Adolescent Suicidal Behavior Research Articles

Food Insecurity, Adolescent Suicidal Thoughts and Behaviors, and Country-Level Context: A Multi-Country Cross-Sectional Analysis

PurposePreventing adolescent suicide is a global priority. Inequalities in adolescent suicide and attempt rates are reported across countries, including a greater risk in adolescents experiencing food insecurity. Little is known about the extent to which country-level contextual factors moderate the magnitude of socio–economic inequalities in suicidal thoughts and behavior. We aimed to examine the cross-country variability and national moderators of the association between food insecurity and suicidal thoughts and behavior in school-attending adolescents. MethodsWe analysed data on 309,340 school-attending adolescents from 83 countries that participated in the Global School-based Student Health Survey between 2003 and 2018. We used Poisson regression to identify whether suicidal thoughts and behavior were more prevalent in adolescents experiencing food insecurity compared to food-secure adolescents. Meta-regression and mixed-effects regression were used to determine whether country-level indicators moderated the magnitude of inequality. ResultsSuicidal ideation, suicide planning, and suicide attempts were more prevalent in food-insecure adolescents compared to food-secure adolescents in 72%, 78%, and 90% of countries respectively; however, the magnitude of these associations varied between countries. We observed wider inequalities in countries with greater levels of national wealth and universal health coverage and lower prevalence of adolescent food insecurity. Economic inequality had no moderating role. DiscussionFood insecurity could contribute to the development of adolescent suicidal thoughts and behavior, and this association is likely to be moderated by country-level context. Food insecurity may be a modifiable target to help prevent adolescent suicide, especially in countries where food insecurity is less common.

Self Harm and Suicide in Adolescents

Self harm is also called Non-Suicidal Self-Injury (NSSI). NSSI is defined as intentional self-injurious behavior to cause minor bodily harm without suicidal intent. Self-harm is strongly associated with suicidal thoughts and approximately 27-30% of adolescents with NSSI have reported suicide attempts. Based on the explanation above, the author is interested in discussing self-harm and suicide to explore the definition and management of self-harm and suicidal behavior in adolescents. In writing this literature review, we used a literature study method from various references and focused on discussions about self-harm and suicide. The search engines used were PubMed, ProQuest, and Google Scholar with the keywords "Self harm and suicide", "Epidemiology", "Diagnosis", and "Management". Overall, there were 30 articles used as references for preparing the literature review. The results of the investigation showed that self-harm and suicide are mental problems that often occur in teenagers and therefore require appropriate management using non-pharmacological and pharmacological medical approaches.

Cross-sectional and longitudinal relationships between complete blood count measures and adolescent suicidal behavior

ObjectiveReplicable biological predictors are needed to distinguish adolescents at risk for suicide attempts (SA) compared to those at risk for suicidal ideation (SI). Early evidence in adults identifies that complete blood count (CBC) measures may be directly related to suicidal behavior (SB). MethodsIn this retrospective chart review, we assessed if CBC measures differed between adolescents psychiatrically hospitalized for SA versus SI, initially in an exploratory test cohort (n = 110, age = 11–18, 67 % female, 72.7 % White) and then in an independent confirmatory replication cohort (n = 97). In longitudinal analyses, we identified if CBC measures predicted future SB over 90 days. CBC measures were also compared to a healthy adolescent cohort (n = 597) and a medically-hospitalized nonsuicidal adolescent cohort (“MH” cohort; n = 51). ResultsSuicide attempters had lower eosinophil percentages, eosinophil counts, and platelet counts as compared to suicide ideators, though in the replication cohort, only eosinophil percentages were lower in suicide attempters. In longitudinal analysis, both lower eosinophil blood counts and percentages were associated with future suicidal behavior. In cross-sectional comparative analyses, the MH cohort had similar or lower eosinophil percentages/counts to adolescents psychiatrically hospitalized with SA. ConclusionsThough lower eosinophil percentages and counts were present in adolescents with recent SA (compared to SI), such effects may be related to physical sequalae of SA. Nevertheless, both lower eosinophil counts and percentages appear to be valuable predictors of prospective suicidal behavior over 90 days amongst psychiatrically hospitalized adolescents. These findings may guide research seeking to effectively identify adolescents at elevated risk of future suicide attempts.

Problematic internet use and suicidal behavior in adolescents: A review.

Suicide is a leading cause of death in adolescents. Problematic internet use (PIU) has been associated with suicidal behavior in this age group. To assess this association, we reviewed population-based studies that examined the relationship between PIU and suicidal behavior. We searched PubMed, PsycINFO, and Web of Science for studies published in English from 1995 through 2021. Only studies with the stated aim to examine the relationship between PIU and suicidal behavior in participants age 13 through 18 were included. Also, each study had to include a measure of internet overuse with resultant impairment/distress. To minimize selection bias, studies with convenience samples were excluded. Seven cross-sectional studies with at least 9,500 participants each met the inclusion/exclusion criteria. Five assessed both suicidal ideation and suicide attempts and 2 examined suicidal ideation only. All studies found a statistically significant association between suicidal behavior and PIU. Effect sizes were mostly in the minimal to small range. All 7 studies supported a positive relationship between PIU and suicidal ideation and suicide attempts, which could be clinically important. Longitudinal studies with improved methodology are needed to identify risk factors and determine whether PIU is causally related to suicidality.

Adolescent suicide: a major mental health issue in pediatric care.

Adolescent suicide is a major public health problem, as suicide is one of the leading causes of death for adolescents. Predicting and preventing suicide represent very difficult challenges for clinicians. Youth suicide might be prevented by identifying risk factors for adolescent suicidal behavior. Diagnostic assessment involves identification of multiple factors including gender differences, psychopathology, comorbidity, interpersonal problems, family discord, family psychopathology, accessibility of lethal suicide methods, exposure to suicide, previous attempt, social support, life stressors, and protective factors. The literature clearly indicates a need for suicide awareness and prevention programs and for early identification of adolescents at risk for suicidal behaviors. However, many health care professionals who have frequent contact with adolescents are not sufficiently trained in suicide evaluation techniques and approaches to adolescents with suicidal behavior. Pediatricians and other health professionals involved in adolescents' care need more in-depth information about the characteristics and the warning signs for suicide.

Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States.

Suicide is among the top three causes of adolescent mortality. There is a scarcity of research examining cannabis use and suicidal behavior in adolescents. To determine the association between cannabis use disorder (CUD) and suicide attempt/self-harm in a hospitalized sample of adolescents. We conducted a cross-sectional observation study using data from the Nationwide Inpatient Sample collected over four years from January 1, 2016, through December 31, 2019. We included adolescents aged 10-19 hospitalized during the above period (N = 807,105). The primary outcome was suicide attempt/self-harm and the main predictor was CUD. The International Classification of Diseases Tenth Revision (ICD 10) diagnostic codes was used to identify a diagnosis of CUD, suicide attempt/self-harm, and other diagnoses included in the analyses. Adolescents diagnosed with CUD (n = 53,751) were compared to adolescents without CUD (n = 753,354). Univariate and multivariate logistic regressions were conducted to determine the association between CUD and suicide attempts/self-harm. 807,105 adolescent hospitalizations were analyzed, of which 6.9% had CUD. Adolescents with CUD were more likely to be older (17 years vs. 15 years), female (52% vs. 48%), have depression (44% vs. 17%), anxiety (32% vs. 13%), an eating disorder (1.9% vs. 1.2%), ADHD (16.3% vs. 9.1%), Conduct Disorder (4.1% vs. 1.3%), Alcohol Use Disorder (11.9% vs. 0.8%), Nicotine Use Disorder (31.1% vs. 4.1%), Cocaine Use Disorder (5.4% vs. 0.2%), Stimulant Use Disorder (0.8% vs. 0.4%) and report suicide attempts/self-harm (2.8% vs. 0.9%) [all ps<0.001]. After adjusting for potential confounders, CUD was associated with a higher risk of suicide attempts/self-harm (OR = 1.4, 95% CI 1.3-1.6, p <0.001). Post-hoc analyses showed the presence of depression moderated the association between CUD and suicide attempts/self-harm in that adolescents with CUD and depression had 2.4 times the odds of suicide attempt/self-harm compared to those with CUD but no depression after controlling for potential confounders (p<0.001). Our study provides evidence for the association between CUD and suicide risk among hospitalized adolescents and underscores the importance of recognizing and addressing co-occurring mental and substance use disorders along with CUD to mitigate suicide risk. Identifying high-risk adolescents in inpatient settings provides an opportunity for intervention.

К вопросу о суицидальном поведении подростков - реалии скоропомощного стационара

&lt;p style="text-align: justify;"&gt;The issue of suicidal behavior in adolescents is one of the most disturbing and complex. The present work is aimed to draw attention to the problem of suicidal behavior in adolescents in modern Russian reality. While analyzing cases of severe injuries due to suicidal behavior in adolescents who were admitted to the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST) in Moscow (Russia) , the authors stated their significant increase in recent years . In 2016-2023, 58 children after suicidal attempts were hospitalized to CRIEPST. All children were teenagers (11-17 years old). The authors not only noted an increased risk of suicide in 14-16 age group of teenagers, but they also noted gender features in this group. Two groups of suicide causation were defined as well: psychopathological processes and affective, impulsive reactions. After summarizing findings obtained in CRIEPST , the researchers have stated an increase in the number of psychopathological predispositions in children in the recent years. An increased number of cases with suicidal behavior in adolescents and predominance of psychopathological processes as risk factors should make adults be more attentive to tendencies in suicide causation and their prevention. The data presented in the article are preliminary and incomplete, as they do not cover cases that did not lead to severe somatic consequences.&lt;/p&gt;

Prevalence of suicidal behavior in adolescents in India: A systematic review and meta-analysis.

Suicidal behaviour (SB) in adolescents is an emerging public health issue globally. The present study was undertaken to estimate the overall prevalence of SB among the adolescents (10-19 years of age) in India. In this systematic review and meta-analysis (SRMA), an extensive literature search in PubMed, Scopus, EBSCO, Web of Science, ProQuest, Embase, Cochrane, and preprint servers (medRxiv, arXiv, bioRxiv, BioRN, ChiRxiv, ChiRN, and SSRN) and assessment of all published articles until 28th February 2023 as per the PROSPERO registration protocol (CRD42023385550), was undertaken. Studies from India which reported the prevalence of suicidal ideation, suicide attempt, and suicidal plan were included. The quality of the included studies was assessed by risk of bias assessment tool. R version 4.2 was used to conduct all the relevant analyses. Heterogeneity was assessed, and a random effects model for estimating the pooled prevalence of the outcomes was applied. Subgroup analyses were planned based on region, locality (urban/rural) and the study settings (educational institutions/community-based). A meta-regression to analyze the effects of potential moderators on outcomes was done. Sensitivity analyses were planned based on the removal of outliers and poor-quality studies. Publication bias was tested by Doi plot and LFK index. Pooled prevalence of suicide attempts, suicide ideations and suicide plans RESULTS: A total of 20 studies were identified as eligible for the systematic review, and 19 studies were identified as eligible for the meta-analysis. The pooled prevalence of suicidal ideation was estimated to be 11% (95% CI 7-15); heterogeneity between the studies was high (I2 98%, p<0.01). The pooled prevalence of suicidal attempts and suicidal plan was estimated to be 3% each (95% CI 2-5); with heterogeneity being high (I2 96%, p<0.01). Subgroup analysis revealed a significant variation in suicidal ideation and attempts between different regions of India (South>East>North), and higher prevalence among the educational-institute-based settings and urban areas. Overall, the prevalence of suicidal behavior among the adolescents in India is high, and they experience all types of suicidal behavior (ideations, plans and attempts).

Parental Support and Gender Moderate the Relationship Between Sexual Orientation and Suicidal Behavior in Adolescents.

The scientific literature indicates that people from sexual minorities may be at increased risk for mental health difficulties. Moreover, parental support could play a protective role against poor mental health. The objective of this study was to examine whether a person's sexual orientation was related to a greater risk of mental health problems in a representative sample of adolescents. In addition, the study analyzed the possible moderating effect of parental support in the relationship between sexual orientation and mental health, as also moderated by participant gender. The sample consisted of 1790 secondary-school students. Indicators of emotional and behavioral difficulties, symptoms of depression, psychotic-like experiences, suicidal behavior, well-being, and self-esteem were assessed. The results indicated significant main effects of gender and sexual orientation. Having a diverse sexual orientation (i.e., lesbian/gay, bisexual and questioning) was related to increased risk of mental health difficulties. Moreover, the results showed a significant interaction effect of gender and sexual orientation on suicidal behavior. Finally, the results showed the moderating effect of parental support and gender in the relationship between sexual orientation and suicidal behavior. These findings highlight the importance of promoting sexual minority youths' mental health and well-being.

A randomized 3-month, parallel-group, controlled trial of CALMA m-health app as an adjunct to therapy to reduce suicidal and non-suicidal self-injurious behaviors in adolescents: study protocol.

Suicidal and non-suicidal self-injurious behaviors are among the leading causes of death and injury in adolescents and youth worldwide. Mobile app development could help people at risk and provide resources to deliver evidence-based interventions. There is no specific application for adolescents and young people available in Spanish. Our group developed CALMA, the first interactive mobile application with the user in Spanish, which provides tools based on Dialectical Behavioral Therapy to manage a crisis of suicidal or non-suicidal self-directed violence with the aim of preventing suicide in adolescents and youth. To test the effectiveness, safety and level of engagement of the CALMA app in people aged 10 to 19 who are treated in mental health services of two public hospitals, we will conduct a parallel-group, two-arm randomized controlled trial. Participants will be assessed face-to-face and via video call at four timepoints: day-0 (baseline), day-30, day-60, and day-90. A total of 29 participants per group will be included. Change in the frequency of suicidal and non-suicidal self-injurious behaviors will be compared between groups, as well as the level of emotional dysregulation, level of app engagement and time of psychiatric admission during the follow-up period. This study is particularly relevant to young people given their widespread use of mobile technology, while there are currently no available smartphone app-based self-guided psychological strategies in Spanish that attempt to reduce suicidal behavior in adolescents who are assisted in the public health sector from low and middle-income countries in Latin America. https://clinicaltrials.gov/, NCT05453370.

Суїцидальна поведінка у підлітків з депресивними розладами

The role of clinical, psychological, social factors in the formation of suicidal behavior in adolescents with depressive disorders has been established. The correlation of symptoms of depression, anxiety, aggression in adolescents with suicidal behavior was determined.

Social problem-solving and suicidal behavior in adolescent girls: A prospective examination of proximal and distal social stress-related risk factors.

Adverse social experiences are often linked to suicidal behavior in adolescence, perhaps particularly for girls. Social problem-solving abilities may indicate more or less adaptive responses to adverse social experiences that contribute to adolescent girls' risk for suicidal behavior. While social problem-solving is implicated in cognitive and behavioral theories of suicidal behavior, prior work is largely cross-sectional and examines bivariate associations between social problem-solving, assessed in neutral conditions, and suicidal behavior. Using a novel performance-based task, this study assessed social problem-solving in adolescent girls (N = 185, Mage = 14.66, SD = 1.41) before and after an experimentally simulated social stressor and examined associations between social problem-solving and past-year suicidal behavior. Prospective analyses tested whether greater changes in specific social problem-solving domains following the social stressor predicted greater likelihood of suicidal behavior over a 9-month follow-up in contexts of elevated, real-life interpersonal stress. Results revealed that adolescent girls who showed greater changes (i.e., reflecting declines) in problem-solving effectiveness following acute social stress were more likely to exhibit suicidal behavior over the following 9 months, but only if they also experienced elevated interpersonal stress in real life. State-dependent changes in social problem-solving may indicate a cognitive vulnerability following social stress that, in combination with cumulative interpersonal stress in real life, distinguishes adolescent girls at heightened risk for future suicidal behavior. Findings demonstrate the importance of examining suicide risk factors under conditions that may more closely mirror the interpersonal contexts in which adolescents' risk for suicidal behavior may be elevated. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

К вопросу о лингво-культурологической экспертизе при исследовании аниме

The authors of the article start from the idea that anime is a special product of the mass media space, which can have a strong and often destructive effect on the psyche of adolescents, becoming a potential or real factor in suicidal behavior in adolescents. In such cases, anime is subject to legal qualification, for the purpose of which various expert studies are carried out – more often psychological, less often linguistic. However, according to the authors of the article, linguistic-cultural examination is called upon to become the optimal tool for an objective study of anime. Within the framework of such a comprehensive study, it is possible not only to establish what exactly is said about the subject of speech, about the attitude towards it, about the purposes of communicating information to the addressee and why something is actually said, but also to explore anime plots from the point of view of social significance, as well as ideological and ideological aspects.&#x0D; Purpose: reveal the possibilities of linguistic-cultural examination for an objective study of anime products.&#x0D; Methods: empirical methods of description, interpretation; theoretical methods of formal and dialectical logic.&#x0D; Results:&#x0D; 1) an idea of linguistic-cultural examination and its methods is proposed for scientific discussion;&#x0D; 2) the need for linguistic-cultural examination in identifying the destructive mechanisms of influence of anime products is emphasized and illustrated.

BMI and perceived weight on suicide attempts in Korean adolescents: findings from the Korea Youth Risk Behavior Survey (KYRBS) 2020 to 2021

BackgroundSuicide is a leading cause of death in South Korea (hereafter ‘Korea’), and there is evidence that body weight and perceived weight affecting suicide have a significant effect on suicidal behavior in adolescence. This study investigated the association between body mass index (BMI), perceived weight, and suicide attempts in adolescents.MethodsWe included nationally representative data for a total of 106,320 students in our final analysis. We calculated and stratified BMI (underweight, normal weight, overweight) to determine the correlation between BMI and suicide attempts. We stratified the participants into three groups (perceived as underweight, normal weight, and overweight) for subjective body weight perception to analyze the relationship between subjective body weight perception and suicide attempts. We further analyzed the combination of BMI and subjective body weight perception to determine the relationship between suicide attempts and distorted subjective weight perception.ResultsCompared with perceiving oneself as having a normal weight, the odds ratios (ORs) for suicide attempts were significantly increased in the group perceiving themselves as overweight. In addition, those who perceived themselves as overweight but were underweight according to their BMI were at significantly increased risk of suicide attempts relative to those who perceived themselves as about the right weight.ConclusionsThere was a significant association with suicide attempts in the underweight and perceived overweight group. This shows the importance of combining BMI and perceived weight when examining the relationship between weight and suicide attempts in adolescents.

Childhood Maltreatment, Executive Function, and Suicide Attempts in Adolescents.

Evidence suggests that child maltreatment is a risk factor for adolescent suicidal behavior. However, the differential influence of distinct forms of child maltreatment on adolescent suicide attempts is understudied and the factors that might exacerbate or ameliorate these associations warrant attention. We examined the associations between two distinct forms of child maltreatment (threat and deprivation) and suicide attempt history, and investigated whether executive function domains moderated these associations. Participants were 119 adolescents (M = 15.24, SD = 1.46, 72.3% female) recruited from an inpatient psychiatric hospital during hospitalization for suicidal thoughts and behaviors. Results indicated that the executive function domains of initiation, shifting, and planning/organization moderated the associations between threat and suicide attempt history. Associations between threat and suicide attempt history were significant only when initiation and shifting T-scores were lower (OR = 1.22, p = .03 and OR = 1.32, p = .01, respectively). The association between threat and suicide attempt history trended toward significance when planning/organization T-scores were lower (OR = 1.15, p = .10). None of the executive function domains moderated the link between deprivation and suicide attempt history. Findings highlight the need for research investigating whether initiation, shifting, and planning/organization might be amendable to intervention in the context of threat-related child maltreatment.

Exploring third factors in the relationship between sleep difficulties and suicidal behaviour in adolescents and young adults: A systematic review

Exploring third factors in the relationship between sleep difficulties and suicidal behaviour in adolescents and young adults: A systematic review

Predictors of Suicide Behavior in Adolescents with Depression

The prevalence of teenage suicide has been progressively rising in recent years, posing a significant public health concern that jeopardizes the physical and psychological well-being of adolescents, and potentially their survival. Adolescents who experience depression are at an elevated risk for suicidal behavior. The present study provides a comprehensive overview of the distinct psychological, familial, and socio-environmental factors that contribute to suicidal tendencies among adolescents diagnosed with depression. The aim of this research is to establish a sound empirical foundation for the development of effective strategies to prevent adolescent suicide behavior.

Factors related to suicidal behavior in adolescents at the Vietnam National Children's Hospital from 2020 - 2022

This is a prospective study on 32 children with suicidal behavior who came to the National Children’s Hospital for examination and treatment from February 2020 to September 2022. There were more girls than boys (71.9%% vs 28.1%). There is a relationship between the child -parents, father-mother with the child’s suicidal behavior. The main events leading to children’s suicidal behavior are mainly related to the family and school environment, accounting for 87.5%, 62.5% children are introverted, 28.1% children have suicidal ideation and behavior and 18.8% of cases had self-destructive behavior. 81.2% of children showed warning signs before committing suicide. Suicide is more common in girls. Family relationships between parents and children are related to children’s suicidal behavior. The main events associated with suicidal behavior are primarily in the home and school settings. We recommend that children should be examined when they show warning signs related to suicide.

A Rapid Systematic Review of the Prevalence of Suicide and Self-Harm Behaviors in Adolescents During the COVID-19 Pandemic.

Background: COVID-19 has caused psychological, social, and physical isolation in adolescents resulting in varying rates of suicidal behavior and self-harm. Aims: We investigated the pandemic's impact on adolescent suicidal behavior and self-harm by reviewing the existing literature. Methods: We searched PubMed using keywords: adolescent, suicide, suicidal behavior, self-harm, prevalence, and COVID-19 and included studies reporting primary data only. Results: Of the 551 studies identified, we included 39 studies in the final analysis. Two of the six high-quality population-based suicide registry studies reported increased suicide rates during the pandemic. Seven of fifteen emergency department-based studies out of which four were of high quality and three high-quality population-based health registry studies reported increased self-harm. A few school and community-based surveys and national helpline data also reported an increase in suicidal behavior or self-harm. Limitations: Methodological heterogeneity of the included studies. Conclusions: There is wide variation in study methodology, population, settings, and age groups in the included studies. Suicidal behavior and self-harm were increased in specific study settings and adolescent populations during the pandemic. More methodologically rigorous research is needed to evaluate the impact of COVID-19 on adolescent suicidal behavior and self-harm.

Adolescent Experiences With Social Media and Suicidality.

Examine social media experiences of the suicidal adolescent presenting to the emergency department with an acute mental health crisis. We used qualitative interviews to obtain in-depth understanding of both negative and positive impacts of social media use on acute adolescent suicidal behavior. A bilingual transcriptionist transcribed audio recordings. Three investigators independently reviewed transcripts to identify themes and develop initial coding scheme through "open coding." Using grounded theory, data collection proceeded along with cultivation of themes until thematic saturation was achieved. Thematic saturation was determined when no new themes were generated from the data. Data were coded in Dedoose software to facilitate reporting of themes and quotes. Techniques to ensure trustworthiness included iterative data collection, use of a coding framework, and multiple coders. Seventeen interviews were conducted from May to October 2020. Median participant age was 15 years. Twenty-four percent were of Hispanic ethnicity and 82% identified as cisgender. Major themes include distraction from negative emotions; facilitated communication resulting in improved social connectedness; metric of connectedness; comparison of self to others; and desensitization and normalization to suicidal acts. Minor theme of increased time on social media is also discussed. These themes echoed components of current suicide theory. Acutely suicidal adolescents report social media experiences that reflect themes of social alienation and learned capacity for suicidal acts. Themes echo components of current suicide theory.Our participants also reported positive uses of social media. These protective experiences should be leveraged to inform strategies to interrupt behaviors leading to acute suicidality.