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Dimensions of Adolescent Psychopathology and Relationships to Suicide Risk Indicators

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Abstract

Youth suicide represents an area of important public and mental health concern. Although diagnostic correlates (e.g., depression) of suicidality have been identified, very few studies of youth have analyzed relationships between empirically-derived dimensions of psychopathology, representing broader dimensions of risk, and different suicidality indicators. We recruited 223 adolescents (57% female; 32% ethnic minority) from mental health agencies and the community to assess psychopathology, substance use, and suicidality relying on multiple measures and reporters (youth, parent, and clinician). Using a 3-factor model of psychopathology, we found that the Internalizing factor (including depression and generalized anxiety) was associated with both suicidal thinking and behaviors (threats/attempts), the Externalizing factor (conduct, oppositional, and attention deficit disorders) was negatively related only to suicidal thinking, and the Substance Use factor (alcohol and cannabis use) related to suicidal behaviors of threats/attempts but not suicidal thinking. The results show the utility of a dimensional conceptualization for clarifying distinct vulnerabilities to suicidal thinking versus overt behaviors and have implications for the construct validity of distinct dimensions of psychopathology.

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Notes

  1. Our full sample of youth reported comparable rates of suicidality (i.e., between 20 and 30%) as those reported in other studies of community-based youth (e.g., about 20% suicidality was reported by Grunbaum et al. 2002). Further, our full sample had comparable diagnostic prevalence rates (e.g., on major depressive disorder, alcohol and drug use) as those reported in other studies with community-based samples of youth (e.g., about 10% met criteria for major depressive disorder; see Reinherz et al. 1993).

References

  • Achenbach, T. M. (1991). Manual for the child behavior checklist/4–18 and 1991 profile. Burlington, VT: Department of Psychiatry, University of Vermont.

    Google Scholar 

  • Achenbach, T. M., & Eldelbrock, C. S. (1984). Psychopathology of childhood. Annual Review of Psychology, 35, 227–256.

    Article  PubMed  Google Scholar 

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.

    Google Scholar 

  • Allen, J. P., Litten, R. Z., Fertig, J. B., & Babor, T. (1997). A review of research on the alcohol use disorders identification test (AUDIT). Alcoholism, Clinical and Experimental Research, 4, 613–619.

    Article  Google Scholar 

  • Ambrosini, P. (2000). Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). Journal of the American Academy of Child and Adolescent Psychiatry, 39, 49–58.

    Article  PubMed  Google Scholar 

  • Anderson, R. N. (2002). Deaths: leading causes for 2000. National Vital Statistics Reports 50, 16. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  • Andrews, J. A., & Lewinsohn, P. M. (1994). Suicidal attempts among older adolescents: Prevalence and co-occurrence with psychiatric disorders. Pediatrics, 93, A36.

    Google Scholar 

  • Apter, A., Gothelf, D., Orback, I., Weizman, R., Ratzoni, G., Har-Even, D., et al. (1995). Correlation of suicidal and violent behavior in different diagnostic categories in hospitalized adolescent patients. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 912–918.

    Article  Google Scholar 

  • Apter, A., Plutchik, R., & van Praag, H. M. (1993). Anxiety, impulsivity and depressed mood in relation to suicidal and violent behavior. Acta Psychiatrica Scandinavica, 87, 1–5.

    Article  PubMed  Google Scholar 

  • Askenazy, F. L., Sorci, K., Benoit, M., Lestideau, K., Myquel, M., & Lecrubier, Y. (2003). Anxiety and impulsivity levels identify relevant subtypes in adolescents with at-risk behavior. Journal of Affective Disorders, 74, 219–227.

    Article  PubMed  Google Scholar 

  • Brent, D. A., Baugher, M., Bridge, J., Tuhao, C., & Chiappetta, L. (1999). Age and sex related risk factors for adolescent suicide. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1497–1505.

    Article  PubMed  Google Scholar 

  • Brent, D. A., Bridge, J., Johnson, B. A., & Connolly, J. (1996). Suicidal behavior runs in families. A controlled family study of adolescent suicide victims. Archives of General Psychiatry, 53, 1145–1152.

    PubMed  Google Scholar 

  • Brent, D. A., & Mann, J. J. (2005). Family genetic studies, suicide, and suicidal behavior. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 133C, 13–24.

    Article  Google Scholar 

  • Bridge, J. A., Goldstein, T. R., & Brent, D. A. (2006). Adolescent suicide and suicidal behavior. Journal of Child Psychology and Psychiatry, 47, 372–394.

    Article  PubMed  Google Scholar 

  • Brown, G. K., Beck, A. T., Steer, R. A., & Grisham, J. R. (2000). Risk factors for suicide in psychiatric outpatients: A 20-year prospective study. Journal of Consulting and Clinical Psychology, 68, 371–377.

    Article  PubMed  Google Scholar 

  • Esposito, C. L., & Clum, G. A. (2003). The relative contribution of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation. Journal of Clinical Child & Adolescent Psychology, 32, 386–395.

    Article  Google Scholar 

  • Evans, E., Hawton, K., & Rodham, K. (2004). Factors associated with suicidal phenomena in adolescents: A systematic review of population-based studies. Clinical Psychology Review, 24, 957–979.

    Article  PubMed  Google Scholar 

  • Farmer, R. F., Seeley, J. R., Kosty, D. B., & Lewinsohn, P. M. (2009). Refinements in the hierarchical structure of externalizing psychiatric disorders: Patterns of lifetime liability from mid-adolescence through early adulthood. Journal of Abnormal Psychology, 118, 699–710.

    Google Scholar 

  • Felts, W. M., Chernier, T., & Barnes, R. (1992). Drug use and suicide ideation and behavior among North Caroline public school students. American Journal of Public Health, 82, 870–872.

    Article  PubMed  Google Scholar 

  • Garrison, C. Z., McKeown, R. E., Valois, R. F., & Vincent, M. L. (1993). Aggression, substance use, and suicidal behaviors in high school students. American Journal of Public Health, 83, 179–184.

    Article  PubMed  Google Scholar 

  • Gould, M. S., Greenberg, T., Velting, D. M., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 386–405.

    Article  PubMed  Google Scholar 

  • Gould, M. S., King, R., Greenwald, S., Fisher, P., Schwab-Stone, M., Kramer, R., et al. (1998). Psychopathology associated with suicidal ideation and attempts among children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 915–923.

    Article  PubMed  Google Scholar 

  • Grunbaum, J. A., Kann, L., Kinchen, S. A., Williams, B., Ross, J. G., Lowry, R., et al. (2002). Youth risk behavior surveillance—United States, 2001. Journal of School Health, 72, 313–328.

    Article  PubMed  Google Scholar 

  • Herba, C. M., Ferdinand, R. F., van der Ende, J., & Verhulst, F. C. (2007). Long-term assoiations of childhood suicide ideation. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1473–1481.

    Article  PubMed  Google Scholar 

  • Hills, A. L., Afifi, T. O., Cox, B. J., Bienvenu, O. J., & Sareen, J. (2009). Externalizing psychopathology and risk for suicide attempt: Cross-sectional and longitudinal findings from the Baltimore epidemiologic catchment area study. Journal of Nervous and Mental Disease, 197, 293–297.

    Article  PubMed  Google Scholar 

  • Hills, A. L., Cox, B. J., McWilliams, L. A., & Sareen, J. (2005). Suicide attempts and externalizing psychopathology in a nationally representative sample. Comprehensive Psychiatry, 46, 334–339.

    Article  PubMed  Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  • Jacobsen, C. M., & Gould, M. (2007). The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: A critical review of the literature. Archives of Suicide Research, 11, 129–147.

    Article  Google Scholar 

  • Javdani, S., Sadeh, N., & Verona, E. (in press). Suicidality as a function of impulsivity, callous/unemotional traits, and depressive symptoms in youth. Journal of Abnormal Psychology.

  • Kandel, D. B., Raveis, V. H., & Davies, M. (1991). Suicidal ideation in adolescence: Depression, substance use, and other risk factors. Journal of Youth and Adolescence, 20, 289–309.

    Article  Google Scholar 

  • Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of American Academy of Child and Adolescent Psychiatry, 36, 980–988.

    Article  Google Scholar 

  • Kendler, K. S., Prescott, C. A., Myers, J., & Neale, M. C. (2003). The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Archives of General Psychiatry, 60, 929–937.

    Article  PubMed  Google Scholar 

  • Kline, R. B. (1998). Principles and practice of structural equation modeling. New York: Guilford.

    Google Scholar 

  • Krueger, R. (1999). The structure of common mental disorders. Archives of General Psychiatry, 56, 921–926.

    Article  PubMed  Google Scholar 

  • Krueger, R. F., & Eaton, N. R. (2010). Personality traits and the classification of mental disorders: Toward a more complete integration in DSM–5 and an empirical model of psychopathology. Personality Disorders: Theory, Research, and Treatment, 1, 97–118.

  • Krueger, R. F., Hicks, B. M., Patrick, C. J., Carlson, S. R., Iacono, W. G., & McGue, M. (2002). Etiologic connections among substance dependence, antisocial behavior, and personality: Modeling the externalizing spectrum. Journal of Abnormal Psychology, 111, 411–424.

    Article  PubMed  Google Scholar 

  • Krueger, R. F., Markon, K. E., Patrick, C. J., & Iacono, W. G. (2005). Externalizing psychopathology in adulthood: A dimensional-spectrum conceptualization and its implications for DSM–V. Journal of Abnormal Psychology, 114, 537–550.

    Google Scholar 

  • Krueger, R. F., McGue, M., & Iacono, W. G. (2001). The higher-order structure of common DSM mental disorders: Internalization, externalization, and their connections to personality. Personality and Individual Differences, 30, 1245–1259.

    Article  Google Scholar 

  • Krueger, R. F., & Piasecki, T. M. (2002). Toward a dimensional and psychometrically-informed approach to conceptualizing psychopathology. Behavior Research and Therapy, 40, 485–499.

    Article  Google Scholar 

  • Lahey, B. B., Moffitt, T. E., & Caspi, A. (2004). Causes of conduct disorder and juvenile delinquency. New York: The Guilford Press.

    Google Scholar 

  • Latkovich, S. A. (1996). An empirical test of the construct validity of the Child Behavior Checklist. Paper presented at the Annual Meeting of the Mid-Western Educational Research Association. Chicago, IL.

  • Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1996). Adolescent suicidal ideation and attempts: Prevalence, risk factors, and clinical implications. Clinical Psychology: Science and Practice, 3, 25–46.

    Article  Google Scholar 

  • Linehan, M. M., Chiles, J. A., Egan, K. J., Devine, R. H., & Laffaw, J. A. (1986). Presenting problems of parasuicides versus suicide ideators and nonsuicidal psychiatric patients. Journal of Consulting and Clinical Psychology, 54, 880–881.

    Article  PubMed  Google Scholar 

  • Little, M., Weaver, S. R., King, K. M., Liu, F., & Chassin, L. (2008). Historical change in the link between adolescent deviance proneness and marijuana use, 1979–2004. Prevention Science, 9, 4–16.

    Article  PubMed  Google Scholar 

  • Marttunen, M. J., Aro, H. M., Henriksson, M., & Lonnqvist, J. K. (1993). Antisocial behavior in adolescent suicide. Acta Psychiatrica Scandinavica, 89, 167–173.

    Article  Google Scholar 

  • Moeller, F. G., Barratt, E. S., Dougherty, D. M., Schmitz, J. M., & Swann, A. C. (2001). Psychiatric aspects of impulsivity. American Journal of Psychiatry, 158, 1783–1793.

    Article  PubMed  Google Scholar 

  • Muthen, B. O. (1989). Multiple-group structural modeling with non-normal continuous variables. British Journal of Mathematical and Statistical Psychology, 42, 55–62.

    Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (2007). MPlus (version 5). Los Angeles: Muthen & Muthen.

    Google Scholar 

  • Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001). The suicidal behaviors questionnaire—Revised (SBQ-R): validation with clinical and nonclinical samples. Assessment, 8, 443–454.

    Article  PubMed  Google Scholar 

  • Patrick, C. J., Fowles, D. C., & Krueger, R. F. (2009). Triarchic conceptualization of psychopathology: Developmental origins of disinhibition, boldness, and meanness. Development and Psychopathology, 21, 913–938.

    Article  PubMed  Google Scholar 

  • Regier, D. A., Narrown, W. E., Kuhl, E. A., & Kupfer, D. J. (2009). The conceptual development of DSM-V. American Journal of Psychiatry, 166, 645–650.

    Article  PubMed  Google Scholar 

  • Reinherz, H. Z., Giaconia, R., Lefkowitz, E. S., Pakiz, B., & Frost, A. K. (1993). Prevalence of psychiatric disorders in a community population of older adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 32, 369–377.

    Article  Google Scholar 

  • Reinherz, H. Z., Giaconia, R. M., Silverman, A. B., Friedman, A., Bilge, P., Forst, A. K., et al. (1995). Early psychosocial risks for adolescent suicidal ideation and attempts. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 599–611.

    Article  PubMed  Google Scholar 

  • Ross, S., & Heath, N. (2002). A study of the frequency of self-mutilation in a community sample of adolescents. Journal of Youth and Adolescence, 31, 67–77.

    Article  Google Scholar 

  • Rowe, C. L., Liddle, H. A., & Dakof, G. A. (2001). Classifying clinically referred adolescent substance abusers by level of externalizing and internalizing symptoms. Journal of Child and Adolescent Substance Abuse, 11, 41–65.

    Article  Google Scholar 

  • Ruiz, M. A., & Edens, J. R. (2008). Recovery and replication of internalizing and externalizing dimensions within the personality assessment inventory. Journal of Personality Assessment, 90, 585–592.

    Article  PubMed  Google Scholar 

  • Sadeh, N., Verona, E., Javdani, S., & Olson, L. (2009). Examining psychopathic tendencies in adolescence from the perspective of personality theory. Aggressive Behavior, 35, 1–9.

    Article  Google Scholar 

  • Saunders, J. B., Aasland, O. G., Babor, T. F., de la Puente, J. R., & Grant, M. (1993). Development of the alcohol use disorders screening test (AUDIT). WHO collaborative project on early detection of persons with harmful alcohol consumption. II. Addiction, 88, 791–804.

    Article  PubMed  Google Scholar 

  • Shaffer, D. (1974). Suicide in childhood and early adolescence. Journal of Child Psychology, 15, 275–291.

    Article  Google Scholar 

  • Shaffer, D., Gould, M. S., Fisher, P., Trautman, P., Moreau, D., Kleinman, M., et al. (1996). Psychiatric diagnosis in child and adolescent suicide. Archives of General Psychiatry, 53, 339–348.

    PubMed  Google Scholar 

  • Silverman, M. M., Berman, A. L., Sanddal, N. D., O’Carroll, P. W., & Joiner, T. E. (2007). Rebuilding the tower of Babel: A revised nomenclature for the study of suicide and suicidal behaviors Part 2: Suicide-related ideations, communications, and behaviors. Suicide and Life Threatening Behavior, 37, 264–277.

    Article  PubMed  Google Scholar 

  • Velez, C. N., & Cohen, P. (1988). Suicidal behavior and ideation in a community sample of children: Maternal and youth reports. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 349–356.

    Article  PubMed  Google Scholar 

  • Verona, E., Javdani, S., & Sprague, J. (in press). Comparing factor structures of adolescent psychopathology. Psychological Assessment .

  • Verona, E., Hicks, B. M., & Patrick, C. J. (2005). Psychopathy and suicidality in female offenders: Mediating influences of personality and abuse. Journal of Consulting and Clinical Psychology, 73, 1065–1073.

    Article  PubMed  Google Scholar 

  • Verona, E., & Patrick, C. J. (2000). Suicide risk in externalizing syndromes: Temperamental and neurobiological underpinnings. In T. E. Joiner & D. Rudd (Eds.), Suicide science: Expanding the boundaries (pp. 137–173). Boston: Kluwer Academic Publishers.

    Google Scholar 

  • Verona, E., Patrick, C. J., & Joiner, T. E. (2001). Psychopathy, antisocial personality, and suicide risk. Journal of Abnormal Psychology, 110, 462–470.

    Google Scholar 

  • Verona, E., & Sachs-Ericsson, N. (2005). The intergenerational transmission of externalizing behaviors in adult participants: The mediating role of childhood abuse. Journal of Consulting and Clinical Psychology, 73, 1135–1145.

    Article  PubMed  Google Scholar 

  • Verona, E., Sachs-Ericsson, N., & Joiner, T. E. (2004). Suicide attempts associated with externalizing psychopathology in an epidemiological sample. American Journal of Psychiatry, 161, 444–451.

    Article  PubMed  Google Scholar 

  • Vierhaus, M., & Lohus, A. (2008). Children and parents as informants of emotional and behavioral problems predicting female and male adolescent risk behavior: A longitudinal cross-informant study. Journal of Youth and Adolescence, 37, 211–224.

    Article  Google Scholar 

  • Weissman, M. M., Wolk, S., Goldstein, R. B., Moreau, D., Adams, P., Greenwald, S., et al. (1999). Depressed adolescents grown up. Journal of the American Medical Association, 281, 1707–1713.

    Article  PubMed  Google Scholar 

  • Welch, S. S. (2001). A review of the literature on the epidemiology of parasuicide in the general population. Psychiatric Services, 52, 368–375.

    Article  PubMed  Google Scholar 

  • Wichstrom, L. (2000). Predictors of adolescent suicide attempts: A nationally representative longitudinal study of Norwegian adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 603–610.

    Article  PubMed  Google Scholar 

  • Wichstrom, L. (2009). Predictors of non-suicidal self-injury versus attempted suicide: Similar or different? Archives of Suicide Research, 13, 105–112.

    Article  PubMed  Google Scholar 

  • Wills, T. A., Vaccaro, D., & McNamara, G. (1994). Novelty seeking, risk taking, and related constructs as predictors of adolescent substance use: An application of Cloninger’s theory. Journal of Substance Abuse, 6, 1–20.

    Article  PubMed  Google Scholar 

  • Woodworth, M., & Porter, S. (2002). In cold blood: Characteristics of criminal homicides as a function of psychopathy. Journal of Abnormal Psychology, 111, 436–445.

    Article  PubMed  Google Scholar 

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Verona, E., Javdani, S. Dimensions of Adolescent Psychopathology and Relationships to Suicide Risk Indicators. J Youth Adolescence 40, 958–971 (2011). https://doi.org/10.1007/s10964-011-9630-1

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