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Clinical and Psychosocial Characteristics of Young Children With Suicidal Ideation, Behaviors, and Nonsuicidal Self-Injurious Behaviors.

ABSTRACT: OBJECTIVE:Based on previous findings that suicidal ideation (SI) and behavior (SB) arose in depressed preschoolers and showed stability into school age, we sought to investigate whether unique clinical and psychosocial correlates of SI/SB and nonsuicidal self-injurious behaviors (NSSI) could be identified in young children recuited into a depression treatment study and healthy controls. METHOD:Data from 288 children 3.0 to 6.11 years of age who were recruited for participation in a psychotherapy treatment study of depression and 26 healthy control subjects (total N = 314) were used. At baseline, subjects received a comprehensive assessment of psychopathology and suicidal ideation/suicidal behavior. Multinominal logistic regressions were conducted comparing those with no SI/SB/NSSI to those with SI/SB or NSSI. Those with SI/SB who also had NSSI were placed in the SI/SB group. RESULTS:In this sample of young children, the rates of NSSI, SI, and SB were 21.3%, 19.1%, and 3.5% respectively. Children with SI/SB or NSSI experienced a greater frequency of violent life events than children with no SI/SB/NSSI. Children with SI/SB had significantly more preoccupation with death compared to subjects with NSSI and subjects with no SI/SB/NSSI. Children with SI/SB had more vegetative signs of depression and greater depression severity, and those with NSSI were more irritable with higher depression severity than those with no SI/SB/NSSI. CONCLUSION:Distinct characteristics of SI/SB and NSSI in early childhood were identified, informing high risk subgroups. Findings suggest that clinicians should be aware of the potential for SI/SB and/or NSSI in young children and should directly address these symptoms in clinical interviews. CLINICAL TRIAL REGISTRATION INFORMATION:A Randomized Controlled Trial of PCIT-ED for Preschool Depression. https://clinicaltrials.gov/; NCT02076425.

SUBMITTER: Luby JL

PROVIDER: S-EPMC6550290 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Clinical and Psychosocial Characteristics of Young Children With Suicidal Ideation, Behaviors, and Nonsuicidal Self-Injurious Behaviors.

Luby Joan L JL Whalen Diana D Tillman Rebecca R Barch Deanna M DM

Journal of the American Academy of Child and Adolescent Psychiatry 20181022 1

<h4>Objective</h4>Based on previous findings that suicidal ideation (SI) and behavior (SB) arose in depressed preschoolers and showed stability into school age, we sought to investigate whether unique clinical and psychosocial correlates of SI/SB and nonsuicidal self-injurious behaviors (NSSI) could be identified in young children recuited into a depression treatment study and healthy controls.<h4>Method</h4>Data from 288 children 3.0 to 6.11 years of age who were recruited for participation in ...[more]

PMID: 30577927

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Project description:Introduction:Although research over the past decade has resulted in significantly increased knowledge about distal risk factors for non-suicidal self-injury (NSSI), little is known about short-term (proximal) factors that predict NSSI thoughts and behaviors. Drawing on contemporaneous theories of NSSI, as well as the concept of ideation-to-action, the present study clarifies (a) real-time factors that predict NSSI thoughts and (b) the extent to which theoretically important momentary factors (i.e., negative affect, positive affect, and self-efficacy to resist NSSI) predict NSSI behavior in daily life, beyond NSSI thoughts. Methods:Using experience sampling methodology, intensive longitudinal data was obtained from 30 young adults with frequent NSSI episodes in the last year. Participants completed assessments up to eight times per day for 12 consecutive days (signal-contingent sampling). This resulted in the collection of 2,222 assessments (median compliance = 79.2%) during which 591 NSSI thoughts and 270 NSSI behaviors were recorded. Using the dynamic structural equation modeling framework, multilevel vector autoregressive models were constructed. Results:Within the same assessment, negative affect was positively associated with NSSI thoughts, whereas positive affect and self-efficacy to resist NSSI were each negatively associated with NSSI thoughts. Across assessments, higher-than-usual negative affect and self-efficacy to resist NSSI were predictive of short-term change in NSSI thoughts. While fluctuations in both negative affect and positive affect prospectively predicted NSSI behavior, these factors became non-significant in models that controlled for the predictive effect of NSSI thoughts. In contrast, self-efficacy to resist NSSI incrementally predicted a lower probability of engaging in NSSI, above and beyond NSSI thoughts. Discussion:This study provides preliminary evidence that affective fluctuations may uniquely predict NSSI thoughts but not NSSI behaviors, and point to the role of personal belief in the ability to resist NSSI in preventing NSSI behavior. These findings illustrate the need to differentiate between the development of NSSI thoughts and the progression from NSSI thoughts to behavior, as these are likely distinct processes, with different predictors.

Project description:BACKGROUND:Data on the prevalence of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background are scarce. There are hints that this population is at risk. The aim of the study is to investigate the epidemiology of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background in Germany while taking gender-specific differences into consideration. METHODS:A representative study with N = 10,638 students (mean age 14.91 years, SD = .73).) in the state of Lower Saxony in Germany was conducted. In the 2014-2015 school year, 672 classes were selected by randomly sampling different school types. The participation rate was 84.1%, excluding any classes for which the director refused to provide consent. A total of 49.8% were female adolescents, and 23.3% of the participants had a migration background. Target variables were assessed with items from the Ottawa Self-Injury Inventory, the Self-Harm Behavior Questionnaire and the Self-Harm Inventory, partly adapted. RESULTS:Of all students, 7.6% had a lifetime history of suicide attempts, and 36.6% answered with a rating of at least "rarely" when asked to rate the lifetime prevalence of suicidal ideation. The 12-month prevalence of direct self-injurious behavior was 17.8%. Adolescents with a migration background showed a significantly higher prevalence of all three constructs (p = .006; p < .001; p = .006). Male students with a migration background reported a significantly higher lifetime prevalence of suicide attempts (4.7% vs. 3.1%) than native males (p = .009). Female students with a migration background reported a significantly higher lifetime prevalence of suicide attempts (15.9% vs. 10.4%) and suicidal ideation ("often" 12.1% vs. 8.9%) than native female students (p < .001; p = .008). CONCLUSION:Our assessment indicates an elevated risk for suicidal behaviors in adolescents with a migration background. From research on adults, it is known that the dominant motives for suicidal behavior in migrants are associated with their migration history/situation. As suggested by Cramer and Kapusta's (Front Psychol 8:1756, 2017) theoretical model, the Social-Ecological Framework of Theory, Assessment, and Prevention, there is a need for culturally sensitive preventions that take into account the specific reasons for suicide attempts in migrants.

Dataset Information

Clinical and Psychosocial Characteristics of Young Children With Suicidal Ideation, Behaviors, and Nonsuicidal Self-Injurious Behaviors.

Publications

Clinical and Psychosocial Characteristics of Young Children With Suicidal Ideation, Behaviors, and Nonsuicidal Self-Injurious Behaviors.

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