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Suicidal Ideation, Depressive Symptomatology, and Self-Concept: A Comparison Between Mexican Institutionalized and Noninstitutio- nalized Children

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Abstract

Previous research reports a significant prevalence of child depression worldwide and self-concept as a predictor of depression and suicide behavior. Although suicide in children is an increasing problem in Mexico, there are scarce studies reporting risk factors and none of children in foster care institutions. This was a comparative, ex post facto study whose aim was to analyze associations between suicidal ideation, depression, and self-concept in two paired samples of Mexican children (83 institutionalized and 83 noninstitution-alized). Results show 16% of the children reported suicidal ideation and statistically significant differences among variables in both samples. Suggestions are made to address this problem from early ages.

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... Higher prevalences of suicide attempts and psychiatric symptoms have been reported in adolescents and adults admitted to long-term foster care during childhood compared with population norms (Berlin, Vinnerljung, & Hjern, 2011). Recently, Chavez-Hernandez et al. (2018) measured suicidal ideation, depressive symptomatology, and self-concept among 166 Mexican children (83 institutionalized and 83 noninstitutionalized). Their results showed that the prevalence rate of depressive symptoms in the institutionalized group was significantly higher than that in the noninstitutionalized group and that the institutionalized group also presented a higher prevalence of suicidal ideation (Chavez-Hernandez et al., 2018). ...
... Recently, Chavez-Hernandez et al. (2018) measured suicidal ideation, depressive symptomatology, and self-concept among 166 Mexican children (83 institutionalized and 83 noninstitutionalized). Their results showed that the prevalence rate of depressive symptoms in the institutionalized group was significantly higher than that in the noninstitutionalized group and that the institutionalized group also presented a higher prevalence of suicidal ideation (Chavez-Hernandez et al., 2018). ...
Article
Objectives We investigated the prevalence rates of childhood trauma, depressive symptoms, anxiety symptoms and suicidal behaviors among Vietnamese adolescents and compared the differences between institutionalized adolescents (IAs) and noninstitutionalized adolescents (NIAs). In addition, we examined the multidimensional associations between childhood trauma and psychopathology among IAs. Methods Five hundred forty-six participants were recruited into two groups (IAs and NIAs) matched by age, sex and grade. They completed a childhood trauma questionnaire, depression scale, anxiety scale, and 3 suicide-related questions. The chi-squared test and logistic regressions were performed. Results The prevalences of anxiety symptoms and suicide attempts among IAs was higher than that among NIAs (25.6 % vs 14.7 %, p = 0.001 and 8.1 vs 3.7, p = 0.03, respectively), while the prevalences of other psychopathologies did not differ significantly. In the IA group, high prevalences of victimization through physical abuse (22.3 %), emotional neglect (57.9 %), and physical neglect (72.9 %) were found, and 58.6 % of the participants had experienced more than one type of trauma. These figures were significantly higher in IAs than in NIAs. Depression and suicidal ideation were more strongly correlated with emotional abuse and neglect than other types of maltreatment, while anxiety, suicide planning and suicide attempts were more strongly correlated with physical abuse. IAs who experienced more than two categories of trauma or greater intensity of trauma were more susceptible to developing depression, anxiety, and suicidal behaviors. Conclusions Childhood trauma was multidimensionally associated with adverse psychological outcomes. We suggest that various aspects of childhood trauma, as well as psychopathologies, must be routinely assessed.
... Emerson et al. (2019) found that decreases in depressive symptoms were linked to increases in selfconcept in adolescents with a chronic illness that participated in a psychosocial, family based intensive outpatient program. Chavez-Hernandez et al. (2018) reported that self-evaluation and family self-concept were associated with depression in middle to late childhood. Similarly, Kuzucu et al. (2014) found that depression was negatively linked to self-concept development from late childhood to adolescence. ...
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The present study aimed to examine the promotive and protective role of general self-efficacy and positive self-concept in the context of the effects of early familial risk factors on children’s development of emotional problems from early to middle childhood. A total of 293 (T1; Mage = 2.81), 239 (T2; Mage = 3.76), and 189 (T3; Mage = 9.69) children from 25 childcare centers took part in the present study. Fourteen familial risk factors were assessed at T1 using an interview and a questionnaire that were administered to children’s primary caregivers. These 14 familial risk factors were used to compute a familial risk factors score. Primary caregivers also reported on their children’s emotional problems at T2 and T3 and on their children’s general self-efficacy at T2. Children reported on their positive self-concept at T2. Results showed that early familial risk factors were positively associated with emotional problems in the short and long term, although the long-term effect was small and non-significant. Further, the pattern of effect sizes of both promotive and protective effects of general self-efficacy as well as positive self-concept was found to be consistent in the short term. However, in the long term, no consistent support for either the promotive or the protective role of general self-efficacy or positive self-concept was found. These results suggest that general self-efficacy and positive self-concept might contribute to promote mental health and to protect from undesired effects of familial risk factors in the short term. Possible reasons for a lack of long-term effects are discussed along with practical implications.
... En la República Mexicana, al igual que en muchos otros países, la incidencia de las tentativas suicidas presenta un incremento constante a lo largo de la adolescencia, pero con mayor acentuación en el grupo etario de 16 a 18 años (Instituto Nacional de Estadística e Informática [INEGI], 2016); asimismo, algunos estudios han reportado que frecuentemente las tentativas empiezan a presentarse a la edad de 12 años (Chávez-Hernández et al., 2017;Quintanilla-Montoya, Sánchez-Loyo & Pérez, 2015). ...
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Resumen El propósito del estudio fue identificar el uso del tiempo libre y su relación con la tentativa suicida en una muestra mexicana adolescente. Participaron 1290 estudiantes de nivel secundaria, entre 12 a 18 años (36 % varones, 64 % mujeres); el instrumento incluyó reactivos cerrados y formato libre. De las 11 categorías del tiempo libre obtenidas, la de relaciones fuera del ámbito familiar obtuvo el mayor puntaje (96 %) y el menor las actividades escolares (1,8 %). Se encontraron asociaciones estadísticamente significativas de riesgo suicida en las actividades pasivas, del hogar, relaciones familiares y cuidar el propio cuerpo; se encontraron actividades con efecto protector las relaciones sociales fuera del ámbito familiar y recreativas (artísticas, deportivas). Se presentan reflexiones sobre la producción y utilización creativa del tiempo libre en jóvenes y familias contemporáneas.
... En la República Mexicana, al igual que en muchos otros países, la incidencia de las tentativas suicidas presenta un incremento constante a lo largo de la adolescencia, pero con mayor acentuación en el grupo etario de 16 a 18 años (Instituto Nacional de Estadística e Informática [INEGI], 2016); asimismo, algunos estudios han reportado que frecuentemente las tentativas empiezan a presentarse a la edad de 12 años (Chávez-Hernández et al., 2017;Quintanilla-Montoya, Sánchez-Loyo & Pérez, 2015). ...
Article
Full-text available
El propósito del estudio fue identificar el uso del tiempo libre y su relación con la tentativa suicida en una muestra mexicana adolescente. Participaron 1290 estudiantes de nivel secundaria, entre 12 a 18 años (36 % varones, 64 % mujeres); el instrumento incluyó reactivos cerrados y formato libre. De las 11 categorías del tiempo libre obtenidas, la de relaciones fuera del ámbito familiar obtuvo el mayor puntaje (96 %) y el menor las actividades escolares (1,8 %). Se encontraron asociaciones estadísticamente significativas de riesgo suicida en las actividades pasivas, del hogar, relaciones familiares y cuidar el propio cuerpo; se encontraron actividades con efecto protector las relaciones sociales fuera del ámbito familiar y recreativas (artísticas, deportivas). Se presentan reflexiones sobre la producción y utilización creativa del tiempo libre en jóvenes y familias contemporáneas.
... In this sense, even economic crisis within the family are related with a higher risk of suicide in children (Kolves, 2010). In 2017 the results from Chavez-Hernández et al., contributed clarifying international concerns about depression and suicide risk in children; a high percentage of their sample presented suicidal ideation, coinciding with official reports and previous studies (Chavez-Hernandez et al., 2017;Miranda de la Torre et al., 2009). Moreover in 2015 a cross-sectional study used a translated version of the Youth Risk Behavior Survey in participants between 14 and 18 years of age, found that females had 1.7-2 times higher possibility of exhibiting suicidal behavior (Hidalgo-Rasmussen and Martin, 2015). ...
Article
Suicide is the second cause of death in youth population. The aim of the present study was to analyze demographic characteristics and suicide methods used, as well as to identify gender differences among Mexican children and adolescents (aged 10-17 years) that committed suicide. Between January 2003 and December 2013, 167 suicides of children and adolescents between 10 and 17 years of age were documented by the Secretary of Health of the state of Tabasco, Mexico. All sociodemographic characteristics were compared according to gender. Our sample included 67.7% males and 32.3% females (male to female 2.1:1). The predominant marital status was single (89.6%) and hanging (93.7%) was the principal method of suicide used. Both female and male adolescents were predominantly students (50%); however, female adolescents were more frequently married (17%) and were housewives (26.4%). Our results identified that hanging is the principal suicide method used by children and adolescents in Mexican population; we also detected main gender differences in terms of poisoning/drug toxicity as the method used, occupation and marital status. These results should be taken into consideration when designing suicide prevention programs due to the differences found by gender.
Article
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Análisis de las propiedades psicométricas de la Escala de Autoconcepto de Piers-Harris 2 en escolares mexicanos Resumen: Actualmente, en México existe escasez de instrumen-tos válidos para evaluar el autoconcepto en niños, por ello el objetivo del presente trabajo fue analizar las propiedades psicométricas de la adaptación de la Es-cala de Autoconcepto de Piers-Harris 2 en 493 esco-lares de 7 a 12 años (mujeres 50.5%), con un prome-dio de nivel escolar de cuarto grado. El estudio fue transversal cuantitativo con enfoque empírico analíti-co no experimental. Se evaluó la consistencia interna empleando la fórmula KR20, obteniendo resultados semejantes a otros estudios (índice = 0.87). El análi-sis con modelamiento Rasch, indica que 58 reactivos de la escala obtuvieron buenas propiedades de vali-dez, confiabilidad y ajuste. Dicha escala presenta propiedades psicométricas adecuadas para ser utiliza-da en niños escolarizados de 7 a 12 años de población mexicana. Abstract: Currently, in Mexico there are few valid instruments to evaluate self-concept in children, so the objective of this work was to analyze the psycho-metric properties of the adaptation of the Piers-Harris Self-Concept Scale 2 in 493 school children from 7 to 12 years of age (female 50.5%), with an average fourth grade school level. The study was transversal quantitative with a non-experimental analytical empirical approach. Internal consistency was evaluated using the KR20 formula, with results similar to other studies (index. 0.87). Rasch mode-led analysis indicates that 58 reagents on the scale obtained good validity, reliability, and fit properties. This scale has adequate psychometric properties for its use in Mexican schoolchildren from 7 to 12 years old.
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The understanding of child suicide has achieved more and more specific notions since it started to be studied from the theory of adult suicide. Now, the implication of certain factors such as the evolution of deafh conceptualization, the desire of joining an absent significant person, the premeditation of the suicidal act, the involvement of family environment as a contributing or protective factor, or a previous mistreatment experience, has become clearly recognized. Suicides which occur during the childhood period have been associated to previous sexual-nature abuse experiences. In adult suicides, the presence of some kind of mistreatment during their childhood period has also been found. Both phenomena, mistreatment and child suicide, are usually under-registered because of the variability of their defining approaches or because of some cultural influences such as violence occurring naturally or negation of child suicide or premeditation. It is postulated that the mechanics of child mistreatment traps the abuser into a dynamics based on the inequality of physical, intellectual and/or moral conditions; this reality plus the defenseless nature of children, impedes the termination of that situation unless it finishes by means of another violent act such, as a suicide. Furthermore, the consequences suffered by a child victim of mistreatment can become contributing factors for a suicidal behavior consummation. Consequently, dysfunctions or disturbances on cognitive, psychological, identity, belonging or hopelessness state of the victim, as well as the emotional pain caused by the mistreatment may favor a suicide behavior. Therefore, the purpose of this study is to determine the presence of any given type of child mistreatment in children (since eight to 14 years old) that incurred in a suicide in the State of Guanajuato between 1995 and 2001. The methodology used for this descriptive, observational, retrospective and transversal study, was ex-post-facto (after the event), since the technique for data gathering was carried out by psychological autopsy. This technique facilitates an access into the families and to the understanding of their dynamics, and also to recognizing the circumstances prior to the decease. This technique included one or several interviews with people close to deceased child, besides a detailed analysis of the suicidal event and of all the deceased child's residual belongings (suicide notes in this case). This study searched some direct and indirect indicators of a possible child mistreatment suffered by suicidal children. The psychological autopsy was conformed by a Questionnaire of Psychosocial data, a Suicidal Act Evaluation Questionnaire and by an Informant's Reliability Scale. Because of the lack of specific backgrounds for the cases of child suicide, the Psychological Questionnaire was specifically developed for this study. Studied cases were those belonging to child suicides, up to 14-year-old children, who consummated their death in the State of Guanajuato in the 1995 to 2001 period. The files were obtained by the General Attorney Department. With the information extracted from such files, we proceeded to establish phone and mail contact with relatives of the deceased children. Later on, some interviews were carried out with one or more people close to each child; these interviews were held by psychologists qualified in Psychological Autopsy and Emotional Contention Techniques. The examined data came basically from the Psycho-Social Questionnaire and from the Content Analysis of suicide notes. The analysis method for first data, of quantitative nature, was by frequency distribution and correlation, computed by SPSS statistical software. Qualitative data resulting from the analysis of suicide notes content were verified by a technical jury integrated by three participating clinical psychologists. Results: Twenty nine suicide cases were analyzed, representing 69% of child suicides up to 14-year-old children in the State of Guanajuato within the aforementioned period. The rest of the files were not included in this research because the impossibility for locating the victim's relatives due to changes of residence, and in a lower percentage because they refused to participate in the study due to the emotional pain of talking about the suicide event, or because they ignored the minor child's data regarding the circumstances and causes of his death. Of all the examined cases, 19 (65.5%) were men and 10 (34.5%) were women. The range of child suicides' age was from eight to 14 years old, with a 12.55 year-old average and a 1.62 year-old standard deviation. Five suicide notes were analyzed, which belonged to 4 children: 3 girls (one of them left two notes) and one boy. With respect to 72.4% of the cases, the interviewed persons were first-degree relatives and regarding the remaining percentage, they were cousins, uncles or grandparents who reported having had a close relationship with the deceased child. The average age of the interviewees was 43 years, with a standard deviation age of 17.19 years. In almost half of the suicides (51.7%) some kind of violence was suffered. According to the interviewees' statements, 31% of the children who committed suicide had suffered some kind of psychological mistreatment, 41.1% of them had received some of kind of physical mistreatment, 3.4% were victims of sexual abuse and 10.34% were neglected. Almost a quarter of all the children had suffered two or three kinds of mistreatment. Additionally, 41.4% of suicidal children had seen physical violence at home. Four of the suicide notes included explicit declarations of mistreatment experiences. Other variables that were found were the presence of previous suicide attempts in 20.7% of the cases; and a 26.3% of cases where a relative also had a previous suicide attempt. Family alcohol consumption was detected in 65.5% and drug consumption in 24% of the cases. Further analysis show a correlation between child previous suicide attempts and psychological mistreatment (p= 0.004) or any other kind of violence exposure (p= 0.015). It is concluded that an important percentage of children who incurred in a suicide were indeed victims of some kind of child mistreatment, of which physical one was particularly evident. However, neither physical nor sexual abuse can be separated from their implicit component: the emotional mistreatment. Studies of pure qualitative nature could contribute with more information about the dynamics that associates both phenomena. It is deemed that child mistreatment prevention would directly impact both suicide occurrence for the same group of age, and probably also within adult populations thus reducing its prevalence.
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This book, which draws together contributions from specialists in child, adolescent and family psychiatry, child psychotherapy, social work, community psychiatric nursing, educational therapy, special needs coordination in teaching, and general practice, provides a valuable resource for those professionals in contact with young people suffering from depression.
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Nowadays, suicide is a public health problem and a social phenomenon that affectds human development. From 1995 to 2002, the state of Sonora showed a 3.8% annual average increase in the occurrence of suicide in productive age population, occupying the national third place with regard to this problem's growth. During the 1970's suicide in groups of infants and school children between 5 and 14 years old started to be noticed in the country. Al present time, self-inflicted injuries are eighth cause of death for this age group. Suicidat behavior is a process comprised by several stages: passive suicidal ideation, active contemplation of suicide itself, planning and preparation, suicide attempt execution, and completed suicide. Since these stages may or not be sequential, it is important to study the steps preceding suicides, such as the ideation and the attempt, in order to know and treat this problem. 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A 631 student sample was considered through clusters connecting the entire schools within the city and the number of students enrolled in the school term. Instruments: A self applied form questionnaire, which evaluates socio-demographic data, was used with the following scales: Children's Depression Inventory CDI; Children's Manifest Anxiety Scale CMAS-R (revised); Self Esteem Inventory. Procedure: In order to carry out this research, authorization was requested to the Ministry of Education of Sonora. In a first phase during an academic hour, a self-applied form questionnaire with socio-demographic information and the depression scale was given. Subsequently, the second part of the questionnaire was given to a sub-sample of two equal groups, one of them identified with suicidal ideation and the other one without ideation. Data analysis: The statistical analyses were performed using the program SPSS version 15.0. Non-parametric test x2 (Chi Square) and prevalence ratio (odds ratio) were used. Results A total of 631 boys and girls were evaluated with the depression questionnaire during the first phase. The mean age was 10.9 years (range: 10-13 years), the gender variable was distributed 50.8% girls and 49.2% boys, as a result of the registration rate for fifth and sixth grades of elementary education; 72.1% of the children were in public schools and 27.9% in private schools. In accordance to answers of CDI item 9, children who marked these two possible answers: «You think in killing yourself but you believe you won't do it» (18.1%) and «You have sometimes seriously thought about killing yourself» (11.1%) were considered with suicidal ideation. This scale evaluated how the children felt during the two weeks previous to taking the questionnaire and 29.2% of the children somehow showed suicidal ideas. The sub-sample defined from the total population was distributed into two groups: one control group with 184 children without suicidal ideation and another group with 184 children with suicidal ideation. Depression: In regard to depression, results showed that group with suicidal ideation presented greater depressive states compared to the group without suicidal ideation (p<0.03, x2= 65.66, gl =2), the highest percentage is located in moderate depression (40.7% and 22.8% respectively). Gender differences were shown only in the group of children without ideation becoming more frequent in boys (p<0.03, x2=6.92, gl =2). While analyzing with the prevalence rate, it was found that children who show severe depression have an 8.8 higher risk of having suicidal ideation when compared with the group of children presenting this level of depression, but not expressing suicidal ideation (Cl: 3.85-20.15). Self-esteem: The group with suicidal ideation showed 52.9% low self-esteem cases a statistically significant difference (p<0.00, X2=32.31, gl =2) compared to the group of children with no ideation that presented a 3.1% of it. Gender differences were not found in these groups. Boys and girls who show low self-esteem level have 3.7 more risk to present suicidal ideation compared with the group of children who have better self-esteem (Cl: 2.3-5.9). Anxiety: Of the children with suicidal ideation, 37.7% showed a high anxiety level compared to the 18.4% presented by the children without ideation. There were no differences between boys and girls. Showing anxiety indicates a 2.6 times higher risk to present suicide ideas (Cl: 1.60-4.32). Discussion Although suicidal ideation was present in school children population in a very significant way, it is considered low risk for this type of behavior. Depression appeared like the risk factor mostly associated with suicidal ideation. Boys showed more depression compared to girls; on the other hand, most studies conducted with adolescents reported that before 12 years old it is likely not to find significant differences between genders perhaps by the gender issues, the biological, hormonal and society characteristics. It is important to point out that some cases of children without depression presenting suicidal ideation were found, this information was supported by other studies. Although depression is an important risk factor, its presence is not essential for the suicidal ideation to be evident. Low self-esteem is more evident as a higher risk factor than anxiety for the presence of suicidal ideation. No significant differences by gender were found. Entering into the subject matter with population under fourteen is difficult not only because the parents' limitations to talk about it, but because of the care it must be taken while working with minors. The access to carry out this kind of research within the private school population is difficult; hence the existing little information about it. As a result of the lack of information, it becomes necessary to put it into execution under a strict methodology and according to the professional ethics in such a way that differences between children with and without suicidal ideation could be identified. Suicide is a multi-factorial character dynamic process and not only a single and changeless event; therefore, it is necessary to study how suicidal ideas are conceived and what context surrounds them from the earliest age. It is recommended to detect at a younger age the process leading to suicidal behavior and factors related to it.
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To summarize the epidemiology of completed suicide and suicidal behavior in Mexico. National data registries on mortality from the year 1970 to 2007 and cross-sectional surveys were used to analyze suicide mortality and suicidal behavior. The suicide rate grew 275% from 1970 to 2007. Suicide has been increasing among Mexicans 15-29 years old since 1970. In adults aged 18-29 years the lifetime prevalence of ideation was 9.7%, and attempt 3.8%. About 6,601,210 Mexicans had suicidal thoughts, 593,600 attempted suicide and 99,731 used some sort of medical service as a direct consequence of the latter in the year prior to the survey. Suicide and suicide-related behaviors are significant public health problems and, as such, actions are urgently required to identify and treat persons with suicidal thoughts, assess suicidal risk in patients with psychiatric disorders and implement population interventions.
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To report baseline mental health measures from the Children in Care study, a prospective epidemiological study of children in court-ordered foster and kinship care in New South Wales, Australia. Mental health, socialization and self-esteem were assessed in 347 children in a statewide mail survey, using two carer-report checklists, the Child Behavior Checklist (CBCL) and the Assessment Checklist for Children (ACC). Children in the study had exceptionally poor mental health and socialization, both in absolute terms, and relative to normative and in-care samples. Levels and rates of disturbance for children in foster care exceeded all prior estimates. Rates of disturbance for children in kinship care were high, but within the range of prior estimates. Boys presented with higher scope and severity of mental health problems than girls on the CBCL, while gender-specific patterns of disturbance were shown on the ACC. A moderate age effect was accounted for by children's age at entry into care. Children in care are at high risk of mental health problems. Psychological support for the children and their carers is an essential secondary prevention strategy. Implications for service delivery are discussed.
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