A Brief Alcohol Intervention During Inpatient Psychiatric Hospitalization for Suicidal Adolescents

Alcohol use and suicide-related thoughts and behaviors are common in psychiatrically hospitalized adolescents and each problem can exacerbate the other. Despite knowledge about the functional relationship between alcohol use and suicide-related thoughts and behaviors, inpatient psychiatric units only cursorily address alcohol use because suicide risk is considered primary. In this paper we provide theoretical and empirical rationale for the inclusion of brief motivational interventions for alcohol use in inpatient treatment settings for suicidal adolescents. We give a case example of the brief intervention in practice, including when and how to use specific techniques. Following the case example, we discuss the flexibility of this intervention and how it can be adapted for adolescents with varying risk profiles. We conclude with recommendations for future research, including the development and testing of technology-based boosters following hospital discharge.     

Dysfunctional Attitudes and Suicidal Ideation in Psychiatric Outpatients

To determine if specific sets of dysfunctional attitudes were related to suicidal ideation, the 100-item Dysfunctional Attitude Scale (DAS) was administered to 908 psychiatric outpatients along with the Beck Depression Inventory (BDI), Hopelessness Scale (BHS), Self-Concept Test (BST), and Scale for Suicide Ideation (SSI). The SSI was used to classify the outpatients into 97 (10.7%) suicide ideators and 811 (89.3%) nonideators, and the DAS was scored for nine subscales described by Beck, Brown, Steer, and Weissman (1991) . None of the DAS subscales discriminated the ideators and nonideators or was significantly related to SSI total scores of the suicide ideators after controlling for sex, age, diagnosis of a mood or panic disorder, comorbidity, presence of a personality disorder, a history of a past suicide attempt, the BDI, the BHS, and the BST. The contributions of sets of dysfunctional attitudes for identifying and explaining suicidal ideation were overshadowed by a history of a past suicide attempt and hopelessness.     

Psychosocial Correlates of Suicidal Ideation in Adolescent Psychiatric Inpatients

The Beck Scale for Suicide Ideation (BSI) was administered to 121 inpatients between 12 and 17 years old who were diagnosed with mixed psychiatric disorders. Twelve background and clinical characteristics, previously found to be associated with adolescent suicidal ideation, were entered into a multiple regression to estimate the BSI scores, along with the Beck Anxiety Inventory, the revised Beck Depression Inventory (BDI), the Beck Hopelessness Scale (BHS), and the Youth Self-Report. The BHS and the BDI were the only two variables that contributed unique variance to the explanation of the BSI scores.     

Prospective Predictors of Suicidal Ideation during Depressive Episodes among Older Adolescents and Young Adults

Suicide is a leading cause of death among older adolescents and young adults; however, few studies have prospectively examined risk for suicidal ideation. The present study in older adolescents and young adults investigated whether two personality traits previously implicated in risk for suicidal ideation, neuroticism and extraversion, as well as certain aspects of interpersonal functioning, prospectively predicted endorsement of suicidal ideation during depressive episodes. Participants (n=117) are a subset of the Northwestern-UCLA Youth Emotion Project sample, which started with a group of high school juniors oversampled for high neuroticism. Baseline interpersonal functioning was measured using the Life Stress Interview. Baseline personality trait composite scores were created from multiple inventories. Depressive disorders and suicidal ideation were assessed at the baseline and three annual follow-up interviews using the SCID. Cox regression was employed to predict suicidal ideation during depressive episodes diagnosed at any follow-up interview. Results showed that baseline extraversion inversely predicts suicidal ideation in males only, and that baseline interpersonal problems in one's social circle, regardless of gender, predict suicidal ideation during depressive episodes.     

Social-Cognitive Moderators of the Relationship between Peer Victimization and Suicidal Ideation among Psychiatrically Hospitalized Adolescents

Peer victimization among children and adolescents is a major public health concern, given its widespread individual and societal ramifications. Victims of peer aggression often face significant levels of psychological distress and social difficulties, such as depression, suicidal ideation, suicide attempts, and social rejection. The purpose of this study was to examine whether cognitive distortions and perceptions of social support moderate the association between peer victimization and suicidal thoughts among psychiatrically hospitalized adolescents. Participants included 183 psychiatrically hospitalized adolescents (ages 13 to 18). In multiple regression analyses that controlled for gender, social and cognitive factors served as significant resource factors. Cognitive factors also moderated the relationship between peer victimization and suicidal ideation.     

A Prospective Study of Adolescent Suicidal Behavior Following Hospitalization

Identification of factors associated with adolescent suicidal behavior following psychiatric hospitalization would facilitate development of effective aftercare interventions. This prospective study identified specific predictors of suicidal behavior in 100 adolescents during a 6-month follow-up period. Standardized baseline assessments and structured follow-up telephone interviews were conducted with adolescents and their guardians. Eighteen percent of adolescents reported suicidal behavior during the follow-up period, primarily of low medical lethality and minimal or ambivalent suicidal intent. This behavior was associated with suicidal thoughts, family dysfunction, and dysthymia. It was not associated with initial posthospitalization treatment compliance. Implications of these findings are discussed.     

Suicide Ideation in Adolescents Following Inpatient Hospitalization: Examination of Intensity and Lability Over 6 Months

Understanding suicide ideation (SI) in adolescents, especially during the high‐risk time following hospitalization for a suicidal event, is a crucial component of improving risk assessment. Most studies rely on single assessments of SI, despite the potential for SI to vary considerably over time. This study examined how indices of SI intensity (mean values) and lability (mean squared successive difference values) over a 6‐month period predict suicide attempts (SAs) and self‐harm, as well as how they relate to psychosocial risk factors and affective functioning, in a sample of 103 adolescents hospitalized for a SA or significant SI. Across the sample, SI intensity, but not lability, was associated with SAs and nonsuicidal self‐injury at 6‐month follow‐up. SI intensity performed similarly to single time point SI assessments, and its relations were not moderated by SI lability. SI intensity was also associated with borderline personality disorder criteria and a history of sexual abuse. In contrast, SI lability was associated with greater negative affect intensity and lability. These findings suggest that intensity of SI may confer more risk posthospitalization, and provide support for using these statistical methods to capture two distinct parameters of SI.     

Self-Cutting and Suicidal Ideation among Adolescents: Gender Differences in the Causes and Correlates of Self-Injury

In recent years, non-suicidal self-injury (NSSI) among adolescents has been identified as alarmingly common place. Some studies have suggested that more than one in eight adolescents have engaged in self-cutting or other self-injuring behaviors. Even more of a concern is that self-injury often foreshadows suicide or suicide attempts. With self-cutting common in middle and high schools, understanding the antecedents and correlates of such behavior may help counselors and others public health officials identify troubled students and initiate preventative measures. This study utilizes data from 2,639 high school students from the Delaware Youth Risk Behavior Survey to investigate the gender differences in NSSI and suicidal ideation. Overall, 13% reported engaging in NSSI within the past year, with females reporting significantly higher rates (17%) of NSSI than males (9%). Results indicate that there are significant gender differences in NSSI and suicidal thoughts based upon previous victimization experiences, reported substance use, depression, health behaviors, and sexual orientation.     

Perceived Social Status and Suicidal Ideation in Maltreated Children and Adolescents

Research on Child and Adolescent Psychopathology - Recent decades have seen an alarming increase in rates of suicide among young people, including children and adolescents (“youth”)....     

Parenting Styles and Suicidal Ideation in Adolescents: Mediating Effect of Attachment

The present study aims to analyze the role of parenting styles in the development of suicidal ideation in adolescents, as well as test the mediating role of attachment to parents in the association between authoritative, authoritarian and permissive parenting style and suicidal ideation. The sample was made up of 604 individuals, aged between 15 and 18. In order to gather data, the Styles & Dimensions Questionnaire: Short Version, the Father/Mother Attachment Questionnaire and the Suicidal Ideation Questionnaire were used. The results suggest that the relations with parents, which are characterized by inhibition of exploration and of individuality, contribute to an emotional maladjustment being positively associated with suicidal ideation (r?=?.26 to r?=?.28). This confirmed the mediating role of parental attachment in the association between authoritative and permissive parenting styles from father and mother to suicidal ideation. It was also verified also a partial mediation, through the attachment to parents, in the association between the parent’s authoritarian style and the mother’s permissive styles and suicidal ideation. Furthermore, it was found the presence of total mediation, by throughout to attachment to the father, in the association between the father’s permissive style and suicidal ideation. The results suggest the importance of adopting authoritative parenting styles, since they seem to facilitate the development of the quality of attachment with parents. The results were analyzed in light of the attachment theory, taking into consideration the importance of parenting styles in understanding the processes inherent to suicidal ideation in adolescence.     

Hopelessness,Parent‐Adolescent Communication,and Suicidal Ideation among Chinese Adolescents in Hong Kong

Based on the responses of 5,557 Chinese secondary students in Hong Kong, the relationships among perceived hopelessness, family functioning, and suicidal ideation were examined. Results showed that suicidal ideation was positively related to hopelessness, but negatively related to parent‐adolescent communication. Compared with father‐adolescent communication, mother‐adolescent communication generally had a stronger association with adolescent suicidal ideation. It was further found that the linkage between hopelessness and adolescent suicidal ideation was stronger under a low parent‐adolescent communication condition, thus suggesting the moderating effect of parent‐adolescent communication on the effect of hopelessness on suicidal ideation. The theoretical and practical implications of the findings are discussed.     

Suicidal Ideation and Associated Factors Among School-Going Adolescents in Harare,Zimbabwe

This study determined the prevalence and associated factors of suicidal ideation among school-going adolescents in Harare, Zimbabwe. Data on 1970 respondents were obtained from a cross sectional study of the Global School-based health survey. Respondents were selected using a two-stage probability sampling technique. The prevalence of suicidal ideation was 21.6%. Males were less likely to have suicidal ideation than females (OR=0.70; 95% CI 0.54,0.91). Worrying (OR=1.81; 95% CI 1.29,2.56), feeling of loneliness (OR=2.04; 95% CI 1.43,2.90), cigarette smoking (OR=1.87; 95% CI 1.11, 3.16), and drinking alcohol (OR=1.74; 95% CI 1.17, 2.60) were associated with suicidal ideation. Public health programs designed to control cigarette smoking and alcohol use may also impact positively on suicidal ideation.     

Six‐Month Trajectory of Suicidal Ideation in Adolescents with Borderline Personality Disorder

Few studies have longitudinally examined suicidal ideation in those with adolescent‐onset borderline personality disorder (BPD). The current study aimed to examine the trajectory of suicidal ideation in adolescents with BPD longitudinally over 6 months, with follow‐ups at 2, 4, and 6 months posthospitalization for elevated suicide risk. Results indicated that the BPD group exhibited a greater decrease in suicidal ideation in the months following hospitalization than those without a BPD diagnosis. The findings of this study indicated that suicidal ideation in adolescents with BPD is not stable, and although ideation may decrease quickly after hospitalization, regular assessment of ideation is recommended.     

Suicidal Ideation and Eating Disorder Symptoms in Adolescents: The Role of Interoceptive Deficits

Eating disorder symptoms and suicidal ideation are relatively common, and often begin to emerge in adolescence. Interoceptive deficits, or the inability to perceive and accurately identify the physiological condition of the body, is an established risk factor for both eating disorders and suicidal thoughts and behaviors. Despite this, longitudinal research examining the temporal dynamics between these variables is scarce, especially within adolescent samples. Using a three-wave longitudinal design, the present study tested bidirectional relationships between interoceptive deficits, eating disorder symptoms, and suicidal ideation to examine whether interoceptive deficits predicted eating disorder symptoms and suicidal ideation over the course of a year among a sample of adolescents. Participants were 436 community adolescents recruited from local middle- and high-schools. Data were collected at baseline, 6-month follow-up, and 12-month follow-up. Study measures assessed current suicidal ideation, eating disorder symptom severity, and interoceptive deficits. Autoregressive cross-lagged modeling was conducted in MPlus. We found baseline eating disorder symptoms significantly predicted suicidal ideation at 6-month follow-up when controlling for baseline suicidal ideation. Baseline interoceptive deficits significantly predicted eating disorder symptoms 6-months later, while 6-month follow-up interoceptive deficits significantly predicted 12-month follow-up suicidal ideation. Our findings highlight the need for early and regular assessment of suicidal ideation and eating disorder symptoms in adolescents. Given that interoceptive deficits was a shared risk factor for both conditions within this sample, these results underscore the need for targeted interventions aimed at improving interoception.     

中国青少年父母教养方式与自杀意念的元分析

如何降低自杀意念是研究者共同面临的问题,其中家庭因素近些年得到了越来越多的关注。本研究采用元分析的方法考察中国青少年父母教养方式与自杀意念的关系及其影响因素,纳入了符合标准的文献22篇,包括158个效应量,总样本量为16980人。结果发现,父母积极教养方式与自杀意念呈显著负相关,父母消极教养方式与自杀意念呈显著正相关。年龄阶段、自杀意念测量工具能够显著调节父母教养方式与自杀意念的关系,独生子女比例能够调节父母消极教养方式与自杀意念的关系。上述结果表明,父母教养方式能够显著影响自杀意念,家长应采用情感温暖、理解等积极教养方式,而非拒绝、过度干涉等消极教养方式。     

Risk for Suicidal Ideation and Attempt among a Primary Care Sample of Adolescents Engaging in Nonsuicidal Self‐Injury

One in five adolescents in the United States has engaged in nonsuicidal self‐injury (NSSI), one in eight have had serious thoughts of suicide, and one in 25 have attempted suicide. Research suggests that NSSI may increase risk for suicide attempt, yet little is known about the relationship between NSSI and suicidal ideation or attempts. In a primary care setting, 1,561 youth aged 14–24 years completed a brief, comprehensive, mental health screen as part of a routine well visit to determine which factors were most likely to predict suicidal ideation and attempt among youth engaging in NSSI. Results of recursive partitioning revealed that current depression and history of alcohol use best differentiated youth engaging in NSSI with low versus high risk for suicidal ideation and attempts. This simple algorithm is presented as a clinical screening tool that might aid medical providers in determining which youth would benefit from more intensive assessment and intervention.     

Crisis Assessment and Psychiatric Hospitalization of Children and Adolescents in State Custody

We investigated the clinical characteristics and placement decisions among a group of children who were wards of the state and had been evaluated for a crisis assessment. The sample consisted of 383 children and adolescents (ages 2-20 years) who were wards of the Illinois Department of Children and Family Services (DCFS). This study retrospectively reviewed the symptoms, risk factors, functioning and co-morbid variables, and placement or system characteristics of these children using a structured assessment tool, the Childhood Severity of Psychiatric Illness (CSPI). Results indicated that risk behaviors as rated on the CSPI, including suicidality, dangerousness, and runaway tendency, were significant predictors of psychiatric hospitalization. The importance of more widespread usage of standardized assessment tools in evaluating children's mental health needs is discussed.     

青少年身体不满意与自杀意念的关系:一个有调节的中介模型

为考察青少年对身体的满意度和自杀意念的关系，探讨自尊是否在青少年身体不满意和自杀意念的关系中起中介作用，以及这个过程是否受到友谊质量的调节作用。采用身体不满意量表、自杀意念量表、自尊量表和友谊质量量表对来自湖北、安徽、河南、吉林四省六所高中的802名高一学生进行调查，结果显示：（1）身体不满意对自杀意念具有显著的正向预测作用；（2）自尊在身体不满意和自杀意念的关系中起部分中介作用；（3）友谊质量在身体不满意通过自尊影响自杀意念的中介模型后半段起调节作用，即在友谊质量较低的青少年中，自尊对自杀意念的影响更大。因此，青少年身体不满意和自杀意念之间存在有调节的中介效应。     

The Benefit of Forgetting Suicidal Ideation

In a sample of young adult Australians, those who had had suicidal ideation but who did not acknowledge ever having had it when asked 4 years later, were experiencing better mental health, as demonstrated by significantly better functioning on a range of psychometric measures, than those who recalled it. These results are consistent with several recent reports and indicate that forgetting painful events such as suicidal ideation is an adaptive defense mechanism. This has implications in terms of therapy focusing on contemporaneous events and the future, rather than on the past.