Clive Richardson

Adolescents’ self-reported suicide attempts, self-harm thoughts and their correlates across 17 European countries

BACKGROUND   Suicide is a leading cause of death among adolescents in Europe. Self-harm thoughts and behaviours are documented precursors of completed suicide. It is therefore of great importance to investigate the prevalence of suicide thoughts and attempts and their correlates, with the aim of preventing this major life-threatening public health problem. This study provides cross-national European data on self-reported suicidal thoughts and attempts among adolescents. METHODS   Data were obtained from 45,806 high school students aged 15-16 years from 17 countries that participated in the European School Survey Project on Alcohol and Other Drugs (ESPAD) 2007 school survey. The standardised methods of the ESPAD survey ensure comparability across countries. Students completed an anonymous questionnaire in their classrooms. The prevalences of suicidal thoughts and attempts are reported as well as their sociodemographic and psychosocial correlates identified in logistic regression. RESULTS   The median prevalence of any lifetime self-reported suicide attempt was 10.5% across the participating countries (range 4.1%-23.5%). The median of frequent self-harm thoughts (at least five times) was 7.4% (range 2.1%-15.3%). Suicidal behaviour and thoughts had significant associations with gender, substance use, family integrity and socioeconomic status. Countries with higher prevalence of substance use tended to have a weaker association between substance use and self-reported suicide attempts. CONCLUSION   Although self-reported self-harm thoughts and suicide attempts vary in prevalence within Europe, there are common correlates across countries. These have an important impact on understanding the phenomenon of suicide among young people and in guiding prevention.

The standardization of Achenbach's Youth Self-Report in Greece in a national sample of high school students

Abstract Achenbachs Youth Self Report (YSR) questionnaire is accepted worldwide for the assessment of adolescent competencies and behaviour problems. As with any similar instrument, it is liable to cultural influences, hence requires standardization for the culture in which it is to be used. This study reports on the standardization of the YSR in Greece, in a national school-based sample of 1456 high school students, 11–18 years of age. Responses at the item level seem to follow the culturally expected gender behaviour. Behaviour problem scale scores were not affected by degree of urbanization, reflecting a high degree of cultural homogeneity between urban and rural areas in Greece. Sex effects were important, with girls showing a greater tendency towards Internalizing and boys towards Externalizing Problems. Age effects were also statistically significant (older adolescents showing more problems, especially of the delinquent type), but numerically small. There was considerable correlation between Internalizing and Externalizing problems, with an odds ratio of 6.9 (95% confidence interval, 4.6–10.4) for exceeding both cut-offs. The analysis showed that Greek adolescents obtained significantly higher mean scores than their American counterparts on all scales. Cut-off points based on the 90th and 98th percentile developed from this sample are presented for the competencies and the problem scales.

Online Social Networking in Adolescence: Patterns of Use in Six European Countries and Links With Psychosocial Functioning

PURPOSE Online communication tools, such as social networking sites (SNS), have been comprehensively embraced by adolescents and have become a dominant daily social practice. Recognizing SNS as a key context of adolescent development, this study aimed to investigate associations between heavier SNS use, and adolescent competencies and internalizing problems. METHODS Data was collected in six European countries: Greece, Spain, Poland, the Netherlands, Romania, and Iceland. Participants were 10,930 adolescents aged 14-17 years (F/M: 5,719/5,211; mean age 15.8 ± .7 years); 62.3% were aged 14-15.9 years and 37.7% were aged 16-17.9 years. Participants reported on their use of online communication tools, and their general competencies and internalizing problems (Youth Self Report). RESULTS SNS are both ubiquitous--used by 70% of adolescents--and engaging, given that 40% of users spend 2 or more hours daily on SNS (labeled heavier SNS use). Heavier SNS use was associated with more internalizing problems, and the relation was consistently more pronounced among younger adolescents. Moreover, heavier SNS use was associated with lower academic performance and lower activities scores, especially for younger adolescents. In contrast, among older adolescents heavier SNS use was positively associated with offline social competence. CONCLUSIONS Although heavier SNS use is associated with higher social competence for older adolescents, it is also associated with increased internalizing problems and diminished competencies in academics and activities, especially for younger adolescents. Age, capturing developmental differences in social and regulatory skills, appears to moderate the effects of heavier SNS use on adolescent functioning.

Knowledge About Schizophrenia and Attitudes Towards People with Schizophrenia in Greece

Background: This study was the first national survey ever conducted in Greece aiming to monitor the level of stigma Greeks hold against people with schizophrenia (PWS). Aim: To investigate sources, degree of knowledge and attitudes towards PWS in Greece. Method: A cross-sectional nationwide survey was conducted by face-to-face household interviews ( n = 1,199, aged 15 years and over). Results: Television was the main source of information (65.9%). Negative portrayals of PWS were recalled by 60.5%. Only 27.7% attributed schizophrenia to a combination of psychosocial, genetic and environmental factors. Respondents believed that PWS are dangerous (74.6%), have split personalities (81.3%) and cannot work (83.2%). Regarding attitudes, a negative relationship between closeness and social distance was observed. Most respondents (92.1%) would not marry someone with schizophrenia, half (50.5%) would be disturbed by working with PWS and one third (32.9%) would feel afraid to start a conversation. Urban residence and higher education were generally associated with better knowledge and more positive attitudes towards PWS. Conclusions: Knowledge about schizophrenia in Greece is poor. The Greek public has stigmatizing attitudes towards PWS. Educational interventions should especially target rural and semi-urban residents of a lower educational level. The role of television can be crucial.

Cyberbullying victimization prevalence and associations with internalizing and externalizing problems among adolescents in six European countries

More than one in five of European adolescents reported cyberbullying victimization.The prevalence rate of cyber victimization was higher among girls than boys.The prevalence rate was highest in Romania while the lowest was in Spain.Externalizing, internalizing and academic problems were associated with cyber victimization. Cyberbullying victimization is an important adolescent health issue. The cross-national study aimed to investigate the prevalence of cyber victimization and associated internalizing, externalizing and academic problems among adolescents in six European countries. A cross-sectional school-based study of 14-17year-old adolescents (N=10,930; F/M: 5719/5211; mean age 15.8?0.7years) was conducted in Spain, Poland, the Netherlands, Romania, Iceland and Greece. In total, 21.4% of adolescents reported cyber victimization in the past 12months. Reports were more frequent among girls than boys (23.9% vs. 18.5%), and among the older adolescents compared to the younger ones (24.2% vs. 19.7%). The prevalence was highest in Romania and Greece (37.3% and 26.8%) and lowest in Spain and Iceland (13.3% and 13.5%). Multiple logistic regression analysis indicated that cyber victimization was more frequent among adolescents using the internet and social networking sites for two or more hours daily. Multiple linear regression analysis showed that externalizing, internalizing and academic problems were associated with cyber victimization. Overall, cyber victimization was found to be a problem of substantial extent, concerning more than one in five of the studied European adolescents. Action against cyber victimization is crucial while policy planning should be aimed at the prevention of the phenomenon.

The Leyton obsessional inventory - child version in Greek adolescents: standardization in a national school-based survey and two-year follow-up.

Abstract.Objective: The aims of this study were a) to standardize the survey form of the Leyton Obsessional Inventory – Child Version (Leyton-CV) in Greece, and estimate its sensitivity and specificity, and b) to assess high-risk factors for the development of adolescent obsessive-compulsive disorder (OCD) within a two year period. Method: The Leyton-CV was administered to a national, representative, school-based population of 2552 Greek adolescents. Adolescents with a wide range of Leyton-CV scores were interviewed with the SADS-LA to determine the sensitivity and specificity of the instrument. Adolescents with high Leyton scores but no OCD diagnosis, and those with obsessive-compulsive symptoms (OCS), were re-interviewed after two years with the SADS-LA. Family history data on OCD and other mental illness were obtained through the Family Informant Schedule at follow-up. Results: Using a cut-off point of 35 for the total score, the sensitivity of the Leyton-CV was 79.4 % and the specificity 72.6 %. High Leyton-CV scores and a positive family history for OCD/OCS appeared to constitute high risk factors for later OCD/OCS in adolescents.

Changes in associations between psychosocial factors and suicide attempts by adolescents in Greece from 1984 to 2007

BACKGROUND Suicide is the second commonest cause of death among adolescents and young adults aged 15-35 years in Europe. Suicide attempts are a strong risk indicator for suicide. This article examines psychosocial factors associated with self-reported suicide attempts in adolescents in Greece and whether the reported increase in suicide attempts from 1984 to 2007 was accompanied by changes in the pattern of related psychosocial factors. METHODS Data were taken from nationwide probability sample surveys of Greek high school students aged 14-18 years in 1984 (n = 10,507) and 2007 (n = 9873). Logistic regression analysis was used to relate any self-reported suicide attempts to basic sociodemographic and psychosocial variables including family and psychological characteristics, and substance use. RESULTS Female gender, smoking, illicit drug use, low socio-economic status, not living with both parents, dissatisfaction with relationship with parents, visits to a doctor for psychological problems, depression, anti-social behaviour and low self-esteem were risk factors for self-reported attempted suicide by adolescents in both surveys. Significant interaction terms showed that the effects of gender and illicit drug use were smaller in 2007 than in 1984. However, low self-esteem became significantly more important. CONCLUSIONS Several common psychosocial factors seem to be steadily related to self-reported suicide attempts by Greek adolescents in 1984 and 2007. However, the increase in self-reported suicide attempts between 1984 and 2007 has been accompanied by changes in the relative importance of correlates.

National Income Inequality and Declining GDP Growth Rates Are Associated with Increases in HIV Diagnoses among People Who Inject Drugs in Europe: A Panel Data Analysis

Background There is sparse evidence that demonstrates the association between macro-environmental processes and drug-related HIV epidemics. The present study explores the relationship between economic, socio-economic, policy and structural indicators, and increases in reported HIV infections among people who inject drugs (PWID) in the European Economic Area (EEA). Methods We used panel data (2003–2012) for 30 EEA countries. Statistical analyses included logistic regression models. The dependent variable was taking value 1 if there was an outbreak (significant increase in the national rate of HIV diagnoses in PWID) and 0 otherwise. Explanatory variables included the growth rate of Gross Domestic Product (GDP), the share of the population that is at risk for poverty, the unemployment rate, the Eurostat S80/S20 ratio, the Gini coefficient, the per capita government expenditure on health and social protection, and variables on drug control policy and drug-using population sizes. Lags of one to three years were investigated. Findings In multivariable analyses, using two-year lagged values, we found that a 1% increase of GDP was associated with approximately 30% reduction in the odds of an HIV outbreak. In GDP-adjusted analyses with three-year lagged values, the effect of the national income inequality on the likelihood of an HIV outbreak was significant [S80/S20 Odds Ratio (OR) = 3.89; 95% Confidence Interval (CI): 1.15 to 13.13]. Generally, the multivariable analyses produced similar results across three time lags tested. Interpretation Given the limitations of ecological research, we found that declining economic growth and increasing national income inequality were associated with an elevated probability of a large increase in the number of HIV diagnoses among PWID in EEA countries during the last decade. HIV prevention may be more effective if developed within national and European-level policy contexts that promote income equality, especially among vulnerable groups.

The Conners-28 teacher questionnaire in clinical and nonclinical samples of Greek children 6 –12 years old

Abstract It is accepted practice in child psychiatry to use more than one source of information in assessing behavioural problems in children and adolescents. Employing standardized tools for these assessments allows cross-cultural comparisons and better interchange of the findings. Achenbachs Child Behavior Checklist (CBCL) and Teachers Report Form (TRF) are two widely accepted instruments that were standardized in Greece within the framework of the European Network for the Study of Hyperkinetic Disorder. We studied the Conners-28 teacher questionnaire in a Greek community sample of primary schoolchildren aged 6–12 years. The factor structure showed to be similar to that originally reported from the USA. Discrimination between the referred and nonreferred sample was high, especially for the Inattentive-passive scale. Conners-28 scores were highly correlated with the TRF (scored by the same informant), much less so with the CBCL (scored by a different informant). Our study demonstrates the usefulness and applicability of the Conners-28 item questionnaire.

Polydrug use by European adolescents in the context of other problem behaviours

Aim Previous studies of the association between polydrug use and other risk behaviours have generally been limited to specific substances and a small number of behaviours. The aim of this study is to obtain better insight into polydrug use (comprising legal and illegal substances: tobacco, alcohol, tranquillisers/sedatives, cannabis, and other illegal drugs) and its association with co-occurring problem behaviours drawn from various broad domains (sexual, aggressive, delinquent, school achievement, relationships) among European adolescents. Methods Data were obtained from 101,401 16-year-old students from 35 European countries participating in the 2011 ESPAD survey. Associations between polydrug use and other problem behaviours were examined by multinomial and binary logistic regression analyses. Results Tranquillisers/sedatives appeared among the commonest combinations in the polydrug use pattern, especially for females. A strong trend was found between levels of involvement with polydrug use and other problem behaviours for both genders. The highest associations with polydrug use were for problems with the police, risky sexual behaviour and skipping school. Gender differences showed higher prevalences among boys than girls of problem behaviours of aggressive, antisocial type, while girls prevailed over boys in relationship problems. Conclusion An incremental relationship exists between the level of involvement with polydrug use and the co-occurrence of problem behaviours. Preventative interventions should consider the misuse of tranquillisers/sedatives within the context of polydrug use by adolescents and expand their target groups towards multiple problem behaviours.