1
|
King CA, Gipson PY, Arango A, Lernihan D, Clark M, Ewell Foster C, Caldwell C, Ghaziuddin N, Stone D. LET’s CONNECT Community Mentorship Program for Adolescents with Peer Social Problems: A Randomized Intervention Trial. American J of Comm Psychol 2021; 68:310-322. [PMID: 34109646 PMCID: PMC9013512 DOI: 10.1002/ajcp.12528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Cheryl A. King
- Department of Psychiatry University of Michigan Ann Arbor MI USA
| | - Polly Y. Gipson
- Department of Psychiatry University of Michigan Ann Arbor MI USA
| | - Alejandra Arango
- Department of Psychology University of Michigan Ann Arbor MI USA
| | - Deanna Lernihan
- Department of Psychiatry University of Michigan Ann Arbor MI USA
| | - Michael Clark
- Consulting for Statistics Computing and Analytics Research University of Michigan Ann Arbor MI USA
| | | | - Cleopatra Caldwell
- Department of Health Behavior and Education School of Public Health University of Michigan Ann Arbor MI USA
| | - Neera Ghaziuddin
- Department of Psychiatry University of Michigan Ann Arbor MI USA
| | - Deborah Stone
- U.S. Centers for Disease Control and Prevention (CDC) Atlanta GA USA
| |
Collapse
|
2
|
Abstract
Suicide is the second leading cause of death for youth in the United States. Fortunately, substantial advances have been achieved in identifying and intervening with youth at risk. In this review, we first focus on advances in proactive suicide risk screening and psychoeducation aimed at improving the recognition of suicide risk. These strategies have the potential to improve our ability to recognize and triage youth at risk who may otherwise be missed. We then review recent research on interventions for youth at risk. We consider a broad range of psychotherapeutic interventions, including crisis interventions in emergency care settings. Though empirical support remains limited for interventions targeting suicide risk in youth, effective and promising approaches continue to be identified. We highlight evidence-based screening and intervention approaches as well as challenges in these areas and recommendations for further investigation.
Collapse
Affiliation(s)
- Alejandra Arango
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA;
| | - Polly Y Gipson
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA;
| | - Jennifer G Votta
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA;
| | - Cheryl A King
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA;
| |
Collapse
|
3
|
Pidano AE, Arora P, Gipson PY, Hudson BO, Schellinger KB. Psychologists and Pediatricians in the Primary Care Sandbox: Communication is Key to Cooperative Play. J Clin Psychol Med Settings 2019; 25:32-42. [PMID: 29322290 DOI: 10.1007/s10880-017-9522-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recent literature, public policy, and funding opportunities call attention to the need for better increased integration of health and mental health care services in primary care settings so as to best meet the needs of children and families. There are many benefits to such integration, but pediatric primary care providers (PCPs) face multiple barriers to identifying and managing patients with mental health difficulties. One way to address this problem is through the integration of psychologists into primary care settings who can collaborate with PCPs to provide integrated behavioral health care to youth and families. However, there are challenges to collaboration, which include differences in training, professional cultures, and expectations held by professionals from various disciplines. Effective communication is a key component in supporting interprofessional collaboration between primary care providers and psychologists working in primary care settings. This paper reviews aspects of pediatric medicine culture, critical components of communication, and strategies to improve communication. Three case examples are presented in which some of these challenges have been successfully addressed. Implications and future directions are discussed.
Collapse
Affiliation(s)
- Anne E Pidano
- Department of Psychology, University of Hartford, 200 Bloomfield Avenue, West Hartford, CT, 06117, USA.
| | - Prerna Arora
- Department of Psychology, Pace University, 41 Park Row, 13th floor, New York, NY, 10038, USA.,School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Polly Y Gipson
- Department of Psychiatry, Michigan Medicine, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109-2700, USA
| | - Bradley O Hudson
- Department of Pediatrics, Keck USC School of Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #53, Los Angeles, CA, 90027-6062, USA
| | | |
Collapse
|
4
|
King CA, Gipson PY, Arango A, Foster CE, Clark M, Ghaziuddin N, Stone D. LET's CONNECT community mentorship program for youths with peer social problems: Preliminary findings from a randomized effectiveness trial. J Community Psychol 2018; 46:885-902. [PMID: 30565735 PMCID: PMC6309270 DOI: 10.1002/jcop.21979] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 11/27/2017] [Accepted: 02/20/2018] [Indexed: 05/31/2023]
Abstract
This study examined the effectiveness of LET's CONNECT (LC), a community mentorship program for youths who report peer social problems, which is based on a positive youth development framework. Participants were 218 youths (66.5% girls), aged 12 to 15 years, who were recruited from an urban medical emergency department and screened positive for bullying victimization, bullying perpetration, and/or low social connectedness. Youths were randomized to LC (n = 106) or the control condition (n = 112). Six-month outcomes were assessed with self-report measures of youth social connectedness, community connectedness, thwarted belongingness, depression, self-esteem, and suicidal ideation. LC was associated with a significant increase in only one of these outcomes, social connectedness (effect size = 0.4). It was associated consistently with trend-level positive changes for thwarted belongingness (decreased), depression (decreased), community connectedness, and self-esteem (effect sizes = 0.2). There was no effect on suicidal ideation (effect size = 0.0), and although not a primary outcome, eight youths in the LC condition and seven youths in the control condition engaged in suicidal behavior between baseline and follow-up. Although LC effect sizes are consistent with those from previous studies of community mentorship, there were multiple challenges to LC implementation that affected dosage and intervention fidelity, and that may account for the lack of stronger positive effects.
Collapse
|
5
|
Cole-Lewis YC, Gipson PY, Opperman KJ, Arango A, King CA. Protective Role of Religious Involvement Against Depression and Suicidal Ideation Among Youth with Interpersonal Problems. J Relig Health 2016; 55:1172-88. [PMID: 26872965 PMCID: PMC5046184 DOI: 10.1007/s10943-016-0194-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study examined religious involvement-private religious practices (PRP), organizational religiousness (OR), and religious support (RS)-in relation to depressive symptoms and suicidal ideation (SI) and its protective role, considering youths' school and parent-family connectedness. Youth, ages 12-15 (n = 161), were screened for peer victimization, bullying perpetration, and low social connectedness, and assessed for depressive symptoms, SI, school connectedness, parent-family connectedness, and religious involvement. Results indicated PRP and RS were associated with lower levels of depressive symptoms; PRP and OR were associated with less SI. Controlling for connectedness, PRP remained associated with less SI only. Results suggest the importance of considering religious involvement as a target of youth depression and suicide prevention interventions.
Collapse
Affiliation(s)
- Yasmin C Cole-Lewis
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Polly Y Gipson
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA
| | - Kiel J Opperman
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA
| | - Alejandra Arango
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Cheryl A King
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA.
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
| |
Collapse
|
6
|
Arango A, Opperman KJ, Gipson PY, King CA. Suicidal ideation and suicide attempts among youth who report bully victimization, bully perpetration and/or low social connectedness. J Adolesc 2016; 51:19-29. [PMID: 27262934 DOI: 10.1016/j.adolescence.2016.05.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [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: 09/06/2015] [Revised: 04/23/2016] [Accepted: 05/06/2016] [Indexed: 01/08/2023]
Abstract
The current study examined characteristics of bullying involvement and social connectedness in relation to suicide ideation and attempts in a sample of youth who report bully victimization, bully perpetration, and/or low social connectedness. The sample was comprised of 321 youth (67% female), ages 12-15 years (M = 13.6), recruited from an emergency department in the Midwest region of the United States. Results indicated that lower levels of social connectedness and higher levels of bully victimization and perpetration were significantly associated with suicide ideation and attempts. Level of social connectedness did not moderate the relationship between bullying involvement and suicide risk. The associations between the severity of subtypes of bully victimization and perpetration (verbal, relational, physical), electronic bullying involvement, and suicide risk were examined. Results highlight a continuum in severity of bullying involvement and social connectedness associated with suicide risk. Implications of these results are discussed.
Collapse
Affiliation(s)
- Alejandra Arango
- Department of Psychiatry, University of Michigan, USA; Department of Psychology, University of Michigan, USA.
| | | | | | - Cheryl A King
- Department of Psychiatry, University of Michigan, USA; Department of Psychology, University of Michigan, USA
| |
Collapse
|
7
|
King CA, Berona J, Czyz E, Horwitz AG, Gipson PY. Identifying adolescents at highly elevated risk for suicidal behavior in the emergency department. J Child Adolesc Psychopharmacol 2015; 25:100-8. [PMID: 25746114 PMCID: PMC4367522 DOI: 10.1089/cap.2014.0049] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. METHOD Participants were 81 adolescents, ages 14-19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. RESULTS Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). CONCLUSIONS In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior.
Collapse
Affiliation(s)
- Cheryl A. King
- Department of Psychiatry, University of Michigan Depression Center, Ann Arbor, Michigan.,Department of Psychology, University of Michigan Depression Center, Ann Arbor, Michigan
| | - Johnny Berona
- Department of Psychiatry, University of Michigan Depression Center, Ann Arbor, Michigan.,Department of Psychology, University of Michigan Depression Center, Ann Arbor, Michigan
| | - Ewa Czyz
- Department of Psychiatry, University of Michigan Depression Center, Ann Arbor, Michigan.,Department of Psychology, University of Michigan Depression Center, Ann Arbor, Michigan
| | - Adam G. Horwitz
- Department of Psychiatry, University of Michigan Depression Center, Ann Arbor, Michigan.,Department of Psychology, University of Michigan Depression Center, Ann Arbor, Michigan
| | - Polly Y. Gipson
- Department of Psychiatry, University of Michigan Depression Center, Ann Arbor, Michigan
| |
Collapse
|
8
|
Abstract
OBJECTIVE Previous research has documented the feasibility of screening in emergency departments for adolescent suicide risk. This randomized trial examined the effectiveness of Teen Options for Change (TOC), an intervention for adolescents seeking general medical emergency services who screen positive for suicide risk. METHODS Participants were 49 youths, ages 14 to 19, seeking services for nonpsychiatric emergencies. They screened positive for suicide risk because of recent suicidal ideation, suicide attempt, or depression plus substance abuse. Youths were randomly assigned to the TOC intervention or to enhanced treatment as usual. Depression, hopelessness, and suicidal ideation were assessed at baseline and two months later. RESULTS Adolescents assigned to TOC showed greater reductions in depression than adolescents assigned to the comparison group (Cohen's d=1.07, a large effect size). Hopelessness, suicidal ideation, and substance abuse outcomes trended positively (nonsignificantly), with small to moderate effect sizes. CONCLUSIONS TOC may be a promising, brief intervention for adolescents seeking emergency services and at risk of suicide.
Collapse
Affiliation(s)
- Cheryl A King
- Dr. King, Dr. Gipson, and Mr. Opperman are with the Department of Psychiatry, and Mr. Horwitz is with the Department of Psychology, all at the University of Michigan, Ann Arbor (e-mail: )
| | | | | | | |
Collapse
|
9
|
Opperman K, Czyz EK, Gipson PY, King CA. Connectedness and Perceived Burdensomeness among Adolescents at Elevated Suicide Risk: An Examination of the Interpersonal Theory of Suicidal Behavior. Arch Suicide Res 2015; 19:385-400. [PMID: 25751375 PMCID: PMC4665648 DOI: 10.1080/13811118.2014.957451] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [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: 10/23/2022]
Abstract
The interpersonal theory of suicidal behavior emphasizes the constructs of perceived burdensomeness, thwarted belongingness, and acquired capacity, which warrant investigation in adolescents at risk for suicide due to interpersonal stressors. This study examined one component of the interpersonal theory of suicidal behavior, "suicidal desire" (suicidal ideation), in 129 adolescents (12-15 years) recruited from a general medical emergency department who screened positive for bully victimization, bully perpetration, or low interpersonal connectedness. Greater perceived burdensomeness combined with low family connectedness was a significant predictor of suicidal ideation. This suggests the importance of addressing connectedness and perceptions of burdensomeness in prevention and early intervention efforts with at-risk adolescents.
Collapse
|
10
|
Kaplow JB, Gipson PY, Horwitz AG, Burch BN, King CA. Emotional suppression mediates the relation between adverse life events and adolescent suicide: implications for prevention. Prev Sci 2014; 15:177-185. [PMID: 23412949 PMCID: PMC5036455 DOI: 10.1007/s11121-013-0367-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [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] [Indexed: 10/27/2022]
Abstract
Suicidal ideation substantially increases the odds of future suicide attempts, and suicide is the second leading cause of death among adolescents. A history of adverse life events has been linked with future suicidal ideation and attempts, although studies examining potential mediating variables have been scarce. One probable mediating mechanism is how the individual copes with adverse life events. For example, certain coping strategies appear to be more problematic than others in increasing future psychopathology, and emotional suppression in particular has been associated with poor mental health outcomes in adults and children. However, no studies to date have examined the potential mediating role of emotional suppression in the relation between adverse life events and suicidal thoughts/behavior in adolescence. The goal of the current study was to examine emotional suppression as a mediator in the relation between childhood adversity and future suicidal thoughts/behaviors in youth. A total of 625 participants, aged 14-19 years, seeking ER services were administered measures assessing adverse life events, coping strategies, suicidal ideation in the last 2 weeks, and suicide attempts in the last month. The results suggest that emotional suppression mediates the relation between adversity and both (1) suicidal thoughts and (2) suicide attempts above and beyond demographic variables and depressive symptoms. This study has important implications for interventions aimed at preventing suicidal thoughts and behavior in adolescents with histories of adversity.
Collapse
Affiliation(s)
- Julie B Kaplow
- Department of Psychiatry, University of Michigan Depression Center, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109-5765, USA.
| | - Polly Y Gipson
- Department of Psychiatry, University of Michigan Depression Center, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109-5765, USA
| | - Adam G Horwitz
- Department of Psychiatry, University of Michigan Depression Center, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109-5765, USA
| | - Bianca N Burch
- Department of Psychiatry, University of Michigan Depression Center, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109-5765, USA
| | - Cheryl A King
- Department of Psychiatry, University of Michigan Depression Center, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109-5765, USA
| |
Collapse
|
11
|
Lyons AL, Carlson GA, Thurm AE, Grant KE, Gipson PY. Gender differences in early risk factors for adolescent depression among low-income urban children. ACTA ACUST UNITED AC 2006; 12:644-657. [PMID: 17087526 DOI: 10.1037/1099-9809.12.4.644] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
One component of a model by Nolen-Hoeksema and Girgus, who propose that risk factors for adolescent depression are more common in girls than in boys during childhood, was tested with 85 low-income, urban, African American and Latino kindergarten through fourth grade children who completed inventories of depression, stress, attributional style, gender role, and body image. Endorsing two of three predicted risk factors, girls reported slightly poorer body image and identified more strongly with a feminine gender role. Boys, however, reported a more negative attributional style. Feminine gender role was not associated with body image or negative attributional style. The applicability of the proposed model to a low-income, ethnic minority, urban population is discussed.
Collapse
|
12
|
Grant KE, Compas BE, Thurm AE, McMahon SD, Gipson PY, Campbell AJ, Krochock K, Westerholm RI. Stressors and child and adolescent psychopathology: evidence of moderating and mediating effects. Clin Psychol Rev 2005; 26:257-83. [PMID: 16364522 DOI: 10.1016/j.cpr.2005.06.011] [Citation(s) in RCA: 249] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2005] [Revised: 06/06/2005] [Accepted: 06/06/2005] [Indexed: 11/29/2022]
Abstract
This paper reviews studies that have tested for moderators or mediators of the relation between stressors and child and adolescent psychopathology. Many studies have tested for moderation, but results of research studying moderators have been inconclusive. There have been few theory-based studies and there have been few consistent findings. Far fewer studies have tested for mediation effects, but these studies have generally been theory-driven, have more often built upon one another in an incremental fashion, and have yielded consistent results. In particular, there is substantial evidence for the mediating role of family relationship in the relation between stressors and child and adolescent psychological symptoms. Future studies should integrate moderator and mediator research by testing for specific mediators in relation to particular moderating contexts, so that we can better understand the complex ways in which stressful life experiences affect the well-being of children and adolescents.
Collapse
Affiliation(s)
- Kathryn E Grant
- Department of Psychology, DePaul University, Chicago, IL 60614, USA.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Grant KE, Compas BE, Thurm AE, McMahon SD, Gipson PY. Stressors and child and adolescent psychopathology: measurement issues and prospective effects. J Clin Child Adolesc Psychol 2004; 33:412-25. [PMID: 15136206 DOI: 10.1207/s15374424jccp3302_23] [Citation(s) in RCA: 294] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This article reviews existing research on the association between stressors and symptoms of psychopathology in children and adolescents with a focus on measurement issues and prospective effects. The first half of the article focuses on the measurement of stressors, emphasizing checklists and interviews. Available measures of stressful experiences are reviewed and critiqued. Results of this review reveal both substantial progress (i.e., development of valid stressor assessment tools) and remaining problems (i.e., inconsistent measurement across studies). The second half of this article reviews studies that have tested for prospective associations between stressors and symptoms of psychopathology in children and adolescents. Studies that have examined the prospective effects of recent or prior stressors on current psychological symptoms, while controlling for prior psychological symptoms, are reviewed. Results overall suggest that stressors predict changes in rates of symptoms of psychopathology in children and adolescents over time. Results also suggest that symptoms of psychopathology predict changes in rates of stressors over time. Implications of these findings are that conclusive evidence now exists for the importance of stressors in the development of child and adolescent psychopathology.
Collapse
Affiliation(s)
- Kathryn E Grant
- Department of Psychology, DePaul University, Chicago, IL 60614, USA.
| | | | | | | | | |
Collapse
|