[Maladaptive strategies, dysfunctional attitudes and negative life events among adolescents treated for the diagnosis of "suicidal behaviour"]

János Csorba, Zsuzsa Sörfozo, Péter Steiner, Beáta Ficsor, Eva Harkány, Zsuzsa Babrik, Eszter Páli, Marianna Solymossy
Psychiatria Hungarica: A Magyar Pszichiátriai Társaság Tudományos Folyóirata 2007, 22 (3): 200-11

OBJECTIVE: To identify underlying factors and subgroups (depression and substance abuse, their school and behavioural consequences, suicide spectrum (ideas + attempts + attitudes), inadequate problem-solving methods, dysfunctional attitudes, maladaptive coping and help-seeking strategies and negative life events) for suicidality in Hungarian adolescent outpatients suffering from "suicidal behaviour".

METHOD: A multidimensional self-report test battery - consisting of the Columbia Depression Scale (CDS), including the BDI and the Drug Use Screening Inventory /DUSI/, and of the Hungarian versions of the Ways of Coping questionnaire, of the Dysfunctional Attitude Scale, and of the Junior High Life Experience?? Survey - was completed by every new adolescent outpatient from a representative patient pool of five local Child Psychiatric Centres of the Western-Hungarian region over an 18-month period (n=596). 99 adolescent outpatients (78 females, 21 males, mean age 16.2 years, SD 1.18) with clinical diagnosis of suicidal behaviour confirmed by the Hungarian version of M.I.N.I. Plus Psychiatric Diagnostic Interview were included in the study.

RESULTS: A four-factor solution of the principal component analysis was constructed to explore the underlying dimensions for suicidality labelled as follows: 1. Stress-laden/Risk-taking, 2. Depressed/Dysfunctional, 3. Addictive/Risk-taking and 4. Suicidal/Maladaptive factors.

DISCUSSION: The robust and isolated representation of suicidal ideas+attempts associated with maladaptive coping strategies and with younger age confirms not only the specificity of coping qualities collected by CDS but also the risk position of younger adolescent generation in the most serious subgroups of suicidal population. Our study confirms the association of depression with dysfunctional attitudes and with maladaptive coping distinctly, but risky problem solving, maladaptive coping and dysfunctional attitudes seem to characterize different groups of depressive syndromes with only a moderate overlap. The demarcated factoring of the "Risky" conflict-solving technique of the Ways of Coping Questionnaire from the coping factor of the Columbia test proves that both presumably measure different dimensions of coping. Authors present and explain the PCA results in detail.

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