Article

Adolescent Suicidal Ideation as Predictive of Psychopathology, Suicidal Behavior, and Compromised Functioning at Age 30

Harvard University, Cambridge, Massachusetts, United States
American Journal of Psychiatry (Impact Factor: 12.3). 08/2006; 163(7):1226-32. DOI: 10.1176/appi.ajp.163.7.1226
Source: PubMed

ABSTRACT

The purpose of this study was to examine whether suicidal ideation in a community population of adolescents represents normative adolescent angst or is predictive of psychopathology, suicidal and problem behaviors, and compromised functioning 15 years after onset.
Participants were 346 largely Caucasian individuals who were part of a single-age cohort from a working class community and whose development had been traced prospectively from ages 5 to 30. Those with suicidal ideation at age 15 were compared to those without suicidal ideation at age 15 on measures of psychopathology, suicidal ideation and behavior, problem behaviors, and adult functioning at age 30. Gender differences were assessed across all domains.
At age 30, there were marked differences between adolescents with suicidal ideation and adolescents without suicidal ideation of both genders in most domains examined. Subjects with suicidal ideation were twice as likely to have an axis I disorder, nearly 12 times more likely to have attempted suicide by age 30, and 15 times more likely to have expressed suicidal thoughts in the past 4 years. Subjects with suicidal ideation had more problem behaviors and poorer overall functioning as assessed by multiple informants. Their self-perceptions of coping ability, self-esteem, and interpersonal relations were also lower. Although subjects with suicidal ideation among both genders had higher levels of psychopathology, suicidal ideation and behavior, and problem behaviors at age 30, male subjects with suicidal ideation had lower salaries and socioeconomic status and were less likely to have achieved residential independence.
Findings underscore the importance of considering suicidal ideation in adolescence as a marker of severe distress and a predictor of compromised functioning, indicating the need for early identification and continued intervention.

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Available from: William Beardslee, Jan 08, 2015
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    • "Dado que es una teoría de diáthesis-estrés, la investigación se ha centrado en dos aspectos fundamentales: por una parte, se han tratado de confirmar los componentes presentes en la relación entre la diáthesis (esquemas cognitivos vulnerables, depresivos) y el estrés ocasionado por situaciones vitales negativas, aversivas (Auerbach, Eberhart y Abela, 2010). Por otro lado, se ha profundizado en las relaciones que la tríada cognitiva presenta con diferentes trastornos psicológicos como la depresión (Beshai, 2010), la ansiedad (Shin, 2008) o la ideación suicida (Chang, Lin, y Lin 2007; Reinherz, Tanner, Berger, Bearsdslee y Fitzmaurice, 2006), entre otros. A la hora de llevar a cabo la evaluación de los diferentes componentes de la tríada cognitiva, uno de los instrumentos de medida diseñados para tal fin es el Inventario de Tríada Cognitiva (CTI; Beckham, Leber, Watkins, Boyer y Cook, 1986). "
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    ABSTRACT: La depresión es uno de los trastornos mentales que más preocupan a nivel mundial. Una de las teorías que más investigación ha suscitado es la teoría cognitiva de la depresión de Beck. El Inventario de Tríada Cognitiva (CTI) se ha elaborado para evaluar los diferentes componentes de la tríada cognitiva, si bien la mayoría de sus estudios se han desarrollado en población adulta y adolescente. El objetivo de este trabajo es mostrar evidencias de validez factorial de la versión reducida del CTI, así como el estudio de las propiedades psicométricas del cuestionario en población infantil. En una muestra de 3292 niños de edades entre los 8 y los 13 años (M=9.8; DT=1.24), los resultados mostraron que el mejor ajuste factorial se obtiene con una estructura bifactorial (tríada positiva y tríada negativa). La fiabilidad de las diferentes dimensiones es buena (α=.88 y .92, respectivamente) y las evidencias de validez convergente adecuadas. El cuestionario fue evaluado también desde la perspectiva de la Teoría de la Respuesta a los Ítems mostrando unas propiedades correctas. Finalmente se realizó la baremación del cuestionario atendiendo a las diferencias por género encontradas previamente. Depression is one of the mental disorders that concern worldwide. One theory that has attracted more researches is the Beck´s cognitive theory of depression. The Cognitive Triad Inventory (CTI) has been developed to evaluate the different components of the cognitive triad, although most studies had been developed in adult and adolescent population. The aim of this work is to show evidence of factorial validity of the reduced version of the CTI, and the study of the psychometric properties of the inventory in children. In the sample of 3292 children with age between 8 and 13 (M=9.86; SD =1.24), the results showed a better factorial fit with a bifactorial model (positive triad and negative triad). The reliability of the dimensions is good (α=.88 and .92 respectively) and convergent validity evidence is adequate. The inventory was evaluated from the Item Response Theory framework, showing correct properties. Finally the norms of the questionnaire were made addressing the gender differences that were found previously.
    Full-text · Article · Jan 2016 · Anales de Psicología
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    • "Suicidal ideation represents a strong indicator of vulnerability to future suicide attempts (Bebbington et al. 2010) and may indicate an underlying diagnosis of depression (Evans et al. 2005). Adolescent suicidal ideation is associated with a twofold increase in future psychiatric disorders, a 12-fold increase in future suicide attempt by the age of 30 as well as poorer overall functioning (Reinherz et al. 2006). The international lifetime prevalence of suicidal ideation in adolescents is estimated at 21.7–37.9%, "
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    ABSTRACT: Objectives A major cause of death in Irish men aged 15–24 is suicide and the rates for those aged 15–19 are amongst the highest in Europe. Despite concerns over suicidal ideation or behaviour, little research has been done in the Irish primary care context. We therefore aimed to carry out a study of Irish General Practitioners (GPs)’ experience regarding suicidal ideation or behaviour in children and adolescents. Methods The study design was a descriptive, cross-sectional, questionnaire survey. We randomly selected 480 GPs and invited them to participate via post. Results In total, 198 GPs replied, representing a response rate of 41% with a sampling error of ±6.8%. In total, 184 of respondents (93%) saw more than 50 children and adolescent patients annually, however, presentations of suicidal ideation and behaviour were relatively rare, with 36% reporting seeing none, 58% seeing between one and five and 6% seeing more than five such presentations annually. In total, 119 (62%) of GPs reported a willingness to prescribe antidepressants for this age group. In total, 66% of GPs felt this was either ‘always’ or ‘usually’ a difficult patient group to manage, and the single most commonly reported difficulty by GPs was access to services [ n =48 (33%)]. Conclusions GPs reported that their management of children and adolescents with suicidal ideation or behaviour is often difficult. GPs play a key liaison role in the area of child and adolescent mental health, but our results indicate that GPs are also involved in the treatment of this patient group. However, ongoing education was not a priority according to GPs themselves.
    Full-text · Article · Nov 2015 · Irish journal of psychological medicine
    • "Thoughts about suicide and wishing to be dead (suicidal ideation) is different from plans and attempts to die by suicide (suicidal behavior). While ideation is a precursor (Birmaher et al. 2004; Herba et al. 2007; Kerr 2008; Lewinsohn et al. 1994; Reinherz et al. 2006), not all youth progress from thoughts to behavior. Furthermore, the ideation item used in the current analyses is arguably reflective of passive ideation, which may be even less specific in identifying youth at risk for suicidal behavior than other one-item ideation measures. "
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    ABSTRACT: While there is an extant research base regarding suicidal ideation in relation to bullying and peer harassment, how findings may be similar and different for lesbian, gay, and bisexual (LGB) and non-LGB youth is less well understood. To address this gap, we analyzed data from 5,542 13- to 18-year-old youth who were nationally surveyed online in the United States in 2010. Results suggest that the relative odds of suicidal ideation are elevated for youth who are victims of bullying (OR = 5.61, 95 % CI, 4.11, 7.64), as well as those who are victims of peer harassment (OR = 2.06, 95 % CI, 1.53, 2.79). Within the context of other important factors, bullying was associated with odds of suicidal ideation twice that of non-victimized youth (aOR = 2.02, 95 % CI, 1.30, 3.13). Within sexual identity, the relation between bullying and suicidal ideation was particularly strong for gay, lesbian, and queer youth, even after adjusting for other influential factors (aOR = 6.29, 95 % CI, 2.69, 14.66). Across sexual identities, the odds of suicidal ideation are higher for bisexual youth (aOR = 1.77, 95 % CI, 1.23, 2.55) but not for other sexual minority youth when compared with otherwise similar heterosexual youth. Other factors, including depressive symptomatology and low self-esteem, were also predictive of recent ideation across all sexual identities. Findings highlight the complexity of bullying and suicidal ideation. Furthermore, given the relation between bullying and suicidal ideation, and the disproportionate level of bullying experienced by LGB youth, our findings suggest the need for more protective environments for LGB youth.
    No preview · Article · Oct 2014 · Prevention Science
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