Low self-esteem and hopelessness in childhood and suicidal ideation in early adulthood

Cognitive Reappraisal Moderates the Longitudinal Relationship between Adolescents' Peer Victimization and Self-Esteem. A Latent Interaction Model

Poor self-esteem relates closely to youth maladjustment and appears to be predicted by peer victimization experiences. However, not all peer victimized adolescents face the same risk for self-esteem erosion over time. Drawing upon the Bi-Dimensional Framework for resilience and extant research, the present study examined the potential moderating role of cognitive reappraisal in the prospective relationship from peer victimization to self-esteem. To increase precision of findings the long-term impact of self-esteem on peer victimization was also tested. Self-reported data were collected from 285 early adolescents (Mage = 10.53 years, SD = 0.16; 54.0% girls) at two waves, spaced 1-year. Latent moderated structural equation analysis showed that peer victimization was negatively related to later self-esteem, but only for youth displaying low levels of cognitive reappraisal. For adolescents with high levels of cognitive reappraising, peer victimization was not found to predict any changes in self-esteem over time. The long-term impact of self-esteem on peer victimization was not supported. Overall the present study suggests that enhancing cognitive reappraisal could be a promising avenue for lowering risk for poor self-esteem in young individuals experiencing peer victimization.

The association of childhood trauma with suicidality in adult psychiatric patients: The mediating role of NSSI and the moderating role of self-esteem

BACKGROUND

The contribution of specific childhood trauma subtypes to suicidal thoughts and the associated mechanisms remains unclear, particularly in psychiatric patients.

METHODS

Face-to-face interviews were conducted with 449 psychiatric patients aged 18-73. Childhood trauma, self-esteem, nonsuicidal self-injury (NSSI), and suicidality were assessed retrospectively. Regression and moderated mediation model were employed to examine these relationships.

RESULTS

Emotional and sexual abuse were independently associated with suicidality. Female patients reported higher levels of emotional and sexual abuse, lower self-esteem, and a heightened risk of suicide. Self-esteem moderated the links between childhood trauma and NSSI, as well as between NSSI and suicidality. NSSI served as a mediator between childhood trauma and suicidality.

CONCLUSIONS

Suicide prevention in mentally ill patients should involve targeted programs addressing specific childhood trauma. Additionally, psychological interventions to enhance self-esteem and assist individuals engaging in NSSI behavior are crucial.

Association of adolescent self-esteem in 2014 and cognitive performance in 2014, 2016, and 2018: a longitudinal study

Background

Cognition has long been regarded as a significant factor influencing individuals' lives. Prior studies have underscored that self-esteem is associated with cognition, and there exists a knowledge gap regarding whether self-esteem remains associated with subsequent cognitive performance during adolescence, a crucial period for neurological development and influencing adult outcomes.

Methods

We conducted this population-based study using longitudinal data stretching three waves (2014, 2016, and 2018) of surveys from the nationally representative China Family Panel Studies (CFPS) to explore the association between adolescents' self-esteem in 2014 and cognitive performance in 2014, 2016, and 2018.

Results

The results of the present study showed that self-esteem during adolescence in 2014 was significantly associated with cognitive performance in 2014, 2016, and 2018. This association remained robust after an extensive range of covariate adjustments (e.g., adolescents, parental, and family characteristics).

Conclusion

The findings in this study provide further insight into the understanding of the related factors for cognitive development across the life course and highlight the importance of improving individual self-esteem during adolescence.

No moderating effect of coping skills on the association between bullying experience and self-esteem: Results from K-CHILD study

Introduction

Few studies have investigated the moderating effect of coping skills on the association between bullying experience and low self-esteem. The aim of this study was to examine whether coping skills have a moderating effect on the association between bullying experience and self-esteem among Japanese students.

Methods

Data from the population-based Kochi Child Health Impact of Living Difficulty (K-CHILD) study conducted in 2016 were analyzed. Participants included fifth-and eighth-grade students living in Kochi Prefecture, Japan. A questionnaire for the students (n = 5,991) assessed the bullying experience, self-esteem (the Japanese Edition of the Harter's Perceived Competence Scale for Children), and coping skills that comprised six types (The shortened version of coping skills for elementary school children). Multivariate linear regression analyses were conducted to examine the association between bullying experience and self-esteem and then the moderating effects of six types of coping as interaction terms on the association were considered.

Results

Bullying experience was inversely associated with self-esteem. All six types of coping did not moderate the relationship between bullying experience and low self-esteem even after adjusting for cofounders (all P for interaction > 0.15).

Conclusion

Coping skills did not moderate the association between bullying experience and self-esteem, suggesting that intervention to boost coping skills to mitigate the adverse effect of bullying experience may not be promising.

Association between parental absence during childhood and depressive symptoms in adulthood in rural Vietnam

BACKGROUND

While parental absence during childhood has been linked to depression/depressive symptoms in adulthood, no research has been conducted on this association in Vietnam, where many children were separated from their parents during and after the Vietnam War (1955-1975). We examined the association between parental absence in childhood and depressive symptoms among rural community dwellers in Khanh Hoa Province, Vietnam.

METHODS

Data came from 3000 individuals aged 40-60 years old who participated in the baseline survey of the Khanh Hoa Cardiovascular Study. Depressive symptoms were assessed with the 11-item Center for Epidemiologic Studies Depression Scale. Self-reported information on parental absence due to death, divorce, or outmigration to other locations before the age of 15 was also obtained. A Poisson regression analysis with a robust variance estimator was used to examine associations.

RESULTS

Experiencing parental absence at 3 - < 15 years old and before 3 years old was associated with a 1.21 times (95% confidence interval [CI] = 1.02-1.43) and 1.41 times (95% CI = 1.15-1.73) higher prevalence of depressive symptoms, respectively (p trend <0.001). When examining the associations by the different reasons for the parental absence, the strongest association was found for parental absence due to outmigration to other locations.

LIMITATIONS

We had no information on who respondents lived with after they experienced parental absence. In addition, self-reported information on childhood experiences was subject to recall bias.

CONCLUSIONS

In rural Vietnam, parental absence during childhood was associated with a significantly increased prevalence of depressive symptoms in middle adulthood.

The interplay between psychopathological symptoms: transdiagnostic cross-lagged panel network model

BACKGROUND

Recent paradigm shifts suggest that psychopathology manifests through dynamic interactions between individual symptoms.

AIMS

To investigate the longitudinal relationships between symptoms in a transdiagnostic sample of patients with psychiatric disorders.

METHOD

A two-wave, cross-lagged panel network model of 15 nodes representing symptoms of depression, (social) anxiety and attenuated psychotic symptoms was estimated, using baseline and 1-year follow-up data of 222 individuals with psychiatric disorders. Centrality indices were calculated to determine important predictors and outcomes.

RESULTS

Our results demonstrated that the strongest relationships in the network were between (a) more suicidal ideation predicting more negative self-view, and (b) autoregressive relationships of social anxiety symptoms positively reinforcing themselves. Negative self-view was the most predictable node in the network as it had the highest 'in-expected influence' centrality, and may be an important transdiagnostic outcome symptom.

CONCLUSIONS

The results give insight into longitudinal interactions between symptoms, which interact in ways that do not adhere to broader diagnostic categories. Our results suggest that self-view can also be a transdiagnostic outcome of psychopathology rather than just a predictor, as is normally posited, and may especially have an important relationship with suicidal ideation. Overall, our study demonstrates the dynamic complexity of psychopathology, and further supports the importance of investigating symptom interactions of different psychopathological dimensions over time and across disorders.

The influence of sedentary behaviour on mental health among children and adolescents: A systematic review and meta-analysis of longitudinal studies

BACKGROUND

Systematic reviews that have examined associations between sedentary behaviour (SB) and mental health among children and adolescents are mainly based on cross-sectional investigations. There is a lack of evidence for a prospective relationship between SB and mental health in children and adolescents. This systematic review synthesized longitudinal studies that examined prospective associations between SB and mental health among children and adolescents.

METHODS

We conducted computer searches for English language literature from electronic databases of PubMed, Embase, PsycInfo and Google scholar, and manually screened the references of existing relevant studies to select studies for the synthesis. We included observational longitudinal studies that assessed the association between SB and mental health among children and adolescents. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

In total, 58 longitudinal studies met the inclusion criteria and were synthesized in the review. We found that higher SB among children and adolescents was associated with increased depression, anxiety and other mental health problems later in life. A dose-response association between SB and mental health was observed, suggesting that children and adolescents who spend more time on SB may have a higher risk of developing poorer mental health later.

CONCLUSIONS

The findings in the present study suggest that intervention programs targeting reducing SB may benefit to the prevention of poor mental health among children and adolescents. Future intervention studies especially randomized controlled trials are needed to elucidate a causal relationship between SB and mental health among children and adolescents.

Negative life events increase the risk of suicidal ideation in 6653 Chinese freshmen: From a 1-year longitudinal study

BACKGROUND

Suicide is one of the leading causes of juvenile death. Suicidal ideation (SI) is a strong predictor of suicide, while negative life events are associated with SI in adolescents. The aim of this study was to investigate the effect of negative life events on SI in a sample of Chinese freshmen.

METHODS

The current study employed a cluster sampling method with 7118 freshmen at baseline and 6653 at follow-up. Negative life events were assessed by using the Adolescent Self-Rating Life Events Check List (ASLEC), and SI was assessed by a separate question for self-report. The PHQ-9 was used to measure depression at baseline.

RESULTS

The incidence of suicidal ideation was 1.52% (95% CI: 1.22%-1.81%). Two dimensions of negative life events, interpersonal relationship and others were risk factors for SI, while female students were more susceptible to them. Consistently, interpersonal relationship and others were risk factors for SI in participants without depression and with mild depression. However, health & adaptation was found to be the only dimension of negative life events contributing to the risk of SI in participants with moderate, severe and extremely severe depression.

LIMITATIONS

There may be recall bias in this study.

CONCLUSIONS

Negative life events increase the risk of SI in college students. Female students are more susceptible to negative life events. The effect of different dimensions of negative life events on SI varies in participants with and without depression.

The Effectiveness of Self-Esteem-Related Interventions in Reducing Suicidal Behaviors: A Systematic Review and Meta-Analysis

Suicide is a serious social issue and is often treated using psychological interventions. The current systematic review and meta-analysis aimed to investigate the effectiveness of self-esteem-related interventions on suicidal behaviors. A systematic literature search for randomized controlled trials (RCTs) including a self-esteem component was conducted on 29 May 2021 and updated on 4 April 2022. In total, 12 studies were included in the systematic review and five studies were included in the meta-analysis. Small effect sizes were found for suicidal ideation at post intervention [g = -0.24, 95% CI (-0.48, 0.00)] and a 3-month follow-up [g = -0.36, 95% CI (-0.62, -0.11)]. However, these results should be interpreted cautiously due to the limited number of included studies and varied sample population. In conclusion, the current review suggests that future intervention studies should incorporate self-esteem enhancement in the treatment of suicidal behaviors, especially for suicidal ideation.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=250882.

Beyond Fundamental Dimensions of Mood in Predicting Depressive Symptoms and Suicidal Ideation in Victims of Interpersonal Violence: Examining the Role of Dispositional Optimism in Chinese Females With and Without Experience of Victimization

The present study tested a prediction model involving affectivity and dispositional optimism as predictors of suicide risk (i.e., depressive symptoms and suicidal ideation) in young adult Chinese females with and without prior interpersonal violence (IPV) victimization (294 nonvictimized and 94 victimized females). Results of hierarchical regression analyses indicated that negative affectivity was a significant predictor of both depressive symptoms and suicidal ideation for Chinese females, regardless of IPV victimization. Beyond affectivity, dispositional optimism was found to further add to the prediction model of depressive symptoms in both groups, but only for suicidal ideation in the IPV victimized group.

Playing High School Football Is Not Associated With an Increased Risk for Suicidality in Early Adulthood

OBJECTIVE

To determine if playing high school football is associated with suicide ideation between the ages of 24 and 32 years.

DESIGN

Data were analyzed from the National Longitudinal Study of Adolescent to Adult Health. This prospective cohort study sampled nationally representative US participants at 4 time points from 1994 to 2008.

SETTING

In-home assessment.

PARTICIPANTS

There were 3147 boys (age: median = 14.9, SD = 1.8) who participated during adolescence in 1994 to 1995 (wave I), of whom 2353 were reinterviewed in 2008 (wave IV, age: median = 29.1, SD = 1.8).

ASSESSMENT OF RISK FACTORS

Football participation, history of psychological counseling, suicide ideation, and a suicide attempt in the past year during high school.

MAIN OUTCOME MEASURES

Lifetime history of depression, suicide ideation within the past year, and feeling depressed in the past 7 days at wave IV.

RESULTS

Men who played high school football, compared with those who did not, reported similar rates of lifetime diagnosis of depression, suicide ideation in the past year, and feeling depressed in the past 7 days. Those who played football reported similar rates of suicide ideation in the past year when they were in their early 20s. Individuals who underwent psychological counseling during adolescence were more likely to report a lifetime history of depression and suicide ideation in the past year.

CONCLUSIONS

Young men who played high school football are not at an increased risk for suicide ideation during both their early 20s and late 20s. By contrast, those who experienced mental health problems in high school were much more likely to experience suicide ideation during their 20s.

The Effect of Cognitive Behavioral Group Therapy on Children's Self-Esteem

(1) Background: Self-esteem plays an important role in developing emotional resilience and wellbeing in children. Yet, there has been little related research on Cognitive Behavioral Group Therapy on this topic. Our aims were to assess the effect of the Child Self-Esteem CBT (CSE-CBT) protocol on children's self-esteem in grades five and six; to assess the effect of the CSE-CBT protocol on the therapeutic process; and to explore the feasibility of delivering the CSE-CBT protocol in a school setting. (2) Methods: Eighty elementary school children in grades five and six, divided into four intervention and four control groups, attended 12 structured sessions using the CSE-CBT protocol, led by specially trained teachers. The children completed questionnaires to assess their self-esteem at the beginning and at the end of the study, and answered weekly questionnaires that assessed therapeutic process. Hierarchical linear modeling was used to analyze the data. (3) Results: The CSE-CBT protocol had a significant effect on improving children's self-esteem over the course of the study, regardless of the children's working alliance with the teacher leading the group. (4) Conclusions: The findings suggest that the CSE-CBT protocol has the potential to benefit children's self-esteem and indicate that school teachers can be trained to administer the CBT-protocol.

Maladaptive personality traits and the course of suicidal ideation in young adults with bipolar disorder: Cross-sectional and prospective approaches

BACKGROUND

Childhood-onset bipolar disorder (BD) has considerable morbidity and mortality, including suicide. Many risk factors have been identified for suicidality, but the potential role of personality traits as assessed by a computer-assisted self-report measure remains unclear.

AIMS

To address this gap in knowledge, we tested relations between pathological-range personality traits and suicidal ideation among young adults whose childhood-onset BD was prospectively confirmed by enrollment in the Course and Outcome of Bipolar Youth study (COBY) as children (n = 45) and a newly enrolled group of typically developing controls (TDCs; n = 52) both cross-sectionally and longitudinally after 1.5 years of follow up.

MATERIALS & METHODS

Personality traits were assessed with the computerized Schedule for Nonadaptive and Adaptive Personality-2 (SNAP-2).

RESULTS

Cross-sectionally, we found that participants with BD had elevated Suicide Proneness and Low Self-esteem versus TDCs at baseline. Furthermore, longitudinal analyses in the BD participants for whom we had 1.5 years of prospectively collected illness-course data showed that greater Suicide Proneness and Low Self-esteem prospectively predicted greater levels, shorter time until occurrence, and greater frequency of suicidal ideation during the follow-up.

CONCLUSION

Our findings suggest the role of specific personality-related vulnerabilities in the course of BD that, pending replication, could contribute to development of interventions focused on personality traits among individuals with BD.

Pathways from bullying victimization to suicidal thoughts among urban African American adolescents: Implications for nurse practitioners

PURPOSE

Children and adolescents who are victimized by their peers are at an elevated risk of suicidal thoughts and behaviors. Bullying and suicide are major public health concerns; however, studies have not fully addressed the link between peer victimization and suicidal behavior among urban African American youth. The current study proposed and explored the pathways from peer victimization to suicidal thoughts via internalizing behaviors (i.e., low self-esteem, depression, and hopelessness).

DESIGN AND METHODS

The sample consisted of 638 African American adolescents (aged 12-22) from low-income communities in Chicago's Southside. A path model using the structural equation model was employed, controlling for biological sex, age, and government assistance.

RESULTS

The study found that victims of bullying are likely to develop low self-esteem and depression, and depression can contribute to feelings of hopelessness, thereby increasing suicidal risks.

CONCLUSIONS

Understanding the pathways from bullying victimization to suicidal thoughts is beneficial for nurse practitioners who assess and provide services and treatment to adolescents.

PRACTICE IMPLICATIONS

Because of limited resources in urban schools, anti-bullying programs need to be cost-effective.

Victimization in traditional and cyberbullying as risk factors for substance use, self-harm and suicide attempts in high school students

Background:

Traditional bullying (or peer bullying) is considered a common and unpleasant experience among students and has serious consequences such as mental health problems and unhealthy behavior. In recent years, another type of bullying named cyberbullying has emerged as a growing problem with negative effects on school achievement, physiology, and mental health of its victims.

Objective:

The purpose of this research is to examine and compare the roles of traditional and cyberbullying victimization in substance use, self-harm and suicide attempts.

Methods:

This was a cross-sectional study and conducted in 2019. A total of 425 high school students were selected for the study in Kermanshah, Iran. For conducting the survey, a multi-stage cluster randomized procedure was used and 18 classes in six different high schools in three urban areas were selected. A total of 400 students (mean age 16.61 years, 53.2% girls) responded to the survey, and it provided usable information for the research. Data were analyzed through binary logistic regression analyses.

Results:

The analysis results revealed that 54.2% of students (n = 217) have experienced traditional or cyber victimization. Any kind of victimization was associated with self-harm. Cyber victimization alone and the combination of cyber plus traditional victimization showed significant association with suicide and substance use. Risk of substance use, self-harm, and suicide was higher when students experienced both types of bullying than when they experienced just one kind of bullying alone.

Conclusions:

The results of this study suggest that traditional and cyber victims may require immediate intervention to reduce the negative effects of victimization. Also, prevention programs should consider the possible relationship between traditional and cyber victimization and substance use, self-harm, and suicide.

A longitudinal study of the impact of school delinquency on self-worth development among Black American adolescents

Previous research found adolescents with low self-worth often utilize delinquency as a method of "self-enhancing" as proposed by Kaplan, which suggests the effects of delinquency can be both enhancing and damaging to adolescents' later reports of self-worth. We tested Kaplan's self-enhancing thesis to determine the extent to which different levels of self-worth in early adolescents foretell long-term levels of self-worth associated with delinquency among adolescents placed at-risk. Data from a sample of 982 primarily Black American (95%) adolescents living in high-poverty neighborhoods were analyzed using global and behavioral self-worth measures collected annually between the ages of 12-17, with school delinquency as the self-enhancing mechanism. Gender (45% female, 55% male) and baseline self-worth measures were included in the model. We found empirical support for the positive effects of school delinquency consistent with self-enhancing theories, although with younger female participants only. Specifically, engaging in delinquent behaviors at age 12 had a positive effect on a females' behavioral self-worth. There were, however, differential effects for males. Although delinquency increased self-worth among females in the short-term, long-term effects were negative, as greater school delinquency resulted in lower self-worth at age 17. Additional gender results and implications for findings are discussed.

Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is associated with self-harm during adolescence and young adulthood, especially among females. Yet little is known about the developmental trajectories or childhood predictors/moderators of self-harm in women with and without childhood histories of ADHD. We characterized lifetime risk for nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts (SA), comparing female participants with (n = 140) and without (n = 88) childhood ADHD. We examined theory-informed childhood predictors and moderators of lifetime risk via baseline measures from childhood. First, regarding developmental patterns, most females with positive histories of lifetime self-harm engaged in such behaviors in adolescence yet desisted by adulthood. Females with positive histories of self-harm by late adolescence emanated largely from the ADHD-C group. Second, we found that predictors of NSSI were early externalizing symptoms, overall executive functioning, and father's negative parenting; predictors of SI were adverse childhood experiences and low self-esteem; and predictors of SA were early externalizing symptoms, adverse childhood experiences, and low self-esteem. Third, receiver operating characteristics analyses helped to ascertain interactive sets of predictors. Findings indicate that pathways to self-harm are multifaceted for females with ADHD. Understanding early childhood predictors and moderators of self-harm can inform both risk assessment and intervention strategies.

Association of Existence of Third Places and Role Model on Suicide Risk Among Adolescent in Japan: Results From A-CHILD Study

Objective: Low self-esteem among adolescents can be considered a risk factor for suicidal behavior in adolescents. Thus, the purpose of this study is to investigate the association between the existence of a third place and role model on self-esteem among adolescents in Japan, where low self-esteem is prevalent among adolescents. Methods: We analyzed data from the 2016 Adachi Child Health Impact of Living Difficulty (A-CHILD) study, in which a school-based questionnaire was conducted among children in grades 4, 6, and 8 living in Adachi City, Tokyo (N = 1,609). Children self-rated their own levels of self-esteem. Low self-esteem was defined as lower 10 percentile group. The existence of a third place was defined as a place where children spent time after school other than the home or school campus, and role model was defined as having someone, other than a parent, who they looked up to, and these concepts were assessed via questionnaire. Results: Adolescents without a third place and role model accounted for 10.5 and 6.1%, respectively. We found that children who lacked a third place also showed a significant association with low self-esteem (OR: 1.75, 95% confidence interval (CI): 1.09-2.81), and those who lacked a role model were 3.34 times more likely to have lower self-esteem (95% CI: 1.98-5.62). Conclusion: The existence of a third place and a role model may be important to prevent low self-esteem among adolescents in Japan.

Improving self-esteem through integrative group therapy for personality dysfunction: Investigating the role of the therapeutic alliance and quality of object relations

OBJECTIVE

We aimed to investigate change in self-esteem through intensive group treatment for personality dysfunction, by exploring: (a) the relationship between patients' experience of therapeutic alliance and improvement in self-esteem during treatment, including patients' quality of object-relations (QOR) as a possible moderator; and (b) the association between improvement in self-esteem during treatment, and depressive symptoms 9 months later.

METHOD

Eighty patients with personality dysfunction, consecutively enrolled in a group-oriented treatment program, were assessed at pretreatment, posttreatment, and 9 months follow-up.

RESULTS

Especially for patients with lower QOR, alliance predicted self-esteem change during treatment. In addition, change in self-esteem during treatment predicted follow-up depression severity, even when controlling for within-treatment symptom change.

CONCLUSIONS

Patients with impoverished inner relational representations may benefit more from a secure alliance in terms of improving their self-esteem. Change in self-esteem may also be important in preventing relapse of depressive symptoms in people with personality dysfunction.

Pathway of the Association Between Child Poverty and Low Self-Esteem: Results From a Population-Based Study of Adolescents in Japan

Child poverty leads to various negative consequences, including low self-esteem, which is a risk factor for mental illness, suicide, or poor academic achievement. However, little is known about why child poverty leads to low self-esteem. We aimed to elucidate the association of child poverty and low self-esteem based on the ecological model, which includes family-level, school-level, and community-level factors. Data were obtained from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2016, and participants included 1,652 children in fourth grade (534 pairs), sixth grade (530 pairs), and eighth grade (588 pairs) living in Adachi City, Tokyo, Japan. A questionnaire survey was implemented to assess child poverty, parental mental health, parental involvement with children, parental social capital by caregivers, and self-esteem and school social capital by children. The structural equation model was applied to elucidate the association between child poverty and low self-esteem, using family-level (parental mental health and parental involvement with children), school-level (school social capital), and community-level (parental social capital) factors. Child poverty was associated with low self-esteem. Child poverty leads to poor parental involvement, which can be indirectly associated with poor parental mental health and poor parental social capital, and poor parental involvement was directly or indirectly associated with low self-esteem through poor school social capital. To mitigate the impact of child poverty on low self-esteem, comprehensive health policies targeting family-level (parental mental health and parental involvement with children), school-level (school social capital), and community-level (parental social capital) factors may be effective.

Implicit interpersonal evaluations as a risk factor for suicidality: Automatic spousal attitudes predict changes in the probability of suicidal thoughts

Thwarted social connection is a critical risk factor for suicidality, and several theoretical perspectives highlight the importance of interpersonal affect to social connection. Given that marriage is an increasingly important source of social connection, we examined the role of automatic spousal attitudes-conceptualized as spontaneously activated affective associations involving one's spouse-in predicting suicidal thoughts in 3 longitudinal studies of married couples. Studies 1a (N = 204) and 1b (N = 159) demonstrated that more positive automatic spousal attitudes, assessed implicitly shortly after the marriage as the speed with which people categorized positive relative to negative words following photo-primes of their spouse, were associated with a weakened probability of the self-reported suicidal thoughts 1 year later. Study 2 (N = 229) provided further evidence that automatic spousal attitudes predict suicidal thoughts by showing that newly conditioned automatic spousal attitudes predicted suicidal thoughts. In that study, more positive automatic spousal attitudes exhibited after an evaluative conditioning procedure were associated with a reduced probability of suicidal thoughts 2 months later. Across studies, an increase (1 SD) in automatic spousal attitudes was associated with approximately a 50% decreased probability of suicidal thought. In all 3 studies, implicitly measured spousal attitudes captured variance in suicidal thoughts not captured by implicitly measured attitudes toward oneself and self-reported marital satisfaction, both of which proved to be less reliable predictors of suicidal thoughts. These findings highlight the importance of automatic interpersonal processes to well-being generally and suicidality specifically, and may thereby suggest novel methods for reducing risk of suicidality. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Self-criticism, interpersonal conditions, and biosystemic inflammation in suicidal thoughts and behaviors within mood disorders: A bio-cognitive-interpersonal hypothesis

We review the theoretical and empirical literature on the role of self-concept in suicidal behavior in the context of mood disorders (i.e., unipolar depression and bipolar spectrum disorders). The main themes emanating from this review are then juxtaposed against (a) the Interpersonal-Psychological Theory of Suicide and (b) biological research on the role of inflammatory processes in suicidality. Such a juxtaposition paves the way for a bio-cognitive-interpersonal hypothesis. Pathologies of the self-concept-primarily self-criticism-propel mood disorder sufferers to generate interpersonal stress that culminates in two proximal causes of suicidality: thwarted belongingness and perceived burdensomeness. In turn, these two interpersonal conditions set in motion systemic biosystemic inflammation, serving as a proximal cause for suicidality in mood disorders. We conclude by describing a research project aimed at testing this hypothesis, and by outlining pertinent implications for assessment, treatment, and prevention.

The impact of psychological problems and adverse life events on suicidal ideation among adolescents using nationwide data of a school-based mental health screening test in Korea

The aim of this study was to investigate the risk factors for suicidal ideation in adolescents by gender and age. This study used 2013 nationwide school-based mental health screening test data from 591,303 seventh grade students and 618,271 tenth grade students in Korea. Suicidal ideation, four psychological problems, and three adverse life events were evaluated using the Adolescents Mental Health and Problem Behavior Screening Questionnaire-II. Of all students, 12.9-14.7% of the boys and 17.1-23.2% of the girls had suicidal ideation. Mood had the greatest impact on the risk for suicidal ideation and other factors also significantly increased the risk of suicidal ideation. Distractibility was positively related to suicidal ideation only in seventh grade students and behavioral problems increased suicidal ideation more in girls than in boys. Violence constituted the most powerful factor for suicidal ideation among the events; however, bullying constituted the most important event that increased suicidal ideation in seventh grade girls. All factors except 'Distractibility' increased the risk of severe suicidal ideation. The risk factors for suicidal ideation in adolescents differed by gender and age. Interventions should be made according to these characteristics to reduce suicidal ideation in adolescents.

The Role of Executive Functioning and Academic Achievement in the Academic Self-Concept of Children and Adolescents Referred for Neuropsychological Assessment

The current study evaluated a model of youth academic self-concept which incorporates practical executive functioning behaviors and academic achievement. Though greater academic achievement has been linked to both positive self-concept and better executive functioning, these constructs have not been examined simultaneously. It was hypothesized that academic achievement would mediate the association between problems with executive functioning and academic self-concept such that youth with more problems with executive functioning would have lower academic achievement and, in turn, lower academic self-concept. Clinical data was analyzed from a diagnostically heterogeneous sample of youth (n = 122) who underwent neuropsychological evaluation. Problems with executive functioning were assessed using the Behavior Rating Inventory of Executive Function. Academic achievement was assessed using the Woodcock–Johnson Tests of Achievement or Wechsler Individual Achievement Test. Academic self-concept was assessed using the youth-report version of the Behavioral Assessment System for Children. Surprisingly, findings indicate that academic achievement is not significantly associated with problems with executive functioning or academic self-concept. However, greater problems with executive functioning are associated with decreased academic self-concept. The overall model included several covariates and accounted for 10% of the variance in academic self-concept. Findings suggest that executive skills may be essential for aligning academic achievement with classroom performance. Though various child characteristic covariates were included, the model accounted for a small amount of variance suggesting that future studies should examine contributing contextual factors.

The importance of health behaviours in childhood for the development of internalizing disorders during adolescence

Background

Poor mental health constitutes a considerable global public health burden with approximately half of all cases of poor mental health having their onset before the age of 14 years. The identification of modifiable risk factors early in life is therefore essential to prevention, however, there are presently very few longitudinal studies on health behaviours for mental health to inform public health decision makers and to justify preventive action. We examined the importance of diet quality, physical activity (PA) and sedentary behaviours in childhood for internalizing disorder throughout adolescence.

Methods

We linked data from a population-based lifestyle survey among 10 and 11 year old grade five students in the Canadian province of Nova Scotia with physician diagnoses of internalizing disorders from administrative health records. We applied negative binomial regressions to examine the associations of health behaviours with the number of health care provider contacts with a diagnosis of internalizing disorder.

Results

Of the 4875 students, 23.9% had one or more diagnoses for internalizing disorder between the age of 10 or 11 years and 18 years. The number of health care provider contacts with a diagnosis of internalizing disorder was statistically significant higher among students with less variety in their diets, and among students who reported less PA and more time using computers and video games. The number of health care provider contacts was also higher for girls, and for students with low self-esteem and from low-income households.

Conclusions

These findings suggest that diets and active lifestyles in childhood affect mental health during adolescence, and imply that succxessful health promotion programs targeting children’s diets and activity will contribute to the prevention of mental health disorders in addition to the prevention of chronic diseases later in life.

Electronic supplementary material

The online version of this article (10.1186/s40359-017-0208-x) contains supplementary material, which is available to authorized users.

Influence of physical activity, sedentary behavior, and diet quality in childhood on the incidence of internalizing and externalizing disorders during adolescence: a population-based cohort study

PURPOSE

Studies among youth suggest that physical inactivity, sedentary behaviors, and poor diet quality are associated with poor mental health. Few population-based studies have investigated these relationships longitudinally. We examined the association between physical activity, sedentary behaviors, and diet quality in childhood and the incidence of internalizing and externalizing disorders throughout adolescence.

METHODS

We linked health behavior survey data from 2003 among 10- to 11-year-old children across Nova Scotia, Canada, with administrative health care data from 2003 to 2011. Students' diet quality was assessed using the Harvard Food Frequency Questionnaire. Physical activity and sedentary behaviors were self-reported, and internalizing and externalizing disorders were diagnosed by a physician. We applied Cox regression to examine the associations of the health behaviors with the incidence of internalizing and externalizing disorders between 2003 and 2011.

RESULTS

Of the 4861 participating students, 23.7% and 9.4% had a diagnosis of internalizing and externalizing disorders, respectively. The incidences of internalizing and externalizing disorders were higher among students who were less physically active and spent more time using computers and video games.

CONCLUSIONS

These findings suggest that promoting an active lifestyle in childhood may contribute to the prevention of both internalizing and externalizing disorders during adolescence.

Mental Health and Self-Worth in Socially Transitioned Transgender Youth

OBJECTIVE

Social transitions are increasingly common for transgender children. A social transition involves a child presenting to other people as a member of the "opposite" gender in all contexts (e.g., wearing clothes and using pronouns of that gender). Little is known about the well-being of socially transitioned transgender children. This study examined self-reported depression, anxiety, and self-worth in socially transitioned transgender children compared with 2 control groups: age- and gender-matched controls and siblings of transgender children.

METHOD

As part of a longitudinal study (TransYouth Project), children (9-14 years old) and their parents completed measurements of depression and anxiety (n = 63 transgender children, n = 63 controls, n = 38 siblings). Children (6-14 years old; n = 116 transgender children, n = 122 controls, n = 72 siblings) also reported on their self-worth. Mental health and self-worth were compared across groups.

RESULTS

Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096). Parents similarly reported that their transgender children experienced more anxiety than children in the control groups (p = .002) and rated their transgender children as having equivalent levels of depression (p = .728).

CONCLUSION

These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety. These findings lessen concerns from previous work that parents of socially transitioned children could be systematically underreporting mental health problems.

Obese Chinese Primary-School Students and Low Self-Esteem: A Cross-Sectional Study

Objectives

The aim of this study was to examine several factors related to low self-esteem among obese Chinese primary-school students.

Methods

A cross-sectional study was conducted between June 2009 and June 2010. A total of 1,410 primary-school students (China grades 4 - 6) in Changsha city were divided into normal weight (n = 1,084), overweight (n = 211), and obese groups (n = 115) according to world health organization (WHO) growth standards for body mass index (BMI). The students were assessed using the self-esteem scale (SES) and a general situation questionnaire. Caregivers completed questionnaires about their child’s weight status. Self-esteem levels were explored; any factors related to low self-esteem were analyzed using logistic regression analysis.

Results

The average self-esteem score among overweight or obese primary-school students was found to be lower than that of normal-weight students. The proportion of students with low self-esteem in the obese group was more than that in the normal-weight and overweight groups. Multiple logistic regression analysis showed that obesity status (odds ratio [OR], 3.74; 95% confidence interval [CI], 2.25 - 6.22), overweight status (OR, 2.60; 95% CI, 1.71 - 3.95), obesity considered by children’s grandparents (OR, 1.76; 95% CI, 1.05 - 2.96), dissatisfaction with height (OR, 1.55; 95% CI, 1.11 - 2.18), and dissatisfaction with weight (OR, 1.45; 95% CI, 1.05 - 2.01) were the risk factors for low self-esteem for primary-school students, while satisfaction with academic performance was a protective factor (OR, 0.22; 95% CI, 0.07 - 0.71).

Conclusions

For Chinese primary-school students, low self-esteem is associated with higher weight status and self-perceived body shape and academic performance. In addition, grandparental opinion of a child’s weight also contributes to low self-esteem.

Health behaviours, body weight and self-esteem among grade five students in Canada

Purpose

This study sought to identify the principal components of self-esteem and the health behavioural determinants of these components among grade five students.

Methods

We analysed data from a population-based survey among 4918 grade five students, who are primarily 10 and 11 years of age, and their parents in the Canadian province of Nova Scotia. The survey comprised the Harvard Youth and Adolescent Questionnaire, parental reporting of students’ physical activity (PA) and time spent watching television or using computer/video games. Students heights and weights were objectively measured. We applied principal component analysis (PCA) to derive the components of self-esteem, and multilevel, multivariable logistic regression to quantify associations of diet quality, PA, sedentary behaviour and body weight with these components of self-esteem.

Results

PCA identified four components for self-esteem: self-perception, externalizing problems, internalizing problems, social-perception. Influences of health behaviours and body weight on self-esteem varied across the components. Better diet quality was associated with higher self-perception and fewer externalizing problems. Less PA and more use of computer/video games were related to lower self-perception and social-perception. Excessive TV watching was associated with more internalizing problems. Students classified as obese were more likely to report low self- and social-perception, and to experience fewer externalizing problems relative to students classified as normal weight.

Conclusion

This study demonstrates independent influences of diet quality, physical activity, sedentary behaviour and body weight on four aspects of self-esteem among children. These findings suggest that school programs and health promotion strategies that target health behaviours may benefit self-esteem in childhood, and mental health and quality of life later in life.

Investigating the Relationship Between Self-Esteem and Stigma Among Young Adults With History of Suicide Attempts

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.

Psychological and Social Predictors of Suicidal Ideation among Young Adolescents

Although there is an enormous amount of literature demonstrating socio-psychological determinants of suicide and self-injurious behaviour among adults or clinical samples of children and adolescents, there is a scarcity of studies focussing on non-clinical adolescent samples. The current study examined associations between self-reported data on self-image, physical and psychological health and suicidal cognitions, self-injurious behaviour and suicidal intent in a large representative sample of German high-school students. Almost 1000 German adolescents (aged 14-18 years) were administered a comprehensive series of questionnaires aimed at assessing anxiety-depression, trait addiction, smoking and drinking behaviour, physical ill-health reports and self-perception of self-image, parental acceptance and educational attainment. Several statements were incorporated to assess self-injury and suicidal ideation. An attempt was made to identify risk and offer preventative factors of adolescent suicide. Suicidal ideation is significantly more endorsed among female than male adolescents: twice as many female adolescents tend to have wishes about being dead or have contemplated suicide than males. Girls also tended to have implemented significantly more self-destructive behaviour than boys. Over one-third of the variance observed in subjective reported suicidal ideation was explained by the socio-psychological variables. The common general significant predictor was anxiety-depression, and for males the specific somatic factor was general colds. In contrast, females displayed several specific significant determinants of suicidal ideation, including educational threat and the somatic variable, circulatory ailments. Conversely, tiredness, social problems and maternal rejection were statistically significant predictors of suicidal ideation but again the direction of impact was opposite to what was anticipated.

How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis

OBJECTIVE

To perform a systematic review and meta-analysis for the effects of physical activity intervention on self-esteem and self-concept in children and adolescents, and to identify moderator variables by meta-regression.

DESIGN

A meta-analysis and meta-regression.

METHOD

Relevant studies were identified through a comprehensive search of electronic databases. Study inclusion criteria were: (1) intervention should be supervised physical activity, (2) reported sufficient data to estimate pooled effect sizes of physical activity intervention on self-esteem or self-concept, (3) participants' ages ranged from 3 to 20 years, and (4) a control or comparison group was included. For each study, study design, intervention design and participant characteristics were extracted. R software (version 3.1.3) and Stata (version 12.0) were used to synthesize effect sizes and perform moderation analyses for determining moderators.

RESULTS

Twenty-five randomized controlled trial (RCT) studies and 13 non-randomized controlled trial (non-RCT) studies including a total of 2991 cases were identified. Significant positive effects were found in RCTs for intervention of physical activity alone on general self outcomes (Hedges' g = 0.29, 95% confidence interval [CI]: 0.14 to 0.45; p = 0.001), self-concept (Hedges' g = 0.49, 95%CI: 0.10 to 0.88, p = 0.014) and self-worth (Hedges' g = 0.31, 95%CI: 0.13 to 0.49, p = 0.005). There was no significant effect of intervention of physical activity alone on any outcomes in non-RCTs, as well as in studies with intervention of physical activity combined with other strategies. Meta-regression analysis revealed that higher treatment effects were associated with setting of intervention in RCTs (β = 0.31, 95%CI: 0.07 to 0.55, p = 0.013).

CONCLUSION

Intervention of physical activity alone is associated with increased self-concept and self-worth in children and adolescents. And there is a stronger association with school-based and gymnasium-based intervention compared with other settings.

Prevalence, correlates, and prospective predictors of non-suicidal self-injury among New Zealand adolescents: cross-sectional and longitudinal survey data

Non-suicidal self-injury (NSSI) is common among adolescents and linked to many maladaptive outcomes. This study aimed to assess the prevalence and correlates of NSSI among a community sample of New Zealand adolescents. A self-report questionnaire was administered to adolescents at time 1 (N = 1162, mean age = 16.35), and approximately five months later (time 2, N = 830, mean age = 16.49). Prevalence and bivariate correlations were assessed at both time points, and cross-lag correlations using matched data (N = 495, mean age = 16.23). Lifetime history of NSSI was 48.7 % (females 49.4 %, males 48 %). Consistent with previous international research, NSSI was associated with higher Alexithymia, depression, anxiety, bullying, impulsivity, substance abuse, abuse history and sexuality concerns and lower mindfulness, resilience and self-esteem. Cross-lag correlations suggested NSSI is directly (perhaps causally) related to psychological vulnerability in various domains (e.g., increased depression and lower self-esteem), while bullying may be more distal to NSSI, rather than a proximal predictor.

Prevalence and predictors of suicidal ideations among school going adolescents in a hilly state of India

BACKGROUND

Adolescent suicide is an important public health issue. Suicidal ideations are often the precursor of suicide and can be targeted by appropriate and timely interventions.

AIMS AND OBJECTIVES

To determine the prevalence of suicide ideation and to study its predictive factors among school going adolescents.

MATERIALS AND METHODS

This cross-sectional study was carried out in selected senior secondary schools in Shimla district of Himachal Pradesh, India. A pre-validated, self-administered questionnaire was used for data collection. Both descriptive and inferential statistics were applied using Epi info software for windows (CDC Atlanta) software for windows.

RESULTS

A total of 218 study subjects (30.9%; confidence interval = 27.6-34.5%) had suicide ideation. Discussing problems with parents (adjusted odds ratio [AOR] =0.5), having good relations with school teachers (AOR = 0.6) and helpful classmates (AOR = 0.6) lowered the odds of having suicidal ideations. On the contrary, adolescents having worrying issues in family (AOR = 2.5), verbally or physically abused (AOR = 2.8) and body image conscious (AOR = 1.8) had increased odds of suicidal ideations.

CONCLUSIONS

Suicidal ideation is a common experience among adolescents residing in Shimla district of North India. The supportive environment at home and in school decrease its vulnerability.

Employment among schoolchildren and its associations with adult substance use, psychological well-being, and academic achievement

PURPOSE

To examine the association between paid part-time employment among schoolchildren, and adult substance use, psychological well-being, and academic achievement.

METHODS

Longitudinal data from the Dunedin Multidisciplinary Health and Development Study were used to evaluate the association between employment at each of 11, 13, and 15 years and adult smoking, regular alcohol binge drinking, regular cannabis use, sense of coherence, social participation, positive coping style, prosociality, no formal qualifications, and university degree. Associations were initially assessed using unadjusted regression analyses and then adjusted for the potential childhood confounders intelligence quotient, reading development, Student's Perception of Ability Scale, socioeconomic disadvantage, family climate, harsh parent-child interaction, parental opinion of their child's attitude to school, and child's personal attitude to school.

RESULTS

Employment at 11 years of age was associated with a lower odds of adult smoking; the odds of subsequent regular alcohol binge drinking were greater for those who were employed at age 13; and higher adult rates of social participation and prosociality were identified for adolescents who were employed at 15 years of age. When the potential confounders were controlled, employment at age 13 was predictive of both adult smoking and regular binge drinking, and working at 15 years of age was protective against regular cannabis use and associated with greater social participation.

CONCLUSIONS

There is no consistent evidence that exposing schoolchildren to part-time employment compromised subsequent health, well-being, and education in a developed country.

Predictors of suicidal ideation in a community sample: roles of anger, self-esteem, and depression

The objective of this cross-sectional study was to investigate the relationships of anger, self-esteem, and depression with suicidal ideation. A survey was conducted in a wide range of community areas across Jeollabuk-do Province, Korea. A total of 2964 subjects (mean age=44.4yr) participated in this study. Hierarchical regression was used to investigate predictors of suicidal ideation in terms of their sociodemographic characteristics, depression, self-esteem, and anger. Hierarchical regression analyses revealed that anger and self-esteem were significantly associated with suicidal ideation regardless of age and after controlling for depression. Moderation analysis showed that the impact of anger on suicidal ideation was significantly greater among females than males in adolescents, but not in other age groups. Additionally, there were some differences in sociodemographic predictors of suicidal ideation among age groups. Predictors included gender and family harmony in adolescents, marital status and family harmony in middle-aged individuals, and economic status and family harmony in elderly individuals. Our results revealed that anger and self-esteem play important roles in suicidal ideation beyond the effect of depression. Development and implementation of preventive strategies, including management of anger and self-esteem, could possibly reduce suicidal ideation and subsequent suicide attempts.

Lifetime prevalence of and risk factors for suicidal ideation and suicide attempts in a Korean community sample

OBJECTIVES

Our study evaluated the lifetime prevalence of and risk factors for suicidal ideation and suicide attempts in Jeollabuk-do Province, Korea.

METHOD

Participants were selected from the population of individuals aged 13-100 years living Jeollabuk-do Province, Korea. A total of 2,964 subjects provided information about lifetime suicidal behavior and sociodemographic and psychological characteristics, completing the Zung Depression Scale, the Scale for Suicidal Ideation, the Multidimensional Anger Inventory, and the Rosenberg Self-Esteem Scale.

RESULTS

The lifetime prevalence of suicidal ideation and suicide attempts, 24.8% and 6.2%, respectively, were higher than in previous studies. Multivariate regression revealed that family harmony had the highest odds ratio of all variables, including psychological factors. Along with depression and self-esteem, anger--which is the basic symptom of the Korean culture-related anger syndrome, Hwa-byung--was significantly associated with lifetime suicidal behavior.

CONCLUSIONS

Lifetime suicidal behavior was highly prevalent in Jeollabuk-do Province. The most significant risk factors were found to be social support, family disharmony, anger, depression, and low self-esteem in Koreans.

Is self-esteem a cause or consequence of social support? A 4-year longitudinal study

Considerable research has been devoted to examining the relations between self-esteem and social support. However, the exact nature and direction of these relations are not well understood. Measures of self-esteem, and social support quantity and quality were administered to 961 adolescents across five yearly time points (M(age) = 13.41 years). Structural equation modeling (SEM) was utilized to test between a self-esteem antecedent model (self-esteem precedes changes in social support), self-esteem consequence model (social support precedes change in self-esteem), and a reciprocal influence model. Self-esteem reliably predicted increasing levels of social support quality and network size across time. In contrast, the consequence model was not supported. The implications of this for helping adolescents to develop higher quality social support structures are discussed.

Sheehan Suicidality Tracking Scale (S-STS): reliability, convergent and discriminative validity in young Italian adults

BACKGROUND AND PURPOSE

The Sheehan Suicidality Tracking Scale (S-STS) is a patient self-report or clinician-administered rating scale that tracks spontaneous and treatment-emergent suicidal ideation and behaviors. This study set out to evaluate the reliability, convergent and divergent validity of the S-STS in a sample of college students, a population with a high risk of completed and attempted suicide.

METHODS

Cross-sectional, survey design. Participants (303 undergraduate students; males: 42%) completed several measures assessing psychological distress (General Health Questionnaire; GHQ); self-esteem (Rosenberg Self Esteem Scale; RSES); social support (Modified Social Support Survey; MOSSS); and suicidal behavior, including ideation and attempts (S-STS).

RESULTS

Both internal consistency and test-retest stability were excellent for the S-STS-global score. The S-STS subscale on suicide ideation also showed good reliability, while the subscale on suicidal behavior showed some inconsistency at retest. Convergent and divergent validity of S-STS was confirmed. All S-STS items loaded on a single factor, which had an excellent fit for the unidimensional model, thus justifying the use of the S-STS as a screening tool. In a mediation model, self-esteem and social support explained 45% of the effects of psychological distress on suicide ideation and behavior as measured by the S-STS-global score.

CONCLUSIONS

This study provided promising evidence on the convergent, divergent, internal consistency and test-retest stability of the Sheehan Suicidality Tracking Scale. The cross-sectional design and lack of measures of hopelessness and helplessness prevent any conclusion about the links of suicidal behavior with self-esteem and social support.

Tobacco smoking in adolescence predicts maladaptive coping styles in adulthood

INTRODUCTION

To examine the extent to which cigarette smoking in adolescence is associated with maladaptive versus adaptive coping behaviors in adulthood.

METHOD

The data came from a longitudinal study of New Zealand adolescents followed into adulthood at age 32 years. Using structural equation modeling (SEM), we examined the predictive association between daily smoking of cigarettes and symptoms of tobacco dependence from 18 to 26 years of age and later coping at age 32 years. We included pathways from childhood family disadvantage in addition to both adolescent stress-worry and adult coping in the model.

RESULTS

SEM revealed that cigarette smoking had a small but direct inverse effect on later adaptive coping (-.14) and a direct effect on maladaptive coping (.23) independent of the relationships between adolescent coping and stress-worry and later adult coping.

CONCLUSIONS

The findings are consistent with the hypothesis that tobacco smoking may inhibit the development of self-efficacy or one's ability to act with appropriate coping behaviors in any given situation.

Early predictors of suicidal ideation in young adults

OBJECTIVE

To identify early predictors of suicidal ideation in young adults, and to determine when specific time-varying determinants become important in predicting later suicidal ideation.

METHODS

Data were available for 877 participants in the Nicotine Dependence in Teens study, an ongoing prospective cohort of students aged 12 to 13 years at cohort inception in 1999. Time-invariant covariates included age, sex, mother's education, language, and self-esteem. Time-varying covariates included depression symptoms, family stress, other stress, alcohol use, cigarette use, and team sports. Independent predictors of past-year suicidal ideation at age 20 years were identified in 5 multivariable logistic regression analyses, one for each of grades 7, 8, 9, 10, and 11.

RESULTS

Eight per cent of participants (mean age 20.4 years [SD 0.7]; 46% male) reported suicidal ideation in the past year. In grade 7, none of the potential predictor variables were statistically significantly associated with suicidal ideation. In grade 8, participation in sports teams in and (or) outside of school protected against suicidal ideation (OR 0.6; 95% CI 0.4 to 0.8; P = 0.002). Depression symptoms in grades 9, 10, and 11 were independent predictors of suicidal ideation (OR 2.2; 95% CI 1.5 to 3.2, OR 1.6; 95% CI 1.0 to 2.5, and OR 1.9; 95% CI 1.1 to 3.4, respectively). No other variables were statistically significant in the multivariate models.

CONCLUSION

Depression symptoms as early as in grade 9 predict suicidal ideation in early adulthood. It is possible that early detection and treatment of depression symptoms are warranted as part of suicide prevention programs.

Association between television viewing and self-esteem in children

OBJECTIVE

Few studies have examined the effect of excess television (TV) viewing on specific mental health outcomes, such as self-esteem. We explored the cross-sectional association between TV viewing hours and self-esteem in young children.

METHODS

A total of 70,210 primary 4 (US grade 4) participants of the Department of Health Student Health Service, Hong Kong, in 1998-2000 reported TV viewing hours in a standardized questionnaire. Self-esteem was assessed using the Culture-Free Self-Esteem Inventories for Children (SEI) with 4 subscales. Multivariate linear regression yielded beta coefficients (β) for SEI subscale scores by TV hours, adjusting for age, sex, body mass index, lifestyle characteristics, and highest parental education and occupational status.

RESULTS

Only 10.9% of children watched >4 hours per day, while 45.3% watched TV for 1 to ≤2 hours per day. Compared with children who watched <1 hour of TV per day, those who watched a moderate amount (1 to ≤2 hours/day) had higher (more favorable) SEI scores in the General (β = 0.09; 95% confidence interval = 0.02-0.16), Social (0.05; 0.01-0.09), and Parent-Related (0.04; 0.00-0.08) subscales but lower scores in the Academic subscale (-0.06; -0.09 to -0.02). Children who watched >2 hours of TV per day had lower SEI scores than those who watched <1 hour per day in all 4 subscales.

CONCLUSIONS

An inverted J-shaped relation was observed between TV viewing hours and self-esteem among young children. The development of self-esteem among children who report little or excessive TV viewing should be further studied.

Developmental course of impulsivity and capability from age 10 to age 25 as related to trajectory of suicide attempt in a community cohort

Hierarchical linear models were used to examine trajectories of impulsivity and capability between ages 10 and 25 in relation to suicide attempt in 770 youths followed longitudinally: intercepts were set at age 17. The impulsivity measure assessed features of urgency (e.g., poor control, quick provocation, and disregard for external constraints); the capability measure assessed aspects of self-esteem and mastery. Compared to nonattempters, attempters reported significantly higher impulsivity levels with less age-related decline, and significantly lower capability levels with less age-related increase. Independent of other risks, suicide attempt was related significantly to higher impulsivity between ages 10 and 25, especially during the younger years, and lower capability. Implications of those findings for further suicidal behavior and preventive/intervention efforts are discussed.

The Suicidal Process and Self-Esteem

Background: It has not been made clear whether self-esteem is associated with the severity of suicidal behavior. Aims: To test the association between responses to a self-esteem inventory and levels of suicidal behavior as conceptualized in the notion of the suicide process. Methods: Questions on the severity of suicidal behavior over the lifespan (death wishes, ideation, plans, and attempts), as well as a self-esteem inventory, were administered to 227 university undergraduates. Results: A negative relationship was found between the level of suicidality and self-esteem. As hypothesized, there were fewer cases in each succeeding level of seriousness of suicidal behavior. However, nearly all cases from any particular level were contained in the cohort of individuals who had displayed suicidal behavior at a less serious level. Conclusions: This suggests a possible progression through each of the stages of suicidal behavior, with very few cases showing a level of suicidal behavior that was not associated with a previous, less serious, form. It was hypothesized that early entry into the suicidal process may be indicated by low self-esteem, thus, allowing for a more timely preventive intervention.