Emotional triggers and psychopathology associated with suicidal ideation in urban children with elevated aggressive-disruptive behavior.

8.6% suicidal ideation (SI) was found among 349 urban 6-9 year olds in the top tercile of aggressive-disruptive behavior. SI was associated with more self-reported depression, ODD, conduct problems, and ADHD symptoms (ES 0.70-0.97) and 3.5-5 times more clinically significant symptoms. Parents rated more symptoms in older children associated with SI compared to parents of similar age children without SI, including greater somatic and behavior problems in 8-9 year olds with SI. Parent ratings did not differentiate SI and non-SI in 6-7 year olds. SI frequently co-occurred with thoughts about death. Children described anger, dysphoria and interpersonal conflict as motivators/triggers for SI and worries about safety/health as motivator/triggers for thoughts about death, suggesting that problems managing emotionally challenging situations are a specific factor in initiating SI. Universal and indicated interventions for children to strengthen emotional self-regulation and behavioral control are recommended to complement the current emphasis on suicide prevention among adolescents.

Reliability of the Lifetime Inventory of Drug Use Consequences (INDUC) in methadone maintenance patients.

One hundred twenty one opiate-dependent individuals in methadone maintenance treatment at an urban university medical center in the U.S. were administered the Inventory of Drug Use Consequences (InDUC), and 68 subjects provided follow-up assessments at two to six weeks. The sample included 61 (50.4%) women; 86 (71.1%) of the subjects reported that they were White, 29 (24.0%) Black, and six (5.0%) other race. The mean age was 41.9 (SD = 9.7) years. Ninety-nine (81.8%) of participants had used opiates intravenously. INDUC total scores and a short form showed high internal consistency (alpha) and test-retest reliability (ICC) across gender, race, ethnicity, and education, supporting their use as global measures of drug use consequences. The interpersonal scale was also reliable across strata whereas the physical and intrapersonal scales were not reliable. The impulse control and social responsibility scales were stable but not internally consistent.

Suicide attempts among individuals with opiate dependence: the critical role of belonging.

This study explored the role of three theoretically important interpersonal variables in attempted suicide and unintentional overdose using a diverse sample of one hundred thirty-one (69 women) methadone patients at an urban university hospital. Subjects completed a standardized interview including self-report measures of perceived 1) belonging 2) burdensomeness, and 3) loneliness. In separate multivariate logistic regression analyses, individuals with a history of attempted suicide were compared to non-attempters, and individuals with a history of unintentional overdose were compared to individuals without such a history. As hypothesized, low belonging distinguished suicide attempters but not individuals with a history of unintentional overdose, after accounting for covariates. Results concerning burdensomeness and suicide attempt were also suggestive. Findings underscore the relevance of a sense of belonging to vulnerability to suicidal behavior, and lend further support to the notion that suicide attempts and unintentional overdose have dissimilar correlates.

Reliability of the Impulsive-Premeditated Aggression Scale (IPAS) in treated opiate-dependent individuals.

The purpose of the study was to evaluate the internal consistency and test-retest reliability of the Impulsive Aggression (IA) and Premeditated Aggression (PM) scales of the Impulsive-Premeditated Aggression Scale (IPAS) in male and female substance-dependent patients, and to compare the findings to those obtained on widely used, validated measures of aggression. Using a sample of 121 patients (61 women) in methadone maintenance treatment, 69 (35 women) of which were re-evaluated after a minimum of 2weeks, the IPAS scales showed acceptable internal consistency (alpha>.72) and test-retest reliability (ICC>.54). These results were comparable to the other aggression measures, and results among women were comparable to men. This was the first study to examine the IPAS scales in a substance use population, to contain a sufficient sample of women for sub-analyses, and to examine the stability of the measure. Findings support the internal consistency and test-retest reliability of the IPAS in male and female opiate-dependent individuals.