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1.
J Am Acad Child Adolesc Psychiatry ; 40(7): 837-46, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11437023

RESUMO

OBJECTIVE: To identify the independent psychosocial and risk behavior correlates of suicidal ideation and attempts. METHOD: The relationships between suicidal ideation or attempts and family environment, subject characteristics, and various risk behaviors were examined among 1,285 randomly selected children and adolescents, aged 9 through 17 years, of whom 42 (3.3%) had attempted suicide and 67 (5.2%) had expressed suicidal ideation only. The youths and their parents were enumerated and interviewed between December 1991 and July 1992 as part of the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. RESULTS: Compared with subjects with suicidal ideation only, attempters were significantly more likely to have experienced stressful life events, to have become sexually active, to have smoked more than one cigarette daily, and to have a history of ever having smoked marijuana. After adjusting for sociodemographic characteristics, a statistically significant association was found between suicidal ideation or attempt and stressful life events, poor family environment, parental psychiatric history, low parental monitoring, low instrumental and social competence, sexual activity, marijuana use, recent drunkenness, current smoking, and physical fighting. Even after further adjusting for the presence of a mood, anxiety, or disruptive disorder, a significant association persisted between suicidal ideation or attempts and poor family environment, low parental monitoring, low youth instrumental competence, sexual activity, recent drunkenness, current smoking, and physical fighting. CONCLUSION: Low parental monitoring and risk behaviors (such as smoking, physical fighting, alcohol intoxication, and sexual activity) are independently associated with increased risk of suicidal ideation and attempts, even after adjusting for the presence of psychiatric disorder and sociodemographic variables.


Assuntos
Cognição , Assunção de Riscos , Tentativa de Suicídio/psicologia , Adolescente , Estudos de Casos e Controles , Criança , Estudos Transversais , Feminino , Humanos , Funções Verossimilhança , Masculino , Porto Rico , Risco , Tentativa de Suicídio/prevenção & controle , Estados Unidos
2.
J Am Acad Child Adolesc Psychiatry ; 39(7): 881-7, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10892230

RESUMO

OBJECTIVES: First, to investigate whether there is covariation between risk behaviors, including suicidality, in a community probability sample of children and adolescents; and second, to investigate whether risk behavior is associated with selected potential correlates. METHOD: A sample of 9- to 17-year-old youths (N = 1,285) and their caretakers were interviewed in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The risk behaviors were marijuana smoking, alcohol use, intercourse, fighting, cigarette smoking, and suicidal ideation/attempts. Relationships between the risk behaviors were described using odds ratios. Linear regression analyses of an index of risk behavior on the selected potential correlates of risk behavior were conducted. RESULTS: There were significant relationships between all pairs of risk behaviors. The score on the index of risk behavior was associated with stressors, lack of resources, family psychiatric disorder, psychopathology, and functional impairment. CONCLUSIONS: Clinicians should be alerted to the possibility of risk behaviors, especially in children and adolescents engaging in other risk behaviors and those with inadequate resources, stressors, functional impairment, or psychopathology.


Assuntos
Assunção de Riscos , Transtornos do Comportamento Social/etiologia , Transtornos do Comportamento Social/psicologia , Tentativa de Suicídio/psicologia , Adolescente , Criança , Connecticut , Feminino , Georgia , Humanos , Modelos Lineares , Masculino , New York , Razão de Chances , Psicologia do Adolescente , Psicologia da Criança , Porto Rico , Fatores de Risco , Estudos de Amostragem , Autorrevelação
3.
J Am Acad Child Adolesc Psychiatry ; 39(6): 761-70, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10846311

RESUMO

OBJECTIVES: To evaluate evidence, in a community sample, for discriminant validity between major depression (MDD) and dysthymia (Dy) in children and adolescents and to examine differential consequences of the 2 disorders for functioning. METHOD: The National Institute of Mental Health (NIMH) Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study consists of probability samples of youths. Data for this study are derived from interviews with 1,285 complete parent-youth pairs aged 9 to 17 years from 4 geographic areas in the United States. Youths with MDD were contrasted with those with Dy and those with both (MDD-Dy) on the NIMH Diagnostic Interview Schedule for Children, Non-Clinician Children's Global Assessment Scale, Columbia Impairment Scale, and the Service Utilization and Risk Factors Module. RESULTS: Groups with MDD, Dy, or MDD-Dy did not differ on sociodemographic, clinical, or family and life event variables. Youths with combined MDD-Dy were significantly less competent and more impaired than youths with either disorder alone. CONCLUSIONS: The findings do not provide support for the differentiation of MDD and Dy but strongly suggest the importance of addressing the needs of youths who meet criteria for both MDD and Dy because this combination is likely to be both serious and disruptive of normal developmental processes.


Assuntos
Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Transtorno Distímico/epidemiologia , Transtorno Distímico/psicologia , Adolescente , Idade de Início , Criança , Comorbidade , Connecticut/epidemiologia , Família , Feminino , Georgia/epidemiologia , Humanos , Acontecimentos que Mudam a Vida , Masculino , New York/epidemiologia , Poder Familiar , Vigilância da População , Escalas de Graduação Psiquiátrica , Porto Rico/epidemiologia , Reprodutibilidade dos Testes , Estudos de Amostragem , Classe Social
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