Suicide Risk, Self-Injury, and Sleep: An Exploration of the Associations in a Sample of Juvenile Justice Involved Adolescents.

Court-involved youth living in the community represent a vulnerable, yet understudied, group that is at risk for a variety of concerning outcomes including increased suicidal ideation, suicide attempts, and non-suicidal self-injury (NSSI). Additionally, sleep disruption, which has been associated with an increase in impulsive decision making, appears to be disproportionately high in this population. However, little is known about any connection between poor sleep and increased suicide risk and NSSI in a group of youth. This study explores the associations between sleep disruption, suicidal ideation, suicide attempts, and NSSI in a sample of court-involved youth in the community referred for mental health evaluation at a court based mental health clinic. Findings suggest that sleep disruption is related to NSSI in this population but not suicidal ideation and suicide attempts. Additional relationships were found between NSSI and being female, as well as having a lifetime history of trauma and marijuana use. Findings suggest that court clinics may wish to screen for sleep disruption as a risk factor for NSSI, and future studies may wish to explore improved sleep as a protective factor for CINI youth.

Screening and Brief Intervention for Psychiatric and Suicide Risk in the Juvenile Justice System: Findings from an Open Trial.

Court-involved non-incarcerated (CINI) youth endorse higher rates of lifetime suicide ideation (SI) and attempts than youth in the community. Brief intervention programs to address SI and related psychiatric symptoms upon entry into the juvenile justice system are rare. The current study reports the results of a pilot trial on a brief, coping intervention for CINI youth. Fifteen CINI youth (and caregivers) were eligible for participation based on youth report of SI or endorsing symptoms on a mental health screening tool. Youth completed a Coping Plan intervention with a master's-level counselor and received a 1-week follow-up call. Follow-up assessments were conducted at 1 and 3-months post-intervention. Participants were also interviewed about intervention acceptability. About half of the sample screened into the study based on SI and half screened in based on psychiatric symptoms on the Anxious/Depressed and Angry/Irritable subscales of the MAYSI-2. A reduction in SI and psychiatric symptoms was observed at 3-months post-intervention. Youth and caregivers reported the brief coping intervention was useful. This study highlights that intervening with youth with SI and psychiatric symptoms upon entry into the juvenile justice system can be successfully conducted with a population who historically has difficulty accessing mental health resources.

Suicidal thoughts and behaviors in psychiatrically hospitalized adolescents pre- and post- COVID-19: A historical chart review and examination of contextual correlates.

BACKGROUND: Psychiatrically vulnerable adolescents may be at heightened risk for suicide during the COVID-19 pandemic. This study characterizes suicidal ideation (SI) and suicide attempts (SA) in a sample of adolescents psychiatrically hospitalized during COVID-19. Rates of SI and SA are compared to a historical hospital sample from a matched period in the year prior. Associations between specific stressors and COVID-related SI are also explored. METHODS: This cross-sectional chart review utilizes hospital intake data, including self-reports of SA, SI (general and COVID-related), and COVID-specific stressors. RESULTS: SA and SI ratings were higher in the COVID-19 sample compared to the historical sample. Stressors related to missing special events, financial problems, in-home conflict, and changes in living circumstances were associated with COVID-related SI. Among first-time admissions, several interpersonal stressors were linked to COVID-related SI. LIMITATIONS: Analyses were cross-sectional, limiting our ability to draw conclusions about causality. CONCLUSIONS: This study offers preliminary evidence that COVID-19 may be contributing to suicidal thoughts and behaviors in high-risk adolescents.

Associations Between Psychiatric Impairment and Sexual Risk Behavior Among Teens in Mental Health Treatment.

AIMS: To assess the associations of sexual risk behavior with psychiatric impairment and individual, peer, and partner attitudes among adolescents receiving mental health treatment. METHODS: Adolescents (N=893, 56% female, 67% African American) completed assessments of psychiatric impairment, rejection sensitivity, peer norms, HIV knowledge, perceived vulnerability, self-efficacy and condom use intentions. Two structural equation models were used to test the study hypotheses; one for sexually active youth and one for non-active youth. RESULTS: For non-active youth, psychiatric impairment influenced self-efficacy and condom use intentions via peer norms, rejection sensitivity, and perceived vulnerability. Among the sexually active youth, sexual risk was related to impairment and previous condom use. DISCUSSION: These results suggest that individual, peer, and partner factors are related to impairment and to sexual risk attitudes, but depend on previous sexual experience.

Reliability and Validity of the Dyadic Observed Communication Scale (DOCS).

We evaluated the reliability and validity of the Dyadic Observed Communication Scale (DOCS) coding scheme, which was developed to capture a range of communication components between parents and adolescents. Adolescents and their caregivers were recruited from mental health facilities for participation in a large, multi-site family-based HIV prevention intervention study. Seventy-one dyads were randomly selected from the larger study sample and coded using the DOCS at baseline. Preliminary validity and reliability of the DOCS was examined using various methods, such as comparing results to self-report measures and examining interrater reliability. Results suggest that the DOCS is a reliable and valid measure of observed communication among parent-adolescent dyads that captures both verbal and nonverbal communication behaviors that are typical intervention targets. The DOCS is a viable coding scheme for use by researchers and clinicians examining parent-adolescent communication. Coders can be trained to reliably capture individual and dyadic components of communication for parents and adolescents and this complex information can be obtained relatively quickly.