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Adolescent Suicidality and Homicidality: Who Is at Risk?

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Adolescent Gun Violence Prevention

Abstract

Suicide and homicide are the second and third leading causes of adolescent mortality in the United States, respectively. Adolescent deaths by these means outnumber all medical causes combined. Suicide and violence prevention begins foremost with an accurate risk assessment. Clinicians, educators, and public officials can significantly improve their effectiveness in adolescent risk assessment through focusing on several key tenets. Key risk factors for both suicide and homicide include the presence of demographic variables, psychiatric diagnoses, and psychosocial stressors. Protective factors, such as strong family cohesion, help-seeking behavior, and resilience, are also key to the assessment. Inquiry into the adolescent’s current mental status and interviewer comfort in performing such an inquiry is also important. As firearms are the leading means of death in both adolescent suicide and homicide, risk assessment is paramount in efforts towards adolescent gun violence prevention.

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References

  1. Centers for Disease Control and Prevention NC for IP and C. Web-based Injury Statistics Query and Reporting System (WISQARS) [Internet]. [cited 2019 Sep 18]. Available from: https://webappa.cdc.gov/sasweb/ncipc/mortrate.html.

  2. Novick LF, Cibula DA, Sutphen SM. Adolescent suicide prevention. Am J Prev Med [Internet]. 2003;24(4 Suppl):150–6. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0749379703000436.

    Article  Google Scholar 

  3. Eaton D, Kann L, Kinchen S. Centers for Disease Control and Prevention (CDC) youth risk behavior surveillance – United States, 2011. MMWR. 2012;61:1–162.

    PubMed  Google Scholar 

  4. Child Trends Databank. Suicidal teens. 2019.

    Google Scholar 

  5. Bilsen J. Suicide and youth: risk factors. Front Psychiatry [Internet]. 2018 Oct 30;9. Available from: https://www.frontiersin.org/article/10.3389/fpsyt.2018.00540/full.

  6. Copelan RI, Messer MA, Ashley DJ. Adolescent violence screening in the ED. Am J Emerg Med [Internet]. 2006;24(5):582–94. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0735675706001264.

    Article  Google Scholar 

  7. Fazel S, Grann M. Psychiatric morbidity among homicide offenders: a Swedish population study. Am J Psychiatry. 2004;161:2129–31.

    Article  Google Scholar 

  8. Flynn S, Abel KM, While D, Mehta H, Shaw J. Mental illness, gender and homicide: a population-based descriptive study. Psychiatry Res [Internet]. 2011 Mar 28 [cited 2014 May 30];185(3):368–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20724002.

  9. Sher L, Rice T, World Federation of Societies of Biological PsychiatryTask Force on Men’s Mental Health. Prevention of homicidal behaviour in men with psychiatric disorders. World J Biol Psychiatry [Internet]. 2015;16(4):212–29. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25913698.

  10. Frankenfield DL, Keyl PM, Gielen A, Wissow LS, Werthamer L, Baker SP. Adolescent Patients—Healthy or Hurting? Arch Pediatr Adolesc Med [Internet]. 2000;154(2):162. Available from: http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/archpedi.154.2.162.

  11. Fallucco EM, Hanson MD, Glowinski AL. Teaching pediatric residents to assess adolescent suicide risk with a standardized patient module. Pediatrics. 2010;125:953–9.

    Article  Google Scholar 

  12. Morriss R, Gask L, Battersby L, Francheschini A, Robson M. Teaching front-line health and voluntary workers to assess and manage suicidal patients. J Affect Disord [Internet]. 1999;52(1–3):77–83. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0165032798000809.

    Article  CAS  Google Scholar 

  13. Pirkola S, Isomets?? E, L??nnqvist J. Do Means Matter? J Nerv Ment Dis [Internet]. 2003 Nov;191(11):745–50. Available from: https://insights.ovid.com/crossref?an=00005053-200311000-00007.

  14. Posner K, Brown GK, Stanley B, Brent DA, Yershova K V., Oquendo MA, et al. The Columbia–suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry [Internet]. 2011 Dec;168(12):1266–77. Available from: http://psychiatryonline.org/doi/abs/10.1176/appi.ajp.2011.10111704.

  15. Interian A, Chesin M, Kline A, Miller R, St. Hill L, Latorre M, et al. Use of the Columbia-Suicide Severity Rating Scale (C-SSRS) to classify suicidal behaviors. Arch Suicide Res [Internet]. 2018 Apr 3;22(2):278–94. Available from: https://www.tandfonline.com/doi/full/10.1080/13811118.2017.1334610.

  16. Gould MS, Greenberg T, Velting DM, Shaffer D. Youth suicide risk and preventive interventions: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry [Internet] 2003 Apr;42(4):386–405. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0890856709609114.

  17. Lee S, Dwyer J, Paul E, Clarke D, Treleaven S, Roseby R. Differences by age and sex in adolescent suicide. Aust N Z J Public Health [Internet] 2019 Jun;43(3):248–53. Available from: http://doi.wiley.com/10.1111/1753-6405.12877.

  18. Thoma BC, Salk RH, Choukas-Bradley S, Goldstein TR, Levine MD, Marshal MP. Suicidality disparities between transgender and cisgender adolescents. Pediatrics [Internet]. 2019 Nov;144(5):e20191183. Available from: http://pediatrics.aappublications.org/lookup/doi/10.1542/peds.2019-1183.

  19. Terada S, Matsumoto Y, Sato T, Okabe N, Kishimoto Y, Uchitomi Y. Suicidal ideation among patients with gender identity disorder. Psychiatry Res [Internet] 2011 Nov;190(1):159–62. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0165178111003556.

  20. Gould MS. Psychosocial risk factors of child and adolescent completed suicide. Arch Gen Psychiatry [Internet]. 1996 Dec 1;53(12):1155. Available from: http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1996.01830120095016.

  21. Carballo JJ, Llorente C, Kehrmann L, Flamarique I, Zuddas A, Purper-Ouakil D, et al. Psychosocial risk factors for suicidality in children and adolescents. Eur Child Adolesc Psychiatry [Internet]. 2019 Jan 25; Available from: http://link.springer.com/10.1007/s00787-018-01270-9.

  22. Hovey JD, King CA. Acculturative stress, depression, and suicidal ideation among immigrant and second-generation Latino adolescents. J Am Acad Child Adolesc Psychiatry [Internet]. 1996 Sep;35(9):1183–92. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0890856709634936.

  23. Kennedy MA, Parhar KK, Samra J, Gorzalka B. Suicide ideation in different generations of immigrants. Can J Psychiatry [Internet] 2005 May 30;50(6):353–6. Available from: http://journals.sagepub.com/doi/10.1177/070674370505000611.

  24. Agerbo E. Psychiatric illness, socioeconomic status, and marital status in people committing suicide: a matched case-sibling-control study. J Epidemiol Community Heal [Internet] 2006 Sep 1;60(9):776–81. Available from: http://jech.bmj.com/cgi/doi/10.1136/jech.2005.042903.

  25. Qin P. Suicide risk in relation to level of urbanicity—a population-based linkage study. Int J Epidemiol [Internet] 2005 Aug 1;34(4):846–52. Available from: http://academic.oup.com/ije/article/34/4/846/692901/Suicide-risk-in-relation-to-level-of-urbanicitya.

  26. Judd F, Cooper A-M, Fraser C, Davis J. Rural suicide—people or place effects? Aust New Zeal J Psychiatry [Internet] 2006 Mar 26;40(3):208–16. Available from: http://journals.sagepub.com/doi/10.1080/j.1440-1614.2006.01776.x.

  27. Kaplan MS, Geling O. Firearm suicides and homicides in the United States: regional variations and patterns of gun ownership. Soc Sci Med [Internet] 1998 May;46(9):1227–33. Available from: https://linkinghub.elsevier.com/retrieve/pii/S027795369710051X.

  28. Grossman DC, Reay DT, Baker SA. Self-inflicted and Unintentional Firearm Injuries Among Children and Adolescents. Arch Pediatr Adolesc Med [Internet]. 1999 Aug 1;153(8):875. Available from: http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/archpedi.153.8.875.

  29. Baxley F, Miller M. Parental Misperceptions About Children and Firearms. Arch Pediatr Adolesc Med [Internet]. 2006 May 1;160(5):542. Available from: http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/archpedi.160.5.542.

  30. Son SE, Kirchner JT. Depression in children and adolescents. Am Fam Physician [Internet]. 2000 Nov 15;62(10):2297–308, 2311–2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11126856.

  31. Thapar A, Collishaw S, Pine DS, Thapar AK. Depression in adolescence. Lancet (London, England) [Internet]. 2012 Mar 17;379(9820):1056–67. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22305766.

  32. Galaif ER, Sussman S, Newcomb MD, Locke TF. Suicidality, depression, and alcohol use among adolescents: a review of empirical findings. Int J Adolesc Med Health [Internet]. 2007 Jan;19(1). Available from: http://www.degruyter.com/view/j/ijamh.2007.19.1/ijamh.2007.19.1.27/ijamh.2007.19.1.27.xml.

  33. Chabrol H, Chauchard E, Girabet J. Cannabis use and suicidal behaviours in high-school students. Addict Behav [Internet] 2008 Jan;33(1):152–5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0306460307001281.

  34. Falcone T, Mishra L, Carlton E, Lee C, Butler R, Janigro D, et al. Suicidal behavior in adolescents with first-episode psychosis. Clin Schizophr Relat Psychoses [Internet] 2010 Apr;4(1):34–40. Available from: http://clinicalschizophrenia.org/doi/abs/.10.3371/CSRP.4.1.2.

  35. Tarrier N, Khan S, Cater J, Picken A. The subjective consequences of suffering a first episode psychosis: trauma and suicide behaviour. Soc Psychiatry Psychiatr Epidemiol [Internet] 2007 Jan 2;42(1):29–35. Available from: http://link.springer.com/10.1007/s00127-006-0127-2.

  36. Septier M, Stordeur C, Zhang J, Delorme R, Cortese S. Association between suicidal spectrum behaviors and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Neurosci Biobehav Rev [Internet] 2019 Aug;103:109–18. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0149763418309412.

  37. Brent DA, Johnson BA, Perper J, Connolly J, Bridge J, Bartle S, et al. Personality disorder, personality traits, impulsive violence, and completed suicide in adolescents. J Am Acad Child Adolesc Psychiatry [Internet]. 1994 Oct;33(8):1080–6. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0890856709641125.

  38. Goodman M, Tomas IA, Temes CM, Fitzmaurice GM, Aguirre BA, Zanarini MC. Suicide attempts and self-injurious behaviours in adolescent and adult patients with borderline personality disorder. Personal Ment Health [Internet] 2017 Aug;11(3):157–63. Available from: http://doi.wiley.com/10.1002/pmh.1375.

  39. Hargus E, Hawton K, Rodham K. Distinguishing between subgroups of adolescents who self-harm. Suicide Life-Threatening Behav [Internet] 2009 Oct;39(5):518–37. Available from: http://www.atypon-link.com/GPI/doi/abs/10.1521/suli.2009.39.5.518.

  40. Cooper J, Kapur N, Webb R, Lawlor M, Guthrie E, Mackway-Jones K, et al. Suicide after deliberate self-harm: a 4-year cohort study. Am J Psychiatry [Internet] 2005 Feb;162(2):297–303. Available from: http://psychiatryonline.org/doi/abs/10.1176/appi.ajp.162.2.297.

  41. Amitai M, Apter A. Social aspects of suicidal behavior and prevention in early life: a review. Int J Environ Res Public Health [Internet] 2012 Mar 19;9(3):985–94. Available from: http://www.mdpi.com/1660-4601/9/3/985.

  42. Gordon M, Melvin G. Risk assessment and initial management of suicidal adolescents. Aust Fam Physician [Internet]. 2014 Jun [cited 2014 Aug 13];43(6):367–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24897985.

  43. Spirito A, Esposito-Smythers C. Attempted and completed Suicide in adolescence. Annu Rev Clin Psychol [Internet] 2006 Apr;2(1):237–66. Available from: http://www.annualreviews.org/doi/10.1146/annurev.clinpsy.2.022305.095323.

  44. Brent DA, Baugher M, Bridge J, Chen T, Chiappetta L. Age- and sex-related risk factors for adolescent suicide. J Am Acad Child Adolesc Psychiatry [Internet]. 1999 Dec;38(12):1497–505. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0890856709667137.

  45. Saner H, Ellickson P. Concurrent risk factors for adolescent violence. J Adolesc Heal [Internet]. 1996 Aug;19(2):94–103. Available from: https://linkinghub.elsevier.com/retrieve/pii/1054139X96001310.

  46. Merrick J, Kandel I, Omar HA. Adolescence, Violence, and Public Health. Front Public Heal [Internet]. 2013;1. Available from: http://journal.frontiersin.org/article/10.3389/fpubh.2013.00032/abstract.

  47. Wymbs B, Molina B, Pelham W, Cheong J, Gnagy E, Belendiuk K, et al. Risk of intimate partner violence among young adult males with childhood ADHD. J Atten Disord [Internet] 2012 Jul;16(5):373–83. Available from: http://journals.sagepub.com/doi/10.1177/1087054710389987.

  48. Duke NN, Pettingell SL, McMorris BJ, Borowsky IW. Adolescent violence perpetration: associations with multiple types of adverse childhood experiences. Pediatrics [Internet] 2010 Apr 1;125(4):e778–86. Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-0597.

  49. Duke N, Resnick MD, Borowsky IW. Adolescent firearm violence: position paper of the Society for Adolescent Medicine. J Adolesc Heal [Internet] 2005 Aug;37(2):171–4. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1054139X05002417.

  50. Meloy JR, Hempel AG, Mohandie K, Shiva AA, Gray BT. Offender and offense characteristics of a nonrandom sample of adolescent mass murderers. J Am Acad Child Adolesc Psychiatry [Internet]. 2001 Jun;40(6):719–28. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0890856709604779.

  51. Hong JS, Espelage DL. An introduction to the special issue: firearms homicide and perceptions of safety in American schools post-columbine. J Sch Violence [Internet] 2020 Jan 2;19(1):1–5. Available from: https://www.tandfonline.com/doi/full/10.1080/15388220.2019.1703721.

  52. Eskin M, Ertekin K, Dereboy C, Demirkiran F. Risk factors for and protective factors against adolescent suicidal behavior in Turkey. Crisis [Internet] 2007 May;28(3):131–9. Available from: https://econtent.hogrefe.com/doi/10.1027/0227-5910.28.3.131.

  53. Gould MS, Marrocco FA, Kleinman M, Thomas JG, Mostkoff K, Cote J, et al. Evaluating iatrogenic risk of youth suicide screening programs: a randomized controlled trial. JAMA [Internet]. 2005;293(13):1635–43. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15811983.

  54. Cox A, Holbrook D, Rutter M. Psychiatric Interviewing Techniques VI. Experimental Study: Eliciting Feelings. Br J Psychiatry [Internet]. 1981;139(2):144–52. Available from: https://www.cambridge.org/core/product/identifier/S0007125000133331/type/journal_article.

  55. Wissow LS, Roter DL, Wilson MEH. Pediatrician interview style and mothers’ disclosure of psychosocial issues. Pediatrics [Internet]. 1994;93(2):289–95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8121743.

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Bjorkman, C., Rice, T. (2021). Adolescent Suicidality and Homicidality: Who Is at Risk?. In: Dodson, N.A. (eds) Adolescent Gun Violence Prevention. Springer, Cham. https://doi.org/10.1007/978-3-030-84710-4_8

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