Temporal Variation in Adolescent Suicide Attempts

The purpose of this study was to examine the association between adolescent suicide attempts and temporal cycles in a multiethnic population. Medical records at two hospitals in the state of Hawaii were reviewed for all adolescents (ages 12–18) admitted for suicide attempts during the years 1987–1991. Results showed 296 adolescents attempted suicide, and as hypothesized, temporal factors were associated with the attempts. A significant increase in attempts was found during the afternoon/evening and on Mondays and Tuesdays, transition points between home and school. The results are discussed and implications for delivery and temporal theory development considered.     

Perceived Peer and Family Relationships,Hopelessness and Locus of Control as Factors in Adolescent Suicide Attempts

ABSTRACT: Thirty hospitalized suicidal adolescents were compared with thirty-four hospitalized nonsuicidal teenagers and thirty-five nonhospitalized coping youngsters (controls) on the extent of their problems, their perceptions of peer and family relationships, degree of hopelessness, and locus of control. Suicidals were found to experience the greatest total number of problems, nonsuicidals the next most, and controls the fewest. Significantly more peer problems differentiated the suicidals from the other two groups, while serious family problems discriminated the three groups from each other. The controls viewed their families as the most well-adjusted, followed by the nonsuicidals, while the suicidals felt their families were the most maladjusted. Suicide attempters experienced a significantly greater degree of hopelessness than all the nonattempters, and significantly more external locus of control than the controls. Some sex differences emerged in the study.     

Problem Solving,Stress, and Coping in Adolescent Suicide Attempts

Twenty adolescents who had made suicide attempts were compared with 20 nonpsychiatric control subjects on measures of problem solving, stress, and coping. The suicidal group did not show evidence of “rigid” thinking or of deficits in the ability to generate solutions to standardized interpersonal problems. However, they did report recent histories of more severe life stress and had inaccurate appraisal of the extent to which stressful events could be controlled. Although suicidal patients were able to generate as many adaptive strategies as control subjects for coping with their own most severe recent real-life stressor, they actually used fewer. They were also more likely to identify maladaptive behaviors as ways of coping. These findings support a transactional model of adolescent suicidal behavior, whereby inaccuracies in the appraisal aspects of problem solving (but not in the solution-generation aspects) in the face of high life stress lead to a reduction in the use of adaptive efforts to cope.     

Parenting and Chinese Adolescent Suicidal Ideation and Suicide Attempts: The Mediating Role of Hopelessness

Various family factors are risk factors for adolescent suicidality (suicidal ideation and suicide attempts). However, little is known about the role of parenting in adolescent suicidality. The present study examined the unique relations between three parenting dimensions (parental warmth, behavioral control, and psychological control) and adolescent suicidality, as well as the mediating role of adolescent hopelessness among these relations. A total of 1529 Chinese adolescents (52 % male; mean age = 14.74 years, SD = 1.48) completed anonymous questionnaires designed to assess three parenting dimensions, hopelessness, suicidal ideation and suicide attempts. After controlling for gender, age, family structure, and socioeconomic status, it was found that parental warmth negatively predicted adolescent suicidality, whereas psychological control positively predicted adolescent suicidality. In addition, parental warmth negatively predicted adolescent hopelessness, whereas psychological control positively predicated adolescent hopelessness, which in turn enhanced adolescent suicidality. Although behavioral control did not predict adolescent suicidality, it did negatively predict adolescent hopelessness, which in turn promoted adolescent suicidality. These findings revealed the differential roles of different parenting dimensions in adolescent suicidality, and the mediation effect of adolescent hopelessness between parenting and adolescent suicidality. Future practices would benefit from incorporating both parenting and hopelessness for optimal intervention effect.     

Anorexia Nervosa,Major Depression,and Suicide Attempts: Shared Genetic Factors

The extent to which genetic and environmental factors influenced anorexia nervosa (AN), major depressive disorder (MDD), and suicide attempts (SA) were evaluated. Participants were 6,899 women from the Swedish Twin Study of Adults: Genes and Environment. A Cholesky decomposition assessed independent and overlapping genetic and environmental contributions to AN, MDD, and SA. Genetic factors accounted for a substantial amount of liability to all three traits; unique environmental factors accounted for most of the remaining liability. Shared genetic factors may underlie the coexpression of these traits. Results underscore the importance of assessing for signs of suicide among individuals with AN.     

Latina Adolescent Suicide Ideations and Attempts: Associations with Connectedness to Parents,Peers, and Teachers

Associations between suicidal behavior and social‐ecological variables were examined among 1,618 Latina high school students (mean age = 15) from the nationally representative Add Health sample (68% were U.S.‐born). Ideations were associated with having a suicidal friend, lower perceived father support, and overall parental caring. Attempts were associated with having a suicidal friend, and lower perceived teacher and parental support. Peer and mother relationship variables were not predictors of ideations or attempts. The protective role of father and teacher support has not previously been emphasized in the literature. Strengthening connections to parents and teachers may reduce suicidal behavior in adolescent Latinas.     

Assessing Motivations for Suicide Attempts: Development and Psychometric Properties of the Inventory of Motivations for Suicide Attempts

This study describes the psychometric properties of the Inventory of Motivations for Suicide Attempts (IMSA). The IMSA was designed to comprehensively assess motivations for suicide emphasized by major theories of suicidality. The IMSA was administered to two samples of recent suicide attempters, undergraduates (n = 66) and outpatients (n = 53). The IMSA exhibited a reliable two‐factor structure in which one factor represented Intrapersonal motivations related to ending emotional pain, and the second represented Interpersonal motivations related to communication or help‐seeking. Convergent validity and divergent validity of IMSA scales were supported by expected patterns of correlations with another measure of suicide motivations. In addition, the IMSA scales displayed clinical utility, in which greater endorsement of intrapersonal motivations was associated with greater intent to die, whereas greater endorsement of interpersonal motivations was associated with less lethal intent and greater likelihood of rescue. Findings suggest the IMSA can be of use for both research and clinical purposes when a comprehensive assessment of suicide motivations is desired.     

Studying Survivors of Nearly Lethal Suicide Attempts: An Important Strategy in Suicide Research

T he series of articles in this special issue of SLTB from the Centers for Disease Control and Prevention (CDC) study of nearly lethal suicide attempts represents an important contribution to research on suicidal behavior. The investigative approach used is attractive, yet also challenging in terms of research methodology. In this commentary I take the opportunity to highlight certain aspects of this line of research as well as to comment on the specific findings of the CDC study and their relationship to existing knowledge. I also discuss the future potential for this research approach and further questions that might be addressed by it.     

Suicide Attempts and Suicide among Marines: A Decade of Follow‐up

Suicidal behavior among military personnel is of paramount public health importance because of the increased risk of death from suicide in this population. Pre‐ and post‐Marine recruit training risk factors for suicide attempts among current and former Marines were examined in 10 years following recruit training. The characteristics of the subsample of current and former Marines who died by suicide during this time are also described. Stressful and traumatic life events (e.g., childhood physical, sexual, and emotional abuse, sexual harassment during recruit training) and pre‐recruit training suicide attempts emerged as having strong associations with post‐recruit training attempts. Half of those who died by suicide in the 10 years following recruit training endorsed at least one significant life stressor prior to joining the Marines. This study highlights the importance of screening for stressful and potentially traumatic experiences occurring both before and during military service as part of a comprehensive suicide risk assessment in military samples.     

Prognosis after Adolescent Suicide Attempt: Mental Health,Psychiatric Treatment,and Suicide Attempts in a Nine‐Year Follow‐up Study

The prevalence of mental health and suicidal behavior was examined 8 to 10 years after an adolescent suicide attempt. Of 71 persons, 79% had at least one psychiatric disorder (mean 1.7) at follow‐up, most commonly depression (46%), personality disorder (46%), and anxiety disorder (42%). The stability of diagnoses was moderate. The suicide attempters had received a substantial amount of treatment. One third had received inpatient treatment, and 78% psychiatric treatment, despite low compliance shortly after the index suicide attempt. At follow‐up, repeated suicide attempts were found in 44% of the sample, and half of those had an affective or personality disorder.     

Cognitive and Social Factors Associated with NSSI and Suicide Attempts in Psychiatrically Hospitalized Adolescents

Although non-suicidal self-injury (NSSI) and suicide attempts (SA) frequently co-occur among youth, there is increasing evidence that both the risk factors and the phenomenology of the behaviors are distinct. This study examined how individuals who engage in NSSI only, individuals who attempt suicide only, and those who have histories of both NSSI and at least one suicide attempt may differ in terms of cognitions and perceived social support. Participants were 185 adolescents (78.1 % female) between the ages of 13 and 18 recruited from a psychiatric inpatient facility in the northeastern United States. One hundred forty-eight teens were identified with a history of self-injurious behavior and divided into three groups: NSSI only (n?=?45), SA only (n?=?24) or both NSSI and SA (NSSI+SA; n?=?79). Analyses showed that the NSSI+SA group exhibited more cognitive errors, negative self-statements, and negative views of self, world, and future, as well as less perceived familial support than either the NSSI or SA only groups. There were no differences between groups on perceived support from teachers or peers. No significant demographic or diagnostic differences were found between the NSSI and SA groups. Limitations and clinical implications of the current research are discussed.     

Factors Associated with the Medical Severity of Suicide Attempts in Youths and Young Adults

T his study examined factors associated with the medical severity of suicide attempts focusing on demographic characteristics, mental health characteristics, and the circumstances of the suicide attempt. Analyses were based on 153 nearly lethal suicide attempters and 47 less lethal suicide attempters aged 13–34 years who presented to emergency departments in Houston, Texas. The results show that young age was significantly associated with a nearly lethal suicide attempt. Prior suicide attempts, hopelessness, depression, and help‐seeking (ever) were significantly and negatively associated with a nearly lethal suicide attempt. None of the suicide attempt factors occurring prior to the attempt were associated with a nearly lethal suicide attempt.     

Suicide Attempts in Preadolescent Child Psychiatry Inpatients

This paper describes a preliminary study examining the relative power of measures of perceived family support, hopelessness, and depression for the classification of suicide attempters and nonattempters in a series of 8- to 13-year-old psychiatric inpatients. Results of a stepwise discriminant-function analysis indicated that a measure of a child's perceived family support discriminated between suicide attempters and nonattempters with an 88% accuracy rate. The addition of measures of hopelessness and depression at later steps did not lead to improved classification. The results are interpreted as providing strong support for a link between suicide attempts in children and perceptions of low family support.     

Comparative Psychopathology of Suicide Attempts and Assaults

ABSTRACT: Using the Katz Adjustment Scales to measure psycho-pathology, systematic samples of 108 suicide attempters and 42 persons arrested for assault were tested in Baltimore, Maryland. The subjects' scores were compared with ratings by third-party respondents, who knew the subjects well, and with scores of 450 controls. Both suicide attempters and assaulters displayed significantly more psychopathology than the controls. The suicide attempters were differentiated from the assaulters on six Katz items: Helplessness, Anxiety, Nervousness, Depression, Stability, and General Psychopathology. An attempt was made to refine prediction and control of these two different life-threatening behaviors by interpreting the data in terms of Henry and Short's concept of “internal restraint.”