Vol.23, No.1, January 2007 - Poor reading skills in adolescence may be linked to risk of suicide - Keep Your Eye On...suicide risk in adolescents with severe acne - Projects



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Vol.23, No.1, January 2007 - Poor reading skills in adolescence may be linked to risk of suicide - Keep Your Eye On...suicide risk in adolescents with severe acne

Poor reading skills may put young people at higher risk of behavioral and emotional difficulties than their peers with typical reading skills, according to a study published in the Journal of Learning Disabilities.

The findings are consistent with earlier research suggesting an interrelationship between learning disabilities and attempted suicide. However, few studies have examined the relationship between specific reading problems, such as fluency or single-word reading ability and suicidality.

The current study was carried out to examine the interrelationship between suicidal behaviors and school drop out among students with poor reading skills and those with typical reading skills. The researchers hypothesized that compared with adolescents with typical reading abilities, adolescents with poor reading skills would have (a) higher rates of suicidal thoughts and attempts; (b) higher rates of dropping out of school; and (c) that school dropout would be significantly related to suicidality. Further, these behaviors would persist after controlling for demographic variables, socioeconomic status (SES), and certain psychiatric disorders (e.g., substance use, major depression, conduct and oppositional defiant disorders).

A total of 188 public high-school students took part in the study and were screened at age 15 to determine when they could legally drop out of school (i.e., age 16 years). Other eligibility criteria were having written consent from a parent or legal guardian to participate in the study, not having a sibling also enrolled in the study, not taking classes designed for students with mental retardation, and having English as a first language.

Reading assessments were carried out during school hours based on the students' decoding, fluency, phonemic awareness, and single word reading skills. Information regarding school drop out and sociodemographic variables was gathered from interviews with the participants and their families. Assessment of psychiatric and suicidal behaviors included a semi-structured diagnostic interview (the Schedule for Affective Disorders and Schizophrenia for School-Age Children Epidemiologic Version [KSADS-E]). Some of the interview questions were "Do (did) you think about hurting or killing yourself?" "What do (did) you think of doing?" "Did you try to kill yourself?" "What did you do?"

At baseline, the sample was evenly divided between poor readers and typical readers, with 94 students in each group. Among students with poor reading skills, compared with typical readers, there were higher rates for suicide attempts/suicidal ideation (25.2% vs 8.5%), school drop out (30.2% vs 5.1%), major depression (29.5% vs 18.5%), conduct disorder/oppositional defiant disorder (13.1% vs 8.6%), and substance use disorder (25.9% vs 18.7%).

School drop out was significantly related to reading status (p<0.001). Taking into account demographic variables, reading status was significantly related to drop out (p<0.01)), race/ethnicity (p<0.05), and SES (p<0.05). There was a higher percentage of school drop outs among European-American students compared with minority students, and a greater likelihood of dropping out of school among students from lower SES compared with higher SES. Further analyses showed a significant relationship between risk of drop out and reading status (p<0.01), major depression (p<0.05), and conduct disorder (p<0.01).

Suicide risk was significantly related to reading status (p<0.01), with a higher incidence of suicidality among students with poor single word reading ability. This relationship was still significant after controlling for sociodemographic variables (p<0.05), with European American youth more likely to report suicidality than minority youth, and older students more likely to report suicidality than younger students. Further analyses showed reading status related to increased risk of suicidality (p<0.05), major depression (p<0.05), conduct disorder (p<0.01), and substance use disorder (p<0.01).

Suicidality was significantly related to increased risk of drop out (p<0.001), also after adjusting for sociodemographic variables and psychiatric diagnoses (p<0.001). Drop out was similarly related to increased risk of suicidality (p<0.001), and after adjusting for demographic and psychiatric diagnoses (p<0.001).

In terms of the practical implications of this study, educators need to be aware of the risk of suicidal thoughts and behaviors among students with poor reading abilities or those who are at risk of dropping out of school, and the increased risk of leaving school prematurely among students who have been referred for suicidal ideation and behaviors.

Daniel SS, Walsh AK, Goldston DB, et al.: Suicidality, school dropout, and reading problems among adolescents. J Learn Disabil 2006; 39(6):507-514.

Keep Your Eye On...suicide risk in adolescents with severe acne

Adolescents with severe acne who are at risk of suicide may not be detected through screening for mood symptoms. According to a youth survey carried out among how many New Zealand students, 12 to 18 years of age, having severe acne was associated with clinically relevant depressive symptoms, anxiety, and increased frequency of suicidal thoughts and suicide attempts. The association between severe acne and suicide attempts remained after controlling for depressive symptoms and anxiety. The findings suggest that severe acne patients who seek treatment for their skin condition warrant special attention as they are at risk for mental health problems. Since screening for mood symptoms may not detect suicide risk in adolescents with severe acne, the authors suggest that these patients should be asked directly about suicidal thoughts and behavior, as well as depression and anxiety.
[Purvis D, Robinson E, Merry, S, et al.: Acne, anxiety, depression and suicide in teenagers: a cross-sectional survey of New Zealand secondary school students. J Pediatr Child Health 2006; 42(12):793-796.]

The Brown University Child and Adolescent Behavior Letter, January 2007
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