
| | - Jayson Spas
- Department of Psychology, Rhode Island College
| | - Lindsay Orchowski
- Warren Alpert Medical School of Brown University and Rhode Island Hospital
| | - Katie Kivisto
- Warren Alpert Medical School of Brown University, Rhode Island Hospital and Bradley Hospital
| | | | - Elisabeth Frazier
- Warren Alpert Medical School of Brown University, Rhode Island Hospital and Bradley Hospital
| | - Jennifer C Wolff
- Warren Alpert Medical School of Brown University, Rhode Island Hospital and Bradley Hospital
| | - Daniel P Dickstein
- Warren Alpert Medical School of Brown University, Rhode Island Hospital and Bradley Hospital
| | - Kerri L Kim
- Warren Alpert Medical School of Brown University, Rhode Island Hospital and Bradley Hospital
| | - Karen Seymour
- Warren Alpert Medical School of Brown University, Rhode Island Hospital and Bradley Hospital
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O'Brien KHM, Knight JR, Harris SK. A Call for Social Responsibility and Suicide Risk Screening, Prevention, and Early Intervention Following the Release of the Netflix Series 13 Reasons Why. JAMA Intern Med 2017; 177:1418-1419. [PMID: 28759674 DOI: 10.1001/jamainternmed.2017.3388] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Almeida J, O'Brien KHM, Norton K. Social Work's Ethical Responsibility to Train MSW Students to Work with Suicidal Clients. Soc Work 2017; 62:181-183. [PMID: 28180907 DOI: 10.1093/sw/swx011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/13/2016] [Accepted: 09/06/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Joanna Almeida
- Joanna Almeida, ScD, MPH, MSW, and Kimberly H. McManama O'Brien, PhD, LCSW, are assistant professors, School of Social Work, Simmons College, Boston. Ken Norton, LICSW, ACSW, is executive director, New Hampshire Chapter, National Alliance on Mental Illness, Concord, NH
| | - Kimberly H McManama O'Brien
- Joanna Almeida, ScD, MPH, MSW, and Kimberly H. McManama O'Brien, PhD, LCSW, are assistant professors, School of Social Work, Simmons College, Boston. Ken Norton, LICSW, ACSW, is executive director, New Hampshire Chapter, National Alliance on Mental Illness, Concord, NH
| | - Ken Norton
- Joanna Almeida, ScD, MPH, MSW, and Kimberly H. McManama O'Brien, PhD, LCSW, are assistant professors, School of Social Work, Simmons College, Boston. Ken Norton, LICSW, ACSW, is executive director, New Hampshire Chapter, National Alliance on Mental Illness, Concord, NH
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McManama O'Brien KH, LeCloux M, Ross A, Gironda C, Wharff EA. A Pilot Study of the Acceptability and Usability of a Smartphone Application Intervention for Suicidal Adolescents and Their Parents. Arch Suicide Res 2017; 21:254-264. [PMID: 27136115 DOI: 10.1080/13811118.2016.1182094] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Interconnectedness through technology presents both challenges and opportunities for suicide prevention and intervention with adolescents and families. The time following discharge from acute care facilities represents a critical period of suicide risk for adolescents, which could be buffered by a technological intervention they could use post-discharge. Crisis Care is a smartphone application intervention developed specifically for suicidal adolescents and their parents to use during this period of increased risk. A web-based prototype of Crisis Care was pilot tested with 20 adolescent-parent dyads. Results demonstrated acceptability and usability, suggesting the utility of technological interventions, such as Crisis Care, as an adjunct to treatment for suicidal adolescents and their parents following discharge from acute care settings.
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May AM, O'Brien KHM, Liu RT, Klonsky ED. Descriptive and Psychometric Properties of the Inventory of Motivations for Suicide Attempts (IMSA) in an Inpatient Adolescent Sample. Arch Suicide Res 2016; 20:476-82. [PMID: 27046630 PMCID: PMC4920692 DOI: 10.1080/13811118.2015.1095688] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Little is known about why adolescents attempt suicide. The current study examined the endorsement, structure, and clinical correlates of adolescents' suicide attempt motivations as measured by the Inventory of Motivations for Suicide Attempts (IMSA). Suicidal adolescents (n = 52) in a psychiatric unit were administered the IMSA and interviewed about their suicide attempts. Psychache, Hopelessness, and Escape were the most strongly endorsed motivations, and Interpersonal Influence the least endorsed. IMSA scales exhibited a 2-factor solution: 1) Internal and 2) Communication. Suicide intent was strongly correlated with Internal motivations and moderately inversely correlated with Communication motivations. Factor structure and mean endorsements were similar to adult samples. The IMSA is a useful measure to assess attempt motivations in adolescents.
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O'Brien KHM, Putney JM, Hebert NW, Falk AM, Aguinaldo LD. Sexual and Gender Minority Youth Suicide: Understanding Subgroup Differences to Inform Interventions. LGBT Health 2016; 3:248-51. [PMID: 27348621 DOI: 10.1089/lgbt.2016.0031] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Sexual and gender minority (SGM) youth are disproportionately affected by suicide-related thoughts and behaviors relative to their heterosexual and/or non-transgender peers. Theory and empirical evidence suggest that there are unique factors that contribute to this elevated risk, with distinguishable differences among SGM subgroups. Although SGM youth suicide prevention research is in its nascence, initial findings indicate that interventions which focus on family support and acceptance may be beneficial. It is critical that we develop and test tailored interventions for SGM youth at risk for suicide, with specific attention to subgroup differences and reductions in suicide-related thoughts and behaviors as outcomes.
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Affiliation(s)
- Kimberly H. McManama O'Brien
- Simmons School of Social Work, Boston, Massachusetts
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Jennifer M. Putney
- Simmons School of Social Work, Boston, Massachusetts
- The Fenway Institute, Boston, Massachusetts
| | - Nicholas W. Hebert
- Simmons School of Social Work, Boston, Massachusetts
- The Fenway Institute, Boston, Massachusetts
| | - Amy M. Falk
- Simmons School of Social Work, Boston, Massachusetts
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts
| | - Laika D. Aguinaldo
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts
- The Ethelyn R. Strong School of Social Work at Norfolk State University, Norfolk, Virginia
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McManama O'Brien KH, Salas-Wright CP, Vaughn MG, LeCloux M. Childhood exposure to a parental suicide attempt and risk for substance use disorders. Addict Behav 2015; 46:70-6. [PMID: 25827333 DOI: 10.1016/j.addbeh.2015.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Revised: 02/19/2015] [Accepted: 03/07/2015] [Indexed: 11/27/2022]
Abstract
Childhood exposure to parental suicidal behavior has been linked to a variety of adverse behavioral and health outcomes. However, relatively little is known about the degree to which such exposure may place individuals at risk for a substance use disorder (SUD). Employing data from the National Epidemiologic Survey on Alcohol and Related Conditions, we compared the prevalence of SUDs among those who experienced childhood exposure to parental suicide attempts. Childhood exposure to parental suicide attempts was not associated with increased risk for the development of alcohol, cannabis, or cocaine use disorders. However, individuals who were exposed to a parental suicide attempt as children were significantly more likely to have met criteria for stimulant (AOR=1.40, 95% CI=1.18-1.67), sedative (AOR=1.24, 95% CI=1.04-1.47), tranquilizer (AOR=1.78, 95% CI=1.45-2.20), and opioid (AOR=1.41, 95% CI=1.19-1.67) use disorders in their lifetime. No significant gender differences were identified with respect to the magnitude of the relationship between exposure to parental suicide attempts and SUD risk among men and women. Findings suggest that, controlling for an array of sociodemographic, parental, mental health, and childhood adversity confounds, childhood exposure to parental suicide attempts is a vulnerability factor for low prevalence illicit drugs (i.e. stimulants, sedatives, tranquilizers, opioids), but not for more commonly used substances.
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Affiliation(s)
- Kimberly H McManama O'Brien
- Simmons School of Social Work, Boston, MA, United States; Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
| | | | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States
| | - Mary LeCloux
- Simmons School of Social Work, Boston, MA, United States
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McManama O'Brien KH. Rethinking Adolescent Inpatient Psychiatric Care: The Importance of Integrated Interventions for Suicidal Youth With Substance Use Problems. Soc Work Ment Health 2015; 11:349-359. [PMID: 26674510 PMCID: PMC4677078 DOI: 10.1080/15332985.2013.774924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Adolescents psychiatrically hospitalized following a suicide attempt are at high risk for a repeat attempt or suicide completion, and substance use is consistently implicated as a risk factor for continued suicidal behavior in adolescents. Despite this knowledge, there have been few studies that have investigated the effectiveness of combined suicidality and substance use interventions within acute psychiatric care settings for suicidal youth with substance use problems. While social workers are well-positioned to deliver such interventions, greater emphasis on teaching integrated therapeutic techniques in social work curriculum and professional training is needed to ensure their implementation.
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Abstract
BACKGROUND Parental monitoring has been identified as a protective factor for adolescent drinking, whereas depressed mood, peer substance use, and peer tolerance of substance use have been identified as risk factors. The purpose of this study was to test the association between depressed mood and alcohol-related problems in adolescents, and to test whether parental monitoring and peer substance use/tolerance of use moderate the strength of this relationship. METHODS Participants included 227 adolescents (Mage = 15.36; 51.5% female) recruited from a hospital emergency department and surrounding community who completed self-report assessments. RESULTS Hierarchical linear regression analysis demonstrated that depressed mood was associated with more alcohol-related problems. A significant interaction between depressed mood and parental monitoring indicated a moderating effect, with high levels of depressed mood being associated with alcohol-related problems when parental monitoring was low; at low levels of depressed mood, parental monitoring was not related to alcohol-related problems. CONCLUSIONS This study highlights the protective role that parental monitoring may play in the association between depressed mood and alcohol-related problems and suggests that parenting practices, in addition to individual counseling, should be addressed in treatment of depressed adolescents who drink.
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Affiliation(s)
- Kimberly H McManama O'Brien
- a Simmons School of Social Work, Boston Children's Hospital , Harvard Medical School , Boston , Massachusetts , USA
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O'Brien KHM, Singer JB, LeCloux M, Duarté-Vélez Y, Spirito A. Acute behavioral interventions and outpatient treatment strategies with suicidal adolescents. Int J Behav Consult Ther 2014; 9:19-25. [PMID: 26279646 PMCID: PMC4533876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Despite the prevalence of suicidal thoughts and behaviors among adolescents, there is limited knowledge of effective interventions to use with this population. This paper reviews the findings of studies on behavioral interventions for adolescents who are at acute suicide risk, as well as outpatient treatment and risk management strategies with suicidal adolescents. The importance of addressing comorbid behaviors and enhancing protective factors are discussed. Cultural considerations in working with suicidal adolescents and strategies for conducting culturally competent treatment are explored.
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Affiliation(s)
| | | | | | - Yovanska Duarté-Vélez
- Institute for Psychological Research, University of Puerto Rico, Rio Piedras Campus ; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
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McManama O'Brien KH, Singer JB, LeCloux M, Duarté-Vélez Y, Spirito A. Acute behavioral interventions and outpatient treatment strategies with suicidal adolescents. ACTA ACUST UNITED AC 2014. [DOI: 10.1037/h0101636] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of suicide attempts among adolescents presenting to an urban general hospital (N=375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without substance abuse. Regression results indicated having depression comorbid with any other diagnosis was not associated with medical lethality. However, having a substance abuse disorder was associated with higher suicide attempt lethality, highlighting the importance of substance abuse as a risk factor for lethal suicide attempts in adolescents. This finding stimulates critical thinking around the understanding of suicidal behavior in youth and the development and implementation of treatment strategies for suicidal adolescents with substance abuse disorders.
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Berzin SC, O'Brien KHM, Frey A, Kelly MS, Alvarez ME, Shaffer GL. Meeting the social and behavioral health needs of students: rethinking the relationship between teachers and school social workers. J Sch Health 2011; 81:493-501. [PMID: 21740435 DOI: 10.1111/j.1746-1561.2011.00619.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND While school-based mental health professionals obviously must provide mental health services to students directly, the literature is increasingly identifying an empowerment role for these professionals, whereby they support teachers as primary service providers. The purpose of this study was to identify subtypes of school social workers within the context of collaborative practice, and to identify individual and contextual factors associated with these classifications as well as overall levels of collaboration. METHODS Latent class analysis, conducted using data collected as part of the National School Social Work Survey 2008 (N = 1639), was employed to examine underlying subtypes of school social work practitioners in relation to collaborative practices and to examine predictors of collaborative practice. RESULTS Four broad categories of school social workers were identified, including (1) noncollaborators, (2) system-level specialists, (3) consultants, and (4) well-balanced collaborators. These classes were associated with the number of schools served, grade level, education, and clinical licensure status; level of administrative responsibility was not associated with class membership. CONCLUSION While school social workers varied in collaborative practices, opportunities exist to enhance their role in educating and supporting teachers to serve as primary providers to students with social, mental health, and behavioral needs. The implications for school-based mental health providers, teachers, administrators, policymakers, and researchers are discussed.
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