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9 - Assessing suicidal behavior in children and adolescents

Published online by Cambridge University Press:  04 December 2009

By
Cynthia R. Pfeffer
Edited by
Robert A. King  and
Alan Apter
Cynthia R. Pfeffer
Affiliation:
Professor of Psychiatry, Director of the Childhood Bereavement Program, Weill Medical College of Cornell University, New York Presbyterian Hospital, 21 Bloomingdale Road, White Plains, NY 10605 USA e-mail: [email protected]
Robert A. King
Affiliation:
Yale University, Connecticut
Alan Apter
Affiliation:
Tel-Aviv University
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Summary

The assessment of suicidal behavior in children and adolescents presents several unique clinical issues, specifically related to developmental factors that make such assessment a dynamic task of arriving at a clinical judgment of how likely it is that a child or adolescent will behave in a suicidal manner. Extensive research of the epidemiology, clinical characteristics, and longitudinal course of suicidal behavior suggests that suicidal behavior occurs throughout the human life span with similarities that make it a clinical necessity to evaluate all individuals who come for medical or psychiatric attention for their level of suicidal risk. The importance of evaluating children and adolescents for suicidal behavior is supported by recent U.S. national epidemiological statistics indicating that in the last two decades the rates of suicide among children and young adolescents, age 5–14 years, have doubled and the rates of suicide among adolescents and young adults, age 15–24 years, are among the highest rates of all ages and they continue to increase (Singh et al., 1996). This chapter will discuss a systematic approach based on an understanding of developmental issues that are important for evaluating children and adolescents for suicidal behavior. It will focus also on evaluating the major issues that are associated with risk for such behavior (American Academy of Child and Adolescent Psychiatry, 2001; see also Pfeffer, 2001).

The concept of suicidal behavior

Conceptualization of what constitutes suicidal behavior among children and adolescents is best considered within a schema of developmental psychopathology.

Keywords

adolescentschildrenclinical assessmentcognitive capacitysuicidal behaviorlethality
Type
Chapter
Information
Suicide in Children and Adolescents , pp. 211 - 226
Publisher: Cambridge University Press
Print publication year: 2003

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References

American Academy of Child and Adolescent Psychiatry (2001). Practice parameter for the assessment and treatment of children and adolescents with suicidal behavior. Journal of the American Academy of Child and Adolescent Psychiatry, 40 [Suppl. 7]:24S–51S
Angold, A., Weissman, M. M., John, K. et al. (1987). Parent and child reports of depressive symptoms in children at low and high risk of depression. Journal of Child Psychology and Psychiatry, 28, 901–915Google Scholar
Apter, A., Bleich, A., Plutchik, R., Mendelsohn, S., and Tyano, S. (1988). Suicidal behavior, depression, and conduct disorder in hospitalized adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 696–699Google Scholar
Beck, A. T., Schuyler, D., and Herman, I. (1974). Development of suicidal intent scales. In Beck, A. T., Resnik, H. L. P., Lettieri, D. J. (eds.) The Prediction of Suicide (pp. 45–56) Bowie, MD: Charles Press
Beck, A. T., Kovacs, M., and Weissman, A. (1979). Assessment of suicide intention: the Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47, 343–352Google Scholar
Brent, D. A., Perper, J. A., Allman, C. J., (1987). Alcohol, firearms, and suicide among youth: temporal trends in Allegheny County, Pennsylvania, 1960–1983. Journal of the American Medical Association, 257, 3369–3373Google Scholar
Brent, D. A., Perper, J. A., Goldstein, C. E., et al. (1988). Risk factors for adolescent suicide: a Comparison of adolescent suicide victims with suicidal inpatients. Archives of General Psychiatry, 45, 581–588Google Scholar
Cicchetti, D., and Cohen, D. J. (1995). Perspectives on developmental psychopathology. In Cicchetti, D., Cohen, D. J. (eds.) Developmental Psychopathology. New York City, NY: Wiley & Sons, Inc.
Coccaro, E. F., Siever, L. J., Klar, H. M., et al. (1989). Serotonergic studies in patients with affective and personality disorders: correlates with suicidal and impulsive aggressive behavior. Archives of General Psychiatry, 46, 587–599Google Scholar
Forgas, J. P., Burnham, D. K., and Trimboli, C. (1988). Mood, memory, and social judgments in children. Journal of Personality and Social Psychology, 54, 697–703Google Scholar
Freud, A. (1963). The concept of developmental lines. Psychoanalytic Study of the Child, 18, 245–265Google Scholar
Goldston, D. B. (2000). Assessment of suicidal behaviors and risk among children and adolescents. Technical report submitted to NIMH under contract 263-MD-909995; http://www.nimh.nih.gov/research/measures.pdf [accessed September 24, 2000]
Gothelf, D., Apter, A., Brand-Gothelf, A., Offer, N., Ofek, H., Tyano, S., and Pfeffer, C. R. (1998). Death concepts in suicidal adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 37(12), 1279–1286Google Scholar
Gregory, R. L. (1987). The Oxford Companion To The Mind. Oxford, England: Oxford University Press
Jacobsen, L. K., Rabinowitz, I., Popper, M., Solomon, R. J., Sokol, M. S., and Pfeffer, C. R., (1994). Interviewing prepubertal children about suicidal ideation and behavior. Journal of the American Academy of Child and Adolescent Psychiatry, 4, 439–452Google Scholar
Kazdin, A. E., French, N. H., Unis, A. S., and Esveldt-Dawson, K. (1983). Assessment of childhood depression: correspondence of child and parent ratings. Journal of the American Academy of Child Psychiatry, 22, 157–164Google Scholar
Peller, L. E., (1954). Libidinal phases, ego development and play. Psychoanalytic Study of the Child, 9, 179–198Google Scholar
Pfeffer, C. R. (1986). The Suicidal Child. New York City, NY: Guilford Press
Pfeffer, C. R. (ed.) (1989). Suicide Among Youth: Perspectives on Risk and Prevention. Washington, D.C.: American Psychiatric Press, Inc.
Pfeffer, C. R. (2001). Diagnosis of childhood and adolescent suicidal behavior: unmet needs for suicide prevention. Biological Psychiatry, 49(12), 1055–1061Google Scholar
Pfeffer, C. R. (2002). Suicidal behavior in children and adolescents: causes and management. In Lewis, M. (ed.) Child and Adolescent Psychiatry: A Comprehensive Textbook (3rd edn.) (pp. 796–805)
Pfeffer, C. R., and Richman, J. (1991). Human figure drawings: an auxiliary diagnostic assessment of childhood suicidal potential. Comprehensive Mental Health Care, 1, 77–90Google Scholar
Pfeffer, C. R., Plutchik, R., and Mizruchi, M. S., (1983). Suicidal and assaultive behavior in children: classification, measurement, and interrelations. American Journal of Psychiatry, 140, 154–157Google Scholar
Pfeffer, C. R., Newcorn, J., Kaplan, G., Mizruchi, M. S., and Plutchik, R. (1989). Subtypes of suicidal and assaultive behaviors in adolescent psychiatric inpatients: a research note. Journal of Child Psychology and Psychiatry, 30, 151–163Google Scholar
Pfeffer, C. R., Klerman, G. L., Hurt, S. W., Kakuma, T., Peskin, J. R., and Siefker, C. A. (1993). Suicidal children grow up: rates and psychosocial risk factors for suicide attempts during follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 106–113Google Scholar
Pfeffer, C. R., Normandin, L., and Kakuma, T. (1994). Suicidal children grow up: suicidal behavior and psychiatric disorders among relatives. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 1087–1097Google Scholar
Pfeffer, C. R., Hurt, S. W., Peskin, J. R., and Siefker, C. A. (1995). Suicidal children grow up: ego functions associated with suicide attempts. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1318–1325Google Scholar
Pfeffer, C. R., Jiang, H., and Kakuma, T. (2000). Child-Adolescent Suicidal Potential Index (CASPI): a screen for risk for early onset suicidal behavior. Psychological Assessment, 12(3), 304–318Google Scholar
Piaget, J. (1952). The Origins of Intelligence in Children. New York City, NY: International Universities Press
Prinstein, M. J., Nock, M. K., Spirito, A., and Grapentine, W. L. (2001). Multimethod assessment of suicidality in adolescent psychiatric inpatients: preliminary results. Journal of the American Academy of Child and Adolescent Psychiatry, 40(9), 1053–1061Google Scholar
Reich, W., Herjanic, B., Welner, Z., and Gandhy, P. R., (1982). Development of a structured psychiatric interview for children: agreement on diagnosis comparing child and parent interviews. Journal of Abnormal Child Psychology, 10, 325–336Google Scholar
Rich, C. L., Young, D., and Fowler, R. C., (1988). San Diego Suicide Study. I: Young versus old subjects. Archives of General Psychiatry, 43, 577–582Google Scholar
Ricklitis, C. J., Noam, G. G., and Borst, S. R., (1992). Adolescent suicide and defensive style. Suicide and Life-Threatening Behavior, 22, 374–387Google Scholar
Singh, G. K., Kochanek, K. E., and MacDorman, M. F. (1996). Advanced Report of Final Mortality Statistics, 1994. Monthly Vital Statistics Report; vol. 45, no. 3, suppl. Hyattsville, MD: National Center For Health Statistics
Waelder, R. (1933). The psychoanalytic theory of play. Psychoanalytic Quarterly, 2, 208–224Google Scholar
Weissman, M. M., Wickramaratne, P., Warner, V., et al. (1987). Assessing psychiatric disorders in children: discrepancies between mother's and children's reports. Archives of General Psychiatry, 44, 747–753Google Scholar
Winnicott, D. W. (1971). Playing and Reality. New York City, NY: Basic Books
Zalsman, G., Netanel, R., Fischel, T., Freudenstein, O., Landau, E., Orbach, I., Weizman, A., Pfeffer, C. R., and Apter, A. (2000). Human figure drawings in the evaluation of severe adolescent suicidal behavior. Journal of the American Academy of Child and Adolescent Psychiatry, 39(8), 1024–1031Google Scholar

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