Adolescent Suicide Prevention Research Articles

81.1 The Double Edge of Digital Media in Preventing Youth Suicide

Adolescents with suicidal ideation and behaviors often communicate their distress online to peers, which suggests that digital tools could be an important way to prevent adolescent suicide. Our objectives for this presentation are as follows: 1) to describe how hospitalized adolescents use digital media to communicate suicidality; and 2) to summarize systematic reviews of digital tools for adolescent suicide prevention.

Developing implementation strategies for firearm safety promotion in paediatric primary care for suicide prevention in two large US health systems: a study protocol for a mixed-methods implementation study

IntroductionThe promotion of safe firearm practices, or firearms means restriction, is a promising but infrequently used suicide prevention strategy in the USA. Safety Check is an evidence-based practice for improving...

Changing the conversation about children and adolescent mental health and suicide prevention

Changing the conversation about children and adolescent mental health and suicide prevention

A Study on the Effectiveness of Adolescent's Suicide Prevention Program

A Study on the Effectiveness of Adolescent's Suicide Prevention Program

4.31 TOWARDS IMPROVED SYSTEMATIC REVIEW AND META-ANALYSIS QUALITY IN CHILD AND ADOLESCENT MENTAL HEALTH: A SYSTEMATIC REVIEW

Systematic reviews and meta-analyses (SR/MA) on the prevention and treatment of child and adolescent mental disorders are increasingly available. When conducted using rigorous methodological standards, these knowledge syntheses provide a gold-standard information source that can guide healthcare decision making and inform priorities for future research. Because little attention has been given to documenting and improving their methodological rigor, we applied SR methods to evaluate the quality of SR/MA on the prevention or treatment of child and adolescent anxiety, depression, and suicide.

Suicidal ideation in adolescents and their caregivers: a cross sectional survey in Japan.

BackgroundsSuicide is a leading cause of death in adolescence. Effective strategies are required to prevent suicide. We aimed to assess the prevalence of suicidal ideation in early teens and the relationship between family mental health and suicidal ideation of their child.MethodsA population-based survey in a rural town included 185 junior high school students and their caregivers. Suicidal ideation and mental states were assessed with General Health Questionnaire (GHQ) and Profile of Mood States (POMS) form.ResultsNineteen (10.3 %) students experienced suicidal ideation in the preceding weeks and had more mental health problems than students without suicidal ideation. Caregivers of students with suicidal ideation demonstrated significantly higher suicidal depression scores in GHQ. Multivariate logistic regression analysis revealed that suicidal depression of caregivers was the most important factor for suicidal ideation of students.ConclusionsSuicidal ideation of children is associated with suicidal depression of their caregivers. For the prevention of suicide in adolescents, not only their own mental status but also that of caregivers should be taken into consideration.

Development and psychometric properties of the Suicidality of Adolescent Screening Scale (SASS) using Multidimensional Item Response Theory

Suicide prevention in adolescents by early detection using screening tools to identify high suicidal risk is a priority. Our objective was to build a multidimensional scale namely “Suicidality of Adolescent Screening Scale (SASS)” to identify adolescents at risk of suicide. An initial pool of items was developed by using in-depth interview, focus groups and a literature review. Initially, 77 items were administered to 307 adolescents and analyzed using the exploratory Multidimensional Item Response Theory (MIRT) to remove unnecessary items. A subsequent exploratory factor analysis revealed 35 items that collected into 4 factors: Stressors, Pessimism, Suicidality and Depression. To confirm this structure, a new sample of 450 adolescents were collected and confirmatory MIRT factor analysis was performed. The resulting scale was shown to be both construct valid and able to discriminate well between adolescents that had, and hadn't previous attempted suicide.

Influence of Peer and Parent-Child Relationships on the Suicidal Ideation of Adolescents

This study examined the influences of both peer and parent-child relationships on suicidal ideation in adolescents with a focus on interpersonal relationships in adolescence that can act as risks as well as protective factors for youth suicide. This study analyzed 5,440 middle and high school students drawn from data, the seventh Happy Planet Index of children-adolescent in Korea, and conducted a series of logistic regressions. The results are as follows. First, both direct and indirect involvement in the school violence affects suicidal ideation as a risk factor in peer relationships. However, the quality and quantity of close friends of adolescents do not represent a protective role against suicidal ideation insofar as they are exposed to school violence. Second, adolescents who live apart from one of their parents are vulnerable to suicidal ideation than those who live with two parents. Third, very poor parent-child relationships in adolescence are not necessarily associated with suicidal ideation in adolescents. Fourth, shared time or activities between parents and adolescents in terms of family meal times are more likely to reduce suicidal ideation in adolescents than the emotional characteristics (trustworthiness or a close relationship) of parents and adolescents. The findings provide implications that frequent contact and shared activities in terms of family dining may contribute to the prevention of adolescent suicide.

Commentary: Prospective trajectory research in adolescent suicidal behavior--a possible basis for the development of empirically based interventions? A reflection on Adrian et al. (2016).

Suicidal behaviour in adolescence is a heterogeneous set of behaviours comprising a variety of behaviours ranging from suicidal ideation, suicidal threats, suicidal gestures, nonsuicidal self-injurious behaviour through medically nonserious to medically serious suicide attempts. Probably the most productive approach to this problem is a developmental one, taking one key concept and tracking it prospectively over the course of time through the developmental stages of adolescence. A natural starting point for such a study is that of suicidal ideation (SI). Thus, the article published in JCPP (Adrian etal. 2015) represents a major contribution to the field. The authors used the data from an important adolescent development study, the Developmental Pathways Project (DPP) to look at this problem. This editorial looks at this article in the context of other major studies in the field. The notion of discerning trajectories and following them up prospectively is a potentially major contribution to paediatric suicide research. Although obviously challenging, linking these trajectories to interventions and to suicide registers could lead to major breakthroughs in adolescent suicide prevention.

The “sick-lit” question and the death education answer. Papageno versus Werther effects in adolescent suicide prevention

Abstract This study analyzes the “sick-lit” narrative phenomenon, a story writing genre rooted in self-harm and suicide, which seems to be gaining remarkable popularity amongst adolescents. This success is a symptom of young people’s need to address the issue of death. The qualitative research was composed of two parts: the first explored the ambivalent representation of sick-lit on the internet, where two opposing factions argue about its educative usefulness vs. its potentially dangerous copycat effect. The second part investigated six novels and their representations of self-harm, death, sufferance and suicide. The analysis confuted the idea that sick-lit may be a positive instrument for making adolescents aware of mortality and showed the need to transform the Werther risk effect into the Papageno possibility by exploring the content of these books with adolescents in death education courses.

Efficacy of Adolescent Suicide Prevention E-Learning Modules for Gatekeepers: A Randomized Controlled Trial.

BackgroundFace-to-face gatekeeper training can be an effective strategy in the enhancement of gatekeepers’ knowledge and self-efficacy in adolescent suicide prevention. However, barriers related to access (eg, time, resources) may hamper participation in face-to-face training sessions. The transition to a Web-based setting could address obstacles associated with face-to-face gatekeeper training. Although Web-based suicide prevention training targeting adolescents exists, so far no randomized controlled trials (RCTs) have been conducted to investigate their efficacy.ObjectiveThis RCT study investigated the efficacy of a Web-based adolescent suicide prevention program entitled Mental Health Online, which aimed to improve the knowledge and self-confidence of gatekeepers working with adolescents (12-20 years old). The program consisted of 8 short e-learning modules each capturing an important aspect of the process of early recognition, guidance, and referral of suicidal adolescents, alongside additional information on the topic of (adolescent) suicide prevention.MethodsA total of 190 gatekeepers (ages 21 to 62 years) participated in this study and were randomized to either the experimental group or waitlist control group. The intervention was not masked. Participants from both groups completed 3 Web-based assessments (pretest, posttest, and 3-month follow-up). The outcome measures of this study were actual knowledge, and participants’ ratings of perceived knowledge and perceived self-confidence using questionnaires developed specifically for this study.ResultsThe actual knowledge, perceived knowledge, and perceived self-confidence of gatekeepers in the experimental group improved significantly compared to those in the waitlist control group at posttest, and the effects remained significant at 3-month follow-up. The overall effect sizes were 0.76, 1.20, and 1.02, respectively, across assessments.ConclusionsThe findings of this study indicate that Web-based suicide prevention e-learning modules can be an effective educational method to enhance knowledge and self-confidence of gatekeepers with regard to adolescent suicide prevention. Gatekeepers with limited time and resources can benefit from the accessibility, simplicity, and flexibility of Web-based training.Trial RegistrationNetherlands Trial Register NTR3625; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3625 (Archived by WebCite at http://www.webcitation.org/6eHvyRh6M)

Suicide Prevention in Adolescents

Good care is out of the question when it is based on misleading foundations. When it comes to suicidal behavior in adolescents, it is necessary to get rid of some beliefs that have been denied by suicidal adolescents themselves, myths that hinder the prevention of this selfdestructive behavior, the different types of suicidal communications hinted by them, and the nature of depression in this particular age group in order to make an early diagnosis and provide timely treatment.

An Integrated Model of Suicidal Ideation in Transcultural Populations of Chinese Adolescents.

This study tested the model of suicidal ideation, incorporating family and personal factors to predict suicidal ideation with hopelessness as a mediating factor in the Hong Kong sample, to a sample in Shanghai. Using MGSEM, the study aims to investigate the personal correlates and the family correlates of suicidal ideation in Hong Kong and Shanghai adolescents. We integrated the family ecological and diathesis-stress-hopelessness models of suicidal ideation in connecting the correlates. A cross-sectional design was used. The full model achieved metric invariance and partial path-loading invariance. Family functioning and social problem solving negatively predicted hopelessness or suicidal ideation in both the Hong Kong and Shanghai adolescents. The results supported an integrative approach in facilitating parent-adolescent communication and strengthening family functioning, and reducing the use of negative social problem-solving styles in adolescent suicide prevention.

Gender differences in suicide prevention responses: implications for adolescents based on an illustrative review of the literature.

Background: There are well-documented gender differences in adolescent suicidal behavior; death by suicide is more common in males, while nonfatal suicide attempts are more common among females. Over the past three decades, researchers have documented the effectiveness of a myriad of suicide prevention initiatives. However, there has been insufficient attention to which types of suicide prevention interventions are effective in changing attitudes and behaviors for young males and females. In this review of the literature, we consider common examples of primarily universal suicide prevention programs from three implementation settings: school-based, community-based, and healthcare-based. Our purpose is to delineate how the potential gender bias in such strategies may translate into youth suicide prevention efforts. Methods: Research in which gender was found to moderate program success was retrieved through online databases. Results: The results that feature programming effects for both males and females are provocative, suggesting that when gender differences are evident, in almost all cases, females seem to be more likely than males to benefit from existing prevention programming. Conclusions: We conclude by considering recommendations that may benefit males more directly. Implications for adolescent suicide prevention in particular are discussed. Personalization of suicide intervention is presented as a promising solution to reduce suicide rates.

77. Effectiveness of Residency Education in Adolescent Depression Screening and Suicide Prevention

77. Effectiveness of Residency Education in Adolescent Depression Screening and Suicide Prevention

The role of a Psychiatric Society: Aligning our aims to needs of the community.

Psychiatric Societies and Associations have variegated roles and functions. They provide their members an academic resource and a place for social networking. They also have responsibilities to the profession and to the community they serve. The nature of work they conduct should be aligned to the needs of all stakeholders. Only when there is such harmonious working will the community respect the fraternity and the Association. We, therefore, need to respond to the need of the hour, which in the current time is prevention of suicide in children and adolescents and facilitation of continuing professional development for our members.

Suicide prevention and mental health promotion in adolescents: Lessons learned from the SEYLE “Saving and Empowering Young Lives in Europe” program

IntroductionThe “Saving and Empowering Young Lives in Europe” (SEYLE) has gathered 12,395 high school students in 10 countries (including 1007 students in the Lorraine Region). It has been funded by the FP7 European program and coordinated by the Karolinska Institute. Its main goals were to encourage teenagers to adopt healthier behaviors by reducing risk behaviors and suicidal behaviors, to assess the benefits from various prevention programs and recommend evidence based and culturally adapted mental health promotion programs for teenagers.Inclusion and methodSEYLE is a randomized control trial evaluating 3 mental health prevention programs:– a program training school staff to identify and refer students at suicidal risk (QPR);– a mental health sensibilization program, aimed at the students (the Awareness program);– a mental health professional screening program, through self-report questionnaires and clinical interview.These prevention programs were compared to a minimal intervention control group. The students (aged 14–16 years old) filled a 127 items questionnaire at Baseline, M3 and M12.ResultsThe most salient results of this research have shown:– the efficacy on suicidal behaviors of prevention programs in schools, in particular the Awareness program (the mental health sensibilization universal program);– the existence of an invisible group of students at risk (highly sedentary students with poor sleep and media overexposure);– a high prevalence of depressive (10.5%) and (5.8%) anxious symptoms as well as non-suicidal injuries (7.8%) in European adolescents.Discussion and perspectivesThis study has provided evidence of the efficiency of mental health awareness programs in schools to decrease the number of suicides and suicidal behaviors in teenagers and to better identify “at risk” students.

청소년 자살예방을 위한 임상미술치료 프로그램

Purpose: The purpose of this study is to examine the effects of clinical art therapy programs utilized at schools on adolescents' suicidal thoughts and stress relief and to validate their effectiveness as a type of adolescent suicide prevention program. Methods: 12 sessions of clinical art therapy for youth suicide prevention were provided, once a week for 90 minutes, for 20 students at five middle schools in Seoul who were at high risk of committing suicide. By using the paired sample t-test, the study presented qualitative data on the analysis of pre- and post- questionnaires and on the subjects’ EEG test and saliva test. Results: First, through the clinical art therapy program, the subjects’ happiness index improved significantly while their scores of depression and suicidal ideation (suicidal thoughts) decreased. Second, in the EEG and saliva test conducted after the art therapy sessions, emotional stability increased and stress was reduced significantly. Third, according to the results of pre- and post- K-HTP tests and individual activities, the subjects started to recognize the seriousness of suicide and show emotional stability and positive changes in overall attitudes, valuing the rights and life of their own ‘precious selves’ (self respect). Conclusion: The results of this study indicate that the clinical art therapy program is significantly effective at preventing suicidal ideation by reducing suicidal impulses and depression, by increasing the happiness index, which can serve as a protective factor against suicide, and by increasing emotional stability while reducing stress. Based on the results, there is a need to develop policy measures regarding art therapy programs which can be utilized at schools.

Effectiveness of adolescent suicide prevention e-learning modules that aim to improve knowledge and self-confidence of gatekeepers: study protocol for a randomized controlled trial

BackgroundProviding e-learning modules can be an effective strategy for enhancing gatekeepers’ knowledge, self-confidence and skills in adolescent suicide prevention. The aim of this study was to test the effectiveness of an online training program called Mental Health Online which consists of eight short e-learning modules, each capturing an important aspect of the process of recognition, guidance and referral of suicidal adolescents (12–20 years). The primary outcomes of this study are participant’s ratings on perceived knowledge, perceived self-confidence, and actual knowledge regarding adolescent suicidality.Methods/DesignA randomized controlled trial will be carried out among 154 gatekeepers. After completing the first assessment (pre-test), participants will be randomly assigned to either the experimental group or the waitlist control group. One week after completing the first assessment the experimental group will have access to the website Mental Health Online containing the eight e-learning modules and additional information on adolescent suicide prevention. Participants in both conditions will be assessed 4 weeks after completing the first assessment (post-test), and 12 weeks after completing the post-test (follow-up). At post-test, participants from the experimental group are asked to complete an evaluation questionnaire on the modules. The waitlist control group will have access to the modules and additional information on the website after completing the follow-up assessment.DiscussionGatekeepers can benefit from e-learning modules on adolescent suicide prevention. This approach allows them to learn about this sensitive subject at their own pace and from any given location, as long as they have access to the Internet. Given the flexible nature of the program, each participant can compose his/her own training creating an instant customized course with the required steps in adolescent suicide prevention.Trial registrationNetherlands Trial Register NTR3625

Connectedness and Suicide Prevention in Adolescents: Pathways and Implications

Adolescent suicide is a major public health concern. Stressing the need for public health-based solutions, the Centers for Disease Control and Prevention identified "connectedness" as one means of pursuing this agenda. To advance this effort in suicide prevention with adolescents, (1) consistencies and variation in the literature overtly linking connectedness to suicide thoughts and behaviors (STB) are reviewed, (2) three more specific mechanistic pathways are proposed whereby connectedness may influence STB, and (3) several implications related to use of connectedness as a public health framework for adolescent suicide prevention and intervention are outlined.