Showing papers by "Madelyn S. Gould published in 2001"
TL;DR: Low parental monitoring and risk behaviors (such as smoking, physical fighting, alcohol intoxication, and sexual activity) are independently associated with increased risk of suicidal ideation and attempts, even after adjusting for the presence of psychiatric disorder and sociodemographic variables.
Abstract: Objective To identify the independent psychosocial and risk behavior correlates of suicidal ideation and attempts. Method The relationships between suicidal ideation or attempts and family environment, subject characteristics, and various risk behaviors were examined among 1,285 randomly selected children and adolescents, aged 9 through 17 years, of whom 42 (3.3%) had attempted suicide and 67 (5.2%) had expressed suicidal ideation only. The youths and their parents were enumerated and interviewed between December 1991 and July 1992 as part of the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Results Compared with subjects with suicidal ideation only, attempters were significantly more likely to have experienced stressful life events, to have become sexually active, to have smoked more than one cigarette daily, and to have a history of ever having smoked marijuana. After adjusting for sociodemographic characteristics, a statistically significant association was found between suicidal ideation or attempt and stressful life events, poor family environment, parental psychiatric history, low parental monitoring, low instrumental and social competence, sexual activity, marijuana use, recent drunkenness, current smoking, and physical fighting. Even after further adjusting for the presence of a mood, anxiety, or disruptive disorder, a significant association persisted between suicidal ideation or attempts and poor family environment, low parental monitoring, low youth instrumental competence, sexual activity, recent drunkenness, current smoking, and physical fighting. Conclusion Low parental monitoring and risk behaviors (such as smoking, physical fighting, alcohol intoxication, and sexual activity) are independently associated with increased risk of suicidal ideation and attempts, even after adjusting for the presence of psychiatric disorder and sociodemographic variables.
435 citations
TL;DR: This paper reviews the extensive research literature on youth suicide that has emerged during the past two decades and concludes that great advances in knowledge have led to increased understanding of the risk factors for child and adolescent suicides but the application of this knowledge for designing prevention strategies remains inchoate.
Abstract: Youth suicide, the third leading cause of death among teenagers and young adults, accounts for more deaths in the United States than all natural causes combined among 15- to 24-year-olds according to the National Center for Health Statistics (2000a). The public health significance of the problem of youth suicide becomes even more apparent when the high rates of nonlethal suicidal behavior are taken into account. This paper reviews the extensive research literature on youth suicide that has emerged during the past two decades. While great advances in knowledge have led to increased understanding of the risk factors for child and adolescent suicides, the application of this knowledge for designing prevention strategies remains inchoate.
323 citations
TL;DR: General practitioners and pediatricians have a role in the office-based treatment of youths with psychotropic medications and significant differences were observed in the prescription of each class of medication by sex, race, and payment source.
Abstract: OBJECTIVE: This study sought to determine sociodemographic characteristics of treatment of children and adolescents for whom psychotropic medications are prescribed and to describe the clinical management approaches associated with the prescription of each major class of psychotropic medication in office-based medical practices in the United States. METHODS: Data for a four-year period (1992-1996) were drawn from the National Ambulatory Medical Care Survey, a nationally representative survey of office-based medical practices, to determine prescribing patterns, patients' sociodemographic characteristics, and clinical management approaches associated with visits during which psychotropic medications were prescribed to patients aged 19 years or under. RESULTS: Psychotropic medications were prescribed during 2.2 percent of all visits. A majority of the prescriptions for psychotropic medications (84.8 percent) were provided by general practitioners or pediatricians. For the visits during which a psychotropic m...
107 citations