The decline of youth suicidal behavior in an urban, multicultural public school system following the introduction of a suicide prevention and intervention program

A 5-year longitudinal study of suicidal behavior of students attending Dade County Public Schools (DCPS) in Miami, Florida, between the 1989-1990 and 1993-1994 school years, is described. As the fourth largest public school system in the United States, DCPS is representative of an urban, multicultural community. The prevalence of suicidal behavior among DCPS students necessitated the development of a districtwide Suicide Prevention and School Crisis Management Program (SPSCMP), including the creation of the "Youth in Crisis Hotline." A review of eight national school districts' suicide prevention and intervention programs indicates similarities with the DCPS model. Statistical data compiled by the DCPS program are organized into annual, monthly, grade level, and school level classifications, and are analyzed to determine the degree and direction of self-destructive behavior among youth in a culturally and linguistically diverse school population following the introduction of a suicide prevention and intervention program. Evaluative data regarding the effectiveness of the program as well as implications for suicide prevention and intervention are discussed.     

School-based suicide prevention with African American youth in an urban setting.

Youth in urban settings are at significant risk for suicide and other mental health issues, but little is known about the utility or outcomes of suicide prevention programs with this population. This article reviews the outcomes of a grant-funded initiative to provide suicide screening to urban, African American youth. Columbia TeenScreen was implemented at 13 middle and high schools in Washington, DC, to 229 Black or African American students. Forty-five percent of students screened positively for previous suicide attempt or ideation, symptoms of depression or anxiety, and/or other emotional problems. Twenty percent of all youth screened endorsed current or previous suicidal ideation or attempts. Over 90% of youth endorsed at least some problem with depression or irritability. Early detection of risk factors through universal screening can lead to earlier treatment, thwarting a suicidal crisis. Implications for conducting screening in an urban setting and how psychologists can engage in screening are explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial risk factors for future adolescent suicide attempts.

An array of psychosocial risk factors for making a suicide attempt were examined in a representative sample of 1,508 older high school students (aged 14–18 yrs), 26 of whom made a suicide attempt during the year following entry into the study. Strongest predictors of future suicide attempt were history of past attempt, current suicidal ideation and depression, recent attempt by a friend, low self-esteem, and having been born to a teenage mother. Results suggest that adolescents who are depressed and those who attempt suicide share many psychosocial risk factors. The efficacy of 2 screeners (one consisting of 4 items and the other of 6 variables) is reported. Potential usefulness for research and community wide prevention is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A college suicide prevention model for American Indian students.

College student suicide prevention efforts are important to campus administrators and mental health professionals due to increasing concerns about managing suicidal students. This article describes the development and preliminary effectiveness of a campus suicide prevention program designed for American Indian (AI) students who are at higher risk for suicide compared with the general population. Using the medicine wheel as a guiding framework, the current prevention model integrates communication links between AI tribes and prevention program staff, educational and cultural programming, and spiritual ceremonies with the larger campus mental health resources available to students. A discussion of the barriers faced and solutions generated for implementing the program is offered, along with suggestions for disseminating this AI-specific prevention program to other universities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Silicone gel and delayed hypersensitivity

The present study explored the relationship of scores on acculturative stress with those on depression and suicidal ideation among 26 male and 28 female Mexican-American students from a southern California high school. Subjects completed the SAFE acculturative stress scale, the Reynolds Adolescent Depression Scale, and the Suicidal Ideation Questionnaire-Junior. Analyses suggested that acculturating Mexican-American adolescents who report high scores on acculturative stress may report elevated scores for depression and suicidal ideation. Researchers should assess suicide risk within this and other acculturating groups, and risk factors specific to acculturating groups should be considered in the development and implementation of suicide prevention programs in schools.     

Suicide and depression among college students: A decade later.

Are suicidal thoughts and depression increasing or decreasing among college students? What life circumstances are the most critical to explore with depressed or suicidal college students? This article focuses on the rate of self-assessed depression and suicide among college students and examines contributing factors and help-seeking behavior. Results of the study indicated that 53% of the sample stated that they experienced depression since beginning college, with 9% reporting that they had considered committing suicide since beginning college. Suggestions for college mental health practitioners related to programming, prevention, and psychoeducation are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathology of adolescent suicide: Hopelessness, coping beliefs, and depression.

Two studies of adolescents examined the relation of several cognitive variables and depression to suicide-related behaviors. Study 1 compared hopelessness and depression in 281 high school students. Unlike research with adults, depression was significantly related to suicidal behaviors, even after hopelessness was statistically controlled. When depression was controlled, hopelessness was unrelated to suicidal behaviors for boys and only modestly related for girls. Study 2 examined depression, hopelessness, survival–coping beliefs, fear of social disapproval, and social desirability in relation to suicidal behaviors in 53 male juvenile delinquents. Again, hopelessness did not account for a significant proportion of the variance in suicide. Depression was uniquely related to past suicide attempts. Survival–coping beliefs were associated with self-predicted future suicide and other suicidal behaviors. Survival–coping beliefs are discussed as a cognitive buffer to suicidal ideation in adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

étude des composantes dépressives chez des adolescents à tendances suicidaires.

Studied symptoms of depression in adolescents with suicidal tendencies. Ss were 2,850 secondary school students (aged 12–18 yrs). Ss completed a questionnaire assessing sociodemographic variables, symptoms of depression, and suicidality. Results from the following subsamples were compared: (1) 105 Ss with suicidal ideation; (2) 206 Ss with suicidal ideation who had contemplated specific means of suicide; (3) 94 Ss who had attempted suicide; (4) 62 Ss with depression but without suicidal ideation; and (5) 336 age-, gender-, and grade-matched comparison Ss without suicidal ideation. The Dysphoria Scale by L. S. Radloff (1977) was used. (English abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent suicide prevention: Current research and social policy implications.

The rate of adolescent suicide has increased dramatically in the past few decades, prompting several interventions to curb the increase. Unfortunately, many of the intervention efforts have not benefited from current research findings because the communication between researchers and those who develop the interventions is inadequate. Of specific concern are the increasingly popular curriculum-based suicide prevention programs, which have not demonstrated effectiveness and may contain potentially deleterious components. This article reviews the current epidemiological research in adolescent suicide and suggests how this knowledge could be used more effectively to reduce the rate of adolescent suicide. Recommendations include support for integrated primary prevention efforts; suicide prevention education for professionals; education and policies on firearm management; education for the media about adolescent suicide; more efficient identification and treatment of at-risk youth, including those exposed to suicidal behavior; crisis intervention; and treatment for suicide attempters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidal ideation among college students in the United States.

This study analyzed data from the 1995 National College Health Risk Behavior Survey (NCHRBS) to assess the prevalence of suicidal ideation among college students in the United States and to examine the association between suicidal ideation and substance use in this population. The NCHRBS used a mail questionnaire to assess health-risk behaviors in a nationally representative sample of undergraduate students. During the 12 months preceding the survey, 10% of the students had seriously considered attempting suicide. When controlling for demographic characteristics, the analysis showed that students who had considered suicide were at increased odds of using tobacco, alcohol, and illegal drugs. These results suggest that colleges and universities should establish suicide prevention programs that also address the related problem of substance use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tennessee Lives Count: Statewide gatekeeper training for youth suicide prevention.

Youth suicide remains a significant public health problem in the United States. In 2004, the Garrett Lee Smith Memorial Act provided states and tribes with funding to implement and evaluate youth suicide prevention programs. The Tennessee Lives Count project was developed through a collaborative model at the state level and delivers an enhanced version of the Question, Persuade, Refer gatekeeper training program to individuals working with youth across the state. This article describes the development of the project and preliminary outcomes of 416 participants in child welfare, juvenile justice, health, and education systems at pretest, posttest, and 6-month follow-up. The findings suggest the training has an immediate and long-term impact on perceived knowledge of suicide prevention, self-efficacy, and attitudes about the inevitability of suicide. Policy and practice implications are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cancer pain management in developing countries: a mosaic of complex issues resulting in inadequate analgesia

OBJECTIVE: To determine the prevalence of suicidal ideation and the symptomatic profile as well as to identify the sociodemographic characteristics highlighting female adolescents with the highest scores on suicidal ideation in adolescents living in Mexico City: students and suicidal patients. MATERIAL AND METHODS: A cross-sectional and ex-post-facto study was carried out in order to analyze information from two samples: 1,712 junior and junior high school women students (representative student sample in Mexico City), and 30 adolescents inpatient hospitalized for her suicide attempts (clinical sample). RESULTS: Prevalence of presence as well as persistence of suicidal ideation were higher in the clinical sample, nevertheless 11.8% of the school sample had everyone of the symptoms in a range of 1 to 7 days. The most persistent of the ideation symptoms was: "My family would be better if I were dead"; and in the clinical sample it was "I thought about killing myself". Finally, the sociodemographic characteristics that best matched the student girls having the highest scores in suicidal ideation were: to be on junior high school, to get low grades, to acknowledge school performance as bad and to have interrupted her studies. The characteristics that highlight the girls with a first attempt were analyzed in the clinic sample in comparison with those ones with two or more attempts. It was significant that girls in the second group were living only with one parent and they thought in the last attempt that their dead would be possible or certain. CONCLUSIONS: The prevalence of suicidal ideation was important in the school sample. If it is considered that this psychological construct has a strong association with suicidal attempt, and multiple suicide conduct, then is a priority to detect adolescents in risk and to make preventive efforts, considering the sociodemographic characteristics that configurate in risk for suicidal ideation.     

Phonological codes are early sources of constraint in visual semantic categorization

Current statistics show a marked increase in suicides among adolescents 15 to 19 years of age. The literature suggests an increase in the use of lethal methods such as firearms by young suicide attempters. Studies show that most adolescent suicide completers have never received mental health treatment, although the majority had exhibited psychiatric symptoms previous to their deaths. This review of the literature identifies the characteristics and precipitants of suicidal behavior among adolescents. The literature clearly indicates a need for suicide awareness and prevention programs and for the early identification of teenagers at risk for suicidal behaviors. The most logical location for suicide prevention programs and activities is in the schools where the greatest number of adolescents can be reached. The master's-prepared psychiatric mental health nurse in a consultive and collaborative role can be instrumental in the successful formation and execution of these programs. In a joint effort, school personnel and the psychiatric mental health nurse specialist may be able to decrease significantly the number of suicidal behaviors among adolescents.     

Suicidality as a function of impulsivity, callous–unemotional traits, and depressive symptoms in youth.

Suicidality represents one of the most important areas of risk for adolescents, with both internalizing (e.g., depression, anxiety) and externalizing–antisocial (e.g., substance use, conduct) disorders conferring risk for suicidal ideation and attempts (e.g., Bridge, Goldstein, & Brent, 2006). However, no study has attended to gender differences in relationships between suicidality and different facets of psychopathic tendencies in youth. Further, very little research has focused on disentangling the multiple manifestations of suicide risk in the same study, including behaviors (suicide attempts with intent to die, self-injurious behavior) and general suicide risk marked by suicidal ideation and plans. To better understand these relationships, we recruited 184 adolescents from the community and in treatment. As predicted, psychopathic traits and depressive symptoms in youth showed differential associations with components of suicidality. Specifically, impulsive traits uniquely contributed to suicide attempts and self-injurious behaviors, above the influence of depression. Indeed, once psychopathic tendencies were entered in the model, depressive symptoms only explained general suicide risk marked by ideation or plans but not behaviors. Further, callous–unemotional traits conferred protection from suicide attempts selectively in girls. These findings have important implications for developing integrative models that incorporate differential relationships between (a) depressed mood and (b) personality risk factors (i.e., impulsivity and callous–unemotional traits) for suicidality in youth. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Asian American college students' suicide ideation: A mixed-methods study.

The purpose of this mixed-methods study was to explore the phenomenon of suicide ideation among 293 Asian American college students. Guided by T. Joiner's (2005) interpersonal-psychological theory of suicidal behavior, the authors examined the relationships among perceived burdensomeness, thwarted belongingness, self-construals, and suicide ideation. Compared with thwarted belongingness, perceived burdensomeness was a more robust predictor of suicide ideation. However, thwarted belongingness moderated the positive association between perceived burdensomeness and suicide ideation. Furthermore, interdependent self-construal and independent self-construal both weakened the link between perceived burdensomeness and suicide ideation and between thwarted belongingness and suicide ideation. The authors also conducted a qualitative analysis of participants' open-ended responses about their perceptions of why Asian American college students might consider suicide. The authors identified a core phenomenon of unfulfilled expectations as well as 2 broad themes related to this core phenomenon: unfulfilled intrapersonal expectations and unfulfilled interpersonal expectations, comprising the subthemes of (a) family, (b) relationship, (c) cultural differences, and (d) racism. These findings are discussed in terms of implications for suicide-related clinical interventions and primary prevention efforts among Asian American college students. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The stress of patient suicidal behavior during clinical training: Incidence, impact, and recovery.

Enhances and replicates an earlier study (P. Kleespies et al, 1990) on the incidence and impact of patient suicidal behavior on psychology interns/trainees, using a much larger sample, a broader spectrum of patient suicidal behaviors, and more adequate comparison groups. The findings indicate that more than one-fourth of the interns/trainees needed to deal with a patient suicide attempt, and that one-ninth had to cope with a patient suicide completion. Stress level followed a graduated increase in impact with increasing severity of patient suicidal behavior (i.e., from suicidal ideation to suicide attempt to suicide completion). Trainees who had a patient suicide were distinguished from those who experienced patient suicide by ideation significantly greater feelings of shock, disbelief, failure, sadness, self-blame, guilt, shame, and depression. Results are discussed in terms of the importance of developing mechanisms to assist trainees in anticipating and working through the strong psychological impact of losing a patient through a self-inflicted death. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicide and depression among college students.

We surveyed 962 college students from three institutions in regard to their experiences with depression and suicide. Results indicate that incidents of depression and suicide are prevalent on college campuses and that there are a number of specific causes of depression, suicidal ideation, and suicidal behavior. Suicide attempters are compared with nonattempters, institutions are compared, and institutional implications for colleges and universities are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidal ideation and behaviours among university students in Australia

OBJECTIVE: The aim of the study was to investigate the prevalence and demographic correlates of suicidal ideation and behaviours among university students in Australia and the utilisation of mental health services by this population. METHOD: Suicidal ideation and behaviours and demographic variables were assessed in a population of 1,678 undergraduate students by use of a modified Suicide Ideation Scale (SIS) and questionnaire. RESULTS: Sixty two percent of students surveyed showed some suicidal ideation and 6.6% reported one or more suicide attempts. Over half of the group who reported suicide attempts did not use any type of mental health services. Suicidal ideation was found to be highly correlated with previous use of mental health services. In examining the relationship between suicidal ideation (SI) and demographic variables, SI was not significantly different for gender or parental marital status but was related to living arrangements, racial groups, religious affiliation and father's education. CONCLUSIONS: The results suggest that a higher proportion of students reported suicidal ideation and behaviours than that documented in related studies undertaken in the USA. While these findings draw attention to a higher level of suicidal ideation in students who utilise mental health assistance, more than half of those who reported suicide attempts did not use any kind of mental health service. The study has particular implications for detecting and assisting young people with a high suicide risk within the university environment.     

Predictive and concurrent validity of the Suicidal Ideation Questionnaire among American Indian adolescents

Suicide is currently the second leading cause of death for ages 15-24 years; reports indicate that 6-8% of American teens have attempted suicide. Rates of suicide and suicide attempts are at least as high, if not higher, for American Indian adolescents and young adults. The Suicidal Ideation Questionnaire (Junior High School Version) (SIQ-JR) could be used to identify young people who may be at risk for attempting suicide, since this questionnaire focuses on suicidal ideation, a major risk factor for suicide attempt. However, little is known about the predictive validity of the SIQ-JR, particularly in American Indian adolescent populations. A suicide attempt cluster at an American Indian boarding school provided the unique opportunity to examine the performance of the SIQ-JR in a group of American Indian high school students who had taken the SIQ-JR approximately 2 months prior to the outbreak of attempts. The SIQ-JR proved to be an excellent predictor of future suicide attempts when compared to other measures of distress: anxiety, depression, and alcohol use. The SIQ-JR is an effective screener for suicide risk in this American Indian adolescent population.