June 5, 2007 Recent dating violence among urban teen females and lifetime history of sexual assault among urban teen males may be associated with suicide attempts, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
"Suicide is the third leading cause of death in adolescents," according to background information in the article. "In 2003, 6.5 per 100,000 U.S. teenagers aged 14 to 19 years committed suicide." In 2005, more than 8 percent of high school students reported one or more suicide attempts in the previous year. Childhood sexual assault has been linked with depression, alcohol use and violence, making it a likely risk factor for a suicide attempt. "Dating violence has also been shown to be associated with depressive symptoms and multiple health-compromising behaviors," the authors write.
Elyse Olshen, M.D., M.P.H., of Columbia University Medical Center, New York, and colleagues analyzed self-administered, anonymous questionnaires completed by 8,080 students (age 14 and older) from 87 New York City public high schools in 2005. The surveys measured different risk behaviors such as use of tobacco, alcohol and other drugs, unintentional injury and violence, sexual behaviors, dietary behaviors and physical activity. Students were also asked how many times they had attempted suicide, if they had experienced dating violence and if they had been sexually assaulted in the past 12 months.
Females made up 51 percent of the students and those who responded were primarily not white (40.1 percent Hispanic, 36 percent black, 16 percent Asian/other and 7.9 percent white). "Persistent sadness (feeling sad or hopeless daily for two weeks in a row during the past year) occurred in 40.2 percent of female students and 24.2 percent of male students; also, 19.9 percent of females and 10.3 percent of males reported suicidal ideation [suicidal thoughts or behaviors] or seriously considering attempting suicide in the past year."
A lifetime history of sexual assault was reported by 9.6 percent of the females and 5.4 percent of the males in the study. In the past year, 10.6 percent of the girls and 9.5 percent of the boys reported that they had experienced dating violence and 11.7 percent of adolescent girls and 7.2 percent of adolescent boys reported that they had attempted suicide one or more times. For girls, violence in the past year was associated with suicide attempts, while lifetime history of sexual assault was not.
Other significant factors influencing suicide attempts among females included sexual orientation, persistent sadness, disordered eating, feeling unsafe at school, being in a physical fight and binge drinking. For male students, lifetime history of sexual assault was associated with suicide attempts, while dating violence in the past year was not. Other factors influencing suicide attempts among boys included sexual orientation, persistent sadness, disordered eating, drug use and gun possession.
"While our study focused on public high school students in a single urban area, our results are likely generalizable to urban youth across the United States," the authors conclude. "Questions about violence, depression, anxiety, substance abuse and suicidality are all extremely important and should be included as part of a comprehensive health assessment of adolescents. Furthermore, clinicians, educators and other professionals working with youth should be trained to routinely screen for violence victimization and should have a low threshold for referring these at-risk teenagers for mental health services."
Reference: Arch Pediatr Adolesc Med. 2007;161:539-545.
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