Suicidal Ideation In Adolescents Research Articles

Under the surface: paranoid and unusual thought content are associated with depressive symptoms and suicidal ideation in adolescents entering psychiatric care

ABSTRACT Background Psychotic Like Experiences (PLEs), suicidal ideation, and depressive symptoms are related and common symptoms in adolescents treated in psychiatric services. However, more granular analysis of the associations between the two types of symptoms is sparse. This study aims to investigate the associations between self-reported PLEs and depressive symptoms on a sub-scale and item level, among adolescents attending secondary level psychiatric care. Methods The sample included 328 adolescents (aged 13–18 years) attending adolescent psychiatry outpatient units of the Helsinki University Hospital. Depressive symptoms were assessed using the BDI-1A (total score and separate Suicidal Ideation item score). PLEs were assessed with the PQ-B and analysed as sum scores for the sub-scales Sensory Distortion, Grandiosity, Disorganised Speech, Paranoia, and Unusual Thoughts. Results High scores on PQ-B subscales Paranoia and Unusual Thoughts were both independently associated with more depression and suicidality. Item analysis showed that the associations between PLEs and depression were driven by two PQ-B Paranoia subscale items, and one Unusual Thoughts subscale item. Discussion The findings suggest that the association between PLEs and depressive symptoms is driven by paranoid experiences and unusual thought content. Professionals in psychiatric care should expect this type of co-occurrence.

The effects of subjective family status and subjective school status on depression and suicidal ideation among adolescents: the role of anxiety and psychological resilience.

Depression and suicidal tendencies are notably prevalent among adolescents, yet few studies have revealed the impact of social status on them. This study aimed to explore the mediating and moderating effects of anxiety and psychological resilience on family status, school status, depression, and suicidal ideation. A total of 1,190 secondary school students aged 13 to 17 years (mean age: 13.57 ± 2.02 years) were evaluated depression, anxiety, and suicidal ideation using the PHQ-8 and GAD-7 questionnaires. Subjective family and school status were also assessed. Data analysis was conducted using Mplus, SPSS's Process, and the RSA 3.0 plugin. Subjective family/school status, anxiety, psychological resilience, depression, and suicidal ideation were significantly correlated. Anxiety played a partial mediating role in the influence of subjective family status and subjective school on depression and suicidal ideation, and psychological resilience moderated the impact of anxiety on adolescent depression and suicidal ideation (βdepression = -0.05, p < 0.01; βsuicidal ideation = -0.06, p < 0.05). Subjective family status and school status played important roles in depression and suicidal ideation in adolescents, and anxiety and psychological resilience played mediating and moderating roles.

Loneliness, Internalizing and Externalizing Problems, and Suicidal Ideation Among Chinese Adolescents: A Longitudinal Mediation Analysis

PurposeResearch indicates that loneliness and emotional and behavioral problems increase the risk of suicidal ideation in adolescents, but less is known about the distinct contributions of these problems. This study aimed to distinguish the pathways through which loneliness, internalizing problems, and externalizing problems contribute to suicidal ideation in Chinese adolescents. MethodsWe did a longitudinal mediation analysis with data collected at 3 time points (2021.05, 2021.10, and 2022.05) from 28 Taizhou high schools. Loneliness and suicidal ideation were assessed using the UCLA 3-Item Loneliness Scale and one suicide item from the Children’s Depression Inventory, respectively. The Strength and Difficulties Questionnaire assessed internalizing (emotional and peer problems) and externalizing problems (conduct and hyperactivity problems). Structural equation modeling was used to construct complete longitudinal path models. ResultsUsing data from 2,190 adolescents in junior and senior high schools, we found that loneliness, internalizing problems, and externalizing problems separately contributed to subsequent higher levels of suicidal ideation. Most notably, loneliness predicted worse subsequent internalizing problems (β = 0.279, p < .001) and externalizing problems (β = 0.159, p < .001), which in turn predicted more severe suicidal ideation (β = 0.019, p < .001; β = 0.018, p < .001). Loneliness also partially mediated the association between internalizing or externalizing problems and suicidal ideation. DiscussionLoneliness, internalizing problems, and externalizing problems were strongly intertwined with suicidal ideation in adolescents. Public health initiatives could reduce loneliness and emotional and behavioral problems by implementing multifaceted interventions, thereby breaking the vicious circle and protecting against the development of suicidal ideation.

The trajectories and associations of sleep disturbance symptoms with suicidal ideation in adolescents: A three-wave longitudinal study

BackgroundThis study aimed to investigate the developmental trajectories of sleep disturbance symptoms and examine whether specific trajectory memberships of sleep disturbance symptoms could prospectively predict suicidal ideation (SI) among a large sample of Chinese adolescents over one year. MethodsA three-wave longitudinal study was conducted from April 2021 to June 2022, with a sample of 19,095 adolescents from Shenzhen in Guangdong Province, China (51.2% males; mean age = 12.4 ± 1.6 years at baseline). Socio-demographics (at baseline), SI, sleep disturbance symptoms (at each assessment), depressive symptoms (at the last follow-up), and negative life events (at two follow-ups) were assessed. Data were analyzed employing Growth Mixture Modeling and binary logistic regressions. ResultsThe Growth Mixture Modeling identified four trajectories of sleep disturbance symptoms over one year: resistant group (76.2%), delayed-dysfunction group (8.8%), recovery group (7.4%), and chronic-dysfunction group (7.6%). Binary logistic regression analysis revealed that adolescents in the group of delayed-dysfunction (OR = 2.86, 95% CI = 2.51-3.27) and chronic-dysfunction (OR = 2.14, 95% CI = 1.84-2.47) exhibited higher risks of developing SI compared to those in the resistant group, even after controlling for socio-demographics, negative life events, depressive symptoms, and baseline SI. ConclusionsThese findings underscore the importance of identifying individuals at higher risks of sleep disturbance and providing personalized and effective mental health services to reduce the incidence of SI.

Navigating the emotional maze: Understanding Adolescent suicidal ideation using CNN-LSTM model

Teenage suicidal ideation is on the rise, which emphasizes how crucial it is to recognize and comprehend the variables that contribute to this problem. Convolutional neural networks (CNNs), which are complex machine learning models capable of analysing intricate relationships within a network, are one possible strategy for addressing this issue. In our study, we employed a CNN-LSTM hybrid model to explore the complex relationships between teen suicide ideation and various risk variables, including depression, anxiety, and social support by analysing a substantial dataset of mental health surveys, seeking patterns and risk factors associated with suicidal thoughts. Our objective was clear: identify adolescents prone to suicidal ideation. With 24 parameters and a sample size of 3075 subjects, our model achieved an impressive F1-score of 97.8%. These findings provide valuable insights which helps in developing effective preventive interventions to address adolescent suicidal ideation, finding out the important patterns and risk variables related to suicidal thoughts. The study results offer important direction for developing preventive interventions that successfully address adolescent suicidal ideation.

How can the Social Family Climate Contribute to Emotional Intelligence in Preventing Suicidal Ideation and Promoting Life Satisfaction Among Adolescents?

While findings have documented the association between emotional intelligence, life satisfaction, and suicidal ideation among adolescents, few studies have investigated the moderating effect of family climate on the association. This study examined the moderating effect of family cohesion, expressiveness, and conflict on the relationships between emotional intelligence, life satisfaction, and suicidal ideation among Spanish adolescents. A total of 2,722 adolescents aged 12 to 18 (Mage = 14.11, SD = 1.42, 52.8% girls) formed the sample. The interaction effects were significant, with family conflict mitigating the effects of emotional intelligence on life satisfaction, and family cohesion and expressiveness strengthening the effects of emotional intelligence on suicidal ideation. These findings provide additional evidence for the protective role of family cohesion and expressiveness in adolescent suicidal ideation, and the harmful role of family conflict in adolescent wellbeing. The results imply that enhancing family cohesion and expressiveness and reducing family conflict may be a promising way to boost the link between emotional intelligence and life satisfaction and to prevent suicidal ideation among adolescents.

Association of Pain Intensity and Sensitivity with Suicidal Ideation in Adolescents with Depressive Disorder.

The purpose of this study was to further explore the association of pain intensity and sensitivity with suicidal ideation in adolescents with depressive disorder by comparing the differences in pain intensity and sensitivity between adolescent patients with depressive disorders and healthy controls. A consecutive enrollment method was used to select 158 adolescent patients with depressive disorders from three hospitals in Anhui Province as the MDD group, and 47 healthy adolescents were recruited as the Control group. The subjects' suicidal ideation was assessed using the Positive and Negative Suicide Ideation scale (PANSI), and the intensity of somatic pain was assessed using the Numerical Rating Scale-11 (NRS-11). Subjects were assessed for forearm and tibial pain sensitivity using a hand-held pressure pain instrument, and experimental pain sensitivity measures included pressure pain threshold (PPT) and pressure pain tolerance (PTO). Differences in pain intensity and sensitivity between the MDD group and the Control group were compared, and the association of pain intensity and sensitivity with suicidal ideation was analyzed. The incidence of physical pain in adolescent depressive disorder was higher at 88.6%, which was significantly higher than the Control group (P<0.001), and the pain intensity in the MDD group (3.77±2.48) was significantly higher than the Control group (0.617±0.99) (P <0.001).The Pain tolerance was significantly higher in the MDD group (forearm 105.37 ± 41.46; tibia 121.29 ± 41.60) than in the Control group (forearm 91.92 ± 37.62; tibia 105.47 ± 35.52) (P < 0.05).Linear regression analysis showed that the greater the pain intensity and pain tolerance, the higher the total PANSI score.Binary logistic regression showed that pain intensity was an influencing factor for suicidal ideation. Adolescents with depressive disorders have higher pain intensity and lower pain sensitivity than healthy adolescents. Increased pain intensity and pain tolerance were positively correlated with suicidal ideation.

The Relationship Between Discrimination Experience and Suicidal Ideation of Adolescents: Moderating Effect of Self-Esteem

The Relationship Between Discrimination Experience and Suicidal Ideation of Adolescents: Moderating Effect of Self-Esteem

Self-compassion, self-referential caudate circuitry, and adolescent suicide ideation

Suicide is the second leading cause of death in youth, and depression is a strong proximal predictor of adolescent suicide. It is important to identify psychological factors that may protect against suicide ideation in depressed adolescents. Self-compassion may be such a factor. Converging evidence indicates the inverse association between self-compassion and suicide ideation, but the neural mechanisms underlying their link remain unknown. Because self-referential caudate activity is associated with both self-compassion and suicide ideation, its functional connectivity might explain their relationship. In this study, we examined the relationship between self-compassion and caudate functional connectivity during self-appraisals, a typical self-referential paradigm, and their associations with suicide ideation in both depressed and healthy youth. In the scanner, 79 depressed youth and 36 healthy controls evaluated, from various perspectives, whether phrases they heard were self-descriptive. Self-compassion and suicide ideation were rated with self-report and interview-based measures. We found that self-compassion was associated with stronger left caudate functional connectivity with bilateral posterior superior temporal sulcus/temporoparietal junction, the left middle temporal gyrus (MTG), and the left middle occipital gyrus during positive versus negative self-appraisals. Stronger left caudate connectivity with the left MTG explained the association between higher self-compassion and lower suicide ideation, even controlling for non-suicide ideation depression severity, anxiety severity, and non-suicidal self-injurious behavior. The findings suggest that the left caudate to MTG connectivity during positive versus negative self-referential processing could be a biomarker to be targeted by neural stimulation interventions for reducing suicide ideation in depressed youth, combined with self-compassion interventions.

Chronic stress and lack of social support: Role in adolescent depression and suicide-related behaviors in the context of the COVID-19 pandemic

ObjectiveThis study aimed to examine acute and chronic stressors, and perceived lack social support, and their associations with depression and suicidal ideation in adolescents during the COVID-19 pandemic. MethodsDeidentified data from (N = 270,153) U.S. adolescents aged 11 to 17 who completed the Patient Health Questionnaire 9-item tool (PHQ-9) in the years 2020 and 2021 were sourced from a collection of online screening tools that are free, confidential, anonymous, and scientifically validated. In addition to depression, the survey included questions about suicidality, past/chronic stressful events, and contributors to mental health problems and sociodemographic variables. SPSS software version 28 for descriptive analyses, and Mplus version 7.31 for confirmatory factor analysis (CFA) and structural equation modeling (SEM), were respectively used. ResultsParticipants were predominantly female, White, and heterosexual, and exhibited a high prevalence of severe depression and a significant frequency of suicidal thoughts. Significant associations were found between past/chronic stressful events, and lack of social support, with suicidality and depression. Mental health stress due to the COVID-19 pandemic itself presented no significant associations with depression and suicidality and was weakly and negatively associated with lack of social support and past/chronic stressors. DiscussionThese findings reinforce the notion that prior traumatic events can create vulnerabilities in the face of acute stressors, while social support can enhance resilience in adolescents. Factors that increase resilience, such as preventing traumatic events, reducing social stressors, and increasing social support, can serve as valuable guidelines for clinical and public health interventions.

An Umbrella Review of Cognitive Behavioural and Dialectical Behavioural Therapies to Treat Self-Harm and Suicidal Behaviour in Adolescents.

The incidence of self-harm and suicidal behaviour in adolescents is increasing. Considering the great impact in this population, an actualization of the evidence of those psychological treatment's excellence for suicidal behaviour. Thus, the aim of this paper is to compile the available evidence on the effectiveness of cognitive behavioural therapy and dialectical behavioural therapy in preventing self-harm and suicidal behaviour in adolescents. A umbrella review was carried out, different databases (PubMed, CINAHL, Cochrane Library, Psyinfo, Embase, Web of Science, Scopus and Google Scholar) were consulted. The 16-item measurement tool to assess systematic reviews-2 (AMSTAR-2) were performed by two independent reviewers and any discrepancies were resolved by consensus. The Rayyan-Qatar Computing Research Institute was used for the screening process. Nine systematic reviews were included. Cognitive Behavioural Therapy appears to reduce the incidence of suicide-related events compared with treatment as usual, compared to usual treatment (which usually consists of drugs and talk therapy) especially when combined with fluoxetine. Dialectical behavioural therapy seems to be associated with a reduction in suicidal ideation and self-harm. Although the results found show results with high heterogeneity. The evidence on cognitive behavioural therapy and dialectical behavioural therapy for suicide prevention, self-harm and suicide ideation in adolescents seems to show positive results. Considering, the special population and great impact, further research is needed and comparable studies should be sought that allow to set up robust recommendations.

An Analysis of the Longitudinal Effects of Academic Stress, Insecure Attachment, and Sense of Community on Adolescent Suicidal Ideation.

This study aimed to examine the independent influences of academic stress, insecure attachment, and sense of community on suicidal ideation among adolescents. In particular, the independent influence of the sense of community on adolescent suicide was verified by controlling for other variables. For this purpose, youth data (7324 persons) from the panel data of the 4th to 6th Korean Education Longitudinal Studies of the Korea Educational Development Institute were used. Statistical analyses were performed using a generalized estimation equation (GEE). The analysis revealed that gender, academic stress, insecure attachment, and sense of community significantly influenced suicidal ideation. Female students had higher suicidal ideation than male students, and the higher the academic stress and degree of insecure attachment, the higher the suicidal ideation. In particular, the independent influence of a sense of community on suicidal ideation was significant; the higher the sense of community, the lower the suicide ideation score. The implication of this study is to comprehensively consider the factors related to adolescent suicidal ideation in various systems based on Bronfenbrenner's ecological theory. This research suggests that helping schools and communities to increase their sense of community, which is a macrosystem factor, is important in preventing adolescent suicide.

Exploration of Risk Factors for Suicidal Ideation in Depressed Adolescents

Background: Adolescents are a vulnerable group for mental health problems, one of which is depression. Research on adolescents with depression with suicidal ideation in the General Hospital Polyclinic is still very rare. Adolescents who undergo depression treatment while in the RSU Polyclinic need to know the cause and how resilient they are to their suicidal ideation to be the basis for further intervention. Research Objective: This study aims to explore the risk factors for suicidal ideation in adolescents who experience depression in the Mental Health Polyclinic of Permata Medika Hospital. Methodology: Phenomenological studies are used as an appropriate method to explore the resilience experiences of adolescents with suicidal ideation who experience depression. Data collection was carried out through in-depth interviews with semi-structured interview guidelines. The participants in this study were 6 young adults who experienced depression. Data analysis used Colaizzi's theory with the stages of data transcription, significant statements, formulating categories, sub-themes and themes contained in significant statements. Results: The data analysis process found 2 themes consisting of risk factors for suicidal ideation: 1) Internal factors consisting of a closed and ambitious personality and physical illness, 2) External factors consisting of unpleasant experiences (bullying, loss, trauma, parental separation), parenting patterns, and unfulfilled desires. Conclusion: Depression and suicidal behaviour are closely related. The causes of suicide from parenting patterns in the family, closed personality, bullying, relationship problems and physical illnesses that result in prolonged sadness, distrust, depression, self-harm behavior to suicide.

The Relationship Between Cumulative Ecological Risk and Adolescent Suicidal Ideation: The Moderating Role of the Meaning in Life

The Relationship Between Cumulative Ecological Risk and Adolescent Suicidal Ideation: The Moderating Role of the Meaning in Life

Suicidal ideation in adolescence: an explanation from three of its associated variables in Bogotá, 2009

Objective: To determine the relationship between hopelessness, loneliness and the level of family health in school-age adolescents with and without suicidal ideation to deepen in the knowledge of this phenomenon from a nursing point of view and to pose promotion and prevention options in Bogotá, Colombia. Method: This was a cross-sectional, comparative, correlational, descriptive and quantitative study. The sample was selected in the period between February and April 2009, through mixed sampling and 482 school-attending 14-17 year-old adolescents were included. Widely recognized and highly qualified psychometric tools were used to measure the variables concerned. Univariate, bivariate and multivariate statistic analysis were used to describe the behavior of each variable, to explore the relationships and contrasts between these variables and to estimate the effect of the independent variables on the presence of suicidal thoughts. This study has followed the ethical considerations necessary for research involving human beings.Results: 20% of the sample used reported the presence of suicidal thoughts or desires. All variables studied influence the presence of suicidal thoughts except age, socioeconomic strata, borough and type of school. However, with the use of logistic regression methods, the variables that best express the presence of suicidal thoughts are: previous suicide attempt, low self-esteem, depression and belonging to an unhealthy family.Conclusions: Data on suicidal ideation and attempts made in this study support the idea of implementing greater preventive efforts within families and schools. Identifying adolescents at risk of suicide or mental health disorders, and build effective prevention and treatment programs is a priority.

Dynamic Deconstructive Psychotherapy for Suicidal Adolescents: Effectiveness of Routine Care in an Outpatient Clinic.

Suicidal behavior and demand for services have been increasing in adolescents. Many of the current treatments are focused on symptom mitigation, crisis management, and safety planning; however, few are aimed at remediating underlying vulnerabilities that may be contributing to suicide risk. Dynamic Deconstructive Psychotherapy (DDP) has been found to be effective for suicidal adults but has never been studied for adolescents. The present study examined real-world outcomes of 65 suicidal adolescents, aged 13-17 years, receiving weekly DDP in an outpatient clinic. The primary outcome was change in suicide ideation from baseline to 6 months of treatment as assessed by the Suicide Ideation Subscale of the Columbia Suicide Severity Rating Scale. In intent-to-treat analyses, suicide ideation significantly decreased over the 6 months with a large treatment effect (d = 1.19). Secondary measures, such as suicide attempts, self-harm, depression, anxiety, disability, self-compassion, and inpatient utilization, also improved significantly. Among the 42 adolescents (65%) who completed at least 6 months of treatment, suicide attempts decreased by 84%. DDP may be effective in reducing suicide ideation and other risk factors in suicidal adolescents and may be cost-effective given reduced inpatient utilization. These initial promising findings warrant further research and development.

Suicide is my only way: The longitudinal reciprocal relations of experiential avoidance, cognitive fusion, and suicidal ideation among adolescents

Experiential avoidance and cognitive fusion, the two interrelated processes central to psychological inflexibility according to Acceptance and Commitment Therapy, were theoretically and empirically related to adolescent suicidal ideation. However, the longitudinal interaction among experiential avoidance, cognitive fusion, and adolescent suicidal ideation has yet to be empirically examined. As such, our study aims to examine the longitudinal reciprocal relationships among these variables using the cross-lagged panel model (CLPM) and random intercept cross-lagged panel model (RI-CLPM). A total of 1720 Chinese adolescents (54.6% females; Mage = 14.44, SDage = 1.35) completed self-reported questionnaires regarding experiential avoidance, cognitive fusion, and suicidal ideation on three occasions, using 6-month intervals. The results showed that in CLPM, experiential avoidance, cognitive fusion, and suicidal ideation positively predicted each other. However, RI-CLPM only provided support for the longitudinal interaction between experiential avoidance and cognitive fusion as well as the role of suicidal ideation in exacerbating experiential avoidance and cognitive fusion. The findings highlight that suicidal ideation may lead to increased levels of experiential avoidance and cognitive fusion in adolescents and the need to distinguish between within-person and between-person effects when studying the relationship between psychological inflexibility and adolescent suicidal ideation.

Perceived functions and importance of digital media use and adolescent depression and suicidal ideation.

Although social media (SM) use is nearly ubiquitous among adolescents, there is a lack of clarity concerning the relationship between SM use and mental health outcomes like depression and suicidal ideation (SI), which increase during adolescence. Much of the previous literature has focused on the frequency of SM use; however, the current study examined the relationship between the perceived importance of three types of interactions and functions of SM use and depressive symptoms and suicidal ideation. A sample of 4057 adolescents (M age = 14.6; 47.0% girls; 69.0% Non-Hispanic/Latine White) were recruited via an online survey manager between February and March 2019. Participants completed the Adolescent Digital Technology Interactions and Importance (ADTI) Scale, which assessed the perceived importance of bridging online and offline experiences (bridging), going outside one's identity or offline experience (identity), and facilitating social connections (social). Participants also completed measures of depressive symptoms and SI and a self-report measure of SM use. A series of path analyses were conducted to examine the relationship between bridging, identity, social, and depressive symptoms and SI. After accounting for covariates (gender identity, racial identity, age, and SM use), bridging was negatively associated with depressive symptoms, whereas identity was positively associated with depressive symptoms. Bridging and social connection were negatively associated with SI, whereas identity was positively associated with SI. Gender moderated these relationships; however, racial identity did not. The results highlight the importance of understanding adolescent SM use beyond screen time in relation to depression and SI.

A Systematic Review on Ketamine and Esketamine for Treatment-Resistant Depression and Suicidality in Adolescents: A New Hope?

Treating depression in adolescents is a significant challenge, and major depressive disorder (MDD) with suicidal ideation and treatment-resistant depression (TRD) are common and potentially devastating to optimal psychological and physical development in this age group. Suicide is among the leading causes of youth mortality, and TRD occurs in up to 40% of adolescents with MDD. TRD involves severe, persistent symptoms that are hard to treat, significantly reducing functioning and quality of life. We conducted a literature search focusing on key terms related to ketamine and esketamine for MDD with suicidal ideation and TRD in adolescents, aiming to review the potential utility of these molecules in adolescents for these conditions. Ketamine has shown efficacy in reducing depressive symptoms in adolescents with TRD. Esketamine has shown efficacy in reducing depressive symptoms and treating suicidal ideation in adolescents. Both ketamine and esketamine have demonstrated favorable safety and tolerability profiles. Using these drugs for serious conditions like adolescent MDD with suicidal thoughts and TRD can effectively treat symptoms, reduce self-harm and suicide risks, and provide a window for longer-term therapeutic interventions. The prompt and effective treatment of TRD could improve adolescents' quality of life. However, more research is needed to optimize treatment protocols and evaluate long-term effects.

Family Functioning and Academic Burnout in Adolescent Suicide Ideation

Family Functioning and Academic Burnout in Adolescent Suicide Ideation