1
|
Duarté-Vélez Y, Jimenez-Colon G, Jones RN, Spirito A. Socio-Cognitive Behavioral Therapy for Latinx Adolescent with Suicidal Behaviors: A Pilot Randomized Trial. Child Psychiatry Hum Dev 2024; 55:754-767. [PMID: 36183051 DOI: 10.1007/s10578-022-01439-z] [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] [Accepted: 09/05/2022] [Indexed: 11/26/2022]
Abstract
Evidence-based treatment for Latinx/Hispanic (L/H) with suicidal behaviors (SB) is scarce. This study evaluated the acceptability and preliminary efficacy of a socio-cognitive-behavioral therapy protocol for SB (SCBT-SB) with L/H adolescents and the feasibility of conducting a randomized controlled trial (RCT) of SCBT-SB compared to treatment-as-usual (TAU). A pilot RCT was conducted with 46 L/H teens. The target outcomes included suicidal ideation (SI), suicide attempts (SAs), and depressive/internalizing symptoms. Results indicated that the SCBT-SB was acceptable and an RCT with diverse L/H families is feasible to implement. Within group analyses showed reductions over time for each group in SI and depressive/internalizing symptoms. Intent-to-treat between-group analyses showed a medium effect for the SCBT-SB at the twelve-month follow-up for depressive/internalizing symptoms and a large effect for SA. Although results must be interpreted cautiously given the small sample size, outcomes suggest that SCBT-SB may be a promising psychosocial treatment for depressive/internalizing symptoms, and SAs in L/H youth.
Collapse
Affiliation(s)
- Yovanska Duarté-Vélez
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Pkwy, East Providence, RI, 02915, USA.
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912, USA.
| | - Gisela Jimenez-Colon
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Pkwy, East Providence, RI, 02915, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912, USA
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912, USA
| |
Collapse
|
2
|
Buitron V, Jiménez-Colón G, Duarté-Vélez Y. Mental health services use and social support among Latinx families with adolescents who engage in suicidal behavior. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2023; 8:194-205. [PMID: 37383484 PMCID: PMC10299760 DOI: 10.1080/23794925.2023.2183433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Latinx communities experience a significant child mental health disparity. Research is needed to examine mental health services use and social support in Latinx adolescents, with particular attention to acculturative factors and youth who have high levels of clinical severity. The current study examined whether acculturation and enculturation, and related proxies, are associated with prior history of services use and social support in Latinx families with adolescents who had a recent suicidal crisis. Participants were 110 youths, recently admitted to psychiatric hospitalization, ages 12 to 17 years and their caregivers. Results indicated that approximately 20% of the overall sample did not access any formal mental health services (e.g., outpatient mental health care, primary care support, school staff support) before high acuity hospital care. First generation status and higher caregiver enculturation were associated with a lower likelihood of formal mental health services use, even when controlling for clinical covariates. Adolescent preference for Spanish was associated with lower social support. Findings suggest that families with higher enculturation and first-generation immigrant families (both caregivers and youth born outside of the U.S.), in the context of severe clinical impairment, experience systemic and sociocultural barriers conducive to limited engagement with mental health support. Implications for improving the accessibility of mental health supports are reviewed.
Collapse
Affiliation(s)
| | - Gisela Jiménez-Colón
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital and Brown University, Coro West Suite 1.300, Box #36, 25 Hoppin St., Providence, RI 02903
| | - Yovanska Duarté-Vélez
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital and Brown University, Coro West Suite 1.300, Box #36, 25 Hoppin St., Providence, RI 02903
| |
Collapse
|
3
|
Two pathways to suicidal intention in Ecuadorian adolescents: The role of parental and peer attachment, depression and impulsivity. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00757-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
4
|
Vargas SM, Calderon V, Beam CR, Cespedes-Knadle Y, Huey SJ. Worse for girls?: Gender differences in discrimination as a predictor of suicidality among Latinx youth. J Adolesc 2021; 88:162-171. [PMID: 33838577 DOI: 10.1016/j.adolescence.2021.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 12/07/2020] [Accepted: 02/28/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Gender and ethnic differences exist in suicidal ideation, plan, and attempt among adolescents in the U.S. However, limited research has used theoretically-informed approaches to integrate how cultural and classic risk factors together account for suicide-related pathways among vulnerable populations. Informed by the interpersonal theory of suicide, the present cross-sectional study examined gender differences in the association between a cultural (i.e., discrimination) and classic (i.e., depressive symptomatology) risk factor, and suicidality among youth of Latin American heritage. METHODS A total of 390 Latinx adolescents (ages 13-18; 50% female) attending a high school in Southern California, U.S.A. completed a series of questionnaires that included measures of depressive symptoms, suicidality (including ideation, past attempts, and likelihood of future behavior), perceived discrimination, and demographics. RESULTS We found that discrimination was associated with increased suicidality among Latinx adolescents. The discrimination-suicidality association was stronger for girls versus boys, such that girls who experienced greater discrimination demonstrated the highest levels of suicidality. Although depression was also significantly associated with suicidality, the discrimination x gender interaction was found above and beyond the main effect of depressive symptomatology and covariates. Additional analyses revealed significant gender and moderation effects only for suicidal ideation and not for attempts. CONCLUSIONS These findings indicate that the relationship between discrimination and suicidality (particularly ideation) is more pronounced for Latinx girls than boys. This study also highlights the importance of drawing on theory-driven and culturally informed work that incorporates classic and cultural correlates of suicidality among diverse subpopulations.
Collapse
Affiliation(s)
- Sylvanna M Vargas
- Department of Psychology, University of Southern California, Los Angeles, USA; Department of Preventive Medicine, University of Southern California, Los Angeles, USA.
| | - Vanessa Calderon
- Department of Psychology, University of Southern California, Los Angeles, USA; Department of Preventive Medicine, University of Southern California, Los Angeles, USA
| | - Christopher R Beam
- Department of Psychology, University of Southern California, Los Angeles, USA
| | - Yolanda Cespedes-Knadle
- Alliant International University, California School of Professional Psychology, Los Angeles, CA, USA; Northeast Valley Health Corporation, Los Angeles, CA, USA
| | - Stanley J Huey
- Department of Psychology, University of Southern California, Los Angeles, USA; Department of American Studies and Ethnicity, University of Southern California, Los Angeles, USA
| |
Collapse
|
5
|
Desmarais M, Montreuil M. Suicide in children: Concept analysis using Rodgers's evolutionary approach. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2020; 34:19-31. [PMID: 33103816 DOI: 10.1111/jcap.12296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/17/2020] [Accepted: 09/28/2020] [Indexed: 11/29/2022]
Abstract
TOPIC Although the concept of suicide in children and adolescents is widely present in the literature, its conceptual definition varies according to context, discipline, and time. How this concept is defined impacts the delivery of care to children and adolescents regarding suicide prevention in mental health settings and in the community. PURPOSE Using Rodgers's evolutionary method, we examined the antecedents, attributes, and consequences of "suicide in children" through temporal trends, and geographic locations. SOURCES In total, 106 articles were included. Searches were performed using CINAHL, PsycINFO, and Medline, as well as Google Scholar as a complementary tool. CONCLUSIONS Through a thematic analysis, we identified three themes: (1) developmental perspectives, (2) factors predicting suicide in children, and (3) the emancipation of children as active agents in society. Recent literature shows a movement toward acknowledging the voice of children and adolescents regarding suicide. We address clinical and future implications for the development of this concept.
Collapse
Affiliation(s)
- Michèle Desmarais
- Faculty of Medicine and Health Sciences, Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Marjorie Montreuil
- Faculty of Medicine and Health Sciences, Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.,Interventions and Services Axis, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Canada.,Mental Health and Society, Centre de recherche de l'Institut universitaire en santé mentale Douglas, Montreal, Canada
| |
Collapse
|
6
|
Bernal G, Rivera-Medina CL, Cumba-Avilés E, Reyes-Rodríguez ML, Sáez-Santiago E, Duarté-Vélez Y, Nazario L, Rodríguez-Quintana N, Rosselló J. Can Cognitive-Behavioral Therapy Be Optimized With Parent Psychoeducation? A Randomized Effectiveness Trial of Adolescents With Major Depression in Puerto Rico. FAMILY PROCESS 2019; 58:832-854. [PMID: 31077610 DOI: 10.1111/famp.12455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive-behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing depressive symptoms, MDD diagnosis, and improving family functioning. Participants (n = 121) were randomized to individual CBT with or without TEPSI. No main group effects were found for most patient domains including depression symptoms, as well as presence of adolescent's MDD diagnosis at posttreatment. Results did show a main effect of CBT over time for depression symptoms, suicide ideation, family criticism, and the presence of MDD diagnosis decreasing from pre- to postintervention. A year post treatment, almost 70% of adolescents in both conditions (CBT and CBT + TEPSI) remained in remission. A main effect was obtained for treatment in the adolescent's perception of familism and family emotional involvement. The primary hypothesis that family psychoeducation would optimize CBT for depression in adolescents was not supported. Both conditions yielded similar clinical end points. The culturally adapted CBT was found effective with Latino/a adolescents showing clinically significant improvements from pretreatment to posttreatment and remained stable at a 1-year follow-up. Regarding family outcomes, adolescents in CBT + TEPSI remained stable from pretreatment to posttreatment on family emotional involvement, while adolescents in CBT-alone showed an increase. The implication of these findings is discussed.
Collapse
Affiliation(s)
- Guillermo Bernal
- University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico
| | | | | | | | | | | | - Lelis Nazario
- University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | | | | |
Collapse
|
7
|
Gomez J, Colón GJ, Spirito A. Socio-Cognitive Behavioral Therapy for Suicidal Behavior with a Puerto Rican Male Adolescent. ACTA ACUST UNITED AC 2018; 3:81-97. [PMID: 30906875 DOI: 10.1080/23794925.2018.1432300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In 2015, fifteen percent of Puerto Rican adolescents attempted suicide. In general, females have more suicidal thoughts while males are more likely to die by suicide. However, few evidence-based treatments have been developed for this population. Objectives The aim of this study was to illustrate the therapeutic process of a male Puerto Rican adolescent treated with the Socio-Cognitive Behavioral Therapy for Suicidal Behavior (SCBT-SB), a culturally informed protocol, and to discuss how developmental, feminist, and family system perspectives were incorporated in the SCBT-SB treatment model. Method A case study is presented: Julio received the SCBT-SB after a psychiatric hospitalization subsequent to threating to commit suicide. Baseline and post-treatment assessments evaluated diagnosis, risk factors (e.g. hopelessness), treatment satisfaction, and suicidal behaviors. Results Julio demonstrated clinically significant change in depressive symptoms, hopelessness, suicidal ideation, and aggressive/impulsive behaviors. Conclusions The SCBT-SB was feasible to implement and proved acceptable to the client and his family.
Collapse
Affiliation(s)
- Judelysse Gomez
- Department of Psychiatry and Human Behavior (DPHB), Brow University, Box G-BH, Brown University, Providence, RI 02912
| | - Gisela Jiménez Colón
- Institute for Psychological Research, University of Puerto Rico, Río Piedras Campus, PO Box 23174, San Juan, PR 00931-3174
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior (DPHB), Brow University, Box G-BH, Brown University, Providence, RI 02912
| |
Collapse
|