Clinical risk factors among youth at high risk for suicide in South Africa and Guyana.

INTRODUCTION: Suicide is the second leading cause of death among youth worldwide, but low- and middle-income countries (LMICs) account for 78% of all suicides. The LMICs South Africa and Guyana rank high in the global suicide rates. To better understand and prevent suicide among the youth, the present study targets youths at high risk for suicide, in an LMIC, to contextually and representatively identify clinical risk factors for suicide. METHODS: One hundred-ninety youths, aged 11-21, separated from biological parents at the time of assessment, in South Africa and Guyana, were administered the Child Behavior Checklist and Behavior Assessment System for Children to assess clinical symptoms. The youths were asked about current suicide ideation and previous attempt(s). Self-report responses to clinical items yielded scale scores for depression, social stress, atypicality, somatization, anxiety, and ADHD. Using an integrative data analytic technique, clinical scale scores were standardized and used to predict suicidal behaviors in a binary logistic regression analysis. RESULTS: Approximately 22% of Black South African youths and 60% of Guyanese youths endorsed suicide ideation and attempt or suicide attempt only. In fully adjusted analyses, the odds of atypicality and somatization were 1.96 and 1.67 times greater among the youths who endorsed suicidal ideation when compared with those who did not (p < .04). Youth social stress was significantly associated with the suicide attempt, controlling for model covariates (odds ratio [OR], 1.88, p = .05). Gender moderated the effect of somatization on youth suicide. CONCLUSION: Our results contextualize how social stress, atypicality, and somatization relate to LMIC youth suicide. Further study on high-risk samples will contribute to generalizable suicide-prevention models.

Cognitive abilities of African American children with prenatal cocaine/polydrug exposure.

The aim of this study was to investigate the effects of prenatal cocaine/polydrug exposure on cognitive abilities of school-aged children. The study examined differences in the performance of low income prenatal cocaine/polydrug-exposed and non-exposed African American children (n=49) between 6 and 8 years of age, on the Wechsler Intelligence Scale for Children-Third Edition. Twenty-five children had a history of prenatal cocaine/polydrug exposure and 24 had no known history. The groups were matched for age, sex, and socioeconomic status. Test scores determined if drug exposure predicted global intelligence score and if there were significant differences between the two groups in specific areas of cognitive ability assessed. Drug exposure predicted IQ scores, as drug-exposed children performed significantly lower than their non-exposed counterparts on global intelligence and verbal comprehension, but comparably on the freedom from distractibility tasks. On individual cognitive tasks, the performances of cocaine/polydrug-exposed and non-exposed children were comparable on 8 of the 11 tasks assessed. The findings call into question earlier predictions about cocaine-exposed children.

Mental health disorders in children of non-drug-abusing parents: a sample from a rural community devastated by methamphetamine.

A representative sample of 58 preschoolers (aged 4 and 5) and 78 school-age children (aged 8 and 9) from methamphetamine-producing (MP) and non-producing (NP) homes was drawn from a rural county in Tennessee, for two separate studies. The researchers assessed the psychological functioning of the children using age appropriate Behavior Assessment System for Children (BASC) forms, and compared the scores of children with NP status with population-based data. The results indicate that in this rural sample, the prevalence of internalizing and externalizing disorders in children from NP homes was higher than in population-based norms. Specifically, the preschoolers showed a higher rate of depression, and the school-age children had higher rates of anxiety, depression, and atypical behaviors than their population-based peers. The results are interpreted in terms of low SES and accessibility to mental health services in rural communities. The authors suggest nurse practitioners include brief psychological screenings in their assessment protocols for this population.

The methamphetamine home: psychological impact on preschoolers in rural Tennessee.

CONTEXT: A growing number of children reside with methamphetamine-abusing parents in homes where the illicit drug is produced. Yet, the effects of a methamphetamine environment on psychological child outcome are still unknown. PURPOSE: To examine whether preschoolers who lived in methamphetamine-producing homes are at increased risk for developing psychological problems. METHODS: The participants were 58 white children between the ages of 4 and 5 years; 31 with a history of living in methamphetamine-producing homes and 27 children who live in non-methamphetamine producing homes in rural Tennessee. The groups were similar in age, gender, and socioeconomic background. The groups were compared for behavioral and emotional adjustment using the behavior assessment system for children-parent rating scale-preschool (BASC-PRS-P) form. Biological or custodian parents completed a rating on their preschoolers that provided information about the children's pattern of behavior and feelings. FINDINGS: Preschoolers from the methamphetamine-producing homes showed more externalizing problems than their peers, but were comparable on internalizing problems. On specific behaviors, the data indicate that preschoolers in the methamphetamine group showed higher aggression symptoms than their peers from non-methamphetamine-producing homes. CONCLUSIONS: These findings, if replicated, point to the need for mental health screening when a child is removed from a methamphetamine-producing home.