Multimethod measurement of proximal risk for persistent suicide ideation and future attempts among adolescents

摘要 儿童期自杀风险评估具有挑战性，部分原因是缺乏可用的发展- 和文化敏感性评估。关于自杀意念特征的信息很少 在儿童中。确定这一信息至关重要，以便确定处于危险中的儿童并进行干预， 防止发展为自杀行为。我们正在进行的青少年研究的初步分析 表明具有持续性自杀意念亚型的青少年具有较早的意念发作年龄 间歇性或短暂性自杀意念亚型的青少年。因此，早期的构思， 儿童期可能与更严重的自杀意念有关--自杀行为的风险更高-- 青春期及早查明这些儿童的身份将有助于采取有针对性的干预措施， 更严重的自杀行为。这一补充的目的是1）适应我们现有的 青少年自杀意念访谈将通过纳入儿童及其父母进行 发展和文化上敏感的方法来评估自杀意念，这样， 评估是儿童自杀意念访谈（CSII）的一部分; 2）管理CSII， 儿童，年龄7-11，和他们的父母收集的内容和亚型的初步数据， 童年自杀意念我们将调整我们的采访，结合视觉图像和方法， 民族志研究，我们将试点测试与种族和民族多样化的样本采访 来自纽约市一家公立医院综合精神病急诊科的儿童。 这一项目将为开展风险评估铺平道路， 儿童自杀意念的内容和亚型，这是建立护理水平所需的， 设计治疗方案。

Abstract Suicide risk assessment in childhood is challenging, due, in part, to the lack of available developmentally- and culturally-sensitive assessments. Little information is known about suicide ideation characteristics among children. Ascertaining this information is critical in order to identify children at risk and to intervene to prevent the progression to suicidal behavior. Preliminary analyses from our ongoing study of adolescents suggest that adolescents with a persistent suicide ideation subtype have an earlier age-of-onset of ideation than adolescents with an intermittent or brief suicide ideation subtype. Thus, an earlier onset of ideation in childhood may be associated with more severe suicide ideation – and higher risk of suicidal behavior – in adolescence. Earlier identification of these children would allow for targeted interventions to prevent the progression to more severe suicidal behavior. The aims of this supplement are 1) to adapt our existing Adolescent Suicide Ideation Interview to be administered to children and their parents by incorporating developmentally and culturally sensitive methodologies to assess suicide ideation, such that this adapted assessment forms part of a Childhood Suicide Ideation Interview (CSII); and 2) to administer the CSII to children, ages 7-11, and their parents to collect preliminary data on the content and the subtypes of childhood suicide ideation. We will adapt our interview by incorporating visual images and methods used in ethnographic research, and we will pilot test the interview with a sample of racially and ethnically diverse children from a Comprehensive Psychiatric Emergency Department in a public hospital in New York City. This project will pave the way for the development of risk assessments that provide rich information about the content and subtypes of childhood suicide ideation, which are needed to establish levels of care and design treatment plans.