Search

Intentional and unintentional firearm injury is the second leading cause of death for youth, underscoring the need for effective primary prevention approaches that focus on increasing safe storage by caregivers and decreasing handling/carriage among youth. This article describes the state of the science for prevention of firearm injuries among children and adolescents. We applied PRISMA guidelines to present results from a scoping review using PubMed, Scopus, CINAHL, and CJ Abstracts for original research articles published between January 1, 1985 and March 1, 2018 in the U.S. focusing on primary screening or interventions for primary prevention of pediatric firearm injuries. In total, 46 articles met inclusion criteria: safe storage (23), screening (2), firearm handling/carriage/use (21). Across school, healthcare, and community settings, few evidenced-based programs exist, and data on firearm safety technologies are lacking. Programs have generally not employed rigorous designs, and/or assessed behavioral (e.g., carriage) or injury-related firearm outcomes. Evidenced-based prevention programs are needed to mitigate firearm morbidity and mortality among youth., Author(s): Quyen M. Ngo [sup.1] [sup.2] , Eric Sigel [sup.3] , Allante Moon [sup.4] , Sara F. Stein [sup.5] [sup.6] , Lynn S. Massey [sup.1] , Frederick Rivara [sup.7] , [...]

Byline: Cheryl A. King (1), David C. R. Kerr (2), Michael N. Passarelli (3), Cynthia Ewell Foster (4), Christopher R. Merchant (5) Keywords: Suicide attempts; Adolescents; Survival analysis Abstract: This longitudinal study of recently hospitalized suicidal youth examined parental mental health history in addition to several indices of adolescent functioning as risk factors for time-to-suicide attempt over a 1-year period. Participants were 352 adolescents (253 girls, 99 boys ages 13--17 years) who participated in self-report and interview assessments within 1 week of hospitalization and 6 weeks, 3, 6, and 12 months post-hospitalization. Multivariable proportional hazards regression modeled time-to-suicide attempt. Results indicate that adolescents were almost twice as likely to make a suicide attempt if they had at least one biological parent with mental health problems. Risk was also increased for adolescents with baseline histories of multiple previous suicide attempts, more severe suicidal ideation and more severe functional impairment. Findings suggest the need to consider the family system when intervening with suicidal youth. Author Affiliation: (1) Departments of Psychiatry and Psychology, Institute for Human Adjustment, University of Michigan, Ann Arbor, MI, USA (2) Department of Psychology, Oregon State University, Corvallis, OR, USA (3) Department of Epidemiology, University of Washington, Seattle, WA, USA (4) Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA (5) Department of Psychology, University of Michigan, Ann Arbor, MI, USA Article History: Registration Date: 10/11/2009 Received Date: 01/08/2009 Accepted Date: 10/11/2009 Online Date: 06/12/2009

The purpose of this study was to examine the efficacy of the Youth-Nominated Support Team--Version II (YST-II) for suicidal adolescents, an intervention based on social support and health behavior models, which was designed to supplement standard treatments. Psychiatrically hospitalized and suicidal adolescents, 13-17 years of age, were randomly assigned to treatment-as-usual (TAU) + YST-II (n = 223) or TAU only (n = 225). YST-II provided tailored psychoeducation to youth-nominated adults in addition to weekly check-ins for 3 months following hospitalization. In turn, these adults had regular supportive contact with adolescents. Adolescents assigned to TAU + YST-II had an average of 3.43 (SD = 0.83) nominated adults. Measures included the Suicidal Ideation Questionnaire-Junior (SIQ-JR; W. M. Reynolds, 1988), Children's Depression Rating Scale-Revised (E. O. Poznanski & H. B. Mokros, 1996), Beck Hopelessness Scale (A. T. Beck & R. A. Steer, 1993), and Child and Adolescent Functional Assessment Scale (CAFAS; K. Hodges, 1996). YST-II had very limited positive effects, which were moderated by history of multiple suicide attempts, and no negative effects. It resulted in more rapid decreases in suicidal ideation (SIQ-JR) for multiple suicide attempters during the initial 6 weeks after hospitalization (small-to-moderate effect size). For nonmultiple attempters, it was associated with greater declines in functional impairment (CAFAS) at 3 and 12 months (small effect sizes). YST-II had no effects on suicide attempts and no enduring effects on SIQ-JR scores. Keywords: suicide risk, psychosocial intervention, teens, social support, psychoeducation

Hawksbill sea turtles, Eretmochelys imbricata, reside around the main Hawaiian Islands but are not common. Flipper-tag recoveries and satellite tracking of hawksbills worldwide have shown variable distances in post-nesting travel, with migrations between nesting beaches and foraging areas ranging from 35 to 2,425 km. Nine hawksbill turtles were tracked within the Hawaiian Islands using satellite telemetry. Turtles traveled distances ranging from 90 to 345 km and took between 5 to 18 days to complete the transit from nesting to foraging areas. Results of this study suggest that movements of Hawaiian hawksbills are relatively short-ranged, and surveys of their foraging areas should be conducted to assess status of the habitat to enhance conservation and management of these areas., Hawksbill sea turtles, Eretmochelys imbricata (L.), are found in nearshore habitats in tropical regions of all oceans. Hawksbill turtles are listed as Critically Endangered in the International Union for Conservation [...]

Psychopathology, social support, and interpersonal orientation were studied in relation to suicide attempt status in acutely suicidal, psychiatrically hospitalized Black adolescents and a matched sample of White adolescents. In the total sample, multiple attempters were differentiated by lower perceived support. Within the Black youth subsample, social comparison and positive stimulation from others differentiated multiple attempters from single attempters/ideators. Only suicidal ideation predicted multiple attempts among White youth and only higher interpersonal orientation predicted multiple suicide attempts within Black adolescents.

Colleen Jollie, the state tribal liaison at the Washington State Department of Transportation, practices a form of transformational public administration that, at its heart, reflects a Coyote or 'trickster' style of management. In indigenous stories across the world, the trickster uses his or her wiles to disrupt, refuse, and dismantle ways that are not working in order to creatively, and sometimes chaotically, build new ways. Jollie's work as lead tribal liaison has transformed the agency, the tribes, and the relationships between tribes and the agency, creating a culture of cooperation across significant differences and honoring the transformational energy required to cooperate across difference. Like the Coyote, who does what needs to be done through many means, but mostly through thoughtful effort, Jollie works to create change that serves both the state and the tribes. As this profile indicates, the work isn't always easy and the outcomes don't always spell success, but the work is necessary for tribes and state governments to forge the kinds of relationships imagined in treaties and in other agreements between sovereign governments.

Intervention research with youths at elevated risk for suicidal behavior and suicide--a vulnerable and high risk population--presents investigators with numerous ethical challenges. This report specifically addresses those challenges involving the informed consent and assent process with parents/guardians and youths. The challenges are delineated in the context of pertinent laws and regulatory requirements, and guidelines are suggested for their practical resolution. These are illustrated with case examples from NIMH-funded intervention trials. Through the sharing of such methodological information, intervention researchers can support each other in conducting ethical research in a manner that does not unduly compromise scientific rigor.

Byline: Cynthia Ewell Foster (1), Melissa C. Webster (1), Myrna M. Weissman (2), Daniel J. Pilowsky (2), Priya J. Wickramaratne (2), A. John Rush (3), Carroll W. Hughes (3), Judy Garber (4), Erin Malloy (5), Gabrielle Cerda (6), Susan G. Kornstein (7), Jonathan E. Alpert (8), Stephen R. Wisniewski (9), Madhukar H. Trivedi (3), Maurizio Fava (8), Cheryl A. King (1) Keywords: Maternal depression; Family functioning; Child adjustment; Gender Abstract: Number of lifetime episodes, duration of current episode, and severity of maternal depression were investigated in relation to family functioning and child adjustment. Participants were the 151 mother--child pairs in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) child multi-site study. Mothers were diagnosed with Major Depressive Disorder children (80 males and 71 females) ranged in age from 7 to 17 years. Measures of child adjustment included psychiatric diagnoses, internalizing and externalizing symptoms, and functional impairment. Measures of family functioning included family cohesion, expressiveness, conflict, organization, and household control parenting measures assessed maternal acceptance and psychological control. Children of mothers with longer current depressive episodes were more likely to have internalizing and externalizing symptoms, with this association being moderated by child gender. Mothers with more lifetime depressive episodes were less likely to use appropriate control in their homes. Author Affiliation: (1) Department of Psychiatry, University of Michigan, Child and Adolescent Psychiatry Section, 4250 Plymouth Rd., Ann Arbor, MI, 48109, USA (2) Columbia University and the New York State Psychiatric Institute, New York, NY, USA (3) University of Texas Southwestern Medical Center, Dallas, TX, USA (4) Vanderbilt University, Nashville, TN, USA (5) University of North Carolina, Chapel Hill, NC, USA (6) University of California, San Diego, CA, USA (7) Virginia Commonwealth University, Richmond, VA, USA (8) Harvard University, Cambridge, MA, USA (9) University of Pittsburgh, Pittsburgh, PA, USA Article History: Registration Date: 14/08/2007 Received Date: 02/04/2007 Accepted Date: 14/08/2007 Online Date: 19/09/2007

A study is conducted to determine whether effective treatment with medication of women with major depression is associated with reduction of symptoms and diagnosis in their children. The findings support the importance of vigorous treatment for depressed mothers in primary care or psychiatric clinics, as remission of maternal depression has positive effects on both mothers and their children, whereas mothers who remain depressed might increase the rates of their children's disorders.

Byline: David C. R. Kerr (1), Lesli J. Preuss (2), Cheryl A. King (1,3,4) Keywords: suicide; social support; adolescence; depression; gender differences Abstract: Perceptions of social support from family, non-family adults, and peers were examined in relation to the psychopathology reported by 220 suicidal adolescents (152 females) during a psychiatric hospitalization. Results of regression analyses showed that, among females, family support was negatively related to hopelessness, depressive symptoms, and suicidal ideation. Among males, peer support was positively associated with depressive symptoms and suicidal ideation. Across gender, more peer support was associated with more externalizing behavior problems whereas, family support was negatively related to these problems and to alcohol/substance abuse. Paralleling normative findings, age was positively associated with peer support, and females perceived more peer support than did males. Findings extend previous research on social support to suicidal adolescents, and broaden the literature by examining extrafamilial support and a broader range of relevant psychopathology. That is, perceived social support relates to psychiatric impairment differentially by gender, and normative, age-related variations in perceptions of social support are detected even among highly impaired adolescents. Clinical implications and directions for future research are discussed. Author Affiliation: (1) Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA (2) New York State Psychiatric Institute, New York, New York, USA (3) Departments of Psychology, University of Michigan, Ann Arbor, Michigan, USA (4) Department of Psychiatry, Child & Adolescent Division, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, Michigan, 48109-0295, USA Article History: Registration Date: 31/10/2005 Received Date: 30/07/2003 Accepted Date: 06/05/2005 Online Date: 24/02/2006

Perceptions of social support from family, non-family adults, and peers were examined in relation to the psychopathology reported by 220 suicidal adolescents (152 females) during a psychiatric hospitalization. Results of regression analyses showed that, among females, family support was negatively related to hopelessness, depressive symptoms, and suicidal ideation. Among males, peer support was positively associated with depressive symptoms and suicidal ideation. Across gender, more peer support was associated with more externalizing behavior problems; whereas, family support was negatively related to these problems and to alcohol/substance abuse. Paralleling normative findings, age was positively associated with peer support, and females perceived more peer support than did males. Findings extend previous research on social support to suicidal adolescents, and broaden the literature by examining extrafamilial support and a broader range of relevant psychopathology. That is, perceived social support relates to psychiatric impairment differentially by gender, and normative, age-related variations in perceptions of social support are detected even among highly impaired adolescents. Clinical implications and directions for future research are discussed. KEY WORDS: suicide; social support; adolescence; depression; gender differences.

Recent research and theory suggest narcissistic features contribute to aggression in adults. The present study examined the association of narcissistic features with aggression and internalizing symptoms in 233 students of 5th-8th grade at three inner-city schools. A factor analysis of the Narcissistic Personality Inventory in this sample revealed three factors: Adaptive Narcissism, Exploitativeness, and Exhibitionism. Regression analyses were used to predict the association of these three narcissistic features with self-, teacher-, and peer-reported aggression and self-reported internalizing symptoms. Results indicate narcissistic exploitativeness positively predicted self-reported proactive aggression, and narcissistic exhibitionism positively predicted internalizing symptoms. Narcissism and self-esteem interacted to predict teacher-reported aggression and self-reported internalizing symptoms. Results are discussed in the context of existing theories of narcissism, threatened egotism, and self-perception bias. KEY WORDS: narcissism; aggression; internalizing; urban African American adolescent.

The clinical assessment of suicidality is one of the most challenging tasks the mental health clinician can face. This article offers 22 recommendations for the outpatient psychotherapeutic treatment of suicidality in adults and adolescents. These recommendations cut across all domains of clinical practice. A rationale is presented that the stated recommendations need an empirical base, in contrast to the existing litigation-determined standard of care that has emerged over the last several decades. The authors review empirical literature, acknowledge identifiable limitations, and emphasize implications for day-to-day clinical practice and the continuing evolution of standards of care.

How can the processes of public participation be improved? This study uses interviews and focus-group discussions to look for some answers. The results suggest that improving public participation requires changes in citizen and administrator roles and relationships and in administrative processes. Specifically, we need to move away from static and reactive processes toward more dynamic and deliberative processes. The article suggests some practical steps to achieve these changes., The appropriate role of the public in public administration has been an active and ongoing area of inquiry, experimentation, revolution, and controversy since the birth of this nation. The contemporary [...]

The Diagnostic Interview Schedule for Children (DISC-2.3) was studied in a sample of 265 adolescent inpatients to determine type and concurrent validity of depressive symptoms and depressive disorder diagnoses for different DISC-2.3 informants (parent, adolescent, both). The Children's Depression Rating Scale - Revised, Reynolds Adolescent Depression Scale (RADS), Suicide Ideation Questionnaire - Junior, Spectrum of Suicide Behavior Scale, and clinical consensus diagnoses were used to assess concurrent validity. Results indicated that (1) parents, compared to adolescents, reported a higher prevalence of all depressive symptoms with the exception of weight change; (2) DISC-2.3 depressive and suicidality symptoms were related positively to independent validating criteria for all informant conditions, suggesting good concurrent validity; (3) the DISC-2.3 both informant condition correctly identified the most depressive disorders; and (4) the parent, but not the adolescent, DISC-2.3 Informant condition contributed to the prediction of clinical consensus diagnoses of depression after taking into account RADS scores. KEY WORDS: Diagnosis; assessment; depression; suicidality; adolescence.

Despite the dramatic increase in Mexican-American immigration over the past two decades, the acculturative experience and its relationship to suicide risk have received little attention within the field of suicidology. This paper summarizes findings from community-based studies that have explored suicide and risk factors among immigrant and Mexican-American groups, and suggests directions for future research. Most of these studies have been epidemiologic, and relatively few have addressed risk and protective factors within well-defined acculturating groups. Further study of the full continuum of suicidal thoughts and behaviors that examines precise cultural risk factors, and uses methodologies that combine quantitative and qualitative data, may improve our understanding of suicide risk among acculturating Mexican Americans.

This study examined psychiatrically disturbed adolescents' history of exposure to suicide attempts, completions, and other deaths in relation to attitudes about life and death. A primary goal of the study was to study the mediating processes involved in the impact of loss on suicidality. Adolescents who experienced the suicide of a friend or immediate family member reported a weaker attraction to life and stronger attraction to death than adolescents lacking this experience. Exposure to attempted suicide resulted in attitudes indicating a stronger attraction to death and repulsion by life. We conclude that a comprehensive history of loss and assessment of current attitudes toward death are important aspects of evaluation and subsequent treatment of at-risk adolescents.

Parents' marital functioning and adolescent psychopathology were investigated in 2 studies. The first study compared parents' marital satisfaction, conflict over childrearing, affective communication, and traditional role orientation in matched samples of psychiatric inpatient and control-group adolescents. The second study examined associations between specific dimensions of marital functioning and adolescent depression severity, suicidal ideation, and social adjustment in a larger sample of adolescent inpatients. In Study 1, parents of inpatients reported less marital satisfaction and more conflicts over childrearing than parents of control-group adolescents. In Study 2, marital conflicts over childrearing were associated with a less active or involved father-adolescent relationship and more severe school behavior and spare time problems. Marital functioning was not associated with depression severity or suicidal ideation.

Rotheram-Borus and Fernandez (1995) propose that the examination of one's sexual orientation can become the 'central development task' and 'central challenge' of homosexual adolescents searching for personal identity. However, the two fail to explain the extent to which this process of homosexual self-identification may be normative or healthy. They also attempt to support their position by referring to previous studies, but they do not take into account the limitations of these studies.

This study examined the extent to which adolescents' perceptions of their family environments were associated with suicidal behavior. Fifteen suicidal adolescents, 14 psychiatric controls, and 14 normal controls rated their families on cohesiveness, adaptability, parent-adolescent communication, parental caring, and parental overprotectiveness. Suicidal adolescents rated their families as the least cohesive and most rigid of the 3 groups, suggesting that adolescent suicidal behavior may occur when isolation is experienced within an inflexible family system. Suicidal and psychiatric control adolescents rated their families as similarly dysfunctional along the remaining variables, and as more dysfunctional than families of normal control adolescents. The implications of these findings are discussed, and it is suggested that several characteristics commonly attributed to families of suicidal adolescents may actually be general risk factors for adolescent psychopathology, rather than for suicidal behavior specifically.

Depression prevalence was examined by race/ethnicity in a nationally representative sample. The Diagnostic Interview Schedule was administered to 8449 (response rate=96.1%) participants (aged 15-40 years). Prevalence of major depressive disorder was significantly higher in Whites than in African Americans and Mexican Americans; the opposite pattern was found for dysthymic disorder. Across racial/ethnic groups, poverty was a significant risk factor for major depressive disorder, but significant interactions occurred between race/etnicity, gender, and education in relation to prevalence of dysthymic disorder. (Am J Public Health. 2005;95:998-1000. doi:10.2105/ AJPH.2004.047225)