Means, Intent, Lethality, Behaviors, and Psychiatric Diagnosis in Latina Adolescent Suicide Attempters

This article describes the means, intent, lethality, behavioral profiles, and psychiatric diagnoses of adolescent Latina suicide attempters. From a large, mixed-method project studying the sociocultural processes of Latina suicide attempts, we selected 76 participants for this report. In addition to quantitative research data, medical records were available for all 76 participants, as was qualitative data from in-depth interviews for 34 of them. Using the qualitative and quantitative research data, we explored intent and behavioral profiles of the suicidal adolescents. Medical records provided additional information about the means the adolescents used in their attempts, and about their psychiatric diagnoses. The lethality of suicide attempts was coded using the Lethality of Suicide Attempt Rating Scale (LSARS) and the Lethality of Suicide Attempt Rating Scale—Updated (LSARS-II). Findings showed that Latina adolescent suicide attempts are low in lethality. Consistent with the literature, most adolescents reported that they attempted by using means available in their homes (cutting and overdosing with medications were the predominant methods). Interesting discrepancies emerged when comparing adolescents’ self-reported behavioral profiles with clinicians’ psychiatric diagnoses. This report has implications for diagnosis and treatment approaches for both inpatient and outpatient service providers

Integrating complex systems science into road safety research and practice, Part 2: Applying systems tools to the problem of increasing pedestrian death rates

Objectives To provide a specific example of how systems dynamics tools can increase understanding of stakeholder mental models' and generate robust systems-based hypotheses about the escalating problem of rising pedestrian death rates in the USA. Methods We designed and facilitated two group model building (GMB) workshops. Participants generated causal loop diagrams (CLDs) individually and in small groups to explore hypotheses concerning time-dynamic interacting factors underlying the increasing rates of pedestrian deaths. Using a grounded theory approach, research team members synthesised the structures and hypotheses into a single CLD. Results CLDs from the 41 participants indicated four core factors hypothesised to have a direct impact on pedestrian fatalities: pedestrian-vehicle crashes, vehicle speed at the time of the crash, vehicle size/dimensions and emergency response time. Participants diagrammed how actions and reactions impacted these proximal factors over time and led to ripple effects throughout a larger system to generate an increase in pedestrian deaths. Hypothesised contributing mechanisms fell within the following broad categories: community responses; research, policy and industry influence; potential unintended consequences of responses to pedestrian deaths; and the role of sprawl. Conclusions This application of systems science tools suggested several strategies for advancing injury prevention research and practice. The project generated robust hypotheses and advanced stakeholder communication and depth of understanding and engagement in this key issue. The CLD and GMB process detailed in this study provides a concrete example of how systems tools can be adopted and applied to a transportation safety topic

Integrating complex systems science into road safety research and practice, part 1: review of formative concepts

Many of our most persistent public health problems are complex problems. They arise from a web of factors that interact and change over time and may exhibit resistance to intervention efforts. The domain of systems science provides several tools to help injury prevention researchers and practitioners examine deep, complex and persistent problems and identify opportunities to intervene. Using the increase in pedestrian death rates as an example, we provide (1) an accessible overview of how complex systems science approaches can augment established injury prevention frameworks and (2) a straightforward example of how specific systems science tools can deepen understanding, with a goal of ultimately informing action

Means, intent, lethality, behaviors, and psychiatric diagnosis in Latina adolescent suicide attempters.

This article describes the means, intent, lethality, behavioral profiles, and psychiatric diagnoses of adolescent Latina suicide attempters. From a large, mixed-method project studying the sociocultural processes of Latina suicide attempts, we selected 76 participants for this report. In addition to quantitative research data, medical records were available for all 76 participants, as was qualitative data from in-depth interviews for 34 of them. Using the qualitative and quantitative research data, we explored intent and behavioral profiles of the suicidal adolescents. Medical records provided additional information about the means the adolescents used in their attempts, and about their psychiatric diagnoses. The lethality of suicide attempts was coded using the Lethality of Suicide Attempt Rating Scale (LSARS) and the Lethality of Suicide Attempt Rating Scale—Updated (LSARS-II). Findings showed that Latina adolescent suicide attempts are low in lethality. Consistent with the literature, most adolescents reported that they attempted by using means available in their homes (cutting and overdosing with medications were the predominant methods). Interesting discrepancies emerged when comparing adolescents’ self-reported behavioral profiles with clinicians’ psychiatric diagnoses. This report has implications for diagnosis and treatment approaches for both inpatient and outpatient service providers