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Ehlers CL, Gilder DA, Benedict J, Wills DN, Phillips E, Gonzales C, Karriker-Jaffe KJ, Bernert RA. Social zeitgeber and sleep loss as risk factors for suicide in American Indian adolescents. Transcult Psychiatry 2024; 61:273-284. [PMID: 38311923 DOI: 10.1177/13634615241227679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
American Indians / Alaska Natives (AI/AN) bear a high burden of suicide, the reasons for which are not completely understood, and rates can vary by tribal group and location. This article aims to identify circumstances reported by a community group of American Indian adolescent participants to be associated with their depression and/or suicide. American Indian adolescents (n = 360) were recruited from contiguous reservations and were assessed with a semi-structured diagnostic interview. Twenty percent of the adolescents reported suicidal thoughts (ideation, plans), an additional 8% reported a history of suicide attempts, and three deaths due to suicide were reported. Suicidal behaviors and major depressive disorder (MDD) co-occurred and were more common among female adolescents. The distressing events that adolescents most often reported were: death in the family, family disruption, peer relationship problems, and school problems. All of these events were significantly associated with suicidal behaviors, however those with suicidal acts were more likely to report death in the family. Those with MDD but no suicidal behaviors were more likely to report disruptions in the family. Disruptions in falling asleep were also associated with suicidal behaviors and having experienced a death in the family. Disruptions in important relationships, particularly through death or divorce, may be interpreted as a loss or disruption in "social zeitgebers" that may in turn disturb biological rhythms, such as sleep, thus potentially increase the risk for MDD and/or suicide. Prevention programs aimed at ameliorating the impact of disruptions in important relationships may potentially reduce suicidal behaviors in AI/AN adolescents.
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Affiliation(s)
- Cindy L Ehlers
- Neurosciences Department, The Scripps Research Institute, USA
| | - David A Gilder
- Neurosciences Department, The Scripps Research Institute, USA
| | | | - Derek N Wills
- Neurosciences Department, The Scripps Research Institute, USA
| | - Evie Phillips
- Neurosciences Department, The Scripps Research Institute, USA
| | - Cathy Gonzales
- Neurosciences Department, The Scripps Research Institute, USA
- Pala Band of Mission Indians, Pala, CA, USA
| | | | - Rebecca A Bernert
- Department of Psychiatry and Behavioral Sciences, Stanford University, USA
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Roche CS, Sang HI, Ahmeti M. A Call for Help: A Retrospective National Study of Self-Inflicted Trauma Among American Indians and Alaskan Natives. Cureus 2024; 16:e53624. [PMID: 38449970 PMCID: PMC10916905 DOI: 10.7759/cureus.53624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Background Self-inflicted injury accounts for approximately 312,000 emergency department visits annually. American Indians/Alaskan Natives (AIAN) have significantly higher rates of suicide. The National Trauma Data Bank (NTDB) was analyzed for the incidence of self-inflicted trauma. Methods Data were obtained from the NTDB 2012-2017. Patients were selected using ICD codes for self-inflicted trauma. Categorical and continuous variables were tested for significance. Results AIAN patients accounted for 1,176 of the 78,668 patients. The AIAN patients were younger, had lower injury severity score (ISS) scores, were more female, utilized Medicaid more frequently, were more likely to present with a cut or piercing injury, and had higher rates of positive alcohol and drug tests. AIAN patients had shorter lengths of stay in the ICU and overall hospital stay. Conclusion Despite a higher rate of suicide completion, the AIAN population had lower rates of presentation to the hospital and lower ISS scores. AIAN patients were younger, had higher rates of drug use, and utilized cutting/stabbing. This discrepancy could indicate a physical manifestation of a "call for help".
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Affiliation(s)
- Conor S Roche
- General Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, USA
- General Surgery, Sanford Health, Fargo, USA
| | | | - Mentor Ahmeti
- Trauma and Acute Care Surgery, Sanford Health, Fargo, USA
- General Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, USA
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Arafat SMY, Baminiwatta A, Menon V, Sharma P, Htay MNN, Akter H, Marthoenis M, Dorji C. Prevalence of Suicidal Behavior Among Students in South-East Asia: A Systematic Review and Meta-Analysis. Arch Suicide Res 2024; 28:50-70. [PMID: 36794580 DOI: 10.1080/13811118.2023.2176272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVES Estimation of rates of suicidal behaviors (ideation, plan, and attempt) would help to understand the burden and prioritize prevention strategies. However, no attempt to assess suicidal behavior among students was identified in South-East Asia (SEA). We aimed to assess the prevalence of suicidal behavior (ideation, plan, and attempt) among students in SEA. METHODS We followed PRISMA 2020 guidelines and registered the protocol in PROSPERO (CRD42022353438). We searched in Medline, Embase, and PsycINFO and performed meta-analyses to pool the lifetime, 1-year, and point prevalence rates for suicidal ideation, plans, and attempts. We considered the duration of a month for point prevalence. RESULTS The search identified 40 separate populations from which 46 were included in the analyses, as some studies included samples from multiple countries. The pooled prevalence of suicidal ideation was 17.4% (confidence interval [95% CI], 12.4%-23.9%) for lifetime, 9.33% (95% CI, 7.2%-12%) for the past year, and 4.8% (95% CI, 3.6%-6.4%) for the present time. The pooled prevalence of suicide plans was 9% (95% CI, 6.2%-12.9%) for lifetime, 7.3% (95% CI, 5.1%-10.3%) for the past year, and 2.3% (95% CI, 0.8%-6.7%) for the present time. The pooled prevalence of suicide attempts was 5.2% (95% CI, 3.5%-7.8%) for lifetime and 4.5% (95% CI, 3.4%-5.8%) for the past year. Higher rates of suicide attempts in the lifetime were noted in Nepal (10%) and Bangladesh (9%), while lower rates were reported in India (4%) and Indonesia (5%). CONCLUSIONS Suicidal behaviors are a common phenomenon among students in the SEA region. These findings call for integrated, multisectoral efforts to prevent suicidal behaviors in this group.
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Nielassoff E, Le Floch M, Avril C, Gohier B, Duverger P, Riquin E. Protective factors of suicidal behaviors in children and adolescents/young adults: A literature review. Arch Pediatr 2023; 30:607-616. [PMID: 37777349 DOI: 10.1016/j.arcped.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/28/2023] [Accepted: 07/07/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Suicidal behaviors present a public health challenge in children and adolescents. Although the risk factors have long been well documented, protective factors have only been documented for a few years, and there has not been a literature review concerning the suicidal behaviors of children and adolescents since 2006. METHODS Relevant articles were collected using the Medline/PubMed, Web of Science, and ScienceDirect databases. Studies meeting the following inclusion criteria were included: age of participants from 6 to 19 years, qualitative and quantitative cohort or case-control studies, multivariate analysis studies, and studies with significant results for at least one protective factor. The methodology used in this review is based on the PRISMA criteria. RESULTS A total of 26 studies were included in this review, which highlights various individual and environmental protective factors. The results were too heterogeneous to perform a meta-analysis, and therefore the discussion is in the form of a narrative summary. High-quality relationships with family and in the school environment were the most frequently found protective factors. The presence of positive links with peers, with other adults, and with the culture of origin was also noted. On an individual level, self-esteem, emotional intelligence, and particular coping abilities were found to be the most important protective factors. CONCLUSION There are numerous important protective factors for suicidal behaviors in children and adolescents and also for adapting care to their needs. A future challenge will be to determine the best protective factors to be consolidated or strengthened using self-assessment tools that are already in use or being developed.
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Affiliation(s)
- Emilie Nielassoff
- Département de Psychiatrie de l'Enfant et de l'Adolescent, CHU d'Angers, France; Fondation de Santé des Étudiants de France, clinique de Sablé sur Sarthe, Sablé sur Sarthe, France
| | - Marine Le Floch
- Département de Psychiatrie de l'Enfant et de l'Adolescent, CHU d'Angers, France
| | - Clémence Avril
- Fondation de Santé des Étudiants de France, clinique de Sablé sur Sarthe, Sablé sur Sarthe, France
| | - Bénédicte Gohier
- Département de Psychiatrie et Addictologie, CHU d'Angers, France
| | - Philippe Duverger
- Département de Psychiatrie de l'Enfant et de l'Adolescent, CHU d'Angers, France; Univ. Angers, [CHU Angers], LPPL EA4638, F-49000 Angers, France
| | - Elise Riquin
- Département de Psychiatrie de l'Enfant et de l'Adolescent, CHU d'Angers, France; Fondation de Santé des Étudiants de France, clinique de Sablé sur Sarthe, Sablé sur Sarthe, France; Univ. Angers, [CHU Angers], LPPL EA4638, F-49000 Angers, France.
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Parshall C, Qeadan F, Espinoza J, English K. The Association Between Resiliency Factors and Suicide Indicators Among American Indian/Alaska Native Middle School Students in New Mexico: A Strength-Based Analysis. Public Health Rep 2023; 138:71S-79S. [PMID: 36971251 PMCID: PMC10515981 DOI: 10.1177/00333549231156607] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVE Suicide is a leading cause of death among American Indian/Alaska Native (AI/AN) young people aged 10-19 years in the United States, but data collection and reporting in this population are lacking. We examined results of an oversample project in New Mexico to determine the association between resiliency factors and suicide-related behaviors among AI/AN middle school students. METHODS We conducted analyses using data from the 2019 New Mexico Youth Risk and Resiliency Survey for students in grades 6 through 8. An oversampling method was used to increase the sample size of AI/AN students. We used logistic regression to determine the association between resiliency factors and suicide indicators among AI/AN students, stratified by sex. RESULTS Among female AI/AN students, community support had the strongest protective effect against having seriously thought about suicide (adjusted odds ratio [aOR] = 0.23; 95% CI, 0.14-0.38), while family support was significantly associated with the lowest odds of having made a suicide plan (aOR = 0.15; 95% CI, 0.08-0.28) and having attempted suicide (aOR = 0.21; 95% CI, 0.13-0.34) (P < .001 for all). Among male AI/AN students, school support had the strongest protective effect against all 3 outcomes: seriously thought about suicide (aOR = 0.34; 95% CI, 0.19-0.62; P < .001), having made a suicide plan (aOR = 0.19; 95% CI, 0.09-0.39; P < .001), and having attempted suicide (aOR = 0.27; 95% CI, 0.12-0.65; P = .003). CONCLUSIONS Oversampling AI/AN young people can help accurately quantify and understand health risk behaviors and strengths of this population, leading to improved health and wellness. Family, community, and school-based support should be considered in interventions geared toward suicide prevention among AI/AN young people.
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Affiliation(s)
- Carolyn Parshall
- Albuquerque Area Indian Health Board/Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA
| | - Fares Qeadan
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health at Loyola University Chicago, Chicago, IL, USA
| | - Judith Espinoza
- Albuquerque Area Indian Health Board/Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA
| | - Kevin English
- Albuquerque Area Indian Health Board/Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA
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De Luca S, Yan Y, O'Donnell K. Is anybody there? A longitudinal examination of help-seeking and suicidal risk among Latino, Black, and non-Hispanic white adolescents. Suicide Life Threat Behav 2023. [PMID: 36808122 DOI: 10.1111/sltb.12951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 02/22/2023]
Abstract
INTRODUCTION Understanding adolescents' and emerging adults' help-seeking behaviors is important to curb suicidal thoughts and behaviors (STB), especially among racial/ethnic minorities who have some of the highest chronic rates of STB in the United States. Learning how diverse groups of adolescents seek help during emotional crises can help us understand the stark health disparities related to suicide risk and respond to them in culturally informed ways. METHODS The study observed adolescents via a nationally representative sample (n = 20,745) over 14 years (National Longitudinal Study of Adolescents to Adult Health [Add Health]) to examine the association between help-seeking behaviors and STB. Longitudinal multinomial logistic regressions were run to assess for racial/ethnic and gender disparities. RESULTS Help-seeking was not protective for Black female STB but alternatively was protective for each male group (non-Hispanic white, Black, and Latino). Latinas in their early-to-late 20s with no self-reported STB were at an extremely high risk of suicide attempts just 6 years later. CONCLUSIONS This is the first study to examine race/ethnicity*gender in six independent groups to assess suicidality longitudinally among a nationally representative sample. Tailoring existing interventions to meet the needs of growing and diverse communities is critical for suicide prevention programs and policies.
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Affiliation(s)
- Susan De Luca
- Population Health Research Institute, Center for Health Care Research and Policy, The MetroHealth System and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Yueqi Yan
- University of California, Merced, California, USA
| | - Kari O'Donnell
- Center for Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Science, Case Western Reserve University, Cleveland, Ohio, USA
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Banandur P, Hasiruvalli Gangappa V, Koujageri JM, Garady L, Arelingaiah M, Ramamurthy SV, Naik V, Rai V, Giboy S, Sajjanar S, Subhash Chandra KL, Rajneesh S, Gopalkrishna G. Youth and suicidality: Correlates among clients attending youth mental health promotion clinics in India. Int J Soc Psychiatry 2023; 69:146-155. [PMID: 35057650 DOI: 10.1177/00207640211070399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Suicidality among youth is one of the most challenging public health issues. A thorough understanding of the risk factors that contribute to youth suicidality is necessary. The main aim of the study is to estimate the proportion of suicidality and understand factors associated with suicidality amongst clients attending youth mental health promotion clinics in Karnataka, India. METHODS A retrospective cross-sectional case record analysis was performed utilising data from real-time digitised management information system specifically developed for the programme. All case records of clients aged 15 to 35 years who received mental health promotion (MHP) services between January 2017 and December 2020 across 30 districts of Karnataka were included in this analysis. Multivariate logistic regression analysis was performed with suicidality among clients as outcome. Socio-demographic characteristics, issues reported, feelings/emotions that indicate underlying mental health issue/crisis, being aware of suicidality among friends and family and personal habits (smoking/chewing tobacco and drinking alcohol) were considered potential exposure variables. FINDINGS Overall proportion of suicidality among youth presenting to youth mental health promotion clinics in Karnataka was 3.5% (357/10,340). Among factors associated with suicidality, the strongest association was found among those clients who reported attempted suicide among friends (AOR 8.94; 95% CI 5.95-13.45), family members (AOR 5.50; 95% CI 3.66-8.29), being anxious (AOR 4.90; 95% CI 3.43-6.99), inability to trust anyone (AOR 4.07; 95% CI 2.75-6.03), had issues of Gender, Sex and Sexuality (AOR 3.16; 95% CI 1.93-5.17) and relationship issues (AOR 2.77; 95% CI 2.05-3.73). CONCLUSION The results alert all institutions, organisations and departments that cater to services and development of youth, to be sensitive towards risk factors of suicidality. The study advocates youth mental health promotion clinics to be equipped with measures/interventions to identify and manage such risk factors. This study has implications for Youth mental health promotion in India and other similar South-East Asian countries.
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Affiliation(s)
- Pradeep Banandur
- Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | | | | | - Lavanya Garady
- International Centre for Public Health Innovations, Ramaiah, Bengaluru, Karnataka, India
| | - Mutharaju Arelingaiah
- SAMA Program, UK-MRC Funded, Department of Psychiatric Social Work, NIMHANS, Bengaluru, Karnataka, India
| | - Sathya Velu Ramamurthy
- Yuva Spandana Program, Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | - Vani Naik
- Yuva Spandana Program, Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | - Veeksha Rai
- Life Skills Training and Counselling Services Program, Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | - Shalin Giboy
- Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
| | - Sateesh Sajjanar
- Department of Youth Empowerment and Sports, Government of Karnataka, Bengaluru, Karnataka, India
| | | | - Shalini Rajneesh
- Department of Youth Empowerment and Sports, Government of Karnataka, Bengaluru, Karnataka, India
| | - Gururaj Gopalkrishna
- Department of Epidemiology, Centre for Public Health, NIMHANS, Bengaluru, Karnataka, India
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Abstract
Approaches to youth development that enhance connectedness and opportunities for young people are key to adolescent health and wellbeing argue Robert Blum and colleagues
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Affiliation(s)
- Robert W Blum
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Joanna Lai
- United Nations International Children's Emergency Fund (Unicef), New York, USA
| | - Michelle Martinez
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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O’Keefe VM, Waugh E, Grubin F, Cwik M, Chambers R, Ivanich J, Weeks R, Barlow A. Development of "CULTURE FORWARD: A strengths and culture-based tool to protect our native youth from suicide". CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2022; 28:587-597. [PMID: 35771514 PMCID: PMC9588522 DOI: 10.1037/cdp0000546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Indigenous knowledge and practices promote American Indian/Alaska Native (AI/AN; Native) communities' health and well-being. Historical losses and continued oppression have resulted in disproportionately higher AI/AN youth suicide rates. This article describes the development of a new national resource guide titled "CULTURE FORWARD" for tribal leaders and stakeholders to support youth suicide prevention efforts through cultural strengths. METHOD The CULTURE FORWARD guide was developed over 6 months through a community-engaged process. We conducted nine roundtables and eight interviews with a wide variety of community members, leaders, and providers representing 36 diverse tribal communities and geographic regions. Participants discussed AI/AN youth risk and protective factors, successful community efforts to prevent suicide, and content and dissemination ideas. A comprehensive literature review complemented qualitative findings. A diverse and representative National Advisory Editorial Board guided content and design throughout development. RESULTS Qualitative data were analyzed iteratively and thematically. Across all listening sessions, culture was identified as a key protective factor against AI/AN youth suicide. Five themes related to cultural strengths informed guide chapters. Each chapter includes an introduction; how that theme helps prevent Native youth suicide; a review of academic literature, community stories and programs; action steps; and additional resources. CONCLUSIONS CULTURE FORWARD honors and empowers communities by weaving strands of knowledge, stories, and practical resources highlighting Native communities' strengths to protect against Native youth suicide. The guide is free online and print copies are being distributed nationally. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Victoria M. O’Keefe
- Department of International Health, Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health
| | - Emma Waugh
- United South and Eastern Tribes, Inc., Nashville, Tennessee, United States
| | - Fiona Grubin
- Department of International Health, Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health
| | - Mary Cwik
- Department of International Health, Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health
| | - Rachel Chambers
- Department of International Health, Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health
| | - Jerreed Ivanich
- Department of Community and Behavioral Health, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
| | - Rose Weeks
- Department of International Health, Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health
| | - Allison Barlow
- Department of International Health, Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health
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Non-Suicidal Self-Injury Among Adolescents: A Structural Model with Socioecological Connectedness, Bullying Victimization, and Depression. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01319-6. [PMID: 35178654 DOI: 10.1007/s10578-022-01319-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2022] [Indexed: 11/03/2022]
Abstract
The objective was to examine the associations of socioecological connectedness with bullying victimization and depressive symptoms in early adolescence and with non-suicidal self-injury (NSSI) in mid-adolescence, and how these might differ between genders. Diverse adolescents (N = 4115; 49.1% girls) in the 7th grade reported on connections with parents/family, peers, school, and neighborhood, as well as bullying victimization and depressive symptoms, and NSSI in 10th grade (Me = 16.1 years). Structural equation modeling with WSLMV indicated that the lower likelihood of NSSI in 10th grade was associated with higher perceptions of connections between adolescents and their families, both directly as well as indirectly through reduced bully victimization and depressive symptoms three years earlier. Higher school connectedness was indirectly associated with the lower likelihood of NSSI through bullying victimization and depressive symptoms. Paths to NSSI varied for girls and boys. Results advance the understanding of developmental pathways leading to NSSI in adolescent girls and boys.
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Allen J, Wexler L, Rasmus S. Protective Factors as a Unifying Framework for Strength-Based Intervention and Culturally Responsive American Indian and Alaska Native Suicide Prevention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:59-72. [PMID: 34169406 DOI: 10.1007/s11121-021-01265-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 12/14/2022]
Abstract
The ongoing challenge of American Indian and Alaska Native (AIAN) youth suicide is a public health crisis of relatively recent historical origin inadequately addressed by contemporary prevention science. A promising development in AIAN suicide prevention highlights the role of protective factors. A protective factor framework adopts a social ecological perspective and community-level intervention paradigm. Emphasis on protection highlights strength-based AIAN cultural strategies in prevention of youth suicide. Attention to multiple intersecting levels incorporates strategies promoting community as well as individual resilience processes, seeking to influence larger contexts as well as individuals within them. This approach expands the scope of suicide prevention strategies beyond the individual level and tertiary prevention strategies. Interventions that focus on mechanisms of protection offer a rigorous, replicable, and complementary prevention science alternative to risk reduction approaches. This selected review critically examines recent AIAN protective factor suicide prevention science. One aim is to clarify key concepts including protection, resilience, and cultural continuity. A broader aim is to describe the evolution of this promising new framework for conducting primary research about AIAN suicide, and for designing and testing more effective intervention. Recommendations emphasize focus on mechanisms, multilevel interactions, more precise use of theory and terms, implications for new intervention development, alertness to unanticipated impacts, and culture as fundamental in a protective factors framework for AIAN suicide prevention. A protective factor framework holds significant potential for advancing AIAN suicide prevention and for work with other culturally distinct suicide disparity groups, with broad implications for other areas of prevention science.
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Affiliation(s)
- James Allen
- Department of Family Medicine and Biobehavioral Health and Memory Keepers Medical Discovery Team-American Indian and Rural Health Equity, University of Minnesota Medical School, Duluth Campus, Duluth, MN, 55812, USA.
| | - Lisa Wexler
- Department of Social Work and Research Center for Group Dynamics, Institute for Social Research, Univeristy of Michigan, Ann Arbor, MI, 48104, USA
| | - Stacy Rasmus
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, 99775, USA
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Marraccini ME, Griffin D, O’Neill JC, Martinez RR, Chin AJ, Toole EN, Grapin SL, Naser SC. School Risk and Protective Factors of Suicide: A Cultural Model of Suicide Risk and Protective Factors in Schools. SCHOOL PSYCHOLOGY REVIEW 2022; 51:266-289. [PMID: 35935591 PMCID: PMC9354860 DOI: 10.1080/2372966x.2020.1871305] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
There are known cultural variations in correlates of and symptoms related to suicide-related thoughts and behaviors; however, the majority of research that informs suicide prevention in school systems has focused on research based on Euro-American/White students. By exploring school-related risk and protective factors in ethnic-racial minoritized students, we expand existing multicultural models of suicide prevention for school settings. Specifically, this systematic literature review identified 33 studies conducted with American Indian and Alaskan Native, Hispanic and Latinx, Black and African American, and Asian American and Pacific Islander students. Findings underscore the importance of building relationships with the school community and fostering a sense of safety for students, the need to approach school-based suicide prevention and intervention with cultural considerations, and the importance of connecting students and families with providers in culturally sensitive and informed ways. Taken together, schools need to build school-family-community partnerships that promote culturally sensitive approaches to suicide prevention.
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Affiliation(s)
| | - Dana Griffin
- School of Education, University of North Carolina at Chapel
Hill
| | - J. Conor O’Neill
- Department of Psychiatry and Behavioral Sciences, Duke
University School of Medicine
| | | | - Andrew J. Chin
- School of Education, University of North Carolina at Chapel
Hill
| | - Emily N. Toole
- School of Education, University of North Carolina at Chapel
Hill
| | | | - Shereen C. Naser
- College of Sciences and Health Professions, Cleveland State
University
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Skye M, Craig S, Donald C, Kelley A, Morgan B, Rajani K, Singer M, Zaback T, Lambert W. Are American Indian/Alaska Native Adolescent Health Behaviors Different? A Review of AI/AN Youth Involved in Native STAND Curriculum, 2014-2017 United States. Matern Child Health J 2021; 25:1893-1902. [PMID: 34705192 PMCID: PMC8599210 DOI: 10.1007/s10995-021-03256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To explore health behavior profiles of AI/AN youth involved in native students together against negative decisions (STAND), a national culture-based curriculum. METHODS We analyzed data from 1236 surveys conducted among AI/AN youth at 40 native STAND implementation sites located in 16 states throughout the US from 2014 to 2017. Health profiles included demographics, sexual orientation, sexual activity, STI testing, cigarette use, and suicide attempts in the past 12-months. We used t-tests and chi square tests of independence to compare risk behavior prevalence among the sample. RESULTS Health behavior profiles of AI/AN youth indicate that 45.6% of youth did not use condoms the last time they had sex, and 82.7% have never been tested for STIs. Differences in cigarette smoking were observed in questioning youth (questioning: 80.3%, straight/heterosexual: 63.8%, LGBTQ2S + : 49.9%, p = 0.03). CONCLUSIONS FOR PRACTICE Health behaviors related to sex, substance, violence and self-harm, are at least as common for AI/AN youth as those observed in other US teens. Future research should consider similarities and differences in health profiles of AI/AN youth when designing interventions that affect them. Further, our findings underscore the need for culturally-relevant curricula like native STAND, not because their health behavior is different, but because their socio-ecologic environment is different.
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Affiliation(s)
- Megan Skye
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA.
| | - Stephanie Craig
- Northwest Portland Area Indian Health Board, Portland, OR, 97201, USA
| | - Caitlin Donald
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | | | - Brittany Morgan
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | - Kavita Rajani
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | - Michelle Singer
- Northwest Portland Area Indian Health Board, Portland, OR, 97201, USA
| | - Tosha Zaback
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | - William Lambert
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
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Abstract
American Indian and Alaska Native (AI/AN) populations have substantial health inequities, and most of their disease entities begin in childhood. In addition, AI/AN children and adolescents have excessive disease rates compared with the general pediatric population. Because of this, providers of pediatric care are in a unique position not only to attenuate disease incidence during childhood but also to improve the health status of this special population as a whole. This policy statement examines the inequitable disease burden observed in AI/AN youth, with a focus on toxic stress, mental health, and issues related to suicide and substance use disorder, risk of and exposure to injury and violence in childhood, obesity and obesity-related cardiovascular risk factors and disease, foster care, and the intersection of lesbian, gay, bisexual, transgender, queer, and Two-Spirit and AI/AN youth. Opportunities for advocacy in policy making also are presented.
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Affiliation(s)
- Shaquita Bell
- Departments of Pediatrics and
- Contributed equally as co-first authors
| | - Jason F Deen
- Departments of Pediatrics and
- Contributed equally as co-first authors
| | - Molly Fuentes
- Rehabilitation Medicine, School of Medicine, University of Washington and Seattle Children's Hospital, Seattle, Washington; and
| | - Kelly Moore
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Epstein S, Roberts E, Sedgwick R, Polling C, Finning K, Ford T, Dutta R, Downs J. School absenteeism as a risk factor for self-harm and suicidal ideation in children and adolescents: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2020; 29:1175-1194. [PMID: 30989389 PMCID: PMC7116080 DOI: 10.1007/s00787-019-01327-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/30/2019] [Indexed: 11/29/2022]
Abstract
Self-harm and suicidal ideation in children and adolescents are common and are risk factors for completed suicide. Social exclusion, which can take many forms, increases the risk of self-harm and suicidal ideation. One important marker of social exclusion in young people is school absenteeism. Whether school absenteeism is associated with these adverse outcomes, and if so to what extent, remains unclear. To determine the association between school absenteeism and both self-harm (including completed suicide) and suicidal ideation in children and adolescents, we conducted a systematic review of observational studies. We conducted meta-analysis and report a narrative synthesis where this was not possible. Meta-analysis of cross-sectional studies showed that school absenteeism was associated with an increased risk of self-harm [pooled adjusted odds ratio (aOR) 1.37, 95% confidence interval 1.20-1.57, P = 0.01] and of suicidal ideation (pooled aOR 1.20, 95% CI 1.02-1.42, P = 0.03). A small number of studies showed that school absenteeism had a longitudinal association with both adverse outcomes. Heterogeneity in the exposure and outcome variables, study design and reporting was prominent and limited the extent to which it was appropriate to pool results. School absenteeism was associated with both self-harm and suicidal ideation in young people, but this evidence was derived from a small number of cross-sectional studies. Further research into the mechanisms of this association could help to inform self-harm and suicide prevention strategies at clinical, school and population levels.
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Affiliation(s)
- Sophie Epstein
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
- Department of Child and Adolescent Psychiatry, King's College London, London, UK.
| | - Emmert Roberts
- South London and Maudsley NHS Foundation Trust, London, UK
- National Addiction Centre, King's College London, London, UK
- Department of Psychological Medicine, King's College London, London, UK
| | - Rosemary Sedgwick
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - Catherine Polling
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, King's College London, London, UK
| | | | - Tamsin Ford
- University of Exeter Medical School, Exeter, UK
| | - Rina Dutta
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, King's College London, London, UK
| | - Johnny Downs
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
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Manzo K, Hobbs GR, Gachupin FC, Stewart J, Knox SS. Reservation-Urban Comparison of Suicidal Ideation/Planning and Attempts in American Indian Youth. THE JOURNAL OF SCHOOL HEALTH 2020; 90:439-446. [PMID: 32212169 DOI: 10.1111/josh.12891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 05/04/2019] [Accepted: 06/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Our aim was to identify sex- and location-specific risk factors for suicide ideation/planning and attempts among American Indian youth. METHODS Biennial data for 6417 American Indian high school students attending reservation and urban schools were extracted from the Montana volunteer sample Youth Risk Behavior Survey data for pooled years 2003 to 2011. Logistic regression was used to identify sex- and school location-specific risk behaviors and psychosocial factors for past 12-month ideation/planning and past 12-month attempts. RESULTS Contrary to our hypothesis, the prevalence of ideation/planning and attempts did not significantly differ between reservation/urban location; however, risk factors associated with suicidality did. Sadness/hopelessness was associated with both outcomes for all groups. However, violent victimization was associated with both outcomes only among girls. Lack of school safety was associated with attempts but not ideation/planning among all students. There were distinct differences in risk factors associated with both outcomes among boys. CONCLUSIONS The results indicate differences and similarities in risk behaviors and psychosocial factors associated with suicidality by sex and reservation/urban setting. Implications include screening potentially at-risk students for depression, violent victimization, substance use, and school safety and use of the findings by tribal and school programs in designing prevention and intervention programs.
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Affiliation(s)
- Karen Manzo
- Native American Studies Program, West Virginia University, PO Box 6284, Morgantown, WV, 26506-6284
| | - Gerald R Hobbs
- Department of Statistics, West Virginia University, Morgantown, WV, 26505
| | - Francine C Gachupin
- Department of Family and Community Medicine, University of Arizona, 655 N Alvernon Way Ste #228, PO Box 210,491, Tucson, AZ, 85711-1823
| | - Jera Stewart
- Independent Contractor, P.O. Box 41 St, Ignatius, MT, 59865
| | - Sarah S Knox
- Department of Epidemiology, West Virginia University, Member West Virginia University Cancer Center 1 Medical Center Drive, PO Box 9190, Morgantown, WV, 26506-9190
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Gray JS, Schrader L, Isaacs DS, Smith MK, Bender NM. Wac'inyeya: Hope Among American Indian Youth. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2020; 26:151-171. [PMID: 31550383 DOI: 10.5820/aian.2602.2019.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This article examines what gives American Indian youth hope. The project included 56 rural tribal youth in focus groups across a Northern Plains reservation. The participants completed a Youth Personal Balance Tool to provide perspective on the balance according to a medicine wheel model of their lives. The focus groups asked questions from a strengths-based perspective about what gives them hope and how they could show others they were hopeful. The project culminated with the youth developing creative representations of hope and presenting these projects to family and community.
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Pycha R, Pompili M, Innamorati M, Schwitzer J, Lester D, Sani G, Tatarelli R, Giupponi G. Sex and ethnic differences among South Tirolean suicides: A psychological autopsy study. Eur Psychiatry 2020; 24:47-56. [DOI: 10.1016/j.eurpsy.2008.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 08/21/2008] [Accepted: 08/26/2008] [Indexed: 10/21/2022] Open
Abstract
AbstractObjectiveThe aim of the research is to study whether any differences exist in the rates and characteristics of suicide by ethnicity and sex in South Tirol, Italy.MethodsPsychological autopsy interviews were conducted for suicides who died between March 1997 and July 2006.Results332 individuals belonging to the three major South Tirolean ethnic groups (Germans, Italians, Ladins [Ladin is a Rhaeto-Romance language related to the Venetian and Swiss Romansh languages]) died by suicide. Around 23% of the victims had experienced suicidal behaviour among family members, and more than 31% of them had experienced trauma during their childhood. Germans were 1.37 times more at risk to commit suicide than Italians (95% CI: 1.04/1.80; z = 2.26, p < .05). 69% of the suicides had attended school for less than 8 years: Germans (OR = 4.62; 95% CI: 2.52/8.47; p < .001) and Ladins (OR = 11.24; 95% CI: 2.99/42.30; p < .001) were more likely to have lower education than Italians. There were several differences by ethnicity and sex but no sex-by-ethnicity interactions.ConclusionsThe study indicated that suicide, an alarming health and social problem in South Tirol, may require different preventive interventions for men and women and for those of different ethnicities.
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Stanley IH, Hom MA, Gallyer AJ, Gray JS, Joiner TE. Suicidal behaviors among American Indian/Alaska Native firefighters: Evidence for the role of painful and provocative events. Transcult Psychiatry 2020; 57:275-287. [PMID: 31088223 DOI: 10.1177/1363461519847812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Firefighters represent a group at elevated suicide risk. Identifying segments of the fire service at increased risk may facilitate the targeted provision of suicide prevention initiatives. Among the general population, American Indian/Alaska Native (AI/AN) individuals report higher rates of suicide attempts. This study sought to examine suicide attempt rates among AI/AN firefighters and to determine if greater exposure to painful and provocative events and/or fearlessness about death explains the relationship between AI/AN identity and suicidal behaviors. A total of 917 US firefighters completed a web-based mental health survey (6.2% AI/AN). Participants completed a modified version of the Self-Injurious Thoughts and Behaviors Interview-Short Form, the Painful and Provocative Events Scale, and the Acquired Capability for Suicide Scale-Fearlessness About Death scale. Bootstrap mediation analyses were conducted, controlling for years of service as a firefighter. Although AI/AN firefighters accounted for only 6.2% of the sample, they accounted for 34.4% of the career suicide attempts. AI/AN firefighters were 16.31 (95% CI = 7.96, 33.42) times more likely to report a career suicide attempt history than non-AI/AN firefighters, adjusting for years of service as a firefighter. Painful and provocative events, but not fearlessness about death, was a statistically significant mediator of the relationship between AI/AN identity and suicide attempts. Firefighters identifying as AI/AN represent a subgroup within the fire service at increased risk for suicide. Findings suggest that greater exposure to painful and provocative events among AI/AN firefighters may explain the elevated suicide risk among this population.
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HAROZ EMILYE, WALSH COLING, GOKLISH NOVALENE, CWIK MARYF, O’KEEFE VICTORIA, BARLOW ALLISON. Reaching Those at Highest Risk for Suicide: Development of a Model Using Machine Learning Methods for use With Native American Communities. Suicide Life Threat Behav 2020; 50:422-436. [PMID: 31692064 PMCID: PMC7148171 DOI: 10.1111/sltb.12598] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 09/23/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Suicide prevention is a major priority in Native American communities. We used machine learning with community-based suicide surveillance data to better identify those most at risk. METHOD This study leverages data from the Celebrating Life program operated by the White Mountain Apache Tribe in Arizona and in partnership with Johns Hopkins University. We examined N = 2,390 individuals with a validated suicide-related event between 2006 and 2017. Predictors included 73 variables (e.g., demographics, educational history, past mental health, and substance use). The outcome was suicide attempt 6, 12, and 24 months after an initial event. We tested four algorithmic approaches using cross-validation. RESULTS Area under the curves ranged from AUC = 0.81 (95% CI ± 0.08) for the decision tree classifiers to AUC = 0.87 (95% CI ± 0.04) for the ridge regression, results that were considerably higher than a past suicide attempt (AUC = 0.57; 95% CI ± 0.08). Selecting a cutoff value based on risk concentration plots yielded 0.88 sensitivity, 0.72 specificity, and a positive predictive value of 0.12 for detecting an attempt 24 months postindex event. CONCLUSION These models substantially improved our ability to determine who was most at risk in this community. Further work is needed including developing clinical guidance and external validation.
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Affiliation(s)
- EMILY E. HAROZ
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - COLIN G. WALSH
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - NOVALENE GOKLISH
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and White Mountain Apache Tribe, Whiteriver, AZ, USA
| | - MARY F. CWIK
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - VICTORIA O’KEEFE
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - ALLISON BARLOW
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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21
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Kaeppler C, Lucier-Greer M. Examining Impacts of Cumulative Risk on Military-Connected Youth and the Role of Family in Coping. CHILD & YOUTH CARE FORUM 2020. [DOI: 10.1007/s10566-020-09544-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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O'Keefe VM, Haroz EE, Goklish N, Ivanich J, Cwik MF, Barlow A. Employing a sequential multiple assignment randomized trial (SMART) to evaluate the impact of brief risk and protective factor prevention interventions for American Indian Youth Suicide. BMC Public Health 2019; 19:1675. [PMID: 31830933 PMCID: PMC6909588 DOI: 10.1186/s12889-019-7996-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study is built on a long-standing research partnership between the Johns Hopkins Center for American Indian Health and the White Mountain Apache Tribe to identify effective interventions to prevent suicide and promote resilience among American Indian (AI) youth. The work is founded on a tribally-mandated, community-based suicide surveillance system with case management by local community mental health specialists (CMHSs) who strive to connect at-risk youth to treatment and brief, adjunctive interventions piloted in past research. METHODS Our primary aim is to evaluate which brief interventions, alone or in combination, have the greater effect on suicide ideation (primary outcome) and resilience (secondary outcome) among AI youth ages 10-24 ascertained for suicide-related behaviors by the tribal surveillance system. We are using a Sequential Multiple Assignment Randomized Trial with stratified assignment based on age and suicidal-behavior type, and randomizing N = 304 youth. Brief interventions are delivered by AI CMHSs, or by Elders with CMHS support, and include: 1) New Hope, an evidence-based intervention to reduce immediate suicide risk through safety planning, emotion regulation skills, and facilitated care connections; and 2) Elders' Resilience, a culturally-grounded intervention to promote resilience through connectedness, self-esteem and cultural identity/values. The control condition is Optimized Case Management, which all study participants receive. We hypothesize that youth who receive: a) New Hope vs. Optimized Case Management will have significant reductions in suicide ideation; b) Elders' Resilience vs. Optimized Case Management will have significant gains in resilience; c) New Hope followed by Elders' Resilience will have the largest improvements on suicide ideation and resilience; and d) Optimized Case Management will have the weakest effects of all groups. Our secondary aim will examine mediators and moderators of treatment effectiveness and sequencing. DISCUSSION Due to heterogeneity of suicide risk/protective factors among AI youth, not all youth require the same types of interventions. Generating evidence for what works, when it works, and for whom is paramount to AI youth suicide prevention efforts, where rates are currently high and resources are limited. Employing Native paraprofessionals is a means of task-shifting psychoeducation, culturally competent patient support and continuity of care. TRIAL REGISTRATION Clinical Trials NCT03543865, June 1, 2018.
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Affiliation(s)
- Victoria M O'Keefe
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA.
| | - Emily E Haroz
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
| | - Novalene Goklish
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
| | - Jerreed Ivanich
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
| | | | - Mary F Cwik
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
| | - Allison Barlow
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
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Lindsey MA, Sheftall AH, Xiao Y, Joe S. Trends of Suicidal Behaviors Among High School Students in the United States: 1991-2017. Pediatrics 2019; 144:peds.2019-1187. [PMID: 31611338 PMCID: PMC7299440 DOI: 10.1542/peds.2019-1187] [Citation(s) in RCA: 199] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine if racial and ethnic subgroups of adolescents are at high risk for engagement in suicidal behaviors. METHODS Using the nationally representative school-based Youth Risk Behavior Survey from the years 1991 to 2017, we conducted logistic regression analyses to examine trends by different racial and ethnic groups, with each suicide indicator serving as a dichotomous outcome. Participants included 198 540 high school students. RESULTS Across all sex and race and ethnic groups, there were significant linear decreases in self-reported suicidal ideation and suicide plans from 1991 to 2017. Female adolescents (odds ratio [OR], 0.98; P < .001) had significant decreases in attempts over time. Black adolescents had positive linear trends for suicide attempts among both boys (OR, 1.04; P < .001) and girls (OR, 1.02; P = .003). Black adolescent boys (OR, 1.04; P = .048) had a significant linear increase in injury by attempt. CONCLUSIONS The results suggest that, over time, black youth have experienced an increase in suicide attempts, which is troubling because attempts are the most prominent risk factor associated with suicide death. For black boys, a significant increase in injury by attempt occurred, which suggests that black boys may be engaging in increasingly lethal means when attempting suicide. Examining trends of suicidal thoughts and behaviors over time by sex and race and ethnicity allow us to determine where to focus prevention and intervention efforts. Future research should examine the underlying reasons for these changes observed in US high school students.
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Affiliation(s)
- Michael A. Lindsey
- McSilver Institute for Poverty Policy and Research, New York University, New York, New York;,Silver School of Social Work, New York University, New York, New York
| | - Arielle H. Sheftall
- Center for Suicide Prevention and Research, Nationwide Children’s Hospital, Columbus, Ohio;,Center for Innovation in Pediatric Practice, Nationwide Children’s Hospital, Columbus, Ohio;,The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio;,Department of Pediatrics, College of Medicine, Ohio State University, Columbus, Ohio
| | - Yunyu Xiao
- McSilver Institute for Poverty Policy and Research, New York University, New York, New York;,Silver School of Social Work, New York University, New York, New York
| | - Sean Joe
- George Warren Brown School of Social Work, Washington University in St Louis, St Louis, Missouri
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Clarke S, Allerhand LA, Berk MS. Recent advances in understanding and managing self-harm in adolescents. F1000Res 2019; 8:F1000 Faculty Rev-1794. [PMID: 31681470 PMCID: PMC6816451 DOI: 10.12688/f1000research.19868.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2019] [Indexed: 12/28/2022] Open
Abstract
Adolescent suicide is a serious public health problem, and non-suicidal self-injury (NSSI) is both highly comorbid with suicidality among adolescents and a significant predictor of suicide attempts (SAs) in adolescents. We will clarify extant definitions related to suicidality and NSSI and the important similarities and differences between these constructs. We will also review several significant risk factors for suicidality, evidence-based and evidence-informed safety management strategies, and evidence-based treatment for adolescent self-harming behaviors. Currently, dialectical behavior therapy (DBT) for adolescents is the first and only treatment meeting the threshold of a well-established treatment for self-harming adolescents at high risk for suicide. Areas in need of future study include processes underlying the association between NSSI and SAs, clarification of warning signs and risk factors that are both sensitive and specific enough to accurately predict who is at imminent risk for suicide, and further efforts to sustain the effects of DBT post-treatment. DBT is a time- and labor-intensive treatment that requires extensive training for therapists and a significant time commitment for families (generally 6 months). It will therefore be helpful to assess whether other less-intensive treatment options can be established as evidence-based treatment for suicidal adolescents.
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Affiliation(s)
- Stephanie Clarke
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
| | - Lauren A. Allerhand
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
| | - Michele S. Berk
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
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Bai W, Specker B. Racial Differences in Hospitalizations Due to Injuries in South Dakota Children and Adolescents. J Racial Ethn Health Disparities 2019; 6:1087-1094. [PMID: 31301060 DOI: 10.1007/s40615-019-00611-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 06/26/2019] [Accepted: 07/01/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine racial differences and trends in pediatric injury hospitalization rates in a rural state. METHODS Hospital inpatient discharge data (2009-2014) for South Dakota residents aged 0-19 years were used to calculate annual hospitalization rates due to injuries. Race-, age-, and sex-specific rates were calculated, and trends over time were determined. RESULTS Between 2009 and 2014, there were 3701 pediatric hospitalizations (1008 American Indian [AI]; 2303 white) due to injuries at an average rate of 269/100,000 (95% CI 260-280/100,000). Injury hospitalization rates were higher for AI than white children (532 vs. 213 per 100,000, respectively; p < 0.001). Rates for both AI and white children increased between 2009 and 2014 (both, p < 0.001). Suicide attempts were the predominant manner of injury in both the 10-14- and 15-19-year age groups, with AI adolescents having 3.5 and 3.2 times higher rates than white adolescents. Among AI adolescents aged 15 to 19 years, hospitalizations due to homicide-related injuries were 12.6 times higher than that of white children. Injury hospitalization rates among females recently exceeded that of males, due primarily to an increase in attempted suicides. Mechanism and nature of hospitalized injuries were consistent with the high rate of suicide-related admissions. CONCLUSION South Dakota AI children have disproportionately higher hospitalization rates due to unintentional and attempted suicide- and homicide-related injuries, and the rate differences between AI and white children are increasing over time. Injury hospitalization rates among females have increased more rapidly and recently surpassed that of males.
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Affiliation(s)
- Wei Bai
- EA Martin Program, South Dakota State University, Brookings, SD, 57007, USA
| | - Bonny Specker
- EA Martin Program, South Dakota State University, Brookings, SD, 57007, USA.
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Abstract
This article summarizes current knowledge and consensus about depression and suicide among the indigenous young people of the United States. American Indians represent more than 500 tribes and also vary among settings-reservations, urban, suburban, and rural-but as a group, remain at high risk for suicide and possibly for depressive syndromes. Particular risk factors and correlates, as well as approaches to treatment, are discussed.
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Hielscher E, Whitford TJ, Scott JG, Zopf R. When the body is the target—Representations of one’s own body and bodily sensations in self-harm: A systematic review. Neurosci Biobehav Rev 2019; 101:85-112. [DOI: 10.1016/j.neubiorev.2019.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 10/14/2018] [Accepted: 03/11/2019] [Indexed: 02/03/2023]
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Bradley RH. Home Environment and Self-Efficacy Beliefs among Native American, African American, and Latino Adolescents. FAMILY PROCESS 2019; 58:418-430. [PMID: 29736952 DOI: 10.1111/famp.12363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Context helps determine what individuals experience in the settings they inhabit. Context also helps determine the likelihood that those experiences will promote adaptive development. Theory suggests likely interplay between various aspects of home context and development of ideas about self that influence patterns of development for children. This study addressed relations between two aspects of home life (companionship and investment, modeling and encouragement) and three types of self-efficacy beliefs (enlisting social resources, independent learning, self-regulatory behavior) considered important for long-term adaptive functioning. The study focused on three groups of minority adolescents (Native American, African American, Latino). Relations were examined using regression models that also included four aspects of household risk that often hinder the development of self-efficacy. Although findings varied somewhat across the three groups, significant relations emerged between the two domains of home life examined and self-efficacy beliefs in all three groups, even controlling for overall household risk. Companionship and investment appeared particularly relevant for African American adolescents, while modeling and encouragement appeared particularly relevant for Native American adolescents. Both were relevant for Latino adolescents.
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Affiliation(s)
- Robert H Bradley
- Center for Child and Family Success, T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ
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Rivkin I, Lopez EDS, Trimble JE, Johnson S, Orr E, Quaintance T. Cultural values, coping, and hope in Yup'ik communities facing rapid cultural change. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:611-627. [PMID: 30407637 DOI: 10.1002/jcop.22141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/05/2018] [Accepted: 09/14/2018] [Indexed: 05/26/2023]
Abstract
Historical trauma and rapid cultural change contribute to a high burden of stress in Alaska Native communities. The goal of the Yup'ik Experiences of Stress and Coping Project was to better understand stress and coping in Yup'ik communities and the role of cultural values and practices in coping. Sixty Yup'ik adults aged 18-84 years took part in semistructured interviews. They discussed how they coped with salient stressful experiences and shared the things that bought them hope and peace. Interview themes were identified and inter-relationships between themes were explored through social network analysis. Participants discussed the importance of cultural traditions in coping, including subsistence, dancing and drumming, intergenerational transmission of knowledge, and reflective awareness of interconnections with others. Participants found strength in family relationships, spirituality, helping others, and coming together as a community. Three coping clusters emerged: Ilaliurucaraq (be welcoming) involved opening one's frame of mind and building connections; Yuuyaraq (Yup'ik way of life) focused on Yup'ik traditions and values; and Assircaarturluni Yuuyaraq (try to live a better life) involved healing from historical trauma. Findings illustrate the resilience and evolving strengths of rural Yup'ik communities facing a continually changing cultural landscape and provide information for developing community-driven culturally based interventions.
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Goebert DA, Hamagami F, Hishinuma ES, Chung-Do JJ, Sugimoto-Matsuda JJ. Change Pathways in Indigenous and Nonindigenous Youth Suicide. Suicide Life Threat Behav 2019; 49:193-209. [PMID: 29357189 PMCID: PMC6054903 DOI: 10.1111/sltb.12420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/29/2017] [Indexed: 11/27/2022]
Abstract
Multivariate dynamic relationships among suicide attempts, anxiety and/or depressive symptoms, hope, and help-seeking were examined across time in Native Hawaiian and non-Hawaiian adolescents, using data from a 5-year longitudinal cohort study (N = 7,317). The rate of suicide attempts decreased over time, but this reduction was significantly less among Native Hawaiian youth than their non-Hawaiian peers. There were also significant differences between groups in hope and help-seeking, with Native Hawaiian youth increasing help-seeking and decreasing hope to a greater degree. Youth-centered, cultural approaches to suicide prevention are essential in enhancing well-being in indigenous communities.
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Affiliation(s)
- Deborah A. Goebert
- Department of Psychiatry, University of Hawai‘i at Mānoa, Honolulu, Hawai‘i,Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, Hawai‘i
| | | | - Earl S. Hishinuma
- Department of Psychiatry, University of Hawai‘i at Mānoa, Honolulu, Hawai‘i
| | - Jane J. Chung-Do
- Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, Hawai‘i
| | - Jeanelle J. Sugimoto-Matsuda
- Department of Psychiatry, University of Hawai‘i at Mānoa, Honolulu, Hawai‘i,Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, Hawai‘i
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Kelley A, Witzel M, Fatupaito B. Preventing Substance Use in American Indian Youth: The Case for Social Support and Community Connections. Subst Use Misuse 2019; 54:787-795. [PMID: 30574816 DOI: 10.1080/10826084.2018.1536724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIMS This study explored the relationship between social support, community connections, self-esteem, and culture on misuse in American Indian youth. METHODS The study team developed a culturally-responsive 16-question survey for American Indian youth ages 12-20 living in six American Indian communities in the Great Plains Region of the United States. The study was grounded in primary socialization theory and variables were explored using regression models. RESULTS A total of 565 American Indian youth completed the participant survey between January 2016 and August 2017. The present study found that community connections were negatively associated with marijuana use in American Indian youth. Higher community connection scores were associated with higher social support and self-esteem scores. CONCLUSIONS Tribally-led prevention initiatives can fill an important socio-behavioral prevention gap by facilitating social support opportunities for American Indian youth who may not have adequate support from immediate family or friends.
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Affiliation(s)
- Allyson Kelley
- a Allyson Kelley & Associates PLLC , Sandia Park , New Mexico , USA
| | - Morgan Witzel
- b Rocky Mountain Tribal Leaders Council , Billings , Montana , USA
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Rukundo GZ, Kemigisha E, Ocan M, Adriko W, Akena DH. A systematic review of the risk factors for suicidal ideation, suicidal attempt and completed suicide among children and adolescents in sub-Saharan Africa between 1986 and 2018: protocol for a systematic review of observational studies. Syst Rev 2018; 7:230. [PMID: 30541623 PMCID: PMC6292009 DOI: 10.1186/s13643-018-0901-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide is one of the leading causes of death among children and adolescents. Most studies about the burden and risk factors for suicide have been conducted in high-income countries. However, there is a dearth in the literature about the burden and risk factors for suicide among children and adolescents in low- and middle-income countries including within Sub-Saharan Africa (SSA). There is need to summarise the available literature about the burden and risk factors for suicide among children and adolescents in SSA. In this review, we will (a) determine the overall prevalence of suicidal ideation, suicidal attempt and completed suicide among children and adolescents in SSA; (b) describe the methods (such as hanging, firearms, overdose, poisoning, drowning and burning) used for suicidal attempt, and completed suicide among children and adolescents in SSA; and (c) document the risk factors for suicidal ideation, suicidal attempt and completed suicide among children and adolescents in SSA. METHODS The review will be conducted and reported in accordance to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. We will include journal articles that have documented the prevalence and risk factors for suicidal ideation, suicidal attempt and completed suicide among children and adolescents aged 5-19 years in SSA. We will also include accessible grey literature about the topic. Qualitative studies will be excluded from the study since they are limited in estimating prevalence. We will search different search engines including PUBMED, EMBASE, Psych-INFO, Cochrane Library, Africa wide-information and global health using suicide, adolescents and children, SSA as the keywords. We will use a meta-analysis, should we find that there is no heterogeneity between included studies. DISCUSSION This protocol describes a systematic review of observational studies reporting completed suicide, suicidal ideation and suicidal attempt among children and adolescents in sub-Saharan Africa. We anticipate that once this review is complete and published, our findings will be of interest to adolescents with suicidal behaviour, their families and caregivers, clinicians and other healthcare professionals, scientists and policy makers. SYSTEMATIC REVIEW REGISTRATION PROSPERO International prospective register of systematic reviews: CRD42016048610 .
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Affiliation(s)
- Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology and African Centre for Suicide Research, Mbarara, Uganda.
| | - Elizabeth Kemigisha
- Faculty of Interdiscilinary Studies, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Moses Ocan
- Department of Pharmacology & Therapeutics, Makerere College of Health Sciences, Kampala, Uganda
| | - Wilson Adriko
- Library, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Dickens Howard Akena
- Department of Psychiatry, Makerere College of Health Sciences and African Centre for Systematic, Kampala, Uganda
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Descriptive epidemiology of suicide attempts and suicide in the remote villages of French Guiana. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1197-1206. [PMID: 30132021 DOI: 10.1007/s00127-018-1570-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 07/24/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The overall rate of suicide in French Guiana is estimated at 6 per 100,000, a rate that is lower than in mainland France. Given the frequent reports of suicide in Amerindian communities, our hypothesis was that this figure fails to capture a more contrasted reality. Our objective was to refine estimates and determine suicide rates in remote villages of French Guiana. METHODS We included patients for whom a suicide attempt or suicide was mentioned in medical records. The Health centers were grouped into two zones according to geographical remoteness. RESULTS The highest suicide rates observed in the remote Amerindian villages of Camopi and Trois Sauts were, respectively, 118 and 78/100,000. The median age at the time of suicide was significantly younger in remote zones [23 years (95% CI 21.59-25.06)] than in non-remote zones-[27 years (95% CI 24.47-29.31)]. The most frequent methods were hanging (78%) and intoxication (22%). CONCLUSIONS The suicide rate in remote areas in French Guiana was eight times higher than in France. The suicide of young people in remote areas in French Guiana and specifically in Amerindian villages must be better understood and prevented with contextualized and adapted care.
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Brockie TN, Elm JHL, Walls ML. Examining protective and buffering associations between sociocultural factors and adverse childhood experiences among American Indian adults with type 2 diabetes: a quantitative, community-based participatory research approach. BMJ Open 2018; 8:e022265. [PMID: 30232110 PMCID: PMC6150153 DOI: 10.1136/bmjopen-2018-022265] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The purpose of this study was to determine the frequency of select adverse childhood experiences (ACEs) among a sample of American Indian (AI) adults living with type 2 diabetes (T2D) and the associations between ACEs and self-rated physical and mental health. We also examined associations between sociocultural factors and health, including possible buffering processes. DESIGN Survey data for this observational study were collected using computer-assisted survey interviewing techniques between 2013 and 2015. SETTING Participants were randomly selected from AI tribal clinic facilities on five reservations in the upper Midwestern USA. PARTICIPANTS Inclusion criteria were a diagnosis of T2D, age 18 years or older and self-identified as AI. The sample includes n=192 adults (55.7% female; mean age=46.3 years). PRIMARY MEASURES We assessed nine ACEs related to household dysfunction and child maltreatment. Independent variables included social support, diabetes support and two cultural factors: spiritual activities and connectedness. Primary outcomes were self-rated physical and mental health. RESULTS An average of 3.05 ACEs were reported by participants and 81.9% (n=149) said they had experienced at least one ACE. Controlling for gender, age and income, ACEs were negatively associated with self-rated physical and mental health (p<0.05). Connectedness and social support were positively and significantly associated with physical and mental health. Involvement in spiritual activities was positively associated with mental health and diabetes-specific support was positively associated with physical health. Social support and diabetes-specific social support moderated associations between ACEs and physical health. CONCLUSIONS This research demonstrates inverse associations between ACEs and well-being of adult AI patients with diabetes. The findings further demonstrate the promise of social and cultural integration as a critical component of wellness, a point of relevance for all cultures. Health professionals can use findings from this study to augment their assessment of patients and guide them to health-promoting social support services and resources for cultural involvement.
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Affiliation(s)
- Teresa N Brockie
- Community Public Health Nursing, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Jessica H L Elm
- Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School, Duluth, Minnesota, USA
| | - Melissa L Walls
- Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School, Duluth, Minnesota, USA
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Oppenheimer CW, Stone LB, Hankin BL. The influence of family factors on time to suicidal ideation onsets during the adolescent developmental period. J Psychiatr Res 2018; 104:72-77. [PMID: 29990669 PMCID: PMC6414226 DOI: 10.1016/j.jpsychires.2018.06.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/23/2018] [Accepted: 06/26/2018] [Indexed: 11/29/2022]
Abstract
Family factors are associated with suicidal behavior in youth, but little is known about how the joint influence of multiple family factors prospectively predicts onsets of suicidal ideation (SI) in adolescence, a developmental period characterized by increases in SI and risk for suicide. This study investigated whether parent history of SI interacted with either positive or negative parent-child relationship quality to longitudinally predict time to SI onsets during the transition into and across adolescence. Specifically, we used a longitudinal, multi-wave design and survival analyses to examine whether the interaction between these family factors prospectively predicted time to emergence of SI onsets (assessed at 6 month intervals over 3 years) in a community sample of youth ages 8 to 15 (N = 238; 57% girls). Results supported an interaction effect, such that more negative relationship quality with parents predicted earlier emergence of SI among those youth whose parents had no history of SI. However, negative parent relationship quality did not amplify risk among youth with parent history of SI; all youth with a parent history of SI were more likely to experience earlier emergence of SI regardless of level of negative relationship quality. Findings did not support an interaction between low levels of parent-child positive relationship quality and parent history of ideation. Implications for the role of family factors in the etiology and prevention of SI are discussed.
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Affiliation(s)
- Caroline W Oppenheimer
- 3811 O'Hara St., Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.
| | - Lindsey B Stone
- Avenue of the Arts, Department of Psychology, Christopher Newport University, Newport News, VA 23606, USA
| | - Benjamin L Hankin
- 603 East Daniel St., Department of Psychology, University of Illinois, Champaign, IL, 61820, USA
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Pacot R, Garmit B, Pradem M, Nacher M, Brousse P. The problem of suicide among Amerindians in Camopi-Trois Sauts, French Guiana 2008-2015. BMC Psychiatry 2018; 18:99. [PMID: 29642878 PMCID: PMC5896108 DOI: 10.1186/s12888-018-1670-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 03/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide within the Amerindian community of Camopi (1741 inhabitants) in French Guiana has been an increasing problem widely reported in the media leading the French Government to mandate a parliamentary mission to investigate the matter. The purpose of the study was to describe this phenomenon and identify factors associated with suicide attempts. METHODS A retrospective observational study was conducted from the health centers' medical records. All suicide attempts and suicides committed between 2008 and 2015 by Amerindians living in Camopi and Trois Sauts were compiled. Contextual factors and suicide representations were also analyzed. RESULTS During the study period, the annual attempted suicide rate and the suicide rate were higher in the last 3 years. The overall annual rate was equal to 6.9/1741 or 396 per 100, 000 inhabitants for attempted suicide and 172 per 100,000 inhabitants for suicide, which is more than 10 times higher than the suicide rate in mainland France. The mortality rate was 30.4% versus 8.2% in mainland France. The 10-20 year-old age group represented 70% of suicide deaths. There was no significant difference between genders. A recent death and interpersonal conflict were the main stressful life events reported by respondents (55 and 52%, respectively). Alcohol addiction (30% of the respondents) was associated with suicide attempts under the influence of alcohol (p = 0.03). Repetition of suicide attempts was associated with cannabis consumption (p = 0.03). Depression was reported among 45% of the respondents. A third of respondents reported having been abused during their childhood. Over half of respondents reported that their suicide attempt was motivated by a spirit (58%). CONCLUSIONS Despite limitations due to the small population size and limited time frame, this is the first study to describe the epidemiology of suicide among Amerindians living in Camopi. In contrast with other French territories, the suicide rate was very high, the sex ratio was balanced and younger age groups were most affected.
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Affiliation(s)
- Rémi Pacot
- 0000 0004 0630 1955grid.440366.3Département des centres délocalisés de prévention et de soins, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
| | - Basma Garmit
- 0000 0004 0630 1955grid.440366.3Département des centres délocalisés de prévention et de soins, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
| | | | - Mathieu Nacher
- Centre d'Investigation Clinique, INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana.
| | - Paul Brousse
- 0000 0004 0630 1955grid.440366.3Département des centres délocalisés de prévention et de soins, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
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Cha CB, Franz PJ, Guzmán EM, Glenn CR, Kleiman EM, Nock MK. Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment. J Child Psychol Psychiatry 2018; 59:460-482. [PMID: 29090457 PMCID: PMC5867204 DOI: 10.1111/jcpp.12831] [Citation(s) in RCA: 276] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Suicide is a leading cause of death and a complex clinical outcome. Here, we summarize the current state of research pertaining to suicidal thoughts and behaviors in youth. We review their definitions/measurement and phenomenology, epidemiology, potential etiological mechanisms, and psychological treatment and prevention efforts. RESULTS We identify key patterns and gaps in knowledge that should guide future work. Regarding epidemiology, the prevalence of suicidal thoughts and behaviors among youth varies across countries and sociodemographic populations. Despite this, studies are rarely conducted cross-nationally and do not uniformly account for high-risk populations. Regarding etiology, the majority of risk factors have been identified within the realm of environmental and psychological factors (notably negative affect-related processes), and most frequently using self-report measures. Little research has spanned across additional units of analyses including behavior, physiology, molecules, cells, and genes. Finally, there has been growing evidence in support of select psychotherapeutic treatment and prevention strategies, and preliminary evidence for technology-based interventions. CONCLUSIONS There is much work to be done to better understand suicidal thoughts and behaviors among youth. We strongly encourage future research to: (1) continue improving the conceptualization and operationalization of suicidal thoughts and behaviors; (2) improve etiological understanding by focusing on individual (preferably malleable) mechanisms; (3) improve etiological understanding also by integrating findings across multiple units of analyses and developing short-term prediction models; (4) demonstrate greater developmental sensitivity overall; and (5) account for diverse high-risk populations via sampling and reporting of sample characteristics. These serve as initial steps to improve the scientific approach, knowledge base, and ultimately prevention of suicidal thoughts and behaviors among youth.
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Affiliation(s)
- Christine B. Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia
University
| | | | - Eleonora M. Guzmán
- Department of Counseling and Clinical Psychology, Teachers College, Columbia
University
| | - Catherine R. Glenn
- Department of Clinical and Social Sciences in Psychology, University of
Rochester
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Arango A, Cole-Lewis Y, Lindsay R, Yeguez CE, Clark M, King C. The Protective Role of Connectedness on Depression and Suicidal Ideation Among Bully Victimized Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:728-739. [DOI: 10.1080/15374416.2018.1443456] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
| | | | | | - Carlos E. Yeguez
- Department of Psychology and Center for Children and Families, Florida International University
| | - Michael Clark
- Consulting for Statistics, Computing, & Analytics Research, University of Michigan
| | - Cheryl King
- Department of Psychiatry, University of Michigan
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Beaudoin V, Séguin M, Chawky N, Affleck W, Chachamovich E, Turecki G. Protective Factors in the Inuit Population of Nunavut: A Comparative Study of People Who Died by Suicide, People Who Attempted Suicide, and People Who Never Attempted Suicide. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010144. [PMID: 29337928 PMCID: PMC5800243 DOI: 10.3390/ijerph15010144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/06/2018] [Accepted: 01/08/2018] [Indexed: 12/05/2022]
Abstract
Epidemiological data shows an alarming prevalence of suicide in Aboriginal populations around the world. In Canada, the highest rates are found in Inuit communities. In this article, we present the findings of a secondary analysis conducted with data previously collected as part of a larger study of psychological autopsies conducted in Nunavut, Canada. The objective of this secondary analysis was to identify protective factors in the Inuit population of Nunavut by comparing people who died by suicide, people from the general population who attempted suicide, and people from the general population who never attempted suicide. This case-control study included 90 participants, with 30 participants in each group who were paired by birth date, sex, and community. Content analysis was first conducted on the clinical vignettes from the initial study in order to codify the presence of protective variables. Then, inferential analyses were conducted to highlight differences between each group in regards to protection. Findings demonstrated that (a) people with no suicide attempt have more protective variables throughout their lifespan than people who died by suicide and those with suicide attempts within the environmental, social, and individual dimensions; (b) people with suicide attempts significantly differ from the two other groups in regards to the use of services; and (c) protective factors that stem from the environmental dimension show the greatest difference between the three groups, being significantly more present in the group with no suicide attempt. Considering these findings, interventions could focus on enhancing environmental stability in Inuit communities as a suicide prevention strategy.
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Affiliation(s)
- Véronique Beaudoin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
| | - Monique Séguin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
- Mood Disorders and Related Disorders, McGill Group on Suicide Studies, Douglas Mental Health University Institute & Québec Network on Suicide, Montreal, QC H4H 1R3, Canada.
| | - Nadia Chawky
- Mood Disorders and Related Disorders, McGill Group on Suicide Studies, Douglas Mental Health University Institute & Québec Network on Suicide, Montreal, QC H4H 1R3, Canada.
| | - William Affleck
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
| | - Eduardo Chachamovich
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Institute, McGill University, Montreal, QC H3A 0G4, Canada.
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Institute, McGill University, Montreal, QC H3A 0G4, Canada.
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Foster CE, Horwitz A, Thomas A, Opperman K, Gipson P, Burnside A, Stone DM, King CA. Connectedness to family, school, peers, and community in socially vulnerable adolescents. CHILDREN AND YOUTH SERVICES REVIEW 2017; 81:321-331. [PMID: 30202142 PMCID: PMC6128354 DOI: 10.1016/j.childyouth.2017.08.011] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Youth who feel connected to people and institutions in their communities may be buffered from other risk factors in their lives. As a result, increasing connectedness has been recommended as a prevention strategy. In this study, we examined connectedness among 224 youth (ages 12-15), recruited from an urban medical emergency department, who were at elevated risk due to bullying perpetration or victimization, or low social connectedness. Regression analyses examined multiple domains of connectedness (family, school, peer, community) in relation to adjustment. Youth who felt more connected to parents reported lower levels of depressive symptoms, suicidal ideation, non-suicidal self-injury, and conduct problems, higher self-esteem and more adaptive use of free time. Youth who felt more connected to their school reported lower levels of depressive symptoms, suicidal ideation, social anxiety, and sexual activity, as well as higher levels of self-esteem and more adaptive use of free time. Community connectedness was associated with less social anxiety but more sexual activity, and peer connectedness was not related to youth adjustment in this unique sample. Findings suggest that family and school connectedness may buffer youth on a trajectory of risk, and may therefore be important potential targets for early intervention services.
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Affiliation(s)
- Cynthia Ewell Foster
- The University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48104, United States
- Corresponding author at: 4250 Plymouth Road, Ann Arbor, MI 48104, United States. (C.E. Foster)
| | - Adam Horwitz
- The University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48104, United States
| | - Alvin Thomas
- The University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48104, United States
| | - Kiel Opperman
- The University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48104, United States
| | - Polly Gipson
- The University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48104, United States
| | - Amanda Burnside
- The University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48104, United States
| | - Deborah M. Stone
- Centers for Disease Control and Prevention, National Center for Injury Control and Prevention, Division of Violence Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Cheryl A. King
- The University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48104, United States
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Maple M, Cerel J, Sanford R, Pearce T, Jordan J. Is Exposure to Suicide Beyond Kin Associated with Risk for Suicidal Behavior? A Systematic Review of the Evidence. Suicide Life Threat Behav 2017; 47:461-474. [PMID: 27786372 DOI: 10.1111/sltb.12308] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 06/09/2016] [Indexed: 01/01/2023]
Abstract
Suicide bereavement and postvention literature often espouses risk for subsequent suicidal behavior among those previously exposed to a suicide death. Most often risk is discussed in relation to kin; however, many more individuals are exposed to suicide, and the impact of this exposure is important to understand in relation to targeting postvention. This review examined the research literature (1990-2014) to determine the evidence base for risk among those exposed to suicide. The findings demonstrate that risk of suicidal behaviors among those exposed to the suicide is significantly higher than those unexposed. These results are discussed within the context of current research in the field of postvention, and suggestions for future research are suggested.
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Affiliation(s)
- Myfanwy Maple
- School of Health, University of New England, Armidale, NSW, Australia
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | | | - Tania Pearce
- School of Health, University of New England, Armidale, NSW, Australia
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Vazsonyi AT, Mikuška J, Gaššová Z. Revisiting the immigrant paradox: Suicidal ideations and suicide attempts among immigrant and non-immigrant adolescents. J Adolesc 2017; 59:67-78. [DOI: 10.1016/j.adolescence.2017.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 05/09/2017] [Accepted: 05/14/2017] [Indexed: 10/19/2022]
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Qiao N, Bell TM. Indigenous Adolescents' Suicidal Behaviors and Risk Factors: Evidence from the National Youth Risk Behavior Survey. J Immigr Minor Health 2017; 19:590-597. [PMID: 27271955 DOI: 10.1007/s10903-016-0443-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The study sought to examine indigenous adolescents' suicidal behaviors and risk factors in a nationally representative sample and explore potential causes of disparities. The study analyzed the 1991-2013 Youth Risk Behavior Survey National Combined Datasets. Suicidal behavior outcomes included suicide consideration, planning, and attempts during the past 12 months. Logit regressions were used to estimate the effects of potential suicide risk factors on these suicidal behaviors. The results showed that a high percentage of indigenous adolescents exhibited suicidal behaviors (consideration: 24.6 %; planning: 20.7 %; attempts: 16.2 %). After adjusting for risk factors, indigenous adolescents were no more likely than other adolescents to consider or plan for suicide (consideration: OR 1.18, CI 0.96-1.45, p = 0.125; planning: OR 1.16, CI 0.95-1.42, p = 0.156); however, they remained significantly more likely to have made suicide attempts (OR 1.73, CI 1.32-2.26, p < 0.001). Disparities in adolescent suicidal behaviors could be explained by the heterogeneous prevalence of suicidal risk factors across different races/ethnicities.
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Affiliation(s)
- Nan Qiao
- Department of Economics, Indiana University-Purdue University Indianapolis, 702 Rotary Circle, Room 022A, Indianapolis, IN, 46202, USA
| | - Teresa Maria Bell
- Department of Surgery, School of Medicine, Indiana University-Purdue University Indianapolis, 702 Rotary Circle, Room 022A, Indianapolis, IN, 46202, USA.
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Henson M, Sabo S, Trujillo A, Teufel-Shone N. Identifying Protective Factors to Promote Health in American Indian and Alaska Native Adolescents: A Literature Review. J Prim Prev 2017; 38:5-26. [PMID: 27826690 PMCID: PMC5313316 DOI: 10.1007/s10935-016-0455-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent's environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents.
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Affiliation(s)
- Michele Henson
- Department of Health Promotion Sciences, Center for American Indian Resilience, Zuckerman College of Public Health, University of Arizona College of Public Health, 1295 N Martin Ave, Tucson, AZ, 85724, USA.
| | - Samantha Sabo
- Department of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona College of Public Health, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Aurora Trujillo
- Native Nations Institute, 803 E 1st Street, Tucson, AZ, 85719, USA
| | - Nicolette Teufel-Shone
- Department of Health Promotion Sciences, Center for American Indian Resilience, Zuckerman College of Public Health, University of Arizona College of Public Health, 1295 N Martin Ave, Tucson, AZ, 85724, USA
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Quigley J, Rasmussen S, McAlaney J. The Associations Between Children's and Adolescents' Suicidal and Self-Harming Behaviors, and Related Behaviors Within Their Social Networks: A Systematic Review. Arch Suicide Res 2017; 21:185-236. [PMID: 27267251 DOI: 10.1080/13811118.2016.1193075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Social influences-including the suicidal and self-harming behaviors of others-have been highlighted as a risk factor for suicidal and self-harming behavior in young people, but synthesis of the evidence is lacking. A systematic review of 86 relevant papers was conducted. Considerable published evidence was obtained for positive associations between young people's suicidal and self-harming behavior and that of people they know, with those reporting knowing people who had engaged in suicidal or self-harming behaviors more likely to report engaging in similar behaviors themselves. Findings are discussed in relation to a number of methodological and measurement issues-including the role of normative perceptions-and implications for the prevention of suicidal and self-harming behavior are considered.
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Peltzer K, Yi S, Pengpid S. Suicidal behaviors and associated factors among university students in six countries in the Association of Southeast Asian Nations (ASEAN). Asian J Psychiatr 2017; 26:32-38. [PMID: 28483087 DOI: 10.1016/j.ajp.2017.01.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/28/2016] [Accepted: 01/16/2017] [Indexed: 12/13/2022]
Abstract
A large data gap remains on suicidal behaviors among youth in the Association of Southeast Asian Nations (ASEAN) countries, despite the increasing rates of suicide in Asian cultures that may be related to rapid economic changes and the loss of social stability. This study was therefore conducted to explore the prevalence of and factors associated with suicidal ideation and suicide attempts among university students in six ASEAN member states. Data were collected in a cross-sectional survey of 4675 undergraduate university students, mean age 20.6 years (SD=2.7), range of 18-30 years, from Cambodia, Indonesia, Malaysia, Myanmar, Thailand and Vietnam. The overall prevalence of ever suicidal ideation and ever suicide attempt among students in this study was 11.7% and 2.4%, respectively. Different rates of these suicidal behaviors were observed across the countries. In multivariable logistic regression models, suicidal ideation was significantly associated with psychosocial factors including childhood sexual abuse, depressive symptoms, involvement in physical fights, and poor academic performance as well as socio-environmental factors including living with parents or guardians and low involvement in organized religious activity. Suicide attempt was significantly associated with childhood sexual abuse, depressive symptoms, low involvement in organized religious activity and being underweight or overweight. Our findings suggest that individual-level strategies for suicide prevention should be targeted toward students with poor academic performance, mental health problems and a history of adverse childhood experiences. Particular attention should be paid to the role of families that could be a potential stressor in the lives of university students.
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Affiliation(s)
- Karl Peltzer
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand; Department of Research & Innovation, University of Limpopo, Turfloop, South Africa; HIV/AIDS/STIs/and TB (HAST), Human Sciences Research Council, Pretoria, South Africa.
| | - Siyan Yi
- KHANA Center for Population Health Research, Phnom Penh, Cambodia; Center for Global Health Research, Touro University California, Vallejo, United States
| | - Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand; Department of Research & Innovation, University of Limpopo, Turfloop, South Africa
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Sarche M, Tafoya G, Croy CD, Hill K. AMERICAN INDIAN AND ALASKA NATIVE BOYS: EARLY CHILDHOOD RISK AND RESILIENCE AMIDST CONTEXT AND CULTURE. Infant Ment Health J 2017; 38:115-127. [PMID: 27966785 DOI: 10.1002/imhj.21613] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
American Indian and Alaska Native (AIAN) adolescent and adult men experience a range of health disparities relative to their non-AIAN counterparts and AIAN women. Given the relatively limited literature on early development in tribal contexts, however, indicators of risk during early childhood specific to AIAN boys are not well-known. The current article reviews sources of strength and challenge within AIAN communities for AIAN children in general, including cultural beliefs and practices that support development, and contextual challenges related to socioeconomic and health disparities and historical trauma affecting the AIAN population as a whole. The research literature on early development is reviewed, highlighting what this literature reveals about early gender differences. The article concludes with calls to action on behalf of AIAN boys that align with each of the five tiers of R. Frieden's (2010) Public Health Pyramid.
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Affiliation(s)
| | | | | | - Kyle Hill
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health
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Serfaini K, Donovan DM, Wendt DC, Matsumiya B, McCarty CA. A Comparison of Early Adolescent Behavioral Health Risks Among Urban American Indians/Alaska Natives and their Peers. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2017; 24:1-17. [PMID: 28832885 PMCID: PMC6282166 DOI: 10.5820/aian.2402.2017.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We sought to examine behavioral health indicators for an early adolescent population of American Indians/Alaska Natives (AI/AN) within an urban setting in Washington State. We conducted secondary data analyses from a randomized clinical trial implemented in local middle schools that compared AI/ANs (n = 43), non-Hispanic Whites (n = 620), and other racial/ethnic minority youth (n = 527) across a variety of behavioral health risks. AI/AN youth reported significantly more depressive symptoms than other racial/ethnic minorities as well as non-Hispanic Whites. They also reported more discrimination, more generalized anxiety, and were more likely to have initiated substance use, in comparison to non-Hispanic Whites. Psychosocial screening and early intervention are critically needed for AI/AN youth.
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Wexler L, Poudel-Tandukar K, Rataj S, Trout L, Poudel KC, Woods M, Chachamovich E. Preliminary Evaluation of a School-Based Youth Leadership and Prevention Program in Rural Alaska Native Communities. SCHOOL MENTAL HEALTH 2016; 9:172-183. [DOI: 10.1007/s12310-016-9203-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hedeland RL, Teilmann G, Jørgensen MH, Thiesen LR, Andersen J. Risk factors and characteristics of suicide attempts among 381 suicidal adolescents. Acta Paediatr 2016; 105:1231-8. [PMID: 27146308 DOI: 10.1111/apa.13458] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 03/02/2016] [Accepted: 05/02/2016] [Indexed: 11/28/2022]
Abstract
AIM This study explored the relationships between suicidal adolescents and their parents, siblings and friends. It examined how much adolescents talked to their parents before suicide attempts, the frequency of self-mutilation, the extent of suicidal ideation, previous suicide attempts and suicide attempts in the adolescent's surroundings. METHODS We performed a cross-sectional case-control study that focused on 381 adolescents aged 10-17 years who were admitted to hospitals across Denmark after suicide attempts with acetaminophen and 296 age- and gender-matched controls recruited from schools. The study used questionnaires and medical and child psychiatric records. RESULTS The study group were ten times more likely to report dissociated parental relationships than the control group (41.5% versus 4%), and there were significant relationships between these reports and feelings of not being heard (p < 0.0001), dissociated relationships with friends (p < 0.0001) and siblings (p < 0.0001) and self-mutilation (p = 0.009). Almost two-thirds (62.5%) of the suicidal adolescents who tried to talk to their parents about their problems felt unheard, and there was a significant relationship between this feeling and the duration of suicidal ideation (p = 0.01) and self-mutilation (p = 0.003). CONCLUSION Early risk factors for suicide were dissociated relationships with parents, siblings and friends, feeling unheard, self-mutilation and extended suicidal ideation.
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Affiliation(s)
| | - Grete Teilmann
- Department of Pediatric and Adolescent Medicine; Nordsjaellands Hospital; Hillerød Denmark
| | | | - Line Rejkjaer Thiesen
- Department of Pediatric and Adolescent Medicine; Nordsjaellands Hospital; Hillerød Denmark
| | - Jesper Andersen
- Department of Pediatric and Adolescent Medicine; Nordsjaellands Hospital; Hillerød Denmark
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