Published online by Cambridge University Press: 04 December 2009
The assessment of suicidal behavior in children and adolescents presents several unique clinical issues, specifically related to developmental factors that make such assessment a dynamic task of arriving at a clinical judgment of how likely it is that a child or adolescent will behave in a suicidal manner. Extensive research of the epidemiology, clinical characteristics, and longitudinal course of suicidal behavior suggests that suicidal behavior occurs throughout the human life span with similarities that make it a clinical necessity to evaluate all individuals who come for medical or psychiatric attention for their level of suicidal risk. The importance of evaluating children and adolescents for suicidal behavior is supported by recent U.S. national epidemiological statistics indicating that in the last two decades the rates of suicide among children and young adolescents, age 5–14 years, have doubled and the rates of suicide among adolescents and young adults, age 15–24 years, are among the highest rates of all ages and they continue to increase (Singh et al., 1996). This chapter will discuss a systematic approach based on an understanding of developmental issues that are important for evaluating children and adolescents for suicidal behavior. It will focus also on evaluating the major issues that are associated with risk for such behavior (American Academy of Child and Adolescent Psychiatry, 2001; see also Pfeffer, 2001).
The concept of suicidal behavior
Conceptualization of what constitutes suicidal behavior among children and adolescents is best considered within a schema of developmental psychopathology.