https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60322-5.pdf

Self-harm and suicide in adolescents.

https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(16)30030-X.pdf

Suicide prevention strategies revisited: 10-year systematic review

Suicidal behavior is a leading cause of death and disability worldwide. Fortunately, recent developments in suicide theory and research promise to meaningfully advance knowledge and prevention. One key development is the ideation-to-action framework, which stipulates that (a) the development of suicidal ideation and (b) the progression from ideation to suicide attempts are distinct phenomena with distinct explanations and predictors. A second key development is a growing body of research distinguishing factors that predict ideation from those that predict suicide attempts. For example, it is becoming clear that depression, hopelessness, most mental disorders, and even impulsivity predict ideation, but these factors struggle to distinguish those who have attempted suicide from those who have only considered suicide. Means restriction is also emerging as a highly effective way to block progression from ideation to attempt. A third key development is the proliferation of theories of suicide that are positioned within the ideation-to-action framework. These include the interpersonal theory, the integrated motivational-volitional model, and the three-step theory. These perspectives can and should inform the next generation of suicide research and prevention.

/pdf/suicide-suicide-attempts-and-suicidal-ideation-h04mwfwr6n.pdf

Suicide, Suicide Attempts, and Suicidal Ideation

PURPOSE OF REVIEW: Suicide is the third leading cause of death among young people in the U.S. and represents a significant public health problem worldwide. This review focuses on recent developments in our understanding of the epidemiology and risk factors for adolescent suicide and suicidal behavior. RECENT FINDINGS: The suicide rate among children and adolescents in the U.S. has increased dramatically in recent years and has been accompanied by substantial changes in the leading methods of youth suicide, especially among young girls. Much work is currently underway to elucidate the relationships between psychopathology, substance use, child abuse, bullying, internet use, and youth suicidal behavior. Recent evidence also suggests sex-specific and moderating roles of sex in influencing risk for suicide and suicidal behavior. SUMMARY: Empirical research into the causal mechanisms underlying youth suicide and suicidal behavior is needed to inform early identification and prevention efforts. Language: en

/pdf/epidemiology-of-youth-suicide-and-suicidal-behavior-337agrqzrz.pdf

Epidemiology of Youth Suicide and Suicidal Behavior

https://zivziv.si/wp-content/uploads/2015schoolbasedsuicide.pdf

School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial

Suicide is a leading cause of death for children and youth in the United States. Although school based programs have been the principal vehicle for youth suicide prevention efforts for over two decades, few have been systematically evaluated. This study examined the effectiveness of the Signs of Suicide (SOS) prevention program in reducing suicidal behavior. 4133 students in 9 high schools in Columbus, Georgia, western Massachusetts, and Hartford, Connecticut were randomly assigned to intervention and control groups during the 2001–02 and 2002–03 school years. Self-administered questionnaires were completed by students in both groups approximately 3 months after program implementation. Significantly lower rates of suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide were observed among students in the intervention group. Students' race/ethnicity, grade, and gender did not alter the impact of the intervention on any of the outcomes assessed in this analysis. This study has confirmed preliminary analysis of Year 1 data with a larger and more racially and socio-economically diverse sample. SOS continues to be the only universal school-based suicide prevention program to demonstrate significant effects of self-reported suicide attempts in a study utilizing a randomized experimental design. Moreover, the beneficial effects of SOS were observed among high school-aged youth from diverse racial/ethnic backgrounds, highlighting the program's utility as a universal prevention program. clinicaltrials.gov NCT000387855.

/pdf/evaluating-the-sos-suicide-prevention-program-a-replication-447hnhy142.pdf

Evaluating the SOS suicide prevention program: a replication and extension.

Adolescent alcohol use, suicidal ideation, and suicide attempts.

Objective Alcohol use is a risk factor for suicidal behavior among adolescents, but it is not clear whether this association is consistent during the adolescent period. This study examined the age-specific associations between heavy episodic drinking (HED) and self-reported suicide attempts in a large and diverse sample of adolescents. Method Screening data from 32,217 students, between the ages of 11 and 19 years, in 225 schools were analyzed. Logistic regression analyses estimating the impact of HED on self-reported suicide attempts in the past year were performed. Results Heavy episodic drinking was significantly associated with self-reported suicide attempts (odds ratio 1.78, p Conclusions Heavy episodic drinking is a clear risk factor for suicidal behavior among younger adolescents, beyond the risk conveyed by depressive symptoms. Further research investigating the bases for increased suicide risk among younger adolescents engaging in HED is warranted. Results provide support to AACAP's practice parameters calling for attention to substance abuse in the assessment of suicide risk and suggest that routine screening for HED by physicians may improve the detection of adolescent suicide risk, particularly among younger adolescents.

Age variability in the association between heavy episodic drinking and adolescent suicide attempts: findings from a large-scale, school-based screening program.

Purpose: To examine the association between self-reported alcohol use and suicide attempts among adolescents who did and did not report suicidal ideation during the past year. Methods: Screening data from 31,953 students attending schools in the United States that implemented the Signs of Suicide (SOS) program in 2001–2002 were used in this analysis. Two types of alcohol use were investigated: heavy episodic drinking, and drinking while down. Self-reported suicide attempts were regressed on suicidal ideation and both measures of alcohol use, controlling for participants’ levels of depressive symptoms, and demographic characteristics. Results: Logistic regression analyses indicated that both drinking while down and heavy episodic drinking were significantly associated with self-reported suicide attempts. Analyses examining the conditional association of alcohol use and suicidal ideation with self-reported suicide attempts revealed that drinking while down was associated with significantly greater risk of suicide attempt among those not reporting suicidal ideation in the past year. Heavy episodic drinking was associated with increased risk of suicide attempt equally among those who did and did not report suicidal ideation. Conclusions: This study identified the use of alcohol while sad or depressed as a marker for suicidal behavior in adolescents who did not report ideating prior to an attempt, and hence, may not be detected by current strategies for assessing suicide risk. Findings from this study should provide further impetus for alcohol screening among clinicians beyond that motivated by concerns about alcohol and substance use. 2009 Society for Adolescent Medicine. All rights reserved.

Jaime L. Glanovsky

Papers

Evaluating the SOS suicide prevention program: a replication and extension.

Adolescent alcohol use, suicidal ideation, and suicide attempts.

Age variability in the association between heavy episodic drinking and adolescent suicide attempts: findings from a large-scale, school-based screening program.

Original article Adolescent Alcohol Use, Suicidal Ideation, and Suicide Attempts