ADOLESCENT SUICIDE: ASSESSMENT AND PREVENTION

Graciela Viale-Val, Psy.D.

University of Illinois at Chicago

Department of Psychiatry

Even though we cannot accurately predict suicide, a carefully obtained clinical and developmental history can provide important clues as to the severity of the risk present in individual cases. Official statistics and results of recent research on completed adolescent suicide have been used to identify a number of risk factors. The proposed method of assessment is based on the underlying assumption that adolescent suicides can be prevented by early identification and treatment of youths who present with risk factors frequently found among adolescents who have completed suicide. These risk factors include:

1. The presence of mood disturbances and intolerable affects including depression, emotional turmoil, anxiety or panic states, and homicidal rage.

2.The presence of suicidal ideation and/or a history of suicidal behavior (threats, attempts).

3. History of other psychiatric or behavioral disturbances (schizophrenia, substance abuse, antisocial behavior or conduct disorder, and severe personality disturbances).

4. Other risk factors such as history of psychiatric disturbances, substance abuse, violence or suicide in the family.

5. History of traumatic events, such as child abuse, early parental loss or divorce which may have contributed to the adolescent's vulnerability

6.The presence of current stresses or precipitating events such a severe conflict with parents, loses or separations, and disciplinary crisis.

7.The availability (or lack thereof) of environmental supports and the adolescent's ability to expect or accept help.

8. The accessibility of the method (i.e., the presence of a gun in the home has been shown to contribute significantly to the risk of suicide even in the absence of overt psychopathology).

A final judgment regarding the severity of the suicide risk present should always be based on the integration of all the information available, and on a careful clinical assessment and formulation of the developmental, environmental and situational factors which contribute to the suicidal crisis and/or to the chronicity of the suicidal behavior among adolescents. Research findings and clinical examples will be discussed to familiarize the audience with a method of suicide risk assessment which attempts to minimize the pitfalls of relying solely on clinical hunches, personal experiences or isolated signs.

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