Using Behavioral Measures to Assess Suicide Risk in the Psychiatric Emergency Department for Youth | mijn-bsl Skip to main content
Top

Tip

Swipe om te navigeren naar een ander artikel

23-02-2023 | Original Article

Using Behavioral Measures to Assess Suicide Risk in the Psychiatric Emergency Department for Youth

Auteurs: Ki Eun Shin, Argelinda Baroni, Ruth S. Gerson, Kerri-Anne Bell, Olivia H. Pollak, Katherine Tezanos, Anthony Spirito, Christine B. Cha

Gepubliceerd in: Child Psychiatry & Human Development

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Suicide screening is critical in pediatric emergency departments (EDs). Behavioral measures of suicide risk may complement self-report measures. The current study examines suicide-specific behavioral measures and tests their potential short-term within-person effects among respondents, ability to discriminate future suicide attempt from suicidal ideation, and translation into interpretable categorical composite scores. The sample included 167 youth (10–17 years), presenting for suicide-related reasons to a pediatric psychiatric ED. During their ED visit, participants completed the Death/Life Implicit Association Test (IAT) and the Suicide Stroop Task. Recurrent suicidal thoughts and attempts were assessed within 6 months of the ED visit via medical records and email surveys. Youth displayed a decrease in the levels of distress and self-injurious desires (negative mood, desire to hurt themselves, and desire to die) after completing the behavioral tasks. The Death/Life IAT prospectively differentiated with 68% accuracy between youth who attempted suicide after their ED visit and those who had suicidal ideation but no attempt, p = 0.04, OR = 5.65, although this effect became marginally significant after controlling for self-report and demographic covariates. Neither the Suicide Stroop Task, nor the categorical composite scores predicted suicide attempts, ps = 0.08–0.87, ORs = 0.96–3.95. Behavioral measures of suicide risk administered in the ED do not appear to increase distress or self-injurious desires. They may be able to distinguish those who go on to attempt suicide (vs. consider suicide) within six months after discharge.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Voetnoten
1
Because several demographic and self-report covariates predicted the 6-month outcomes at the level of p < .10, we ran supplemental analyses while including a broader range of covariates (age, gender, sexual orientation, HSC total score, lifetime suicide attempt presence, autism spectrum disorder diagnosis, and patient prediction of a future suicide attempt). The distinction between the suicide attempt group and the suicidal ideation-only group stayed marginally significant, p = .06, aOR = 6.64, 95% CI [0.94, 46.68]. Covariates did not have significant effects, ps = .08-.99. Relative to the univariate model, adding the demographic and self-report measure covariates did not significantly improve prediction accuracy, AUC = .74, 95% CI = [.62, .86].
 
Literatuur
6.
go back to reference Chun TH, Mace SE, Katz ER, American Academy of Pediatrics, Committee on Pediatric Emergency Medicine, American College of Emergency Physicians, & Pediatric Emergency Medicine Committee (2016) Executive summary: evaluation and management of children and adolescents with acute mental health or behavioral problems part I: common clinical challenges of patients with mental health and/or behavioral emergencies. Pediatrics 138(3):e20161570. https://​doi.​org/​10.​1542/​peds.​2016-1570 CrossRefPubMed Chun TH, Mace SE, Katz ER, American Academy of Pediatrics, Committee on Pediatric Emergency Medicine, American College of Emergency Physicians, & Pediatric Emergency Medicine Committee (2016) Executive summary: evaluation and management of children and adolescents with acute mental health or behavioral problems part I: common clinical challenges of patients with mental health and/or behavioral emergencies. Pediatrics 138(3):e20161570. https://​doi.​org/​10.​1542/​peds.​2016-1570 CrossRefPubMed
10.
go back to reference The Joint Commission (2019) National patient safety goal for suicide prevention (R3 Report: Requirement, Rationale, Reference, Issue 18) The Joint Commission (2019) National patient safety goal for suicide prevention (R3 Report: Requirement, Rationale, Reference, Issue 18)
11.
go back to reference National Action Alliance for Suicide Prevention: Research Prioritization Task Force (2014) A prioritized research agenda for suicide prevention: An action plan to save lives. Rockville, MD: National Institute of Mental Health and the Research Prioritization Task Force National Action Alliance for Suicide Prevention: Research Prioritization Task Force (2014) A prioritized research agenda for suicide prevention: An action plan to save lives. Rockville, MD: National Institute of Mental Health and the Research Prioritization Task Force
15.
go back to reference King CA, Brent D, Grupp-Phelan J, Casper TC, Dean JM, Chernick LS, Fein JA, Mahabee-Gittens EM, Patel SJ, Mistry RD, Duffy S, Melzer-Lange M, Rogers A, Cohen DM, Keller A, Shenoi R, Hickey RW, Rea M, Cwik M, Page K, McGuire TC, Wang J, Gibbons R, Network PECAR (2021) Prospective development and validation of the computerized adaptive screen for suicidal youth. JAMA Psychiat 78(5):540–549. https://​doi.​org/​10.​1001/​jamapsychiatry.​2020.​4576 CrossRef King CA, Brent D, Grupp-Phelan J, Casper TC, Dean JM, Chernick LS, Fein JA, Mahabee-Gittens EM, Patel SJ, Mistry RD, Duffy S, Melzer-Lange M, Rogers A, Cohen DM, Keller A, Shenoi R, Hickey RW, Rea M, Cwik M, Page K, McGuire TC, Wang J, Gibbons R, Network PECAR (2021) Prospective development and validation of the computerized adaptive screen for suicidal youth. JAMA Psychiat 78(5):540–549. https://​doi.​org/​10.​1001/​jamapsychiatry.​2020.​4576 CrossRef
24.
go back to reference Stewart JG, Glenn CR, Esposito EC, Cha CB, Nock MK, Auerbach RP (2017) Cognitive control deficits differentiate adolescent suicide ideators from attempters. J Clin Psychiatry 78(6):614–621 CrossRef Stewart JG, Glenn CR, Esposito EC, Cha CB, Nock MK, Auerbach RP (2017) Cognitive control deficits differentiate adolescent suicide ideators from attempters. J Clin Psychiatry 78(6):614–621 CrossRef
36.
go back to reference Balis T, Postolache TT (2008) Ethnic differences in adolescent suicide in the United States. Int J Child Health Hum Dev 1(3):281–296 PubMedPubMedCentral Balis T, Postolache TT (2008) Ethnic differences in adolescent suicide in the United States. Int J Child Health Hum Dev 1(3):281–296 PubMedPubMedCentral
44.
go back to reference van Buuren S, Groothuis-Oudshoorn CGM (2011) mice: multivariate imputation by chained equations in R. J Stat Softw 45(3):1–67 CrossRef van Buuren S, Groothuis-Oudshoorn CGM (2011) mice: multivariate imputation by chained equations in R. J Stat Softw 45(3):1–67 CrossRef
45.
go back to reference Rubin DB (2004) Multiple imputation for nonresponse in surveys (Vol. 81). John Wiley & Sons, Hoboken Rubin DB (2004) Multiple imputation for nonresponse in surveys (Vol. 81). John Wiley & Sons, Hoboken
47.
go back to reference Greenfield B, Henry M, Weiss M, Tse SM, Guile JM, Dougherty G, Zhang X, Fombonne E, Lis E, Lapalme-Remis S, Harnden B (2008) Previously suicidal adolescents: predictors of six-month outcome. J Can Acad Child Adolesc Psychiatry 17(4):197–201 PubMedPubMedCentral Greenfield B, Henry M, Weiss M, Tse SM, Guile JM, Dougherty G, Zhang X, Fombonne E, Lis E, Lapalme-Remis S, Harnden B (2008) Previously suicidal adolescents: predictors of six-month outcome. J Can Acad Child Adolesc Psychiatry 17(4):197–201 PubMedPubMedCentral
Metagegevens
Titel
Using Behavioral Measures to Assess Suicide Risk in the Psychiatric Emergency Department for Youth
Auteurs
Ki Eun Shin
Argelinda Baroni
Ruth S. Gerson
Kerri-Anne Bell
Olivia H. Pollak
Katherine Tezanos
Anthony Spirito
Christine B. Cha
Publicatiedatum
23-02-2023
Uitgeverij
Springer US
Gepubliceerd in
Child Psychiatry & Human Development
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI
https://doi.org/10.1007/s10578-023-01507-y