Risk-taking behavior and adolescent suicide attempts

This study examined the overall rates of common risk-taking behaviors in a sample of 109 adolescents, aged 13 to 18 years, who made a suicide attempt, compared to a matched control sample of 218 adolescents in the community. No differences in either the total number of risk-taking behavior or the frequency of individual risk-taking behaviors were found. These findings suggest that suicide attempts in adolescents are not a function of risk-taking behavior.     

Risk of future suicide attempts in adolescent psychiatric inpatients at 18-month follow-up

This study investigated potential predictors of suicidal behavior in adolescents during an 18-month follow-up period. Subjects included 60 adolescent psychiatric inpatients initially assessed in a private psychiatric hospital. Follow-up suicidality was most strongly predicted by high intake levels of hopelessness, and an increase in or persistent problems with depression during follow-up. Some family functioning variables measured at intake were predictive of suicidal behavior at the univariate level but did not add to the predictive ability of individual functioning variables. A mediational model was proposed in which the impact of family functioning on adolescent suicidality is mediated by its impact on individual functioning.     

Mental health professionals' determinations of adolescent suicide attempts

The degree of ambiguity in the term suicide attempt was examined among 14 expert suicidologists, and 59 general mental health clinicians who either did or did not receive a standard definition of the term. The participants judged whether each of ten vignettes of actual adolescent self-harm behaviors was a suicide attempt. Low levels of agreement were found within each group, although agreement was better for the most and least serious cases. Possible explanations were examined, including how professionals weight suicidal intent and medical lethality in their suicide attempt decisions, and the use of a "fuzzy," natural language conceptualization of suicide attempts was proposed.     

The role of drugs in adolescent suicide attempts

Drug histories of 46 adolescent suicide attempters and their parents are described. In addition, these attempters and their parents are compared with a group of non-attempters and their parents on selected measures of drug use. Findings indicate that adolescent drug use is closely related to and perhaps symptomatic of suicidal behaviors and overall pathology. The relationship between adolescent suicidal behaviors and parental drug use is unclear because of the discrepancy between parent-adolescent responses.     

Sociological correlates of alienation among adolescent suicide attempts.

The purpose of this research is to assess the relationship between adolescent alienation and a number of sociological factors in a sample adolescent suicide attempts from a northern metropolitan area. First, Dean's alienation scale is employed and the distribution of responses of the adolescent suicide attempts are analyzed. Second a number of sociological variables are examined by means of multiple regression procedures. In the regression analysis, eight variables were found to be statistically significant-in descending order: social contact with peers in the neighborhood, conflict with parents, broken romance, economic status of parents, communication blockage with parents, school performance, stepparents, and broken romance, These variables have been salient in previous research and theorizing about adolescent suicidal behavior. The fact that adolescence, by itself, seems to be a good predictor of whether or not a person will attempt suicide strongly suggests that there is something about the condition of adolescence which underlies this type of behavior. One possibility is that biological maturation is itself the crucial variable. Alternatively, the argument which follows concentrates on a major sociological aspect of adolescence-the adolescent's relative alienation from institutionalized social life. Alienation may be endemic to the period of adolescence.     

Suicide attempts and family history of suicide in three psychiatric populations

The influence of a family history of suicide on suicide attempt rate and characteristics in depression, schizophrenia, and opioid dependence was examined. One hundred sixty inpatients with unipolar depression, 160 inpatients with schizophrenia, and 160 opioid-dependent patients were interviewed. Overall, a family history of suicide was associated with a higher risk for suicide attempt, with high-lethality method, with repeated attempts, and with number of attempts, while the interaction between family history and diagnostic group was not significant. Thus, a positive family history of suicide was a risk factor for several suicide attempt characteristics independent of psychiatric diagnosis.     

The impact of a medical student's suicide

The suicide of a medical classmate can have a profound effect upon the survivors. After the violent death of a third-year medical student at the University of California-San Francisco, the level of concern expressed in discussion groups suggested a need to study the impact in more detail. Interviews and scale data from 20 volunteer medical students identified a pattern of posttraumatic symptoms persisting over several months. The interviewees' tendency to identify with the victim was related to the prevalent experience of medical student depression. Specific suggestions are made both for immediate crisis management and for preventive intervention strategies within a medical school.     

Comparison of non-suicidal self-injurious behavior and suicide attempts in patients admitted to a psychiatric crisis unit

The aim of the current study was to examine differences in personality, coping skills, and select psychopathology symptoms in psychiatric patients with and without non-suicidal self-injury and/or suicide attempts. We collected data in a sample of 128 psychiatric patients by means of self-report questionnaires measuring self-harm, psychological symptoms, personality and coping skills. Results support a continuum of self-harm such that patients with both non-suicidal self-injury and suicide attempts exhibit significantly greater levels of psychopathology and lower levels of adaptive personality traits and coping skills. The findings point to the clinical importance of making a distinction between non-suicidal self-injury and suicide attempts, and offers additional variables to consider outside of intent when appraising suicide risk.     

Examining a dimensional representation of depression and anxiety disorders' comorbidity in psychiatric outpatients with item response modeling

The current study replicated, in a sample of 2,300 outpatients seeking psychiatric treatment, a previous study (R. F. Krueger & M. S. Finger, 2001) that implemented an item response theory approach for modeling the comorbidity of common mood and anxiety disorders as indicators along the continuum of a shared latent factor (internalizing). The 5 disorders examined were major depressive disorder, social phobia, panic disorder/agoraphobia, specific phobia, and generalized anxiety disorder. The findings were consistent with the prior research. First, a confirmatory factor analysis yielded sufficient evidence for a nonspecific factor underlying the 5 diagnostic indicators. Second, a 2-parameter logistic item response model showed that the diagnoses were represented in the upper half of the internalizing continuum, and each was a strongly discriminating indicator of the factor. Third, the internalizing factor was significantly associated with 3 indexes of social burden: poorer social functioning, time missed from work, and lifetime hospitalizations. Rather than the categorical system of presumably discrete disorders presented in DSM-IV, these 5 mood and anxiety disorders may be alternatively viewed as higher end indicators of a common factor associated with social cost.     

Current suicide ideation and prior suicide attempts of bipolar patients as influences on caregiver burden

We examined whether caregivers of bipolar patients reporting current suicidal ideation and/or a history of a suicide attempt reported higher levels of burden and/or poorer health compared to caregivers of patients without these suicidality indices. In a cross-sectional design, caregivers (N = 480) associated with (a) patients with current suicidal ideation or (b) patients with a positive lifetime history of at least one suicide attempt, reported lower general health scores than caregivers associated with patients with neither of these indices. Parents of patients with at least one lifetime attempt reported more burden secondary to role dysfunction than spouses. Levels of depression in caregivers varied with whether the caregiver was a spouse or a parent, and whether patients had a history of suicide attempts, current suicidal ideation, or both.     

The social context of adolescent suicide attempts: interactive effects of parent, peer, and school social relations

An ecological developmental model of adolescent suicidality was used to inform a hierarchical logistic regression analysis of longitudinal interactions between parent, peer, and school relations and suicide attempts. Reanalyzing data from the National Longitudinal Study of Adolescent Health, it was found that parent relations were the most consistent protective factor, and among boys with prior suicide attempts, school relations augmented the effects of parent relations when peer relations were low. Results indicated the need to understand suicidal behavior as a component of interactive social processes in the design of clinical interventions.     

Serotonin transporter (5-HTTLPR) genotype, childhood abuse, and suicide attempts in adult psychiatric inpatients

There is growing evidence that a functional polymorphism in the serotonin transporter gene (5-HTTLPR) moderates the impact of negative life events (e.g., childhood abuse) on the development of depression. However, it is unclear whether the gene x environment interaction predicts suicide attempts specifically. In addition, previous studies have not examined different forms of childhood abuse separately. In the current study, we found that 5-HTTLPR genotype moderated the link between childhood physical and sexual, but not emotional, abuse and adult psychiatric inpatients' histories of suicide attempts.     

Additive impact of childhood emotional,physical, and sexual abuse on suicide attempts among low-income African American women

This study examines the association between exposures to multiple forms of childhood abuse (emotional, physical, sexual) and adult suicidal behavior in a sample of low-income, African American women. We hypothesized a linear relation between childhood abuse and risk for making a suicide attempt, such that the more forms of childhood abuse to which a woman was exposed, the greater her risk would be to make a suicide attempt. Logistic regression analyses revealed that, compared to women who did not report any experiences of childhood abuse, women who experienced one, two, or three forms of abuse were 1.83, 2.29, or 7.75 times more likely to attempt suicide, respectively (all statistically significant). Furthermore, compared to women who reported one or two types of abuse, women who reported all three types of abuse were statistically more likely to attempt suicide. These findings have implications for clinicians working with African American women who report either childhood abuse or exhibit suicidal behavior.     

Predictors of suicide attempts: state and trait components

The authors examined the state and trait components of 3 predictors of suicide attempts (depression, hopelessness, and anxiety), and their relationship to suicidal behavior. Self-report questionnaire and interview data from 180 adolescents enrolled in a prospective naturalistic study were analyzed. Between 23% and 30% of the variance in the predictors was attributable to subjects' trait levels of these variables; the trait, as well as the state, components of the predictor variables were interrelated; and trait levels of these variables were consistently related to suicide attempts. To reduce long-term risk of suicide attempts, clinicians should focus not only on reducing short-term distress but also on reducing individuals' more enduring patterns (trait levels) of negative affectivity.     

Emotional antecedents and consequences of deliberate self-harm and suicide attempts

Emotional experiences immediately prior to (emotional antecedents) and following (emotional consequences) deliberate self-harm and suicide attempts in female inmates (N = 63) were examined. Anger was the antecedent emotion reported by the largest proportion of individuals who had engaged in deliberate self-harm (45.16%), suicide attempts (40.9%), and ambivalent suicide attempts (30%). Relief and other positive emotional shifts were more common in deliberate self-harm (41.94%) (involving no intent to die) than in suicide attempts or ambivalent suicide attempts, particularly for persons with borderline personality disorder. These findings underscore the utility of discriminating between deliberate self-harm and suicidal behavior and highlight the potential role of anger in triggering such behaviors.     

Predicting the suicide attempts of lesbian, gay, and bisexual youth

In this study predictors of serious suicide attempts among lesbian, gay, and bisexual (LGB) youth were examined. Three groups were compared: youth who reported no attempts, youth who reported attempts unrelated to their sexual orientation, and youth whose attempts were considered related to their sexual orientation. About one third of respondents reported at least one suicide attempt; however, only half of the attempts were judged serious based on potential lethality. About half of all attempts were related to youths' sexual orientation. Factors that differentiated youth reporting suicide attempts and those not reporting attempts were greater childhood parental psychological abuse and more childhood gender-atypical behavior. Gay-related suicide attempts were associated with identifiability as LGB, especially by parents. Early openness about sexual orientation, being considered gender atypical in childhood by parents, and parental efforts to discourage gender atypical behavior were associated with gay-related suicide attempts, especially for males. Assessment of past parental psychological abuse, parental reactions to childhood gender atypical behavior, youths' openness about sexual orientation with family members, and lifetime gay-related verbal abuse can assist in the prediction of suicide attempts in this population.     

Social-psychological correlates of adolescent and youthful suicide

Recently it has been suggested that social-psychological profiles of suicide attempters are useful to identify high-risk persons. There also is evidence that the complexity of interpersonal and intrapersonal factors constrict the extent to which such identification can be made. Using data from a nonprobability sample of 455 adolescent and youthful committers to test the hypothesis that attempters and committers do not differ with respect to environmental and stress-producing factors, the results reveal some differences between committers and attempters. Social-psychological characteristics of committers and factors relating to their social support systems are also discussed in the context of these differences.     

Prevalence of and risk factors for suicide attempts versus suicide gestures: analysis of the National Comorbidity Survey

Definitions and classification schemes for suicide attempts vary widely among studies, introducing conceptual, methodological, and clinical problems. We tested the importance of the intent to die criterion by comparing self-injurers with intent to die, suicide attempters, and those who self-injured not to die but to communicate with others, suicide gesturers, using data from the National Comorbidity Survey (n = 5,877). Suicide attempters (prevalence = 2.7%) differed from suicide gesturers (prevalence = 1.9%) and were characterized by male gender, fewer years of education, residence in the southern and western United States; psychiatric diagnoses including depressive, impulsive, and aggressive symptoms; comorbidity; and history of multiple physical and sexual assaults. It is possible and useful to distinguish between self-injurers on the basis of intent to die.