Skip to main content
Log in

Suicidal Risk in Adolescent Residential Treatment: Being Female Is More Important Than a Depression Diagnosis

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

We investigated the relationship between gender and clinician diagnosis of a depressive disorder at intake on variables reflecting depression among adolescents in residential treatment. It was hypothesized that females diagnosed with a depressive disorder would have the highest scores on measures of suicide risk, the number of symptoms of a major depressive episode, suicidal behavior, and suicidal ideation. Results indicated partial support for the predicted comparisons. Females diagnosed with a depressive disorder scored significantly higher on measures of depressive symptom count and suicidal ideation. Surprisingly, females without a diagnosis of a depressive disorder had higher suicide risk scores than the remaining groups. The results of this study highlight the importance of assessment and treatment of internalizing disorders in youth entering residential programs, particularly female adolescents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Angold, A., & Rutter, M. (1992). Effects of age and pubertal status on depression in a large clinical sample. Development and Psychopathology, 4, 5–28. doi:10.1017/S0954579400005538.

    Article  Google Scholar 

  • Bongers, I. L., Koot, H. M., Ende, J., & Verhulst, F. C. (2003). The normative development of child and adolescent problem behavior. Journal of Abnormal Psychology, 112, 179–192. doi:10.1037/0021-843X.112.2.179.

    Article  PubMed  Google Scholar 

  • Brent, D. A. (2001). Assessment and treatment of the youthful suicidal patient. Annals of the New York Academy of Sciences, 932, 106–131. doi:10.1111/j.1749-6632.2001.tb05801.x.

    Article  PubMed  Google Scholar 

  • Burket, R. C., & Myers, W. C. (1995). Axis I and personality comorbidity in adolescents with conduct disorder. Bulletin of the American Academy of Psychiatry and the Law, 23, 73–82.

    PubMed  Google Scholar 

  • Chamberlain, P., & Reid, J. B. (1994). Differences in risk factors and adjustment for male and female delinquents in treatment foster care. Journal of Child and Family Studies, 3, 23–39. doi:10.1007/BF02233909.

    Article  Google Scholar 

  • Child Welfare League of America (2005). Quick facts about foster care. Retrieved November 13, 2010 from http://www.cwla.org/programs/fostercare/factsheet.htm.

  • Connor, D. F., Doerfler, L. A., Toscano, P. F., Jr., Volungis, A. M., & Steingard, R. J. (2004). Characteristics of children and adolescents admitted to a residential treatment center. Journal of Child and Family Studies, 13(4), 497–510. doi:10.1023/B:JCFS.0000044730.66750.57.

    Article  Google Scholar 

  • Cull, J. G., & Gill, W. S. (1988). Suicide probability scale. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Davis, J., & Daly, D. L. (2003). Girls and Boys Town long-term residential program: Training manual (4th ed.). Boys Town, NE: Father Flanagan’s Boys’ Home.

    Google Scholar 

  • Eme, R. F. (1992). Selective Female Affliction in the developmental disorders of childhood: A literature review. Journal of Clinical Child Psychology, 21(4), 354–364. doi:10.1207/s15374424jccp2104_5.

    Article  Google Scholar 

  • Fasulo, S. J., Cross, T. P., Mosley, P., & Leavey, J. (2002). Adolescent runaway behavior in specialized foster care. Child and Youth Services Review, 24(8), 623–640. doi:10.1016/S0190-7409(02)00211-6.

    Article  Google Scholar 

  • Friman, P. C., Handwerk, M. L., Smith, G. L., Larzelere, R. E., Lucas, C. P., & Shaffer, D. M. (2000). External validity of conduct and oppositional defiant disorders determined by the NIMH Diagnostic Interview Schedule for Children. Journal of Abnormal Child Psychology, 28, 277–286. doi:10.1023/A:1005148404980.

    Article  PubMed  Google Scholar 

  • Giordano, P. C., & Cernkovich, S. A. (1997). Gender and antisocial behavior. In D. M. Stoff, J. Breiling, & J. D. Maser (Eds.), Handbook of antisocial behavior (pp. 496–510). New York: Wiley.

    Google Scholar 

  • Goldston, D. B., Reboussin, B. A., & Daniel, S. S. (2006). Predictors of suicide attempts: State and trait components. Journal of Abnormal Psychology, 115(4), 842–849. doi:10.1037/0021-843X.115.4.842.

    Article  PubMed  Google Scholar 

  • Griffith, A. K., Trout, A. L., Chmelka, M. B., Farmer, E. M. Z., Epstein, M. H., Reid, R., et al. (2009). Youth departing from residential care: A gender comparison. Journal of Child Family Studies, 18, 31–38. doi:10.1007/s10826-008-9204-3.

    Article  Google Scholar 

  • Handwerk, M. L., Clopton, K., Huefner, J. C., Smith, G. L., & Hoff, K. E. (2006). Gender differences in adolescents in residential treatment. American Journal of Orthopsychiatry, 76(3), 312–324. doi:10.1037/0002-9432.76.3.312.

    Article  PubMed  Google Scholar 

  • Hartung, C. M., & Widiger, T. A. (1998). Gender differences in the diagnosis of mental disorders: Conclusions and controversies of DSM-IV. Psychological Bulletin, 123(3), 260–278. doi:10.1037//0033-2909.123.3.260.

    Article  PubMed  Google Scholar 

  • Hetrick, S., Vance., A., & Hall, N. (2008). In young people with a depressive disorder, does diagnostic specificity matter in the prediction of suicidality?. Australian e-Journal for the Advancement of Mental Health, 7(3), 1–7. Retrieved from www.auseinet.com/journal/vol7iss3/hetrick.pdf.

  • Hollis, C. (1996). Depression, family environment, and adolescent suicidal behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 35(5), 622–630. doi:10.1097/00004583-199605000-00017.

    Article  Google Scholar 

  • Hussey, D. L., & Guo, S. (2002). Profile characteristics and behavioral change trajectories of young residential children. Journal of Child and Family Studies, 11(4), 401–410. doi:10.1037/0002-9432.72.4.539.

    Article  Google Scholar 

  • Jewell, J., Handwerk, M., Almquist, J., & Lucas, C. (2004). Comparing the validity of clinician-generated diagnosis of conduct disorder to the diagnostic interview schedule for children. Journal of Clinical Child and Adolescent Psychology, 33(3), 536–546. doi:10.1207/s15374424jccp3303_11.

    Article  PubMed  Google Scholar 

  • Keenan, K., Loeber, R., & Green, S. (1999). Conduct disorder in girls: A review of the literature. Clinical Child and Family Psychology Review, 2(1), 3–19. doi:10.1023/A:1021811307364.

    Article  PubMed  Google Scholar 

  • Keenan, K., & Shaw, D. (1997). Developmental and social influences of young girls’ early problem behavior. Psychological Bulletin, 121(1), 95–113. doi:10.1037//0033-2909.121.1.95.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.

    Article  PubMed  Google Scholar 

  • Kroneman, L. M., Loeber, R., Hipwell, A. E., & Koot, H. M. (2009). Girls disruptive behavior and its relationship to family functioning: A review. Journal of Child Family Studies, 18(3), 259–273. doi:10.1007/s10826-008-9226-x.

    Article  Google Scholar 

  • Lahey, B. B., Schawb-Stone, M., Goodman, S. H., Waldman, I. D., Canino, G., Rathouz, P. J., et al. (2000). Age and gender differences in oppositional behavior and conduct problems: A cross-sectional household study of middle childhood and adolescence. Journal of Abnormal Psychology, 109(3), 488–503. doi:10.1037/0021-843X.109.3.488.

    Article  PubMed  Google Scholar 

  • Larzelere, R. E., Daly, D. L., Davis, J. L., Chmelka, M. B., & Handwerk, M. L. (2004). Outcome evaluation of the Girls and Boys Town Family Home Program. Education & Treatment of Children, 27, 130–149. doi:10.1097/00004583-199602000-00009.

    Google Scholar 

  • Larzelere, R. E., Smith, G. L., Batenhorst, L. M., & Kelly, D. B. (1996). Predictive validity of the Suicide Probability Scale among adolescents in group home treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 166–172.

    Article  PubMed  Google Scholar 

  • Loeber, R., & Keenan, K. (1994). Interaction between conduct disorder and its comorbid conditions: Effects of age and gender. Clinical Psychology Review, 14(6), 497–523. doi:10.1016/0272-7358(94)90015-9.

    Article  Google Scholar 

  • Loeber, R., & Stouthamer-Loeber, M. (1998). Development of juvenile aggression and violence: Some common misconceptions and controversies. American Psychologist, 53(2), 242–259. doi:10.1037//0003-066X.53.2.242.

    Article  PubMed  Google Scholar 

  • Maughan, B., Pickles, A., Rowe, R., Costello, E., & Angold, A. (2000). Developmental trajectories of aggressive and non-aggressive conduct problems. Journal of Quantitative Criminology, 16, 199–221. doi:10.1023/A:1007516622688.

    Article  Google Scholar 

  • McCabe, K. M., Lansing, A. E., Garland, A., & Hough, R. (2002). Gender differences in psychopathology, functional impairment, and familial risk factors among adjudicated delinquents. Journal of American Academy of Child Adolescent Psychiatry, 41(7), 860–867. doi:10.1097/00004583-200207000-00020.

    Article  Google Scholar 

  • McWhirter, J. J., McWhirter, B. T., McWhirter, E. H., & McWhirter, R. J. (2004). Youth suicide. In At-risk youth: A comprehensive response for counselors, teachers, psychologists, and human services professionals (pp. 195–217). Belmont, CA: Brooks/Cole–Thomson Learning.

  • Morash, M., Bynum, T. S., & Koons, B. A. (1998). Women offenders: Programming needs and promising approaches. Washington, DC: USDOJ, National Institute of Justice.

    Google Scholar 

  • Nrugham, L., Larsson, B., & Sund, A. M. (2008). Specific depressive symptoms and disorders as associates and predictors of suicidal acts across adolescence. Journal of Affective Disorders, 111, 83–93. doi:10.1016/j.jad.2008.02.010.

    Article  PubMed  Google Scholar 

  • Offord, D. R., Boyle, M. C., & Racine, Y. A. (1991). The epidemiology of antisocial behavior in childhood and adolescence. In D. J. Pepler & K. H. Rubin (Eds.), The development and treatment of childhood aggression (pp. 31–54). Hillsdale, NJ: Lawrence Earlbaum Associates.

    Google Scholar 

  • Offord, D. R., Boyle, M. H., Szatmari, P., Rae-Grant, N. I., Links, P. S., Cadman, D. T., et al. (1987). Ontario child health study: II. Six-month prevalence of disorder and rates of service utilization. Archives of General Psychiatry, 44, 832–836.

    Article  PubMed  Google Scholar 

  • Piccinelli, M., & Wilkinson, G. (2000). Gender differences in depression. Critical review. British Journal of Psychiatry, 177, 486–492. doi:10.1192/bjp.177.6.486.

    Article  PubMed  Google Scholar 

  • Putallaz, M., & Bierman, K. L. (Eds.). (2004). Aggression, antisocial behavior, and violence among girls: A developmental perspective. New York: Guilford Press.

    Google Scholar 

  • Ransom, G., Schneider, J., & Robinson-Sanford, K. P. (1996). Drug dependent women in boot camp programs: Practical considerations. Alcoholism Treatment Quarterly, 14, 79–87. doi:10.1300/J020V14N02_07.

    Article  Google Scholar 

  • Rutter, M., Caspi, A., & Moffitt, T. E. (2003). Using sex differences in psychopathology to study causal mechanisms: Unifying issues and research strategies. Journal of Child Psychology and Psychiatry, 44(8), 1092–1115. doi:10.1111/1469-7610.00194.

    Article  PubMed  Google Scholar 

  • Schwab-Stone, M. E., Shaffer, D., Dulcan, M. K., Jensen, P. S., Fisher, P., Bird, H. R., et al. (1996). Criterion validity of the NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3). Journal of the American Academy of Child and Adolescent Psychiatry, 35, 878–888.

    Article  PubMed  Google Scholar 

  • Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 28–38. doi:10.1097/00004583-200001000-00014

    Article  Google Scholar 

  • Shaffer, D., Schwab-Stone, M., Fisher, P., Cohen, P., Piacentini, J., Davies, M., et al. (1993). The diagnostic interview schedule for children-revised version (DISC-R): I. Preparation, field testing, interrater reliability, and acceptability. Journal of the American Academy of Child & Adolescent Psychiatry, 32, 643–650. doi:10.1097/00004583-199305000-00023.

    Article  Google Scholar 

  • Smith, D. K., Stormshak, E., Chamberlain, P., & Whaley, R. B. (2001). Placement disruption in treatment foster care. Journal of emotional and behavioral disorders, 9(3), 200–205. doi:10.1177/106342660100900306.

    Article  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). Boston, Massachusetts: Allyn & Bacon.

    Google Scholar 

  • Wasserman, G. A., McReynolds, L. S., Ko, S. J., Katz, L. M., & Carpenter, J. R. (2005). Gender differences in psychiatric disorders at juvenile probation intake. American Journal of Public Health, 95, 131–137. doi:10.2105/AJPH.2003.024737.

    Article  PubMed  Google Scholar 

  • Weis, R., Whitemarsh, S. M., & Wilson, N. L. (2005). Military-style residential treatment for disruptive adolescents: Effective for some girls, all girls, when, and why? Psychological Services, 2(2), 105–122. doi:10.1037/1541-1559.2.2.105.

    Article  Google Scholar 

  • Wiesner, M., & Kim, H. K. (2006). Co-occuring delinquency and depressive symptoms and adolescent boys and girls: A dual trajectory modeling approach. Developmental Psychology, 42(6), 1220–1235. doi:10.1037/0012-1649.42.6.1220.

    Article  PubMed  Google Scholar 

  • Wolf, M. M., Phillips, E. L., Fixsen, D. L., Braukmann, C. J., Kirigin, K. A., Willner, A. G., et al. (1976). Achievement place: The teaching-family model. Child Care Quarterly, 5, 92–103.

    Article  Google Scholar 

  • Zahn-Waxler, C., Shirtcliff, E. A., & Marceau, K. (2008). Disorders of childhood and adolescence: Gender and psychopathology. Annual Review of Clinical Psychology, 4, 275–303. doi:10.1146/annurev.clinpsy.3.022806.091358.

    Article  PubMed  Google Scholar 

  • Zwirs, B. W. C., Burger, H., Schulpen, T. W. J., Wiznitzer, M., Fedder, H., & Buitelaar, J. K. (2007). Prevalence of psychiatric disorders among children of different ethnic origin. Journal of Abnormal Child Psychology, 35, 556–566. doi:10.1007/s10802-007-9112-9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Danice L. Brown.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brown, D.L., Jewell, J.D., Stevens, A.L. et al. Suicidal Risk in Adolescent Residential Treatment: Being Female Is More Important Than a Depression Diagnosis. J Child Fam Stud 21, 359–367 (2012). https://doi.org/10.1007/s10826-011-9485-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-011-9485-9

Keywords

Navigation