Studies of preadolescents strongly suggest that the prevalence of depression and suicidal activity among them has been seriously underestimated. The authors review current thinking about preadolescent suicide; discuss its implications for clinicians, supervisors, and agency administrators; and recommend a research agenda to guide and support effective practice with preadolescents at risk for suicide.
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References
1.
AckerlyW. C. (1967). Latency-age children who threaten or attempt to kill themselves. Journal of the American Academy of Child Psychiatry, 6, 242–261.
2.
Adams-TuckerC. (1982). Proximate effects of sexual abuse in childhood: A report of 28 children. American Journal of Psychiatry, 139, 1252–1256.
3.
ApterA., BleichA., PlutchikR., MendelsohnS., & TyranoS. (1988). Suicidal behavior, depression, and conduct disorder in hospitalized adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 696–699.
4.
BeitchmanJ. H., ZuckerK. J., HoodJ. E., DaCostaG. A., & AkmanD. (1991). A review of the short-term effects of child sexual abuse. Child Abuse and Neglect, 15, 537–556.
5.
BettesB. A., & WalkerE. (1986). Symptoms associated with suicidal behavior in childhood and adolescence. Journal of Abnormal Child Psychology, 14, 591–604.
6.
Boy, 11, is rescued from jump attempt. (1994, January 21). New York Times, p. B3.
7.
BradleyJ., & Rotheram-BorusM. J. (1990). Suicide: Imminent danger for suicide: A training manual.Tulsa, OK: University of Oklahoma.
8.
BrekkeJ. S. (1987). Detecting wife and child abuse in clinical settings. Social Casework, 68, 332–338.
9.
BrentD. A., KalasR., EdelbrockC., CostelloA. J., DulcanM. K., & ConoverN. (1986). Psychopathology and its relationship to suicidal ideation in childhood and adolescence. Journal of the American Academy of Child Psychiatry, 25, 666–673.
10.
BriereJ., & RuntzM. (1986). Suicidal thoughts and behaviors in former sexual abuse victims. Canadian Journal of Behavioral Sciences, 18, 413–423.
11.
CarlsonG. A., & CantwellD. P. (1982). Suicidal behavior and depression in children and adolescents. Journal of the American Academy of Child Psychiatry, 21, 361–368.
12.
CarlsonG. A., & KashaniJ. H. (1988). Phenomenology of major depression from childhood through adulthood: Analysis of three studies. American Journal of Psychiatry, 145, 1222–1225.
13.
Centers for Disease Control. (1986, November). Youth suicide in the United States, 1970–1980.Atlanta, GA: Author.
14.
Cohen-SandierR., BermanA. L., & KingR. A. (1982a). Life stress and symptomatology: Determinants of suicidal behavior in children. Journal of the American Academy of Child Psychiatry, 21, 178–186.
15.
Cohen-SandierR., BermanA. L., & KingR. A. (1982b). A follow-up study of hospitalized suicidal children. Journal of the American Academy of Child Psychiatry, 21, 394–403.
16.
EdelsonG., IalongoN., Werthamer-LarssonL., CrockettL., & KellmanS. (1992). Self-reported depressive symptoms in first-grade children: Developmental or transient phenomena?Journal of the American Academy of Child Psychiatry, 31, 282–285.
17.
EisenbergL. (1980). Adolescent suicide: On taking arms against a sea of troubles. Pediatrics, 66, 315–320.
18.
FanshelD., FinchS. J., & GrundyJ. F. (1990). Foster children in a life course perspective.New York: Columbia University Press.
19.
GarbarinoJ. (1993). Let's talk about living in a world with violence. Chicago: Erikson Institute.
20.
GarbarinoJ., GuttmannE., & SeeleyJ. W. (1986). The psychologically battered child.San Francisco: Jossey-Bass.
21.
GreenA. H. (1978). Psychopathology of abused children. Journal of the American Academy of Child Psychiatry, 17, 92–101.
22.
GreeneD. B. (1994). Childhood suicide and myths surrounding it. Social Work, 39, 145–240.
23.
HarkavyJ. M., & AsnisG. (1985). Suicide attempts in adolescence: Prevalence and implications. New England Journal of Medicine, 313, 1290–1291.
24.
HarringtonR., FudgeH., RutterM., PicklesA., & HillJ. (1990). Adult outcomes of childhood and adolescent depression. Archives of General Psychiatry, 47, 465–473.
25.
HawtonK., BancroftJ., & SimkinS. (1978). Attitudes of psychiatric patients towards deliberate self-poisoning. British Journal of Psychiatry, 132, 31–35.
26.
HendinH. (1982). Suicide in America.New York: W. W. Norton.
27.
HendinH. (1986). Suicide: A review of new directions in research. Hospital and Community Psychiatry, 37, 148–154.
28.
HermanJ. L. (1992). Trauma and recovery.New York: Basic Books.
29.
HessP., & FolaronG. (1991). Ambivalences: A challenge to permanency for children. Child Welfare, 70, 403–424.
30.
HobermanH. M., & GarfinkelB. D. (1988). Completed suicide in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 689–695.
31.
HolingerP. C. (1978). Adolescent suicide: An epidemiological study of recent trends. American Journal of Psychiatry, 135, 754–756.
32.
JacksonH., & NuttallR. (1993). Clinician responses to sexual abuse allegations. Child Abuse and Neglect, 17, 127–143.
33.
JacobsonA., & RichardsonB. (1987). Assault experiences of 100 psychiatric inpatients: Evidence of the need for routine inquiry. American Journal of Psychiatry, 144, 908–913.
34.
KashaniJ. H., GoddardP., & ReidJ. (1989). Correlates of suicidal ideation in a community sample of children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 912–917.
35.
KazdinA. E., FrenchH. N., UnisA. S., Esveldt-DawsonK., & SherickR. B. (1983). Hopelessness, depression, and suicidal intent among psychiatrically disturbed inpatient children. Journal of Consulting Clinical Psychology, 51, 504–510.
36.
KlermanG. L., & WeissmanM. M. (1989). Increasing rates of depression. Journal of the American Medical Association, 261, 2229–2235.
37.
KovacsM., GoldstonD., & GatsonisC. (1993). Suicidal behaviors and childhood onset depressive disorders: A longitudinal investigation. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 8–20.
38.
LeonG. R., KendallP. C., & GarberJ. (1980). Depression in children: Parent, teacher, and child perspectives. Journal of Abnormal Psychology, 8, 221–235.
39.
LivingstonR. (1987). Sexually abused and physically abused children. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 413–415.
40.
LivingstonR. L., & BrachaS. (1992). Psychotic symptoms and suicidal behavior in hospitalized children. American Journal of Psychiatry, 149, 1585–1586.
41.
MarttunenM., HilleviM., & LonnquvistJ. K. (1992). Adolescent suicide: Endpoint of long-term difficulties. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 649–654.
42.
MillingL., GyureK., DavenportC. W., & BairP. (1991). Suicidal behavior among psychiatric outpatient children: An estimate of prevalence. Child Psychiatry and Human Development, 21, 283–289.
43.
MorrisonG. C., & CollierJ. G. (1969). Family treatment approaches to suicidal children and adolescents. Journal of the American Academy of Child Psychiatry, 8, 140–153.
44.
MoynihanD. P. (1990). Family and nation revisited. Social Thought, 16, 49–59.
45.
MyersK. M., BurkeP., & McCauleyE. (1985). Suicidal behavior by hospitalized adolescent children on a psychiatric unit. Journal of the American Academy of Child Psychiatry, 24, 474–480.
46.
MyersK., McCauleyE., CalderonR., MitchellJ., BurkeP., & SchloredtK. (1991). Risks for suicidality in major depressive disorder. Journal of the Academy of Child and Adolescent Psychiatry, 30, 86–94.
47.
NuttallR., & JacksonH. (1994). Personal history of childhood abuse among clinicians. Child Abuse and Neglect, 18, 455–472.
48.
OrbachI. (1988). Children who don't want to live.San Francisco: Jossey-Bass.
49.
PfefferC. R. (1978). The Child Suicide Potential Scale. In LewinsohnP. M., GarrisonC. Z., LanghinrichsenJ., & MarstelellerF. (Eds.), The assessment of suicidal behavior in adolescents: A review of scales suitable for epidemiologic and clinical research (pp. 39–40). Washington, DC: National Institute of Mental Health.
50.
PfefferC. R. (1986). The suicidal child.New York: Guilford.
51.
PfefferC. R. (1987). Elements of treatment for suicidal preadolescents. American Journal of Psychotherapy, 41, 172–184.
52.
PfefferC. R., ConteH. R., PlutchikR., & JerrettI. (1979). Suicidal behavior in latency aged children. Journal of the American Academy of Child Psychiatry, 18, 679–692.
53.
PfefferC. R., KlermanG. L., HurtS. W., KakumaT., PeskinJ. R., & SiefkerC. A. (1993). Suicidal children grow up: Rates and psychosocial risk factors for suicide attempts during follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 106–113.
54.
PfefferC. R., KlermanG. L., HurtS. W., LesserM., PeskinJ. R., & SiefkerC. A. (1991). Suicidal children grow up: Demographic and clinical risk factors for adolescent suicide attempts. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 609–616.
55.
PfefferC. R., LipkinsR., PlutchikR., & MizruchiM. (1988). Suicidal behavior in latency age children. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 34–41.
56.
PfefferC. R., PeskinJ. R., & SiefkerC. A. (1992). Suicidal children grow up: Psychiatric treatment during follow-up period. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 679–685.
57.
PfefferC. R., PlutchikR., MizruchiM. S., & LipkinsR. (1986). Suicidal behavior in child psychiatric inpatients and outpatients and in nonpatients. American Journal of Psychiatry, 143, 733–738.
58.
PfefferC. R., & TradP. B. (1988). Sadness and suicidal tendencies in preschool children. Developmental and Behavioral Pediatrics, 9, 86–88.
59.
PlutchikR., & van PraagH. M. (1990). Psychosocial correlates of suicide and violence risk. In van PraagH. M., PlutchikR., & ApterA. (Eds.), Violence and suicidality (pp. 37–67). New York: Brunner/Mazel.
60.
PostR. D., WillettA. B., FranksR. D., HouseR. M., BackS. M., & WeissbergM. P. (1980). A preliminary report on the prevalence of domestic violence among psychiatric inpatients. American Journal of Psychiatry, 137, 974–975.
61.
Puig-AntichJ. (1980). Affective disorders in childhood: A review and perspective. PsychiatricClinics of North America, 3, 402–424.
62.
RaoU., WeissmanM. M., MartinJ. A., & HammondR. W. (1993). Childhood depression and risk of suicide: A preliminary report of a longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 21–27.
63.
RoeslerT. A., SavinD., & GroszC. (1993). Family therapy of extrafamilial sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 967–970.
64.
RosenbergM. L., EddyD. M., WolpertR. C., & BroumasE. P. (1989). Developing strategies to prevent youth suicide. In PfefferC. R. (Ed.), Suicide among youth (pp. 203–225). Washington, DC: American Psychiatric Press.
65.
RosenthalP. A., & RosenthalS. (1984). Suicidal behavior by preschool children. American Journal of Psychiatry, 141, 520–525.
66.
Rotheram-BorusM. J. (1989). Evaluating suicidal youth in community settings. In KellerP. A. & HeymanS. R. (Eds.), Innovations in clinical practice: A source book (vol. 8, pp. 229–247). Sarasota, FL: Professional Resource Exchange, Inc.
67.
Rotheram-BorusM. J., & BradleyJ. (1991). Triage model for suicidal runaways. American Journal of Orthopsychiatry, 61, 122–127.
68.
Sansonnet-HaydenH., HaleyG., MarriageK., & FineS. (1987). Sexual abuse and psychopathology in hospitalized adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 753–757.
69.
SgroiS., BlickL., & PorterF. (1982). A conceptual framework for child sexual abuse. In SgroiS. (Ed.), Handbook of clinical intervention in child sexual abuse.Lexington, MA: Lexington Books.
70.
ShafferD. (1974). Suicide in childhood and early adolescence. Journal of Child Psychology and Psychiatry, 15, 275–291.
71.
ShafferD. (1982). Diagnostic considerations in suicidal behavior in children and adolescents. Journal of the American Academy of Child Psychiatry, 21, 414–416.
72.
ShafferD. (1993). Developmental psychology: Childhood and adolescence.Pacific Grove, CA: Brooks/Cole.
73.
ShafiiM., CarriganS., WhittinghillJ. R., & DerrickA. (1985). Psychological autopsies of completed suicide in children and adolescents. Americon Journal of Psychiatry, 142, 1061–1064.
74.
Six-year-old commits suicide. (1993, June 17). New York Times, p. A22.
75.
VelezC. N., & CohenP. (1988). Suicidal behavior and ideation in a community sample of children: Maternal and youth reports. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 349–356.
76.
WeissmanM. (1974). The epistemology of suicide attempts, 1960–1971. Archives of General Psychiatry, 32, 1166–1171.
77.
WozencraftX, WagnerW., & PellegrinA. (1991). Depression and suicidal ideation in sexually abused children. Child Abuse and Neglect, 15, 505–511.