Correlates of firesetting in a community sample of young adolescents

OBJECTIVE: To investigate relationships between firesetting, antisocial behaviour, individual, family and parenting factors in a large community sample of adolescents. METHOD: A cross-sectional study of students (n = 2596) aged 13 years on average, from 27 schools in South Australia with a questionnaire on firesetting, antisocial behaviour (adapted 21-item Self Report Delinquency Scale), risk-taking, drug use, suicidality, physical and sexual abuse, depressive symptomatology, hopelessness, anxiety, locus of control, self-esteem, family functioning (McMaster Family Assessment Device) and parenting style (Influential Relationships Questionnaire). Data analysis included chi2, anova and logistic regression. RESULTS: Large significant differences are found between firesetters and non-firesetters on all measures. Among adolescents with serious levels of antisocial behaviour (7+ acts included in diagnostic guidelines for DSM-IV conduct disorder), firesetters differ from non-firesetters in reporting more extreme antisocial behaviour (10+ acts), extreme drug use, suicidal behaviour, and perceived failure at school. Gender differences are apparent. A study limitation is the single item assessment of firesetting. CONCLUSIONS: Self-report firesetting is strongly associated with extreme antisocial behaviour in young community adolescents, in support of existing evidence from incarcerated delinquent and psychiatric populations. Early detection of community firesetters demands further assessment and intervention. Clinicians should consider its coexistence with serious drug use and high risk-taking (especially in girls), and suicidality, sexual and physical abuse (in boys).     

Hopelessness,depression, substance disorder,and suicidality

Abstract. Background: Most earlier studies of hopelessness as a risk factor for suicidal behavior were based on either clinical or restricted samples. Using a longitudinal study design with a community sample of more than 3,000 participants, we aimed to examine if hopelessness was a long-term predictor of suicidal behaviors. Methods: Using longitudinal data from the Baltimore Epidemiologic Catchment Area (ECA) Program, we assessed the association of hopelessness at baseline and incident suicidal behaviors in the 13-year follow-up period, adjusting for the presence of depression and substance use disorders. Suicide behaviors studied included completed suicide, self-reported attempted suicide, and suicide ideation. Results: Hopelessness was predictive of all three types of suicidal behaviors in the follow-up period, even after adjustment. Persons who expressed hopelessness in 1981 were 11.2 times as likely to have completed suicide over the 13-year follow-up interval (95% confidence interval [1.8, 69.1]). The association between suicidality and hopelessness was stronger and more stable than the association of suicidality with the presence of depression and substance use disorders. Conclusion: Hopelessness was an independent risk factor for completed suicide, suicide attempts, and suicidal ideation. Intervention strategies that lower hopelessness may be effective for suicide prevention.Dr. Kuo is currently with Medical and Health Research Association (MHRA) and National Development and Research Institute, Inc (NDRI), New York, NY, USA. Dr. Gallo is currently with the Department of Family Practice and Community Medicine, University of Pennsylvania, Philadelphia, PA, USA.     

Impulsivity,hostility and suicidality in patients diagnosed with obsessive compulsive disorder

Abstract

Background: There are limited data on suicidal behaviour in obsessive-compulsive disorder (OCD). This study aimed to evaluate several aspects affecting suicidality in OCD patients and determine whether impulsivity or hostility are associated with suicide attempts in this vulnerable group.

Methods: Eighty-one patients with OCD were assessed by structured clinical interview for DSM-IV (SCID I), Yale-Brown Obsessive–Compulsive Scale (Y-BOCS), Suicide Probability Scale (SPS), Barratt impulsivity scale-11 (BIS) and Scale for suicide ideation (SSI).

Results: Of the 81 patients, 22 (27%) had suicide ideation, 29 (33%) attempted suicides with OCD and 30 (37%) OCD patients who never experienced suicide ideation nor attempted suicide. Suicide ideation was associated with high hopelessness, higher severity of OCD and the presence of aggressive obsessions. On the other hand, suicide attempts were associated with longer duration of untreated illness, cognitive impulsivity, higher severity of OCD symptoms and the presence of religious obsessions.

Conclusion: Higher severity of OCD symptoms is associated with both suicide ideation and attempts. And while hopelessness was related to suicidal thoughts, cognitive impulsivity may have acted as a facilitating factor for suicide attempts. Higher frequency of symptoms like religious/ aggressive obsessions was also associated with suicidality. It is vital that patients with OCD undergo detailed assessment for suicide risk.

• Key points

• OCD is associated with a high risk for suicidal behaviour.

• Suicide ideation was associated with high levels of hopelessness, OCD severity, and the presence of aggressive obsessions.

• Suicide attempts were associated with longer duration of untreated illness, cognitive impulsivity, severity of OCD, and the presence of religious obsessions.

     

Suicidal ideation in family carers of people with dementia

Objective: Two small studies have suggested that family carers of people with dementia may be a high-risk group for suicide. The objective of this study was to further explore the rate of suicidal ideation in a large sample of carers and identify psychosocial risk and protective factors.

Method: A cross-sectional survey was conducted with 566 family carers. The survey included measures of suicidality, self-efficacy, physical health, depression, anxiety, hopelessness, optimism, burden, coping strategies, and social support.

Results: Sixteen percent of carers had contemplated suicide more than once in the previous year. There were univariate differences between suicidal and non-suicidal carers on self-efficacy, social support, coping, burden, depression, anxiety, hopelessness, optimism, reasons for living, and symptoms of dementia, as well as age and income management. In a multivariate model, age, depression, and reasons for living predicted suicidal ideation. In tests for mediation, satisfaction with social support and dysfunctional coping had indirect effects on suicidal ideation via depression.

Conclusion: Family carers of people with dementia have high rates of suicidal ideation, with depression a risk factor and increasing age and reasons for living as protective factors. Depression and reasons for living should be targeted in interventions to reduce suicide risk in dementia carers.     

Parenting,self-concept,and attitudes about romantic relationships

IntroductionThis study examined associations among the perceived parenting, self-concept, and adolescent attitudes of Chinese adolescents regarding romantic relationships.MethodsA survey of 729 high school students in Macau was carried out to collect information on the degree to which they perceived their fathers and mothers as demanding or responsive, their general self-concept, and their attitudes about romantic relationships.ResultsStructural equation modeling showed that maternal and paternal responsiveness positively associated with adolescents’ self-concept, which then positively contributed to their attitudes about romantic relationships. Maternal demandingness could link directly to positive adolescent attitudes about romantic relationships and indirectly to negative self-concept.ConclusionsThe present study's findings suggest that perceived maternal parenting may be more important than perceived paternal parenting regarding adolescents' romantic attitudes, and parental responsiveness is particularly critical to positive self-concept and positive romantic attitudes in Chinese culture.     

A cross-sectional investigation of the suicidal spectrum: typologies of suicidality based on ambivalence about living and dying

ObjectiveThe aim of this study was to determine the validity of assigning suicidal individuals into differing typologies of suicidality based on their reported wish to live and wish to die.MethodsOne hundred five inpatients who reported suicidal ideation in the previous 48 hours completed a battery of assessments during inpatient psychiatric hospitalization. An algorithm was used to assign participants into 1 of 3 typologies of suicide: wish to live, ambivalent, or wish to die. Discriminant function analysis and group classification were used to predict group membership, followed by multiple analysis of variance and follow-up contrasts to measure between-group differences.Main ResultsGroup classification resulted in 76% accuracy for predicting typology of suicidality based on scores from suicide-specific measures. Self-perceived risk of suicide and hopelessness were the strongest variables at differentiating between the 3 groups. Patients in the wish to die typology were less likely to report having never made a suicide attempt.ConclusionsCreating typologies of suicidality may prove useful to clinicians seeking to better differentiate among suicidal patients within a limited period of assessment.     

Parental bonding and suicidality in pregnant teenagers: a population-based study in southern Brazil

Purpose

To assess the associations of the perceived quality of parental bonding with suicidality in a sample of pregnant adolescents.

Methods

A cross-sectional study with a sample size of 828 pregnant teenagers receiving prenatal medical assistance in the national public health system in the urban area of Pelotas, southern Brazil. Suicidality and psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview (MINI), and the Parental Bonding Instrument (PBI) was employed to measure the perceived quality of parental bonding. A self-report questionnaire was used to collect sociodemographic, obstetric and other psychosocial data.

Results

Forty-three (4.94 %) teenagers from a consecutive sample of 871 refused to participate, resulting in 828 participants. Prevalence of suicidality was 13.3 %, lifetime suicide attempts were 7.4 % with 1.3 % reporting attempting suicide within the last month. Significant associations of suicidality with the 18–19-year-old subgroup, low education, prior abortion, physical abuse within the last 12 months were present, and most psychiatric disorders were associated with a higher suicidality prevalence. Additionally, after adjustment in the multivariate analysis, the style of parental bonding was independently associated with suicidality in the pregnant adolescent, with a PR of 2.53 (95 % CI 1.14–5.59) for the maternal ‘affectionless control’ and a PR of 2.91 (95 % CI 1.10–7.70) for the paternal ‘neglectful parenting.’

Conclusions

We found that maternal ‘affectionless control’ and paternal ‘neglectful parenting’ were independent predictors of suicidality in this sample of pregnant teenagers.     

Insomnia and suicide risk: a multi-study replication and extension among military and high-risk college student samples

Objective/backgroundA clear link between insomnia concerns and suicidal ideation has been shown in a variety of populations. These investigations failed to use a theoretical lens in understanding this relationship. Research within the veteran population has demonstrated that feelings of thwarted belongingness (TB), but not perceived burdensomeness (PB), mediate the insomnia and suicidal ideation relationship. Using two high risk samples, the present investigation replicated and extended this line of inquiry to include interpersonal hopelessness about TB, a key component of the Interpersonal Psychological Theory of Suicide.Methods/results/conclusionsUsing medical record review and survey data, study 1 replicated the finding that TB is a stronger explanatory factor of the insomnia to suicidal ideation/suicide risk relationship in a sample of N = 200 treatment-seeking active-duty personnel. Study 2 found that insomnia symptoms had an indirect effect on suicidal ideation through TB and PB but not interpersonal hopelessness in a sample of N = 151 college students with a history of suicidal thoughts and/or behaviors. TB was the only mediator of the insomnia-suicide attempt likelihood link and insomnia to clinically significant suicide risk screening status. Limitations include cross-sectional design of both studies and the lack of formal diagnoses of insomnia. Implications and future research directions are discussed.     

Predicting latent classes of drug use among adolescents through parental alcohol use and parental style: a longitudinal study

Purpose

The present study examined the roles of parental alcohol use and parental style as predictors of adolescent patterns of drug use.

Methods

6391 students in the 7th and 8th grades at 72 Brazilian public schools participated in a three-wave randomized controlled trial to evaluate a school drug-use prevention program. Patterns of drug use were identified through two latent class analyses using measures of the adolescents’ past-year drug use. Multinomial logistic regression analyses examined whether parental alcohol use and parenting style at baseline predicted patterns of drug use in waves 2 and 3 of the study after controlling for sociodemographic covariates.

Results

In each of the two waves, three latent classes of drug use were identified among the students, defining three different groups of individuals: (1) abstainers/low users, (2) alcohol users/binge drinkers, and (3) polydrug users. First, parenting style (especially monitoring) was the strongest predictor for the prevention of polydrug use among adolescents. Second, occasional alcohol use by parents can act as a central predictor for adolescent alcohol use and binge drinking. Above all, maternal episodes of drunkenness were involved in the predictive models for both drug use classes in both waves.

Conclusion

Parental alcohol use and parenting style seem to be important predictors of adolescent’s likelihood of belonging to different latent classes of drug use. This conclusion may point to the importance of considering the inclusion of parenting skills and parental alcohol use within the scope of adolescents’ preventive interventions.

     

Parental bonding in severely suicidal adolescent inpatients

Family environment has a clear role in suicidal behavior of adolescents. We assessed the relationship between parental bonding and suicidal behavior in suicidal (n = 53) and non-suicidal (n = 47) adolescent inpatients. Two dimensions of parental bonding: care and overprotection, were assessed with the Parental Bonding Instrument. Results showed that adolescents with severe suicidal behavior tended to perceive their mothers as less caring and more overprotective compared to those with mild or no suicidal behavior. A discriminant analysis distinguished significantly between adolescents with high suicidality and those with low suicidality [χ²(5) = 15.54; p = 0.01] in 71% of the cases. The perception of the quality of maternal bonding may be an important correlate of suicidal behavior in adolescence and may guide therapeutic strategies and prevention.     

Stressful life events and adolescent suicidality: An investigation of the mediating mechanisms

IntroductionWhile a number of studies have found an association between stressful life events and adolescent suicidality, underlying mechanisms linking the two continue to be inadequately understood. Drawing upon the stress process, general strain, and support deterioration theories, this study examined the relationship between stressful life events and suicidality in U.S. adolescents, focusing on the mediating roles of depression, substance use, and perceived social support.MethodsThe data came from the first two waves of the National Longitudinal Study of Adolescent to Adult Health (N = 12,801; M age = 15 at Wave I; 50.2% female). Mediation analyses were performed using the Karlson-Holm-Breen (KHB) method developed for nonlinear probability models.ResultsDepression, substance use, and perceived social support accounted for a substantial part of the effect of stressful life events on suicidal ideation (57%) and attempts (43%). All mediating effects were statistically significant. Depression was a relatively stronger mediator for both suicidal outcomes. Significant relationships among stressful life events and suicidal outcomes persisted even after adjusting for the proposed mediators.ConclusionStressful life events increase suicidality in adolescents, partly by increasing psychological distress and eroding perceived social support. Findings underscore the necessity of continued emphasis on stress management and support programs in reducing suicidality among vulnerable adolescents exposed to these types of occurrences.     

The role of depression in perceived parenting style among patients with anxiety disorders

Despite a long tradition of research on the relationship between parenting style and anxiety disorders, few studies have taken the effect of comorbid depression into account. This study investigated perceived parenting in 504 outpatients with panic disorder/agoraphobia, social phobia or obsessive–compulsive disorder, and in 210 psychology students. The anxiety group reported both parents as less caring and their fathers as more controlling than did the student group. However, these between-group differences disappeared when taking self-reported depressive symptoms into consideration. Also no differences in parental style were found between the three diagnostic anxiety groups, when depressive symptoms were taken into account. Self-reported depressive symptoms were more consistently associated with negatively perceived parenting style than with self-reported anxiety symptoms in both the anxiety group and the student group. Results do not support theories of parental control as a specific risk factor for anxiety disorders, but they are in accordance with prior findings showing an association between depression and perceived lack of parental care.     

La théorie interpersonnelle du suicide. Présentation et application dans la compréhension des idées suicidaires chez l’étudiant en médecine : étude dans un groupe de 178 étudiants

ObjectivesThe current paper presents firstly the Interpersonal Psychological Theory of Suicide (IPTS) and its interest in the risk of suicide in physicians and/or medical students and secondly an original study on 178 medical students.MethodsIn total, 178 medical students of the Université Libre de Bruxelles filled out an ad hoc questionnaire rating suicidal ideations (life-time), recent suicidal plans and recent suicidal ideations rated by the 9th item of the Beck Depression Inventory-II (BDI). The subjects completed the French version of the Interpersonal Needs Questionnaire (INQ) rating Perceived burdensomeness and Thwarted belongingness and the Acquired Capability for Suicide Scale (ACSS) as well as the Beck Depression Inventory-II (BDI-II). Among the 178 medical students, 95 had no suicide risk, 24 had life-time suicidal ideation, 28 had recent suicidal ideations and 26 had recent suicidal plans. The four groups were compared for gender and age as well as for the different rating scales using Chi² tests or analyses of variance (ANOVA).ResultsThe four groups had no significant differences for age, gender and scores on the ACSS. ANOVA revealed significant differences for perceived burdensomeness, thwarted belongingness and depression. To control the potential effect of depression, analyses of covariance (ANCOVA) were done taking as covariate a subscale of the BDI-II rating the cognitive component of depression. The two ANCOVA were significant. Post hoc tests comparing two by two the different groups reported that students with recent suicidal ideations or suicidal plans have significantly higher thwarted belongingness than students without suicide risk or students with life time suicidal ideations. Moreover, higher level of perceived burdensomeness was found only in students with suicidal plans comparatively with the three other groups.ConclusionHigh levels of thwarted belongingness and perceived burdensomeness characterize medical students with recent suicidal ideations or suicidal plans independently of the level of depression.     

Suicidality among Norwegian youth: Review of research on risk factors and interventions

Background and Aim: Published research on suicidality among Norwegian youth and publications describing interventions were summarized in order to access the current status of knowledge building via empirical research. Method: A systematic Medline search identified 29 studies on risk factors on the entire spectrum of suicidal phenomena from self-harm without suicidal ideation to completed suicide with the mean age at/under 25 years. A specialist Norwegian journal, Suicidologi, was searched for additional matter, especially interventions. Result: Most studies focussed on psychological and psychiatric risk factors of attempted suicide. Other suicidal phenomena, psychosocial and societal risk factors, and impact of interventions were hardly studied. Depression, previous suicidal behaviour, alcohol use and non-intact parental unit were consistent significant risk factors found in suicide and attempted suicide studies. Conclusion: Supporting non-intact parental units and the maintenance of intact parental units along with early detection and management of suicide attempts, depression and alcohol use should be targeted as suicide prevention interventions among adolescents.     

The effects of maternal parenting style and religious commitment on self-regulation, academic achievement, and risk behavior among African-American parochial college students

This study explored relations between religiosity, both parent and student, and maternal parenting style and student academic self-regulation, academic achievement, and risk behavior among African-American youth attending a parochial college. Eighty-five students completed self-report survey measures of religiosity, self-regulation, academic achievement, and risk behavior. Participants also completed youth report measures of parental religiosity and perceived maternal parenting style. Correlational analyses show authoritative parenting to be associated with high levels of academic performance and study skills. Additional correlations revealed that highly religious students tend to perform well academically, study better, and engage in fewer risk behaviors than youth less committed to religion. Although no direct relations were observed between parenting style and student religiosity, maternal parenting style was found to moderate relations between parental and student religiosity. Findings are discussed in terms of their relevance to the population studied.     

Parenting styles and socio-demographic dynamics associated with mental health of in-school adolescents in Ibadan,south-west Nigeria

Background: Positive parenting and enabling socio-demography, engenders good conduct in adolescence. Balanced parental demandingness and emotional responsiveness, deployed by authoritative parents, supports adolescents’ mental health. Parental emotional responsiveness deters peer-pressured risky behaviours; while parental negligence, permissiveness, or demandingness encourages mental health problems. This is especially in the context of unfavourable socio-demographic setting.

Aim: We aimed to evaluate parenting styles and socio-demographic factors associated with adolescents’ mental health.

Method: A cross-sectional multistage study was conducted with 286 in-school adolescents in Ibadan, Nigeria. Data were collected with questionnaires. The questionnaires evaluated socio-demography, mental health, and perceived parenting styles using the Strength and Difficulty Questionnaire (SDQ) and Scale of Parenting Styles (SPS) questionnaires. Data analysis was conducted using SPSS 21.

Results: Some of the adolescents in this study, experienced peer problems (4.9%), conduct problems (9.4%), hyperactivity problems (0.7%), emotional problems (14.3%), and they lacked pro-social behaviours (11.1%). In comparison to adolescents who perceived fathers as authoritative, adolescents who perceived fathers as less demanding experienced emotional (p = 0.01) and peer (p = 0.02) problems. Perceived maternal negligence and authoritarian parenting was associated with more peer problems (1.5±2.3 and 1.3±2.2) in comparison to perceived maternal authoritative style (0.6±1.5). Most adolescents from lower social class experienced conduct (88.8%; p = 0.07) and emotional problems (73.2%; p = 0.20).

Conclusion: Competent parenting style and socio-economic resources supports resilience to mental health problems in adolescents.     

Hopelessness and suicidal risk in bipolar disorder. A study in clinically nonsyndromal patients

Objective

Attempted suicide and death due to suicide are not uncommon among patients with bipolar disorder. Although some risk factors for suicidality in bipolar patients have been identified, little is known about hopelessness and other possible trait or diathesis-related factors. Consequently, the objective of this study was to investigate variables associated with suicidal risk in clinically nonsyndromal bipolar patients.

Methods

A sample of 102 outpatients with a diagnosis of bipolar disorder according to International Classification of Diseases, 10th Revision criteria during nonsyndromal stage were evaluated. On the basis of suicidal history, patients were divided into suicide attempt, suicidal ideation, and nonsuicidal groups. Sociodemographic, clinical, and psychopathological variables were assessed.

Results

As compared with the nonsuicidal group, female sex, combined psychopharmacologic treatment, and hopelessness were independently associated with suicide attempt. Hopelessness and insight into having a mental disorder were independently associated with history of suicidal ideation.

Conclusions

Patients with bipolar disorder and suicidal history are characterized by the presence of hopelessness, which probably confers greater vulnerability for suicidal behavior in the presence of stress factors. This identification of the risk profile for suicidal behavior in nonsyndromal bipolar patients adds complementary information to risk factors established for suicidality during acute phases of the disease, allows for differentiated preventive and treatment approaches of patients at risk, and suggests psychotherapy as an advisable intervention in this group of patients.     

Suicide risk in civilian PTSD patients

Abstract Background There appears to be a strong connection between suicidality and the experience of trauma. The study investigated suicidality in chronic civilian post–traumatic stress disorder (PTSD). Method Ninety–four participants suffering from chronic PTSD were assessed for suicidal ideation, plans and attempts since the index trauma as part of a comprehensive assessment. The prevalence of these was assessed and characteristics of those reporting suicide–related thoughts and behaviour were investigated through logistic and multinominal regression analyses. Results Over half of the sample (56.4%) reported some aspect of suicidality with 38.3% reporting ideation, 8.5% reporting suicide plans and 9.6% having made suicide attempts since the trauma. Of the nine participants who reported suicide attempts, six had made more than one attempt. The proportions of participants who reported suicidality in this sample were significantly greater than reported within the general population, when comparisons were made with an epidemiological study. Logistic regression analysis indicated that a unit increase in life impairment (OR = 3.1) and depression (OR = 1.14) scores were independently and significantly associated with suicidality. Multinominal regression indicated that life impairment (OR = 2.71) and depression (OR = 1.13) scores were associated with the presence of suicidal ideation compared to no ideation, and life impairment (OR = 5.75), depression (OR = 1.2) scores and receiving psychotropic medication (OR = 10.6) were associated with the presence of plans and attempts compared to no suicidal behaviour. Conclusions Suicide risk is elevated in those suffering from chronic PTSD and is associated with impaired functioning in combination with depression.