Adolescent Attempters Research Articles

School Program Lessens School Bullying

Bullied students sustain pernicious sequelae, including vulnerability to suicidal attempts in adolescence (NEJM JW Psychiatry Jan 2016 and J Am Acad

Uncompleted suicide attempts in adolescents

To analyze the characteristics of suicidal behavior, which was the reason of urgent admission to the psychiatric hospital, in adolescents. Clinical and psychopathological analysis was performed for 143 adolescents, 55 boys and 88 girls, aged 15-17 years, admitted to a Moscow psychiatric hospital due to suicidal behavior. Among all hospitalized on medical emergencies suicidal behavior was identified in 42%, repeated suicidal attempts were in 27% of boys and in 47% of girls. Mental disorders on admission and in the past history were found in 75%; 25% of the patients received psychiatric examination and treatment. Personality disorders and adaptation disorders were most prevalent; schizophrenia spectrum disorders made up 13%. Common features of suicidal behavior in adolescents were: the use of low fatal methods, mild expression of antivital feelings, short duration of pre-suicidal stage, suddenness of commitment of suicidal actions, an additional stressful event (conflict situation) for the development of suicidal behavior. Significant differences in the methods of realization of suicidal intentions, preferable character of suicidal behavior (blackmailing/demonstrative in girls, brutal and compulsive in boys) and typology of psychopathological symptoms were established.

Soft Drink Consumption and Suicide Attempts in Adolescents: The Korean Youth Risk Behavior Web-Based Survey

Evidence regarding mental health problems caused by related to excessive beverage intake is growing, but it is unclear which types of beverage increase mental health risks and at what level of consumption. We investigated the association between beverage intake and suicide attempts in a nationally representative sample of Korean adolescents. We used the cross-sectional data of the 11th Korean Youth Risk Behavior web-based Survey, which adopted an internet-based, self-reported questionnaire with anonymity. We estimated the odds ratios (ORs) and used 95% confidence intervals (95% CIs) with multiple logistic regression models. In total, 68,043 adolescents participated in this study, and 1,662 (2.4%) reported a suicide attempt in the last 12 months. Students who drink carbonated beverages more than 5–6 times per week had higher odds of attempting suicide (OR, 3.237; 95% CI, 2.272–4.613). Adolescents who drink energy drinks more than three times per day had approximately five times higher odds of attempting suicide (OR, 5.203; 95% CI, 3.194–8.474). Beverage intake of more than three times a day was positively associated with suicide attempt in Korean adolescents. In particular, energy drink consumption was in robust, positive association with suicide attempt.

The relevance of non-suicidal self-injury to suicide and suicide attempts in adolescents

The relevance of non-suicidal self-injury to suicide and suicide attempts in adolescents

Trait anger and anger expression styles in adolescents

Objective: The aim of this study was to investigate the trait anger levels and anger expression styles of students in the second stage of primary education and the factors affecting them. Methods: The study was carried out on students in the second stage of primary education (classes 6, 7 and 8) at three schools in the center of the city of Manisa in an area with inhabitants at various socioeconomic levels. A sociodemographic form, The State-Trait Anxiety Scale for Children, and The State Trait Anger Scale were applied to the students. Variables affecting students’ trait anger and anger expression styles were examined using multiple linear regression analysis. Results: It was observed that levels of trait anger in the adolescents remained at the level of ‘a little’, that they did not express out their anger and that they tended to control their anger moderately, and that the levels of suppressed anger were not high. The factors which most affected levels of trait anger and anger expression styles in the adolescents were anxiety, gender and family type. A positive correlation was found between anxiety and trait anger, suppressed anger and expressed anger, while a negative correlation was found between anxiety and anger which was kept under control. Male students had a higher level of trait anger and expressed their anger more often, while female students controlled their anger more. The levels of trait anger, expressed anger and suppressed anger were higher in adolescents living in split-up families, and their anger was less controlled. Discussion: The results of this study suggest that adolescents in Turkey are not prone to experiencing anger and they tend to control their anger; when they get angry; they do not suppress it or bear grudges, they are not prone to argue with others; and when they get angry they do not express it in words or behavior. Because of the reduction of anxiety levels increase the ability to control the anger level, reduction of anxiety should definitely be placed in anger control training programs and therapeutic attempts in adolescents.

Social networking sites and mental health problems in adolescents: The mediating role of cyberbullying victimization

BackgroundPrevious research has suggested an association between the use of social networking sites (SNSs) and mental health problems such as psychological distress, suicidal ideation and attempts in adolescents. However, little is known about the factors that might mediate these relationships. The present study examined the link between the use of social networking sites and psychological distress, suicidal ideation and suicide attempts, and tested the mediating role of cyberbullying victimization on these associations in adolescents. MethodsThe sample consisted of a group of 11-to-20-year-old individuals (n=5126, 48% females; mean±SD age: 15.2±1.9 years) who completed the mental health portion of the Ontario Student Drug Use and Health Survey (OSDUHS) in 2013. Multiple logistic regression analyses were used to test the mediation models. ResultsAfter adjustment for age, sex, ethnicity, subjective socioeconomic status (SES), and parental education, use of SNSs was associated with psychological distress (adjusted odds ratio, 95% confidence interval=2.03, 1.22–3.37), suicidal ideation (3.44, 1.54–7.66) and attempts (5.10, 1.45–17.88). Cyberbullying victimization was found to fully mediate the relationships between the use of SNSs with psychological distress and attempts; whereas, it partially mediated the link between the use of SNSs and suicidal ideation. ConclusionFindings provide supporting evidence that addressing cyberbullying victimization and the use of SNSs among adolescents may help reduce the risk of mental health problems.

Early Substance Use Initiation and Suicide Ideation and Attempts among School-Aged Adolescents in Four Pacific Island Countries in Oceania.

This study aimed to investigate the correlations between early initiation (<12 years) of smoking cigarettes, alcohol use, and drug use (cannabis) with suicidal ideation and suicide attempts in school-aged adolescents in four Pacific Island countries in Oceania. The sample included 6540 adolescents (≤13 to ≥16 years old) from Kiribati, Samoa, Solomon Islands, and Vanuatu. Bivariate and multivariable analyses were conducted to assess the association between pre-adolescent substance use initiation and suicidal ideation and suicide attempts. Results indicate a prevalence of 25.8% suicidal ideation in the past 12 months (ranging from 17.2% in Vanuatu to 34.7% in Kiribati) and 34.9% suicide attempts in the past 12 months (ranging from 23.5% in Vanuatu to 62.0% in Samoa). The prevalence of early cigarette smoking initiation was 15.7%, early alcohol initiation 13.8%, and early drug use initiation was 12.9%. Students who reported pre-adolescent substance use initiation, compared with non-substance users, were more likely reporting suicidal ideation and suicide attempts. The concurrent initiation of cigarette smoking, alcohol, and drug use should be targeted in early prevention programmes in order to prevent possible subsequent suicidal behaviours.

The association of self-injurious behaviour and suicide attempts with recurrent idiopathic pain in adolescents: evidence from a population-based study.

BackgroundWhile several population-based studies report that pain is independently associated with higher rates of self-destructive behaviour (suicidal ideation, suicide attempts, and self-injurious behaviour) in adults, studies in adolescents are rare and limited to specific chronic pain conditions. The aim of this study was to investigate the link between self-reported idiopathic pain and the prevalence and frequency of self-injury (SI) and suicide attempts in adolescents.MethodsData from a cross-sectional, school-based sample was derived to assess SI, suicide attempts, recurrent pain symptoms and various areas of emotional and behavioural problems via a self-report booklet including the Youth Self-Report (YSR). Adolescents were assigned to two groups (presence of pain vs. no pain) for analysis. Data from 5,504 students of 116 schools in a region of South Western Germany was available. A series of unadjusted and adjusted multinomial logistic regression models were performed to address the association of pain, SI, and suicide attempts.Results929 (16.88%) respondents reported recurrent pain in one of three areas of pain symptoms assessed (general pain, headache, and abdominal pain). Adolescents who reported pain also reported greater psychopathological distress on all sub-scales of the YSR. The presence of pain was significantly associated with an increased risk ratio (RR) for SI (1–3 incidences in the past year: RR: 2.96; >3 incidences: RR: 6.04) and suicide attempts (one attempt: RR: 3.63; multiple attempts: RR: 5.4) in unadjusted analysis. Similarly, increased RR was observed when adjusting for sociodemographic variables. While controlling for psychopathology attenuated this association, it remained significant (RRs: 1.4–1.8). Sub-sequent sensitivity analysis revealed different RR by location and frequency of pain symptoms.ConclusionsAdolescents with recurrent idiopathic pain are more likely to report previous incidents of SI and suicide attempts. This association is likely mediated by the presence of psychopathological distress as consequence of recurrent idiopathic pain. However, the observed variance in dependent variables is only partially explained by emotional and behavioural problems. Clinicians should be aware of these associations and interview adolescents with recurrent symptoms of pain for the presence of self-harm, past suicide attempts and current suicidal thoughts. Future studies addressing the neurobiology underpinnings of an increased likelihood for self-injurious behaviour and suicide attempts in adolescents with recurrent idiopathic pain are necessary.

Immigration as risk factor for non-suicidal self-injury and suicide attempts in adolescents in Germany.

BackgroundWhereas non-suicidal self-injury (NSSI) and suicide attempts (SA) are rather common among adolescents, the description of risk factors has often failed to take migration into perspective. Our study aimed to describe immigration status in adolescents with regards to their lifetime history of NSSI and SA.MethodsWe carried out a population based study in a school community of ninth-graders (N = 452, mean age 14.85, SD 0.58) in southern Germany. Data were collected via adolescent self report on sociodemographic variables and on NSSI and SA using the Self Harm Behavior Questionnaire.ResultsAdolescents born outside Germany showed an elevated rate of a lifetime history of NSSI and SA. When compared to German adolescents without a (family) history of migration (NSSI 19.16%, SA 3.24%), adolescents who were born in another country had an elevated risk for NSSI (42.86%, OR 3.36) and SA (17.86%, OR 6.78), which was higher than the risk of adolescents who had at least one parent who had emigrated from another country (NSSI 30.08%, OR 2.46 and SA 8.94%, OR 4.45).ConclusionOur findings should inform intervention services and prevention programs for NSSI and suicidality in youth. Adopting such programs to include culturally sensible modules could improve the outcome in ethnically diverse adolescents.

Associations between time in bed and suicidal thoughts, plans and attempts in Korean adolescents

ObjectivesTo examine the hypothesis that respondents with any of three specific sleep patterns would have a higher likelihood of suicidality than those without reports of these patterns in Korean adolescents.SettingData...

Factors Affecting Suicidal Ideation and Suicidal Attempts in Adolescents who have been Bullied

Purpose:The purpose of this study was to determine the factors that influence suicidal ideation and suicidal at- tempts of adolescents who had been bullied. Methods: This study used data extracted from Korea Youth Risk BehaviorWeb-BasedSurveyof 2014.Thedataof 1,926adolescents,intotal, whohadexperiencedviolencewere included in theanalysis, Theanalysis was doneusing SPSS/WIN. Results:The adolescents withanexperience of beingbulliedweremore likelyto engage insuicidal ideationandsuicidal attempts thanthe averageteenagers inKorea. Inaddition, suicidal thoughts were affectedby gender, experienceof habitual druguse, subjectivehappi- ness, as well assadness anddespair. Suicidal attempts wereinfluenced bygender, grade, smokingexperience, experienceof habitual druguse, sizeof thecityof residence, subjectivehappiness, sadnessandhopelessness, existenceof peopleto get counseling, and habit of walkingfor 10minutes everyday. Conclusion:More attention should be given to the suicidal risk of adolescents having experienced violence. Further studies are required to developaninterventionprogramforsuicidepreventiontargetingadolescentswhohave experiencedviolenceand assess the program's effectiveness.

Predicting suicide attempts in depressed adolescents: Clarifying the role of disinhibition and childhood sexual abuse

BackgroundSuicide is the second leading cause of death among adolescents, and depressed youth are six times more likely to make suicide attempts as compared to non-depressed adolescents. The present study examined the unique and interactive effects of two well-established correlates of suicidality – childhood sexual abuse (CSA) and disinhibition – in predicting suicide attempts among depressed adolescents. MethodParticipants were 163 adolescents (125 females) aged 13–18 (M=15.60, SD=1.27) diagnosed with Major Depressive Disorder (n=95, 58.3%) and/or Dysthymia (n=69, 42.3%) recruited from an acute residential treatment service. Participants completed interviews assessing psychopathology and suicidality, self-report measures of depressive symptoms and CSA, and a computerized disinhibition task. ResultsConsistent with hypotheses, CSA moderated the association between disinhibition and adolescents' report of their past year and lifetime suicide attempts. Specifically, higher disinhibition was associated with a greater likelihood of having made a suicide attempt among adolescents with a history of CSA, but not among those without. The same pattern of results held in analyses of suicide attempt frequency. LimitationsPrimary findings were based on observational, cross-sectional data, and therefore, causal relationships cannot be inferred. The gender imbalance in the sample precluded stratifying our analyses by gender. CSA was ascertained by self-report; replication of the results with more objective measures is warranted. ConclusionsOur findings indicate that CSA and disinhibition may work together to predict elevated suicide risk, and these results have implications for early identification efforts in youth at high risk for suicide.

Auditory verbal hallucinations increase the risk for suicide attempts in adolescents with suicidal ideation

ObjectiveIt is important to prevent patients with suicidal ideation from actually attempting suicide. A school based cohort study suggested that auditory verbal hallucinations (AVHs) might play an important role in driving young people with mental health problems to attempt suicide. However, no clinical study to date has specifically investigated the association between AVHs and suicide attempts among young patients with suicidal ideation. MethodWe conducted a cross-sectional study of first-visit psychiatric referrals aged 10–15years at two general child and adolescent mental health hospitals in Japan. We administered self-reported questionnaires to measure suicidal ideation and suicide attempts, AVHs, and depression in the two weeks prior to the date of first-visit. ResultsAmong 188 patients with suicidal ideation, the presence of AVHs was associated with increased odds of suicide attempts (OR 3.4, 95% CI 1.7–6.9; p<0.05); however, depression was not associated with a significant change of odds (OR 0.7, 95% CI 0.4–1.3; p=0.29). ConclusionsAVHs may increase the risk of suicide attempts made by adolescents with suicidal ideation. Clinicians should consider AVHs when adolescent patients present with suicidal ideation.

Testing a path model of relationships between gender, age, and bullying victimization and violent behavior, substance abuse, depression, suicidal ideation, and suicide attempts in adolescents

The goal of this study was to test a path model for the relationships between age, gender, traditional bullying and cyberbullying victimization, and violent behavior, substance abuse, depression, suicidal ideation and suicide attempts in adolescents. A hypothesized path model was fit to data from the 2011 Youth Risk Behavior Surveillance System (YRBSS) on a nationally representative sample of 15,425 high-school students from across the United States. Results suggested that the effects of traditional and cyberbullying victimization on suicidal thinking, suicide planning, and suicide attempts were mediated by violent behavior, substance abuse, and depression. Results also suggested reciprocal paths between substance abuse and violent behavior. There were statistically significant indirect paths from both traditional and cyberbullying victimization to suicide attempts without the involvement of depression, suicidal thinking, or suicide planning, findings suggesting a model for spontaneous, unplanned adolescent suicides. Results suggested that female adolescents who reported cyberbullying victimization also reported higher rates of depression and suicidal behaviors compared to their male counterparts, and that as adolescents got older, depression and substance abuse tended to increase, while violent behavior and suicidal thinking tended to decrease. The implications of these findings for social workers, school counselors, and others who work with adolescents are considered.

Beyond Depression: Correlates of Suicidal Behavior in Abused Children

The current study aimed to examine the role that a history of abuse plays in the association with suicide attempts in children and adolescents who have experienced trauma. Children and adolescents were recruited from a local community mental health center specializing in the treatment of child trauma. Abuse history, history of suicide attempts, various demographics, and psychosocial measures were gathered from children and adolescents as well as their mothers. Hierarchical logistic regression analyses revealed the overall model, as well as individual predictors of age, child depression, physical and sexual abuse to be significant in the association with a history of suicide attempts. The current study revealed significant risk factors for suicide attempts in children and adolescents who have been maltreated, including age, depressive symptoms, history of sexual abuse, and history of physical abuse. Future research should further delineate the magnitude of these risk factors in order to inform and strengthen the process of risk assessment and subsequent treatment of these individuals for mental health clinicians.

Suicidality among military-connected adolescents in California schools.

Previous research indicates that suicidal ideation is higher among military-connected youth than non military-connected youth. This study extends prior work by examining suicidal ideation, plans, and attempts in military-connected and non military-connected adolescents. Data were gathered from 390,028 9th and 11th grade students who completed the 2012-2013 California Healthy Kids Survey. Bivariate comparisons and multivariate logistic analyses were conducted to examine differences in suicidal ideation, plans, attempts, and attempts requiring medical attention between military and not military-connected youth. In multivariate logistic analyses, military-connected youth were at increased risk for suicidal ideation (OR = 1.43, 95 % CI = 1.37-1.49), making a plan to harm themselves (OR = 1.19, CI = 1.06-1.34), attempting suicide (OR = 1.67, CI = 1.43-1.95), and an attempted suicide which required medical treatment (OR = 1.71, CI = 1.34-2.16). These results indicate that military-connected youth statewide are at a higher risk for suicidal ideation, plans, attempts, and attempts requiring medical care because of suicidal behaviors. It is suggested that policies be implemented to increase awareness and screening among primary care providers, school personnel, and military organizations that serve military-connected youth.

Self-Reported Psychopathology, Trauma Symptoms, and Emotion Coping Among Child Suicide Attempters and Ideators: An Exploratory Study of Young Children

This study examined self-reported psychopathology, trauma symptoms, and emotion coping in 7 to 12 year old children with suicidal ideation and attempts. This study compared 70 psychiatric inpatient children with current suicidal ideation to 59 psychiatric inpatient children with recent suicide attempts on measures of depression, anxiety, anger, emotional intelligence, and family/contextual factors. Results revealed greater self-reported anger as well as psychological distress associated with traumatic experiences (dissociation, anger, depression), among children who attempted suicide, in addition to increased reports of special education utilization, when compared to ideators only. These relationships were not affected by age or gender. Overall, the findings suggest self-reports of younger children who attempt suicide share similarities with older children and adolescent attempters, when compared with ideators who do not attempt. Implications for assessment and treatment are discussed.

Dissociative Episodes, Body-art & Suicide Attempts: a Case- Control Study

Introduction 'Body- Art” and dissociative episodes are associated with a higher risk for self harm and suicide attempts (SA) in adolescents. Evidence of these associations in adults are lacking. Objectives we investigate the association between body-art, SA and dissociative episodes in a sample of adult psychiatric in-patients. AIMS: to investigate and further describe the relationship between these issues. Methods all subjects aged more than 18 hospitalized for a SA in the Psychiatric Clinic of Genova (February 2013- 2014) were recruited. For each of them an age- and sex- matched control hospitalized for reasons other than SA was enrolled. Each of them completed SCID I, II; ISS; DES. A semistructured interview about the body-art, the method used in the SA, the presence of family TS was conducted. Results positive association between body-art, more previous SA and dissociative episodes. 75% of patients with more than one body-art had a diagnosis in both axis and repeated SA. No association between axis II diagnosis and dissociative episodes. Positive association between violent methods in SA and dissociative episodes, but not with body art. Discussion our results support in adults evidence from previous literature concerning adolescents. The results can be understood in the light of recent epigenetic evidence and of the altered pain threshold in suicidal people. Conclusion The altered perception of the body mind bond could be an important target for prevention and treatment strategies of suicidal patients. Further studies are needed to better investigate these associations in adult population.

Risks of psychiatric disorders and suicide attempts in children and adolescents with type 1 diabetes: a population-based cohort study.

OBJECTIVETo assess the risk of psychiatric disorders and suicide attempts in children with type 1 diabetes and their healthy siblings.RESEARCH DESIGN AND METHODSWe performed a population-based case-cohort study of individuals born in Sweden between 1973 and 2009. Children with type 1 diabetes (n = 17,122) and their healthy siblings (n = 18,847) were identified and followed until their 18th birthday. Their risk of psychiatric disorders was compared with that of matched control subjects.RESULTSThe risk of psychiatric morbidity in children with type 1 diabetes compared with the general population was tripled within 6 months after the onset of diabetes (hazard ratio [HR] 3.0 [95% CI 2.7–3.4]) and doubled within the total observation period (HR 2.1 [95% CI 2.0–2.2]). An increased risk was noted in suicide attempts (HR 1.7 [95% CI 1.4–2.0]) and in most categories of psychiatric disorders. The risk of psychiatric disorders in probands declined from HR 2.7 (95% CI 2.2–3.3) for those in the cohort born 1973–1986 to 1.9 (95% CI 1.8–2.0) in those born 1997–2009. The risk for any psychiatric disorders among siblings of patients with type 1 diabetes was estimated to be HR 1.1 (95% CI 1.0–1.1), and there was no increased risk in any of the specific category of disorders.CONCLUSIONSChildren with type 1 diabetes are at high risk of psychiatric disorders, which seems to be a consequence of the disease rather than due to a common familial etiology. The results support recommendations on comprehensive mental health surveillance in children with type 1 diabetes, especially in recently diagnosed children.

Suicide ideation and attempts in children with psychiatric disorders and typical development.

Children and adolescents with psychiatric disorders are at increased risk for suicide behavior. This is the first study to compare frequencies of suicide ideation and attempts in children and adolescents with specific psychiatric disorders and typical children while controlling for comorbidity and demographics. Mothers rated the frequency of suicide ideation and attempts in 1,706 children and adolescents with psychiatric disorders and typical development, 6-18 years of age. For the typical group, 0.5% had suicide behavior (ideation or attempts), versus 24% across the psychiatric groups (bulimia 48%, depression or anxiety disorder 34%, oppositional defiant disorder 33%, ADHD-combined type 22%, anorexia 22%, autism 18%, intellectual disability 17%, and ADHD-inattentive type 8%). Most alarming, 29% of adolescents with bulimia often or very often had suicide attempts, compared with 0-4% of patients in the other psychiatric groups. It is important for professionals to routinely screen all children and adolescents who have psychiatric disorders for suicide ideation and attempts and to treat the underlying psychiatric disorders that increase suicide risk.