Findings highlight varying level of risk across subgroups of LGBQ youth and suggest the importance of considering LGBQ groups separately in the context of a behavioral health assessment, especially for females.

The study's limitations include the use of cross-sectional and self-data reports. When medical providers evaluate suicide risk, bullying should be considered as a possible precipitant, especially if the patient is depressed. Verbal bullying may be particularly important in understanding severity of suicide risk.

Research shows that gay and bisexual males are at increased risk for disordered eating symptoms (DES); however, studies examining DES amongst lesbians and bisexual women have produced mixed findings. Furthermore, few studies have included questioning or "unsure" individuals. This study examined DES symptoms in adolescents and young adults across self-reported sexual attraction and behavior. Participants were recruited from ten primary care sites in Pennsylvania and administered the Behavioral Health Screen (BHS) - a web-based screening tool that assesses psychiatric symptoms and risk behaviors - during a routine visit. As expected, males who were attracted to other males exhibited significantly higher disordered eating scores than those only attracted to members of the opposite sex. Males who engaged in sexual activities with other males also exhibited significantly higher scores than those who only engaged in sexual activities with females. Amongst females, there were no significant differences in DES scores between females who were only attracted to females and those only attracted to males. Those who reported being attracted to both sexes, however, had significantly higher scores, on average, than those only attracted to one sex. More surprisingly, females who were unsure of who they were attracted to reported the highest DES scores of all. These findings are contrary to previous assumptions that same-sex attraction plays a protective role against eating pathology in females. Females who are unsure or attracted to both sexes may actually be at increased risk for developing DES.

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Externalizing problems are common in children ages 6–14, can have lifelong consequences, and may pose a particular risk when combined with other risk factors and symptoms (like depression and anxiety). Schools are uniquely positioned to assess and address these types of behavioral health concerns, but many school-based assessments do not focus on mental health distress (partially because they often lack the infrastructure for identification, screening, and referral). To address this gap, the Behavioral Health Works program student mental health software system has integrated teacher training, psychometrically strong assessments, feedback, and referral tools. However, this self-report tool for adolescents needed to be adapted for younger children. Thus, a parent-report version was added as well as new scales for better assessing this age group. The present study examines the psychometric properties of the new parent-report attention-deficit hyperactivity disorder (ADHD) and oppositional defiant/conduct scales within a sample of 440 children referred for school-based assessments. Overall, the new scales demonstrated good structural validity, measurement invariance across most demographic groups, discrimination in item response theory analyses, and evidence of convergent validity and good classification accuracy in relation to a validation battery. These externalizing scales are distinct and precise and show promise for improving the effectiveness of school-based programs for identifying at-risk children.

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Objectives: This study evaluates the relationship between substance use and impairment and current suicidal thoughts or behaviors in adolescent patients screened in a pediatric emergency department (ED).Methods: Data were collected between June 2013 and February 2018 from adolescent patients who presented to a single, urban, pediatric ED. Adolescents completed a computerized, self-administered assessment that evaluates depression, suicide, posttraumatic stress, violence, traumatic exposure, bullying, and substance use. Assessments are administered as standard care to all ED patients aged 14 to 18 years. We used binary logistic regression to estimate the odds of reporting current suicidal thoughts or behaviors associated with patient demographics (ie, age, sex, and race), substance use in the past month, and substance-related impairment.Results: A total of 11,623 adolescent patients (65.4% female and 52.9% African American) completed the assessment. Participants were, on average, 15.7 years old (SD = 1.27). Younger age (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.74-0.84) and substance use impairment (OR, 0.44; 95% CI, 0.33-0.58) decreased the odds of reporting current suicidal thoughts or behaviors, whereas male sex (OR, 1.51; 95% CI, 1.28-1.79) and those with past-month substance use (OR, 1.85; 95% CI, 1.51-2.26) increased the odds. Conclusions:Recent substance use and male sex are associated with a higher likelihood of adolescents reporting current suicidal thoughts or behaviors during an ED visit. Standardized screening during pediatric ED visits may allow for more efficient evaluation of patients in higher-risk groups.