A longitudinal examination of the interpersonal theory of suicide and effects of school-based suicide prevention interventions in a multinational study of adolescents.


Journal

Journal of child psychology and psychiatry, and allied disciplines
ISSN: 1469-7610
Titre abrégé: J Child Psychol Psychiatry
Pays: England
ID NLM: 0375361

Informations de publication

Date de publication:
10 2019
Historique:
accepted: 29 07 2019
entrez: 13 9 2019
pubmed: 13 9 2019
medline: 3 10 2020
Statut: ppublish

Résumé

Predictions of two different models for suicide attempts (SA) over 12 months, as differentially impacted by specific school-based suicide prevention interventions, were compared. These were as follows: (a) interpersonal theory (IPTS) and (b) a two-pathway model, one path associated with externalizing symptoms and continuum of self-harm behaviors, and the other with internalizing symptoms. Self-report questionnaires were completed by 11,110 high school students from ten EU countries enrolled in the Saving and Empowering Young Lives in Europe (SEYLE) study. Baseline measures included perceived burdensomeness, thwarted belongingness from parents and peers, health risk behaviors, self-injury, suicide ideation (SI), and attempts (SA). SI and SA were reassessed at 12-month follow-up. Each model's predictions of SI and SA groups over time (i.e., repeated SA, remitted SA, SA onset, and no SA) were estimated in the no intervention/control group. The superior model was estimated across intervention groups. Interpersonal theory showed better fit compared to the two-pathway model. In partial agreement with IPTS predictions, parental low belongingness but not peer belongingness or burdensomeness predicted greater likelihood of SI. The likelihood of repeated SA versus no SA was higher among adolescents who reported SI, self-injury, risk behaviors, and particularly both SI and self-injury. All three interventions attenuated the combined effect of SI and self-injury. Youth Aware of Mental Health Program (YAM) additionally decreased the effect of risk behaviors on the likelihood of repeated SA. Interpersonal theory assumptions were partially supported. Perceived interpersonal difficulties with parents were primarily related with SI, and risk behaviors and self-injury were important predictors of SA. Suicide prevention interventions may be effective by mitigating the hazardous effect of varying self-harm behaviors and may be further advanced by increasing parental involvement.

Sections du résumé

BACKGROUND
Predictions of two different models for suicide attempts (SA) over 12 months, as differentially impacted by specific school-based suicide prevention interventions, were compared. These were as follows: (a) interpersonal theory (IPTS) and (b) a two-pathway model, one path associated with externalizing symptoms and continuum of self-harm behaviors, and the other with internalizing symptoms.
METHODS
Self-report questionnaires were completed by 11,110 high school students from ten EU countries enrolled in the Saving and Empowering Young Lives in Europe (SEYLE) study. Baseline measures included perceived burdensomeness, thwarted belongingness from parents and peers, health risk behaviors, self-injury, suicide ideation (SI), and attempts (SA). SI and SA were reassessed at 12-month follow-up. Each model's predictions of SI and SA groups over time (i.e., repeated SA, remitted SA, SA onset, and no SA) were estimated in the no intervention/control group. The superior model was estimated across intervention groups.
RESULTS
Interpersonal theory showed better fit compared to the two-pathway model. In partial agreement with IPTS predictions, parental low belongingness but not peer belongingness or burdensomeness predicted greater likelihood of SI. The likelihood of repeated SA versus no SA was higher among adolescents who reported SI, self-injury, risk behaviors, and particularly both SI and self-injury. All three interventions attenuated the combined effect of SI and self-injury. Youth Aware of Mental Health Program (YAM) additionally decreased the effect of risk behaviors on the likelihood of repeated SA.
CONCLUSIONS
Interpersonal theory assumptions were partially supported. Perceived interpersonal difficulties with parents were primarily related with SI, and risk behaviors and self-injury were important predictors of SA. Suicide prevention interventions may be effective by mitigating the hazardous effect of varying self-harm behaviors and may be further advanced by increasing parental involvement.

Identifiants

pubmed: 31512239
doi: 10.1111/jcpp.13119
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1104-1111

Informations de copyright

© 2019 Association for Child and Adolescent Mental Health.

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Auteurs

Shira Barzilay (S)

Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel.

Alan Apter (A)

Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel.

Avigal Snir (A)

Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel.

Vladimir Carli (V)

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

Christina W Hoven (CW)

Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.

Marco Sarchiapone (M)

Department of Health Sciences, University of Molise, Campobasso, Italy.
National Institute for Health, Migration and Poverty, Rome, Italy.
Kazakh National Medical University, Almaty, Kazakhstan.

Gergö Hadlaczky (G)

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

Judit Balazs (J)

Institute of Psychology, Eotvos Lorand University, Budapest, Hungary.
Bjørknes University College, Oslo, Norway.

Agnes Kereszteny (A)

Institute of Psychology, Eotvos Lorand University, Budapest, Hungary.

Romuald Brunner (R)

Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany.

Michael Kaess (M)

Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.

Julio Bobes (J)

Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain.

Pilar A Saiz (PA)

Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain.

Doina Cosman (D)

Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Christian Haring (C)

Research Division for Mental Health, University for Medical Information Technology (UMIT), Hall in Tirol, Austria.

Raphaela Banzer (R)

Addiction help services B.I.N., Innsbruck, Austria.

Elaine McMahon (E)

National Suicide Research Foundation, Cork, Ireland.

Helen Keeley (H)

National Suicide Research Foundation, Cork, Ireland.

Jean-Pierre Kahn (JP)

Department of Psychiatry and Clinical Psychology, Centre Hospitalo-Universitaire (CHU) de Nancy, Universite de Lorraine, Nancy, France.

Vita Postuvan (V)

Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia.

Tina Podlogar (T)

Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia.

Merike Sisask (M)

Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia.
School of Governance, Law and Society, Tallinn University, Tallinn, Estonia.

Airi Varnik (A)

Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia.
School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia.

Danuta Wasserman (D)

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

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