Objective-To describe the elements of a manualized cognitive behavior psychotherapy for suicide prevention (CBT-SP) and to report its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide.Method-CBT-SP was developed using a risk reduction, relapse prevention approach and theoretically grounded in principles of cognitive behavior therapy, dialectical behavioral therapy and targeted therapies for suicidal, depressed youth. CBT-SP consists of acute and continuation phases, each lasting about 12 sessions, and includes a chain analysis of the suicidal event, safety plan development, skill building, psychoeducation, family intervention, and relapse prevention.Results-CBT-SP was administered to 110 depressed, recent suicide attempters aged 13-19 years (mean 15.8±1.6) across five academic sites. Twelve or more sessions were completed by 72.4% of the sample.Conclusions-A specific intervention for adolescents at high risk for repeated suicide attempts has been developed and manualized, and further testing of its efficacy appears feasible.

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The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to 13 years (n = 1,825 assessments). Semistructured psychiatric diagnostic instruments were administered at repeated assessments to assess psychiatric disorders and suicide attempts. After controlling for demographic variables and prehospitalization suicide attempts, most contemporaneous psychiatric disorders (major depressive disorder [MDD], dysthymic disorder, generalized anxiety disorder [GAD], panic disorder, attentiondeficit/hyperactivity disorder [AD/HD], conduct disorder, and substance use disorder [SUD]) were related to increased risk of attempts. The relationship between suicide attempts and MDD, GAD, AD/HD, and SUD strengthened as participants got older. MDD, dysthymic disorder, GAD, and panic disorder were more commonly associated with repeat than 1st-time suicide attempts. In sum, most major psychiatric disorders are associated with increased risk for suicide attempts, but the strength of the relationships between these disorders and attempts changes over the course of development. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAccording to the National Strategy for Suicide Prevention, suicide attempts among adolescents and young adults occur at alarming rates, pose significant public health costs and burden, and are associated with increased likelihood for repeat suicide attempts and eventual death by suicide (U.S. Public Health Service, 2001). In efforts to better understand factors associated with increased risk for suicidal behavior, several community studies have examined the relationship between current psychiatric disorder and lifetime history of suicide attempts among adolescents (Andrews & Lewinsohn, 1992;Gould et al., 1998;Velez & Cohen, 1988). In studies focusing on lifetime histories of suicidal behavior, however, previous suicidal behavior may have occurred prior to the onset of the current psychiatric disorders (Foley, Goldston, Costello, & Angold, 2006). With cross-sectional studies of clinical samples, it has been possible to examine the relationships between psychiatric disorders and suicidal behavior occurring in the same window of time (e.g., Goldston et al., 1998). However, the period of time preceding hospitalization or entry into treatment is likely atypical, even for the highest risk young people.Longitudinal studies of psychiatric disorders and suicidal behavior may help clarify proximal associations because they offer the opportunity to examine relationships between suicidal behaviors and psychiatric disorders occurring in the same period of time, without the biases associated with one-time assessments in clinical settings. In the seminal community longitudinal study of Lewinsohn, Rohde, Seeley, and Ba...

The purpose of this study was to examine the severity of behavioral and emotional problems among adolescents with poor and typical single word reading ability (N = 188) recruited from public schools and followed for a median of 2.4 years. Youth and parents were repeatedly assessed to obtain information regarding the severity and course of symptoms (depression, anxiety, somatic complaints. aggression, delinquent behaviors, inattention), controlling for demographic variables and diagnosis or ADHD. After adjustment for demographic variables and ADHD, poor readers reported higher levels of depression, trait anxiety, and somatic complaints than typical readers, but there were no difference, in reported self-reported delinquent or aggressive behaviors. Parent reports indicated no difference, in depression, anxiety or aggression between the two groups but indicated more inattention, somatic complaints, and delinquent behaviors for the poor readers. School and health professionals should carefully assess youth with poor reading for behavioral and emotional symptoms and provide services when indicated.

The purpose of this study was to examine the risk of suicidal ideation and suicide attempts and school dropout among youth with poor reading in comparison to youth with typical reading (n = 188) recruited from public schools at the age of 15. In a prospective naturalistic study, youth and parents participated in repeated research assessments to obtain information about suicide ideation and attempts, psychiatric and sociodemographic variables, and school dropout. Youth with poor reading ability were more likely to experience suicidal ideation or attempts and more likely to drop out of school than youth with typical reading, even after controlling for sociodemographic and psychiatric variables. Suicidality and school dropout were strongly associated with each other. Prevention efforts should focus on better understanding the relationship between these outcomes, as well as on the developmental paths leading up to these behaviors among youth with reading difficulties.

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The aim of the current article is to review the literature on religion and spirituality as it pertains to adolescent psychiatric symptoms. One hundred and fifteen articles were reviewed that examined relationships between religion/spirituality and adolescent substance use, delinquency, depression, suicidality, and anxiety. Ninety-two percent of articles reviewed found at least one significant (p < .05) relationship between religiousness and better mental health. Evidence for relationships between greater religiousness and less psychopathology was strongest in the area of teenage substance use. Methods of measuring religion/spirituality were highly heterogeneous. Further research on the relationship of religion/spirituality to delinquency, depression, suicidality, and anxiety is warranted. Measurement recommendations, research priorities, and clinical implications are discussed.

Clinicians should examine risk of rehospitalization before discharge, especially for younger patients and those with depression. Future research must focus on methods of intervention for this high-risk group.