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Biomedical subjects

Julie Cerel

Publications and source records attributed to Julie Cerel.

5 recordsLinked to original sources

Consumer and family experiences in the emergency department following a suicide attempt.

OBJECTIVE: To understand the separate experiences of consumers (patients) and family members in the Emergency Department (ED) following a suicide attempt. METHODS: Separate anonymous surveys were created for two groups: 1) consumers (n = 465) who had made a suicide attempt and been to the ED, and 2) others (referred to here as family members; n = 254) who had a close friend or relative treated in an ED due to suicidal behavior. Surveys were available on the National Alliance on Mental Illness (NAMI) website (www.nami.org) for 2 months. RESULTS: Almost half of consumers were accompanied by a family member to the ED following their suicide attempt. Over half of consumers and family members felt that staff treated them with respect and addressed ethnic and cultural issues appropriately. However, fewer than 40% of consumers felt that staff listened to them, described the nature of treatments to them, or took their injury seriously. Family members were more likely than consumers to feel heard or to receive information about treatment. More than half of consumers and almost a third of family members felt directly punished or stigmatized by staff. Consumers and family members also reported negative experiences involving a perception of unprofessional staff behavior, feeling the suicide attempt was not taken seriously, and long wait times. CONCLUSIONS: Individuals who visited the NAMI website reported a range of negative experiences in EDs following visits for suicide attempts. The effects of these experiences on retention in care and subsequent self-injurious behavior are largely unexplored. A greater understanding of these effects may inform development of interventions to increase the satisfaction of consumers and their families and friends and improve outcomes that result from emergency care of suicidal patients and their families.

Adolescent↗

Childhood bereavement: psychopathology in the 2 years postparental death.

OBJECTIVE: Although the death of a parent is one of the most significant stressors a child can experience, the psychiatric sequelae of parental death are not fully understood. METHOD: A total of 360 parent-bereaved children (ages 6-17) and their surviving parents were directly interviewed four times during the first 2 years following the death (at 2, 6, 13, and 25 months). Data collection occurred from 1989 to 1996. Psychiatric symptomatology was compared among the bereaved children, 110 depressed children, and 128 community control children and their informant parents. Additional analyses examined simple bereavement without other stressors versus complex bereavement with other stressors and anticipated versus unanticipated death. RESULTS: Bereavement following parental death is associated with increased psychiatric problems in the first 2 years after death. Bereaved children are, however, less impaired than children diagnosed with clinical depression. Higher family socioeconomic status and lower surviving parents' level of depressive symptoms are associated with better outcomes. Complex bereavement was associated with a worse course, but anticipation of the death was not. CONCLUSIONS: Childhood bereavement from parental death is a significant stressor. Children who experience depression in combination with parental depression or in the context of other family stressors are at the most risk of depression and overall psychopathology.

Bereavement↗

Suicidal behavior in the family and adolescent risk behavior.

PURPOSE: The purpose of this study was to examine the prevalence and sociodemographic characteristics of adolescents exposed to suicide attempts and suicide deaths by a family member and to evaluate the separate associations between exposure to a family member's suicide attempts or suicide death and risk behaviors, social-emotional functioning, and family connectedness. METHOD: We performed a cross-sectional analysis of data collected in 1995 for wave I of the National Longitudinal Survey of Adolescent Health (n = 5,918). The independent variable was the exposure to suicidal behavior by a family member during the past 12 months (death by suicide, suicide attempt, and no suicidal behavior). The dependent variables were substance use, suicidal behavior, violent behavior, perceived shortened life expectancy, emotional distress, and parental and adolescent reports of family connectedness. RESULTS: In the year before the survey, 3.9% of adolescents experienced a family member's suicide attempt whereas 1.2% experienced a family member's death by suicide. In regression analyses adjusting for sociodemographic variables, adolescents who had experienced the suicide attempt of a family member were more likely than those with no exposure to report the following: cigarette and marijuana use, alcohol misuse, suicidal ideation and attempts, fighting and inflicting injuries, decreased life-expectancy, emotional distress, and decreased adolescent reports of parent-child and family connectedness. Adolescents who had experienced a family member's death by suicide were more likely to report marijuana use and alcohol misuse, suicidal ideation and attempts, inflicting severe injuries, and emotional distress. CONCLUSIONS: Adolescents who have experienced suicide attempts or suicide deaths in the family show high levels of at-risk behaviors, most notably their own suicidal ideation and attempts.

Adolescent↗

Peer suicidal behavior and adolescent risk behavior.

The relationship between adolescent suicide attempts and death by suicide and psychosocial functioning of peers remains poorly understood, especially in the myriad ways that these suicidal behaviors might impact friends. This study explored the relationship between peer suicidal behavior and adolescent risk behavior using a large, nationally representative sample of adolescents (N = 5852). Results indicate that youth exposed to peer suicidal behavior are significantly more likely to have their own suicidal ideation and attempts, and to smoke cigarettes and marijuana, binge drink, be involved in a serious physical fight, and have inflicted injuries that require medical attention. These results highlight the need for professionals to be aware of these risks in friends of those who have attempted or died by suicide. Assessment and intervention for peers is appropriate and required for this at-risk group.

Adolescent↗