Correlates and Short-Term Course of Self-Poisoning in Adolescents

Abstract

Family dysfunction could be a useful focus in a clinical trial of the aftercare of adolescents who have taken an overdose.

Randomized Trial of a Home-Based Family Intervention for Children Who Have Deliberately Poisoned Themselves

“…Cases in which it was unclear whether the overdose was deliberate or not (e.g., overdose of a drug usually used for kicks, or the adolescent denied that the overdose was deliberate) were also excluded because the intervention program assumes that the overdose is deliberate. Young people with major depression were not excluded because in a previous study in the same hospitals we had shown that major depression after a deliberate overdose resolved rapidly in most cases (Kerfoot et al, 1996) [15].…”

“…A pilot study in the same hospitals (Kerfoot et al, 1996) [15] showed that after routine aftercare, the mean Suicidal Ideation Questionnaire score (mean = 36.2, SD = 26.3) was still much higher than in matched community controls (mean = 8.8, SD = 16.9). In line with other research (Jacobson and Truax, 1991) [11], an empirical decision was made that clinically significant change would be defined as a mean level of symptomatology after active treatment that was more than halfway between the mean score after the control treatment and the mean score for the general population.…”

“…The essential features of the program were that it was short-term, intensive, focused, action-orientated, and homebased. The rationale behind it was that because self-poisoning in adolescents is strongly associated with family dysfunction (Hawton et al, 1996;Kerfoot, 1988;Kerfoot et al, 1996) [9,14,15], improvements in family functioning should lead to reduced suicidality in the child and to reduced stress within the family.…”

“…The primary outcome measures were validated in a pilot study conducted by the two outcomes assessors (Kerfoot et al, 1996) [15] and comprised the Suicidal Ideation Questionnaire (Reynolds, 1988) [22] and the Hopelessness Questionnaire (Kazdin et al, 1986) [12] completed by the patients, and a questionnaire measure of family functioning completed independently by both the patient and the parent(s) (Miller et al, 1985) [20].…”

“…We chose a brief home-based program because previous work has shown that this group comply poorly with traditional hospital out-patient appointments and frequently fail to complete lengthy courses of treatment (Trautman et al, 1993) [26]. A family intervention was used because our previous research has shown a strong and specific association between deliberate self-poisoning in adolescence and family dysfunction (Kerfoot, 1988;Kerfoot et al, 1996) [14,15]. The two main hypotheses were (1) that the intervention would lead to lower levels of adolescent suicidal ideation and (2) that the families would function better.…”