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Professionals in secure residential youth care (SRYC) in the Netherlands are regularly confronted with suicides of adolescents and can be referred to as secondary victims. However, little is known about the impact of suicides on these professionals. This study explores the impact of suicides on professionals working in SRYC. Semi-structured interviews (n = 14) were conducted with professionals from several SRYC institutions. A thematic analysis of the material yielded four main themes: i) impact of suicide on a personal level, ii) impact of suicide on a vocational level, iii) impact of suicide on professional responses, and iv) facilitators and barriers that facilitated or obstructed professional resilience and the prevention of future suicides. The experience of suicide is extremely distressing for professionals. Some interviewees were traumatized by the impact. The findings suggest that most professionals draw on coercive measures for other youngsters sooner and more often after being exposed to suicide. The most commonly reported reason for doing so was the fear of experiencing a fatal incident. Professionals in SRYC require skilled and dedicated support (postvention) following a suicide to minimize its detrimental effects on personal, professional, and team functioning. Further implications for daily practice and policymaking are discussed. Practical implications: Create an organizational culture in which professionals feel supported to discuss fear and uncertainties in balancing safety and accountability when working with suicidal adolescents. Postvention is needed for professionals and teams exposed to suicide. Train and facilitate professionals in nonviolent resistance to prevent coercion and suicide. The need for more trained personnel and increased knowledge of suicide prevention is highlighted. The use of experiential knowledge from lived experience experts could be a valuable additional resource to improve care. [ABSTRACT FROM AUTHOR] more...

The aim of the current study was to compare levels of oxytocin, cortisol, and testosterone in adolescents with either autism spectrum disorder (ASD), or oppositional defiant disorder (ODD)/conduct disorder (CD), and in typically developing individuals (TDI), and relate hormone levels to severity and subtype of aggression and callous-unemotional (CU) traits. Saliva concentrations of oxytocin, cortisol, and testosterone were assessed in 114 male participants (N = 49 ASD, N = 37 ODD/CD, N = 28 TDI,) aged 12–19 years (M = 15.4 years, SD = 1.9). The ASD and the ODD/CD groups had significantly lower levels of oxytocin than the TDI group, and the ODD/CD group had significantly higher levels of testosterone than the ASD group. There were no group effects on cortisol levels. Group differences remained for oxytocin after correcting for the influence of CU traits, but were not significant after controlling for aggression. Results for testosterone became non-significant after correction for either CU traits or aggression. Across groups, higher levels of CU traits were related to higher levels of cortisol and testosterone, however, proactive and reactive aggression were unrelated to all three hormonal levels. The current findings show that, regardless of cognitive ability or comorbid disorders, the diagnostic groups (ASD, ODD/CD) differ from each other by their hormonal levels, with the ASD group characterized by relative low level of oxytocin, and the ODD/CD group by a relative low level of oxytocin and high level of testosterone. These group effects were partly driven by differences in CU traits between the groups. [ABSTRACT FROM AUTHOR] more...