Young Suicide Attempters: A Comparison Between a Clinical and an Epidemiological Sample

Department Group of Psychiatry, University of Oslo, Norway.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 08/2000; 39(7):868-75. DOI: 10.1097/00004583-200007000-00015
Source: PubMed


To compare risk factors for self-harm in 2 groups: hospitalized adolescents who had attempted suicide and adolescents reporting suicide attempts in a community survey.
All suicide attempters aged 13 to 19 years admitted to medical wards (n = 91) in a region of Norway were assessed and interviewed. Risk factors were identified by comparisons with a general population sample participating in a questionnaire study in the same community (n = 1,736). In this population sample, a separate analysis of risk factors for reporting deliberate self-harm (n = 141) was performed, applying bivariate and multivariate logistic regression models.
Adjusted risk factors for suicide attempts in hospitalized adolescents were depression (odds ratio [OR] = 4.7), disruptive disorders (OR = 9.4), low self-worth (OR = 1.3), infrequent support from parents (OR = 3.3) or peers (OR = 3.3), parents' excessive drinking (OR = 4.3), and low socioeconomic status (OR = 2.4). For adolescents who self-reported self-harm, depression (OR = 3.1) and loneliness (OR = 1.13) were significant adjusted risk factors (p < .001). Low self-worth, low socioeconomic status, and little support from parents or peers characterized hospitalized suicidal adolescents compared with those who were not hospitalized.
The risk factors were more powerful for hospitalized than for nonhospitalized adolescents. Prevention efforts should target the same factors for both groups, at a population level for nonhospitalized adolescents and at an individual level for hospitalized adolescents, with a focus on depression, low self-esteem, and family communication.

7 Reads
  • Source
    • "Numerous studies have found that childhood abuse, particularly sexual abuse, is a robust predictor of future suicidal behavior (Martin et al. 2004; Calder et al. 2010; Hahm et al. 2010; Yen et al. 2013). In addition, perception of insufficient family support has been positively correlated with adolescents' suicide attempts (Morano et al. 1993; King et al. 1995; Groholt et al. 2000) and suicidal patients have been found to report lower levels of family support and parental affection and engagement than nonsuicidal inpatients and adolescents from the community (King et al. 1993; Morano et al. 1993; Groholt et al. 2000). However, to the best of our knowledge, no longitudinal study has examined the role of perceived family emotional invalidation as a predictor of suicidal and self-injurious behavior. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The present study investigates the longitudinal relationship between perceived family and peer invalidation and adolescent suicidal events (SE) and self-mutilation (SM) in a 6 month follow-up (f/u) study of adolescents admitted to an inpatient psychiatric unit for suicide risk. Methods: Adolescents (n=119) and their parent(s) were administered interviews and self-report assessments at baseline and at a 6 month f/u, with 99 (83%) completing both assessments. The Adolescent Longitudinal Interval Follow-Up Evaluation (A-LIFE) was modified to provide weekly ratings (baseline and each week of f/u) for perceived family and peer invalidation. Regression analyses examined whether: 1) Prospectively rated perceived family and peer invalidation at baseline predicted SE and SM during f/u; and 2) chronicity of perceived invalidation operationalized as proportion of weeks at moderate to high invalidation during f/u was associated with SE and SM during f/u. Results: Multiple regression analyses, controlling for previously identified covariates, revealed that perceived family invalidation predicted SE over f/u for boys only and perceived peer invalidation predicted SM over f/u in the overall sample. This was the case for both baseline and f/u ratings of perceived invalidation. Conclusions: Our results demonstrate the adverse impact of perceived family and peer invalidation. Specifically, boys who experienced high perceived family invalidation were more likely to have an SE over f/u. Both boys and girls who experienced high perceived peer invalidation were more likely to engage in SM over f/u.
    Journal of Child and Adolescent Psychopharmacology 09/2014; 25(2). DOI:10.1089/cap.2013.0132 · 2.93 Impact Factor
  • Source
    • "Self-harming behaviour and suicidal behaviour was assessed with two questions: “Have you ever taken an overdose of pills or otherwise tried to harm yourself on purpose?” (“no”, “yes, once”, and “yes, more than once”), a question derived from the CASE study and has been used in several other studies [13,20,25,26]. Suicide attempt was assessed with the question: “Have you ever tried to kill yourself?” "
    [Show abstract] [Hide abstract]
    ABSTRACT: Studies have shown that adolescents with a history of both suicide attempts and non-suicidal self-harm report more mental health problems and other psychosocial problems than adolescents who report only one or none of these types of self-harm. The current study aimed to examine the use of child and adolescent psychiatric services by adolescents with both suicide attempts and non-suicidal self-harm, compared to other adolescents, and to assess the psychosocial variables that characterize adolescents with both suicide attempts and non-suicidal self-harm who report contact. Data on lifetime self-harm, contact with child and adolescent psychiatric services, and various psychosocial risk factors were collected in a cross-sectional sample (response rate = 92.7 %) of 11,440 adolescents aged 14-17 years who participated in a school survey in Oslo, Norway. Adolescents who reported any self-harm were more likely than other adolescents to have used child and adolescent psychiatric services, with a particularly elevated likelihood among those with both suicide attempts and non-suicidal self-harm (OR = 9.3). This finding remained significant even when controlling for psychosocial variables. In adolescents with both suicide attempts and non-suicidal self-harm, symptoms of depression, eating problems, and the use of illicit drugs were associated with a higher likelihood of contact with child and adolescent psychiatric services, whereas a non-Western immigrant background was associated with a lower likelihood. In this study, adolescents who reported self-harm were significantly more likely than other adolescents to have used child and adolescent psychiatric services, and adolescents who reported a history of both suicide attempts and non-suicidal self-harm were more likely to have used such services, even after controlling for other psychosocial risk factors. In this high-risk subsample, various psychosocial problems increased the probability of contact with child and adolescent psychiatric services, naturally reflecting the core tasks of the services, confirming that they represents an important area for interventions that aim to reduce self-harming behaviour. Such interventions should include systematic screening for early recognition of self-harming behaviours, and treatment programmes tailored to the needs of teenagers with a positive screen. Possible barriers to receive mental health services for adolescents with immigrant backgrounds should be further explored.
    Child and Adolescent Psychiatry and Mental Health 04/2014; 8(1):13. DOI:10.1186/1753-2000-8-13
  • Source
    • "bully - only persons than it is among those who are victim only or both bully and victim ( Patchin & Hinduja , 2010 ) . Low self - esteem can generate a sense of worthlessness , which can negatively affect interpersonal relationships ( Baldwin & Hoffmann , 2002 ) and put youth at a heightened risk of suicide ( Beautrais , Joyce , & Mulder , 1999 ; Groholt et al . , 2000 ; Lewinsohn et al . , 1994 ; Martin , Richardson , Ber - gen , Roeger , & Allison , 2005 ; Wichstrom , 2000 ; Wilburn & Smith , 2005 ) . For instance , McGee and Williams ( 2000 ) reported from a large sample of 9 - to 13 - year - old children in New Zealand that low self - esteem at age 9 is correlated with suicidal ideation at age 15 "
    [Show abstract] [Hide abstract]
    ABSTRACT: In the wake of several highly publicized adolescent suicides attributed to bullying victimization, national attention has been brought to bear on the profound public health problem of bullying. This article reviews the extant literature on the associations between bullying perpetration, victimization, and thoughts of or attempts at suicide, and proposes five potential mediators: depression, anxiety, low self-esteem, loneliness, and hopelessness that may explain this relationship. Numerous studies have found empirical support for the interrelations between internalizing behaviors and both bullying perpetration and victimization, and suicide. We find that further longitudinal research needs to be conducted to more conclusively determine the role and causal ordering these various psychosocial factors may play in bullying perpetration, victimization, and suicide. Although the research literature implies causal directions among all these potential mediators, untangling the unique influence of bullying perpetration, victimization, and bully-victimization on suicide and its mechanisms of action has major research and practice implications.
    Trauma Violence & Abuse 01/2014; 16(4). DOI:10.1177/1524838014537904 · 3.27 Impact Factor
Show more