Suicidal Ideation In Youth Research Articles

The Association between Parental Attachment and Youth Suicidal Ideation: A Three-Level Meta-analysis

Youth suicidal ideation is regarded as a serious psychological problem that hinders their mental health development. Parental attachment is considered a critical factor linked with youth suicidal ideation, but existing findings are still inconsistent. The present study was based on the PRISMA method; it employed a three-level meta-analysis to obtain reliable estimates of effect size and examined a range of moderators (sample, publication, outcome). Through the retrieval of articles published before November 2020, a systematic search yielded 31 independent studies (N = 12848) from which 109 effect sizes could be extracted. The present meta-analysis revealed a significant negative correlation between parental attachment and youth suicidal ideation (r = −0.108, p < 0.001), implying that youths show a higher level of suicidal ideation when they experienced lower quality of parental attachment. Moreover, the overall association was influenced by different parental attachment patterns. More specifically, youth suicidal ideation was more strongly associated with parental alienation (r = 0.501, p < 0.001) than with parental communication (r = −0.173, p < 0.001). The moderator analyses also showed that the type of instrument used was a significant moderator of the association between parental attachment and youth suicidal ideation. The strength of the overall association was significantly stronger when measured with the IPPA (Inventory of Parent and Peer Attachment) (r = −0.181, p = 0.003) than with the ECR (Experiences in Close Relationships) (r = 0.085, p = 0.003). These results indicate that assessing parental attachment is important in strengthening interventions that target suicidal ideation among youths. HIGHLIGHTS Our analysis revealed a significant negative association between parental attachment and youth. Specifically, the presence of a secure relationship with parents, as perceived by the youth, brings forth feelings of appreciation, acceptance, safety, and confidence, that predispose the individual to seek help in a more consistent manner and to resist to maladjusted behavior when faced with adversity. However, a low quality of attachment produces cognitions associated with perceived burdensomeness and failed belongingness, which increase a youth’s vulnerability to suicidal ideation. The parental attachment pattern showed a significant moderating effect on the association between parental attachment and youth suicidal ideation. Regarding the association between parental attachment and youth suicidal ideation, we observed that the manner in which parental attachment is measured is another moderating effect.

Drag Expression Among Older Gay Men: Exploratory Findings of a Pilot Study

This poster presentation highlights pilot findings of how older gay male drag queens define drag expression and its associated positive and negative attributes. While drag has become more mainstream, little is known about this sexual and gender minority (SGM) and what it means to be an older drag queen and how it interfaces with societal gender expectations. (Knutson, Koch, Sneed, Lee, & Chung, 2020; O’Brien, 2018). Research to date reports that while sexual minority youth experience bullying, anxiety, lower self-esteem, and suicidal ideation at higher rates than their heterosexual and gender conforming peers, research has not examined the role drag expression plays as a healthy coping mechanism and, in particular, what role it may play for older drag queens. (Levasseur, Kelvin, Rosskopf, 2013; Mueller, James, Abrutyn, & Levin, 2015). Several studies have found that familial support and connectedness offers valuable protective factors for sexual minority youth in their sexual identity development, but again, little is known about the benefits this may provide older drag queens (Brandon-Friedman & Kim, 2016; Eisenberg & Resnick, 2006). Utilizing Grounded Theory, in-depth interviews were conducted with gay males over the age of fifty (n=5) who identified as drag queens to understand how drag expression is integrated into one’s persona, how it may serve as a healthy coping mechanism, and how it interfaces with dragism, generativity, and family relationships over their lifespan (Donorfio, 2020). In addition to sharing the qualitative findings, demographic and data measures of personality, coping, resilience, and mood are also be reported.

Prevalence and risk factors for depression, anxiety and suicidal ideation in youth with persistent post-concussive symptoms (PPCS)

ABSTRACT Objectives: To assess the prevalence and risk factors for emotional distress in youth with persistent post-concussive symptoms (PPCS) greater than one month. Methods: We used baseline data from an intervention study for youth with PPCS, utilizing Poisson regression to examine factors associated with exceeding clinical cut-points on measures of depression, anxiety, self-harm and suicidal ideation. Predictors included: age, sex, socioeconomic status, mental health history, duration of concussion symptoms, history of prior concussion, trauma history and sleep quality. Results: The sample included 200 youth with PPCS, (mean 14.7 SD 1.7 years, 82% white, 62% female). Forty percent reported clinically significant depressive symptoms, 25% anxiety, 14% thoughts of self-harm and 8% thoughts of suicide. History of depression was associated with 3-fold higher risk for thoughts of self-harm (95% CI:1.82–6.99) and 6-fold higher risk for suicidal ideation (95% CI:1.74–24.46). Better sleep quality was associated with lower risk for all outcomes. History of prior concussion and duration of PPCS were not significantly associated with any outcomes. Conclusions: Suicidal thoughts are common post-concussion, and history of depression is a strong risk factor. Tailored interventions may be needed to address mental health in this population.

44.1 International Meta-Analysis of Youth Suicide Ideation and Attempt

44.1 International Meta-Analysis of Youth Suicide Ideation and Attempt

Validation of a brief tool to assess and monitor suicidal ideation: The Youth Suicide Ideation Screen (YSIS-3)

Background. Suicidal ideation is common in young people. Assessment and monitoring can help to understand its dynamic nature and inform treatment planning. Aims. The aims were to evaluate psychometric properties of a brief screening tool - the Youth Suicide Ideation Screen-3 item (YSIS-3) and determine its correlation with the Suicidal Ideation Question-Junior (SIQ-JR) and measures of depressive and anxiety symptoms a. Method. Cronbach's alpha (α) was used to evaluate internal consistency of the YSIS-3 in 1107 young people. Convergent validity was evaluated using network analysis based on individual item polychoric correlations. Structural equation modelling was used to understand latent constructs; pearson product moment correlations to validate the integrity of the underlying construct. and two-way mixed Intraclass Correlation Coefficient to examine longitudinal stability and Cohen's d to assess sensitivity to change. Results. The YSIS-3 was found to have internal consistency, convergent validity and criteria validity almost identical to the 15-item SIQ-JR. There was a high correlation (0.91) between the latent factor underpinning YSIS-3 and SIQ-JR. The YSIS-3 was more sensitive to change among those presenting with suicidal ideation at baseline. Conclusions. The YSIS-3 is a valid measure for the assessment and monitoring of suicidal ideation, and is sensitive to change. This brief measure can contribute to regular monitoring of the presence and nature of suicidal ideation, which when included in comprehensive assessment, will inform the clinical management of those at risk of suicide.

Perceived Social Status and Suicidal Ideation in Maltreated Children and Adolescents

Recent decades have seen an alarming increase in rates of suicide among young people, including children and adolescents (“youth”). Although child maltreatment constitutes a well-established risk factor for suicidal ideation in youth, few efforts have focused on identifying factors associated with maltreated youths’ increased risk for suicidal ideation, especially across development. The present study examined the relations between maltreated youths' (N = 279, M = 12.06 years, 52% female, 53% Latinx) perceptions of their social status and suicidal ideation and compared those relations between pre-adolescents and adolescents. Findings revealed unique developmental patterns: Perceived social status was associated with suicidal ideation, but only in adolescents, who showed greater risk for suicidal ideation if they viewed themselves as lower ranked in society and lower risk for suicidal ideation if they viewed themselves as higher ranked in society. Findings have implications for scientific and practical efforts aimed at better understanding and preventing suicide in a high-risk developmental population.

Dysfunction of default mode network is associated with active suicidal ideation in youths and young adults with depression: Findings from the T-RAD study

Deaths due to suicide are one of the leading causes of mortality among youths and young adults. Active suicidal ideation (SI) is considered one of the strongest risk factors for suicide. Here, we evaluated the neurocircuitry of SI in a sample of youths and young adults (aged 10–26 years) with current or past diagnosis of either major depression or bipolar disorder who were enrolled in Texas Resilience Against Depression Study (T-RAD), and had neuroimaging and SI (assessed with the 3-item Suicidal Thoughts factor of Concise Health Risk Tracking self-report scale) data available (n = 72, 53 females). Resting-state functional connectivity (FC) was computed amongst 121 cortical and subcortical regions of interest resulting in 7260 FC pairs. Mean (SD) age and SI levels of participants were 19.6 years (4.01) and 1.48 (2.36) respectively. In univariate analyses, 34 out of the 7260 FC pairs were correlated with SI (p < .005). Stronger connectivity of default mode network (DMN) with striatum was associated with higher SI. Conversely, higher SI was associated with weaker connectivity of limbic network with hippocampus, DMN, dorsal attention network, and executive control network. In multivariate analyses, these 34 FC pairs together had an average correlation of 0.54 after five-fold cross-validation. In conclusion, SI was associated with distinct patterns of resting-state functional connectivity among youths and young adults with regions in DMN and the ventral striatum as key nodes.

Suicidal ideation in LGBT youth: a literature review

A review of the literature on experiences and meanings surrounding suicide ideation in LGBT youth was conducted. It was found that a large part of the studies were carried out in Anglo-Saxon populations that tended to compare "heteronormative" with "non-heteronormative" populations, through eminently quantitative designs, where the main results were greater vulnerability in comparison to the heterosexual population, internalized homophobia and rejection of one's own sexual orientation. Social and family vulnerability that fed the experience of diverse violence in different areas of their lives. In addition, alcohol and drugs were predictors of suicidal ideation. These living conditions favored mood disturbances and affected mental health, as well as a tendency to develop self-injurious behaviors. However, family and social support were protective against suicidal ideation. Few authors used the recognized categories within the LGBT community to describe their participants, the category most commonly used was "non-heteronormative population", tending to reproduce heterosexist models. Most of the papers on experiences and meanings did not give their participants a voice.

Letter to the Editor: The Impact of the COVID-19 Pandemic on the Mental Health of Youth with Developmental Disabilities.

Letter to the Editor: The Impact of the COVID-19 Pandemic on the Mental Health of Youth with Developmental Disabilities.

Factors related to suicide among students: a narrative review of psychological literature

PurposeThe purpose of this paper is to provide an educational overview of suicidal behavior and the factors related to suicidality among students between the ages of 18 and 30 years.Design/methodology/approachThe literature related to suicide among students were identified through various electronic database searches. The databases searched included: PsycINFO, PubMed, MEDLINE, ERIC/ProQuest, Embase, Scopus, Google Scholar and PMC using the following search terms and their derivatives: suicide/self-harm, suicide risk and students, mental health issues and suicide, substance use and suicide, childhood adversities and suicide, recent life stressors, help-seeking attitude and elevated suicidal risk, help-seeking behavior and suicide and subjective factors and suicide.FindingsSuicide is an important public health problem. Several factors influence suicide (including suicidal ideation and taking life or dying by suicide) such as genetics, family functions, socioeconomic status, personality and psychiatric comorbidity. The main themes that were investigated included: mental health issues, childhood adversity and recent life stressors, barriers toward seeking professional help and subjective factors (psychache risk of suicidal behavior, impulsivity, aggression).Originality/valueThis review focuses on several modifiable psychological factors that have been shown to contribute toward suicidal ideation in youth, especially among university students.

Neurocircuit Mechanisms of Active Suicidal Ideation in Youths and Young Adults: Findings From the T-Rad Study

Neurocircuit Mechanisms of Active Suicidal Ideation in Youths and Young Adults: Findings From the T-Rad Study

Deconstructing the role of the exposome in youth suicidal ideation: Trauma, neighborhood environment, developmental and gender effects

Environment (E) is pivotal in explaining variability in brain and behavior development, including suicidal ideation (SI) and behavior. It is therefore critical to systematically study relationships among environmental exposures (i.e., exposome) and suicidal phenotypes. Here, we evaluated the role of individual-level adversity and neighborhood environment and their interaction (E x E) in association with youth SI. Sample included youth (N = 7,054, ages 11–21) from the Philadelphia Neurodevelopmental Cohort, which investigated clinical phenotypes in a diverse US community population. We examined cross-sectional associations of environmental exposures with lifetime history of SI (n = 671), focusing on interactions between individual-level exposures to assaultive trauma (n = 917) and neighborhood-level socioeconomic status (SES) quantified using geocoded Census data. Models included potential confounds and overall psychopathology. Results showed that assaultive trauma was strongly associated with SI (OR = 3.3, 95%CI 2.7–4, p < .001), while low SES was not (p = .395). Both assault and low SES showed stronger association with SI in females, and in early adolescence (all E X gender/age interactions, p < .05). In traumatized youths, lower SES was associated with less SI, with no SES effects on SI in non-traumatized youths (Assault X SES interaction, Wald = 8.19, p = .004). Associations remained significant controlling for overall psychopathology. No single SES variable emerged above others to explain the moderating effect of SES. These findings may suggest a stress inoculation effect in low SES, where youths from higher SES are more impacted by the deleterious trauma-SI association. Determining which environmental factors contribute to resilience may inform population specific suicide prevention interventions. The cross-sectional study design limits causal inferences.

Predictors of Suicidal Thoughts in Children with Autism Spectrum Disorder and Anxiety or Obsessive-Compulsive Disorder: The Unique Contribution of Externalizing Behaviors.

Children with autism spectrum disorder (ASD) are at elevated risk of suicidal ideation, particularly those with comorbid anxiety disorders and/or obsessive-compulsive disorder (OCD). We investigated the risk factors associated with suicidal ideation in 166 children with ASD and comorbid anxiety disorders/OCD, and the unique contribution of externalizing behaviors. Suicidal ideation was reported in the child sample by 13% of parents. Controlling for child age, sex, and IQ, perceived loneliness positively predicted the likelihood of suicidal ideation. In addition, externalizing behaviors positively predicted suicidal ideation, controlling for all other factors. Reliance on parental report to detect suicidal ideation in youth with ASD is a limitation of this study. Nonetheless, these findings highlight the importance of assessing and addressing suicidal ideation in children with ASD and comorbid anxiety disorders/OCD, and more importantly in those with elevated externalizing behaviors and perceptions of loneliness.

Conducting School Suicide Risk Assessment in Distance Learning Environments.

The social distancing mandate, implemented in response to the coronavirus disease 2019 (COVID-19) global pandemic, has guided many schools to deliver instruction via distance learning. Among the many challenges generated by this delivery system is the need for school mental health services, including school suicide prevention and intervention, to be conducted remotely. After briefly discussing the magnitude of the problem of youth suicide and how the COVID-19 pandemic has likely increased risk for youth suicidal ideation and behaviors, this article provides guidance on how school systems can prepare for and conduct suicide risk assessments in distance learning environments.

Pediatric Suicide Screening: A Review of the Evidence

BackgroundSuicide rates are increasing for youths and suicide is the second leading cause of death for 10–24 year olds. This evidence-based practice project critically reviews literature regarding the effectiveness of pediatric suicide screening. MethodsA literature search was guided by the following question: In pediatric patients, does suicide screening at every health encounter compared to an annual screen increase clinician identification of patients at-risk. Ten articles met inclusion criteria and were critically appraised and synthesized. FindingsYouths had high rates of suicidal ideation (SI), anxiety, and depression. Pediatric universal suicide screening identified SI in youths with both psychiatric and non-psychiatric medical complaints. Patients with chronic health conditions reported higher rates of mental health symptoms and SI. A specific suicide screening instrument should be used as general mental health screens likely miss youths at-risk for SI. The Ask Suicide-Screening Questions tool is an easy to use and highly sensitive instrument for detecting suicide risk in youths. DiscussionMany youths that screen positive for SI do not have known mental health concerns and would have been missed if not asked directly. Universal screening for SI identifies at-risk youth and allows nurses and other providers to intervene. The need for universal screening across pediatric health care settings using brief, validated screening tools is paramount. Application to practiceNurses working in pediatric settings should champion universal screening for SI. Unit-based quality improvement projects using the Plan-Do-Study-Act change cycle provides a model for instituting universal screening for SI.

43.3 CLINICAL OUTCOME OF REMINDER-FOCUSED POSITIVE PSYCHIATRY AND SUICIDE PREVENTION EMERGENCY ROOM INTERVENTION IN CHILDREN WITH PTSD

PTSD is a prevalent disorder in children, associated with suicidality and increased psychiatry emergency room visits. This study investigates the effect of the Brief Reminder Focused Positive Psychiatry and Suicide Prevention Intervention (RFPP-S) on well-being, suicide ideation (SI), and PTSD symptoms in youth with PTSD admitted to Olive View-UCLA Psychiatry Emergency Room (OV-PER).

The relations between childhood maltreatment, shame, guilt, depression and suicidal ideation in inpatient adolescents

BackgroundPrevious studies demonstrated positive relations between various forms of maltreatment and suicidal ideation in youth; however, mechanisms underlying these relationships are not well understood. We propose that the experience of maltreatment in childhood may lead to high levels of generalized guilt and shame, resulting in an increase of depressive symptoms and suicidal thoughts in adolescents. The aim of the current study was to test our model of relations between these constructs using path analysis. Methods112 inpatient adolescents aged 12-17 years completed the Childhood Trauma Questionnaire to measure various types of maltreatment, the Personal Feelings Questionnaire to evaluate generalized guilt and shame, the Beck Depression Inventory-II to assess depressive symptoms, and the Columbia-Suicide Severity Rating Scale to assess suicidal ideation. ResultsFindings partly confirmed the theoretical model. Indirect positive effects of sexual and emotional abuse, as well as emotional and physical neglect on suicidal ideation via generalized self-conscious emotion and/or depression were demonstrated. In contrast to our predictions, indirect negative effects of physical abuse on suicidal thoughts via generalized guilt and shame and depression were found. LimitationsSample characterized by predominately Caucasian inpatient adolescents from financially stable and well-educated environments, over-reliance on self-report measures and the lack of a longitudinal design were main limitations of the study. ConclusionsThe study provides novel information on the potential mechanisms underlying the association between childhood maltreatment and suicidal ideation in adolescents. Generalized guilt and/or shame could be possible targets for interventions for victims of some forms of maltreatment to reduce depressive symptoms and suicidal ideation.

Youth Substance Use and Suicide Behavior

Suicidal behavior in adolescents has increased by 56% over the last 10 years [1]. Suicide was the second leading cause of death for adolescents in 2016 [2]. The number of hospitalizations for teen suicide attempts nearly doubled from 2008 to 2015 [3]. Understanding the underlying causes of adolescent suicide is necessary for suicide prevention [4]. Because of the complex setting in which suicide behaviors occur, the literature has not definitively identified factors that cause suicide behavior but it has identified a complex combination of precipitating or contributing factors including mental illness, lack of connectedness, stress, and substance use [5]. The current review focuses on four substances identified by SAMHSA’s as core measures [6]: alcohol, tobacco, marijuana and prescription drugs. These are the substances most commonly reported to be used by youth. We reviewed their relationship with youth suicidal ideation (SI), suicidal planning (SP) and attempts (SA).

Restrictive eating, but not binge eating or purging, predicts suicidal ideation in adolescents and young adults with low-weight eating disorders.

This study examined the relationship between eating-disorder behaviors-including restrictive eating, binge eating, and purging-and suicidal ideation. We hypothesized that restrictive eating would significantly predict suicidal ideation, beyond the effects of binge eating/purging. Participants were 82 adolescents and young adults with low-weight eating disorders. We conducted a hierarchical logistic regression, with binge eating and purging in Step 1 and restrictive eating in Step 2, to predict suicidal ideation. Step 1 was significant (p = .01) and explained 20% variance in suicidal ideation; neither binge eating nor purging significantly predicted suicidal ideation. Adding restrictive eating in Step 2 significantly improved the model (ΔR2 = .07, p = .009). This final model explained 27% of the variance, and restrictive eating (but not binge eating/purging) significantly predicted suicidal ideation (p = .02). Restrictive eating is associated with suicidal ideation in youth with low-weight eating disorders, beyond the effects of other eating-disorder behaviors. Although healthcare providers may be more likely to screen for suicidality in patients with binge eating and purging, our findings indicate clinicians should regularly assess suicide and self-injury in patients with restrictive eating. Future research examining how individuals progress from suicidal ideation to suicidal attempts can further enhance our understanding of suicide in eating disorders.

Predicting risk of suicidal ideation in youth using a multigene panel for impulsive aggression

Childhood traumatic experiences and impulsive aggression are strong predictors of suicide ideation in youth. This study examines whether a gene panel previously associated with impulsive aggression, together with a measure of traumatic experience, will predict suicidal ideation in youth. The sample consisted of 158 youth (ages 9–17 years) of European ancestry that participated in a case-control study for childhood aggression. The Massachusetts Youth Screening Instrument (MAYSI-2) was used to examine suicide ideation and traumatic experiences. The impulsive aggression gene panel consists of 5 markers across 5 susceptibility genes (CRH, CRHR2, MC2R, OXTR, BDNF). A multi-gene risk score (MRS) for each individual was calculated by taking the total number of risk genotypes for that person. The covariates for the multiple regression model included sex, age, symptoms of anxiety/depression, MRS, traumatic experiences, and MRS x traumatic experience interaction. Results show the MRS x traumatic experience interaction term and the anxious/depressed symptoms to be significant predictors of suicide ideation in the full model. Importantly, genetic susceptibility to impulsive aggression and traumatic experiences remained a significant predictor for suicide ideation over and above the youth's level of anxiety and depression. This finding may have important implications for early intervention for youth suicide-related behaviors.