Examining the Impact of Psychopathological Comorbidity on the Medical Lethality of Adolescent Suicide Attempts

• Main Author: O'Brien, Kimberly Hayes McManama
• Format: Others
• Language: English
• Published: Boston College 2011
• Subjects: adolescent; comorbidity; lethality; psychopathology; suicide
• Online Access: http://hdl.handle.net/2345/2366

Thesis advisor: Stephanie C. Berzin === The primary aim of this study was to determine if various typologies of psychiatric diagnoses and patterns of comorbidity are differentially related to the medical lethality of adolescent suicide attempts. The secondary aim was to determine if the relationship between psychopathological comorbidity and suicide attempt lethality is significantly different across gender, age, and race in adolescents. To investigate these relationships, psychiatric evaluations were reviewed for all adolescents that presented to Children's Hospital Boston (CHB) from 2006 to 2010 for a suicide attempt (N = 375). Bivariate and OLS regression analyses were used to test hypotheses. Bivariate results showed that attempters diagnosed with a Substance Abuse Disorder comorbid with any other disorder had higher levels of suicide attempt lethality than those without the diagnosis. Additionally, having Bipolar or Mood Disorder NOS in combination with either Substance Abuse alone or Substance Abuse and Disruptive Disorders had a significant positive relationship with suicide attempt lethality when compared to other comorbidity patterns. In OLS regression, having Substance Abuse comorbid with any other disorder was the only significant diagnostic predictor of lethality. Female gender did not have a significant relationship with lethality. Age group was not predictive of lethality in regression analysis. African-American/Black race had a negative relationship with lethality in bivariate and multivariate analyses. Study findings have important implications for practice, policy, and future research with suicidal adolescents. Results suggest that improvements in the assessment and treatment of substance abuse in suicidal adolescents can play a critical role in decreasing the adolescent suicide rate. Screening for symptoms other than depression, such as substance use, will be critical to effective suicide prevention practices. Future research should focus on the development of effective treatment strategies with suicidal adolescent substance abusers, and aim for a better understanding of suicidal behaviors of adolescents with comorbid bipolar and substance abuse diagnoses. In order to further develop prevention and treatment strategies with this population, policies must be initiated that will support their advancement. === Thesis (PhD) — Boston College, 2011. === Submitted to: Boston College. Graduate School of Social Work. === Discipline: Social Work.