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      Risk Factors Reduction in Suicidal Youth Through Social Connectedness Opportunities Provided by Community Services Translated title: Redução de fatores de risco em jovens suicidas através de oportunidades de estabelecimento de laços sociais em serviços comunitários

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          Abstract

          Aim

          This study examined the trajectory (life course) of youths, referred to community services following their suicidal behavior, in order to measure the extent to which these young people have taken this opportunity to modify connectedness with family, school, and workplace, and to change high-risk factors related to suicidal behaviors (mental health problems, delinquency, drug consumption).

          Method

          Fifteen youths (aged 16-19), who made one or more suicide attempts or had serious ideation in the previous 24 to 48 months, were referred to community services (Vallée-Jeunesse). They were interviewed using an intensive personal interview measures (Trajectory Instrument Measure, TIM) in order to document significant life events and adversities that occured during different periods of their life.In addition, we administered the Structured Clinical Interview for DSM-IV Axis-I and Axis-II disorders (SCID-I and SCID-II) to identify past and current psychopathologies.

          Results

          Several important changes took place following their entry into the community services: a reduction in delinquency and substance abuse/dependence, and positive changes in occupational status and suicidal behaviors (ideation and suicide attempt).

          Conclusion

          Our findings can inform policies and strategies that support the prevention of suicidal behavior among young adults. Community services providers can play a role in the prevention of suicidal behaviors for the most vulnerable youths. These types of services could complement traditional suicide prevention strategies, which are mostly mental-health based.

          Translated abstract

          Objetivo

          Este estudo analisou a trajetória (curso de vida) de jovens encaminhados para serviços comunitários após comportamento suicida, a fim de verificar em que medida aproveitaram essa oportunidade para modificar a ligação à família, escola e local de trabalho, e mudar fatores de alto risco relacionados com comportamentos suicidas (problemas de saúde mental, delinquência, consumo de drogas).

          Método

          Quinze jovens (16-19 anos) que fizeram uma ou mais tentativas de suicídio ou manifestaram ideação suicida nos últimos 24 a 48 meses foram referenciados para serviços comunitários (Vallée-Jeunesse). Estes foram entrevistados através de entrevistas pessoais intensivas (Trajectory Instrument Measure, TIM), a fim de registar eventos significativos e adversidades que ocorreram durante diferentes períodos de sua vida. Adicionalmente, foi utilizada a Entrevista Clínica Estruturada para perturbações do Eixo-I e Eixo-II do DSM-IV (SCID-I e SCID-II) para identificar psicopatologias passadas e atuais.

          Resultados

          Várias mudanças importantes ocorreram após a sua entrada nos serviços comunitários: uma redução na delinquência e abuso/dependência de substâncias, e mudanças positivas na situação ocupacional e comportamentos suicidas (ideação e tentativa de suicídio).

          Conclusão

          Os resultados podem fundamentar políticas e estratégias que apoiem a prevenção do comportamento suicida em jovens adultos. Os prestadores de serviços comunitários podem desempenhar um papel na prevenção de comportamentos suicidas para os jovens mais vulneráveis. Esses tipos de serviços poderão complementar estratégias tradicionais de prevenção do suicídio, que são principalmente baseadas em abordagens da saúde mental.

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          Most cited references38

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          Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data.

          To describe the psychometric properties of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) interview, which surveys additional disorders not assessed in prior K-SADS, contains improved probes and anchor points, includes diagnosis-specific impairment ratings, generates DSM-III-R and DSM-IV diagnoses, and divides symptoms surveyed into a screening interview and five diagnostic supplements. Subjects were 55 psychiatric outpatients and 11 normal controls (aged 7 through 17 years). Both parents and children were used as informants. Concurrent validity of the screen criteria and the K-SADS-PL diagnoses was assessed against standard self-report scales. Interrater (n = 15) and test-retest (n = 20) reliability data were also collected (mean retest interval: 18 days; range: 2 to 36 days). Rating scale data support the concurrent validity of screens and K-SADS-PL diagnoses. Interrater agreement in scoring screens and diagnoses was high (range: 93% to 100%). Test-retest reliability kappa coefficients were in the excellent range for present and/or lifetime diagnoses of major depression, any bipolar, generalized anxiety, conduct, and oppositional defiant disorder (.77 to 1.00) and in the good range for present diagnoses of posttraumatic stress disorder and attention-deficit hyperactivity disorder (.63 to .67). Results suggest the K-SADS-PL generates reliable and valid child psychiatric diagnoses.
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            Toward an experimental ecology of human development.

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              The interpersonal theory of suicide.

              Suicidal behavior is a major problem worldwide and, at the same time, has received relatively little empirical attention. This relative lack of empirical attention may be due in part to a relative absence of theory development regarding suicidal behavior. The current article presents the interpersonal theory of suicidal behavior. We propose that the most dangerous form of suicidal desire is caused by the simultaneous presence of two interpersonal constructs-thwarted belongingness and perceived burdensomeness (and hopelessness about these states)-and further that the capability to engage in suicidal behavior is separate from the desire to engage in suicidal behavior. According to the theory, the capability for suicidal behavior emerges, via habituation and opponent processes, in response to repeated exposure to physically painful and/or fear-inducing experiences. In the current article, the theory's hypotheses are more precisely delineated than in previous presentations (Joiner, 2005), with the aim of inviting scientific inquiry and potential falsification of the theory's hypotheses. PsycINFO Database Record (c) 2010 APA, all rights reserved.
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                Author and article information

                Journal
                PCH
                Psychol Community Health
                Psychology, Community & Health
                Psychol. Community Health
                PsychOpen
                2182-438X
                21 December 2018
                2018
                : 7
                : 1
                : 109-121
                Affiliations
                [a ]Department of Psychoeducation & Psychology, Université du Québec en Outaouais , Gatineau, Canada
                [2]Departamento de Psicologia, Universidade de Évora, Portugal CERIS-CESUR - IST - Universidade de Lisboa, Portugal
                Author notes
                [* ]283, Boulevard Alexandre-Taché, Case postale 1250, Succursale Hull, Gatineau (Québec), Canada J8X 3X7. marie.robert@ 123456uqo.ca
                Article
                pch.v7i1.231
                10.5964/pch.v7i1.231
                7c2cae1f-457a-42f5-8a66-41a0c77d2f92

                This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) 3.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 January 2017
                : 07 September 2017
                Product
                Self URI (journal-page): https://journals.psychopen.eu/
                Categories
                Empirical Articles

                Psychology
                serviços comunitários,jovens,mental health,connectedness,prevention of suicidal behaviors,prevenção de comportamento suicida,youth,suicídio,suicide,community services,saúde mental,laços sociais

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