BACKGROUND:Clinical and demographic factors influencing prescribed sleep medication use in children and young people (CYP) have been studied inadequately. We aimed to examine the prevalence of prescribed sleep medication use among CYP experiencing mental health crises and its associations with clinical and demographic factors. MATERIALS AND METHODS:Electronic medical records of CYP (n = 201) attending the Macarthur Safeguards Acute Mental Health Crisis Service (referred to as the Safeguards Service) in Sydney, Australia, were reviewed. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. Multivariate logistic regression was used to estimate the Adjusted Odds Ratio (AOR) with 95% confidence intervals, examining the associations between prescribed sleep medication use and clinical and demographic factors. RESULTS:The prevalence of prescribed sleep medication use (e.g., melatonin, benzodiazepines) among CYP was 20.9%. Multivariate regression analysis indicated that CYP's length of stay with the Safeguards Service was positively associated with increased prescribed sleep medication use (AOR = 3.61, 95% CI: 1.19-10.94, p = 0.023). CYP who were diagnosed with trauma-related psychiatric conditions tended to use more prescribed sleep medication use (AOR = 2.81, 95% CI: 1.09-7.19, p < 0.032). Moreover, multiple medication prescriptions (polypharmacy) were strongly associated with increased prescription of SM (AOR = 11.36, 95% CI: 4.46-28.95, p < 0.000). CONCLUSION:Prescribed sleep medication use is significant in CYP experiencing mental health crises. This requires careful consideration due to potential risks, drug interactions, and limited evidence of long-term benefits. There needs to be a focus on addressing the underlying causes of sleep difficulties and exploring adjunct non-pharmacological interventions, especially for those with trauma-related psychiatric conditions, those who tend to have a longer length of stay and are prescribed multiple medications, including for sleep.
BACKGROUND:Adolescent suicidal ideation is a critical public health issue, with limited support options in low-resource settings. PURPOSE:This study aimed to evaluate the acceptability, usability, and preliminary effects of Emo-Safe, an Android-based application designed to enhance emotional regulation and reduce suicidal ideation among adolescents. METHODOLOGY:This study utilized a sequential, explanatory mixed-methods approach, consisting of quantitative followed by qualitative methods. Sixty students, aged 15-18, participated in the study, divided into an intervention group (n = 30) and a control group (n = 30) for 4 weeks. Core app features included daily mood tracking, reflective journaling with AI-assisted reframing guided by cognitive-behavioral therapy (CBT) principles, breathing exercises, personalized insights, and an AI "friend" for encouragement. Outcomes measured were the Indonesian Depression Anxiety Stress Scales for Youth (IDASS-Y) and the Suicidal Ideation Scale (SIS). RESULT:Results indicated that the intervention group had significantly lower post-test IDASS-Y scores (28.43 vs. 33.17; p = 0.037) and reduced stress levels (8.83 vs. 12.37; p = 0.001). The SIS also favored the intervention group (14.83 vs. 21.70; p < 0.001). Acceptability was high (mean rating 4.24/5) with positive feedback on material clarity and facilitator effectiveness, along with suggestions for improvements. CONCLUSIONS:Findings demonstrate the acceptability and usability of Emo-Safe, alongside promising short-term reductions in stress and suicidal ideation. However, further systematic evaluation of broader feasibility indicators, such as recruitment and long-term engagement, is needed in future trials.
BACKGROUND:Developmental dysgraphia affects 5% to 20% of school-age children and reaches 59% among children with ADHD or autism. The condition produces task avoidance, eroded self-esteem, and behavioral presentations that frequently result in psychiatric referral for anxiety, depression, school refusal, and behavioral disturbance. More than 37% of children with learning disabilities reach clinical thresholds for affective and ADHD problems. Despite this clinical footprint, dysgraphia remains nosologically contested and rarely identified within psychiatric evaluation. OBJECTIVES:This integrative review synthesizes the multidisciplinary evidence on developmental dysgraphia and examines its implications for child and adolescent psychiatric-mental health nursing. DATA SOURCES:Eight databases (PubMed/MEDLINE, CINAHL, PsycINFO, Scopus, ERIC, Cochrane, OTseeker, Web of Science) yielded 8290 records published between January 2000 and March 2026. After deduplication, 6308 records were screened, 1476 were assessed for eligibility, and 56 contributed to synthesis. Synthesis followed Whittemore and Knafl (2005) under PRISMA 2020 reporting conventions. CONCLUSIONS:Findings document definitional disagreement, fragmented assessment, underpowered intervention evidence, and substantial psychosocial burden. Three nursing publications addressed dysgraphia, and none reported original research on the condition. IMPLICATIONS FOR PRACTICE:Dysgraphia screening may be integrated into psychiatric evaluations of children referred for ADHD, anxiety, depression, school refusal, or behavioral disturbance. Handwriting may be monitored as a stimulant medication outcome. On inpatient units, writing-based therapeutic activities require adaptation when dysgraphia is suspected. Pediatric primary care and school health represent upstream identification opportunities.
BACKGROUND:Attention-deficit/hyperactivity disorder (ADHD) affects 5%-7% of school-aged children globally and is characterized by a 40%-60% comorbidity rate with oppositional defiant disorder (ODD). Irritability has emerged as a key transdiagnostic construct linking ADHD severity to oppositional defiant behavior (ODB); however, whether the structural pattern of associations among these constructs differs across clinical and non-clinical populations remains unexamined. PURPOSE:This study employed multi-group path analysis within the SEM framework to test whether the structural pathways linking ADHD symptom severity, child irritability, and ODB are invariant across a Clinical ADHD Group (n = 42) and a Healthy Control Group (n = 43; total N = 85). Maternal psychological distress was controlled as an exogenous covariate across all groups. METHODS:A cross-sectional design was employed. ADHD severity, child irritability, ODB, and maternal distress were assessed via validated parent-report instruments (CPRS-R/S, ARI, BSI). Observed-variable multi-group path analysis was performed in R using the lavaan package (Rosseel, 2012) (see Supplementary Material S1 for reproducible code and fit index selection) via a nested model comparison, with omnibus structural invariance evaluated using the Chi-square difference test (Δχ2); ODB was regressed on ADHD severity, child irritability, and maternal distress, with the three exogenous variables permitted to covary. Bias-corrected bootstrapping (2000 resamples) was used for parameter confidence intervals. RESULTS:The omnibus test of structural invariance was statistically significant, Δχ2 (3) = 10.494, p = 0.015, indicating that the structural associations among the focal constructs differ across groups. In the Healthy Control Group, ODB was most strongly associated with child irritability (β = 0.636, p < 0.001), with ADHD severity showing a weaker association (β = 0.358, p = 0.001; R2 = 0.560). In the Clinical ADHD Group, the pattern differed: ODB was most strongly associated with ADHD symptom severity (β = 0.667, p < 0.001), whereas the association with irritability was weaker (β = 0.232, p = 0.044; R2 = 0.585). Maternal psychological distress was not uniquely associated with ODB in either group. CONCLUSIONS:Child irritability was the strongest correlate of ODB in neurotypical children, consistent with frustration-based oppositional expression. In clinical ADHD, oppositional behavior was more strongly associated with ADHD symptom severity than with irritability, a pattern consistent with conceptualizations emphasizing executive dysfunction. These findings carry distinct assessment and intervention implications for psychiatric-mental health nursing practice.
PURPOSE:This study aimed to determine the effects of a cognitive-behavioral therapy (CBT)-based psychoeducation program (the Social Media Addiction Reduction Psychoeducation Program (SMARPP), on university students' social media addiction and self-control. METHOD:The study used pre-test, post-test, and follow-up method with university students. Ninety-five students took part. Data were collected using a general information form, the Social Media Addiction Scale (SMAS), and the Short Self-Control Scale (SSCS). The data were analyzed using basic statistics such as number, percentage, average, and standard deviation, as well as independent sample t-tests and variance analysis. RESULTS:The average age of the experimental group was 20.39 ± 1.81years, and that of the control group was 20.16 ± 2.09 years. In the experimental group, students' SMAS total scores and subdimension scores (occupation, mood regulation, conflict, and repetition) decreased significantly. Their total SSCS scores went up significantly (p < 0.05). In the control group, there were no significant changes in the scores (p > 0.05). CONCLUSION:The SMARPP effectively reduced university students'social media addiction and increased their self-control. In this regard, it is recommended that mental health nurses and psychological counselors working in schools apply the SMARPP.
BACKGROUND:Playing online games is one of the main activities in leisure time for adolescents but it has started to cause serious concerns about their mental and physical health. PURPOSE:The current study, based on the Health Belief Model (HBM), examines the relationship between online gaming habits and health perceptions among adolescents in Jordan. HBM provides a framework to understand how perceptions of susceptibility to harm and cues to action influence health behaviors, mainly through hours of playing games a day. METHODOLOGY:This cross-sectional study utilized a sample of 403 adolescents aged 10-17 years, employing a Google form to assess daily gaming duration, types of games played, and perceptions of physical and mental health. We used SPSS 24.0 to do both descriptive and inferential statistics. RESULTS:Participants spent approximately 3.1 h daily on gaming. More than a quarter of participants did not perceive gaming as harmful to physical or mental health, suggesting low perceived susceptibility. Also, 36.7% had not received any counseling on the potential harms of online gaming, highlighting a gap in cues to action. Among those who received guidance, parents were recognized as the principal source of counseling. The study found significant negative correlations among age, daily gaming hours, and perceptions of physical and mental health. Regression analyses revealed that older age, type of game played, and increased daily hours of gaming significantly predicted poorer physical health ratings (β = -0.220, p < 0.01; β = -2.838, p < 0.05, β = -0.310, p < 0.01, respectively). On the other hand, older age (β = -0.199, p < 0.05), increased daily gaming hours (β = -0.176, p < 0.05), and believing that online games harm mental health (β = -0.285, p < 0.01) were significant predictors of poorer mental health perceptions. CONCLUSIONS:The study results underscore the necessity for initiatives designed to foster healthier gaming habits and improving awareness of potential harms among adolescents, parents, teachers, school nurses, and healthcare practitioners in Jordan.
BACKGROUND:Adolescent depression is a major public health issue in Thailand, with post-pandemic rates at 27%-37%. While perceived stress, coping, and social support are linked to depressive symptoms, their combined predictive contributions during the COVID-19 pandemic-to-endemic transition are underexplored among Southeast Asian adolescents. PURPOSE:This study examined the effects of perceived stress, approach coping, avoidance coping, and social support on depressive symptoms among Thai adolescents during this transition. METHODOLOGY:A predictive cross-sectional design was used with 605 Thai high school students via multistage sampling from two central Thailand schools (September 2023-March 2024). Measures included the CES-D, Perceived Stress Scale, Self-Report Coping Measure, and revised Thai Multidimensional Scale of Perceived Social Support. Hierarchical multiple regression assessed the variance explained by each predictor. RESULTS:Depressive symptoms were found in 27.8% of participants. Perceived stress was the strongest predictor (β = 0.664, p < 0.001), accounting for 54.3% of the variance. Avoidance coping was a significant secondary predictor (β = 0.133, p < 0.001; ΔR2 = 0.012). Approach coping and social support did not reach independent significance in the final model after perceived stress and avoidance coping were accounted for. CONCLUSIONS:Perceived stress and avoidance coping are key modifiable predictors of adolescent depression during Thailand's pandemic-to-endemic transition. School-based psychiatric nurses should integrate stress screening, adaptive coping skills training, and family-inclusive psychoeducation to address the mental health burden among Thai youth.
BACKGROUND:Psychological maturity represents the evolution of meaning-making systems from impulsive to self-authoring minds. In the Turkish cultural context, understanding how internal regulatory mechanisms and paternal influences foster this developmental transition is crucial for adolescent mental health. METHODS:This correlational study included 271 high school students in Istanbul, Türkiye. Data were collected using the Psychological Maturity Scale, Adolescent-Parent Conflict Scale, Emotion Regulation Scale, and Positive Father Scale. Multiple linear regression was employed to analyze relationships. RESULTS:The regression model was statistically significant (F(3, 267) = 22.33, p < 0.001), explaining 20.1% of the variance in psychological maturity. Internal functional emotion regulation emerged as the strongest predictor (β = 0.326, p < 0.001), followed by adolescent-parent conflict (β = -0.197, p = 0.001) and positive father (β = 0.131, p = 0.020). FINDINGS:Psychological maturity is an interactive process where internal regulation serves as the important developmental architecture. While paternal support and internal regulation function as independent pathways to maturity, positive fathering provides a vital secure base that buffers the negative impact of conflict. Clinical interventions should prioritize both paternal engagement and adolescent regulatory skills to facilitate the transition to adult-level maturity.
PURPOSE:This study investigated the correlations between family anthropometric and physiological health (i.e., body mass index [BMI], percent body fat, blood pressure [BP], skin carotenoids) and preschoolers' parent- and teacher-rated socio-behavioral outcomes (i.e., externalizing behaviors: self-centered/explosive, attention problems, antisocial/aggressive behaviors; internalizing behaviors: social withdrawal, anxiety/somatic problems; social skills: social cooperation, interaction, and independence). METHODS:Baseline data from a cluster randomized clinical trial were analyzed using R 4.0. A total of 168 preschoolers (Mage = 46.98 months) and 154 parents (Mage = 31.3 years) were non-randomly recruited from 16 Head Start centers in the Midwest U.S. Both parents and teachers completed an online survey assessing preschoolers' socio-behavioral health, and blinded trained data collectors measured each dyad's height, weight, percent body fat, skin carotenoids, and parents' BP. Generalized linear mixed-effects models with restricted maximum likelihood estimation were applied, accounting for random cluster effects of childcare centers and classrooms. FINDINGS:Preschoolers' BMI-z was positively associated with teacher-rated social skills (B = 3.66, p = 0.034). Parents' BMI had a positive relationship with preschoolers' self-centered/explosive behaviors (B = 0.61, p = 0.031) and antisocial/aggressive behaviors (B = 0.50, p = 0.045), while their percent body fat and systolic BP were negatively associated with preschoolers' anxiety/somatic problems (B = -0.40, p = 0.034; B = -0.31, p = 0.032). Preschoolers' skin carotenoids were positively correlated with their social independence (B = 0.07, p = 0.025), and parents' skin carotenoids were negatively associated with preschoolers' antisocial/aggressive behaviors (B = -0.07, p = 0.038). CONCLUSIONS:The results offer important insights into the complex impact of poor anthropometric and physiological health on socio-behavioral development during early childhood.
Background Childhood anxiety is an increasing concern globally, with rates rising significantly following the COVID-19 pandemic. However, there are relatively few evidence-based interventions specifically designed to directly target and involve younger children under 7 years old. To address this gap, a six-session manualised programme was developed to assist children aged 4-7 in managing their anxiety. The programme integrates Cognitive Behavioural Therapy (CBT) with Sensory Modulation (SM) strategies, providing simple and practical tools to aid young children in coping with anxiety. This study aimed to evaluate the effectiveness, acceptability, and practicality of this CBT-SM intervention when delivered through community-based child and adolescent mental health services (CAMHS).Methods A single-case experimental design (SCED) was employed, involving six children diagnosed with anxiety across two sites. At least three children were reported to have sensory challenges. A psychologist assessed the children's anxiety at three intervals: at the beginning of the study, after the intervention was completed, and 4 weeks later. Parents also completed questionnaires measuring behavioural issues (both internalising and externalising) and the impact of anxiety on daily life at baseline, prior to treatment, and after treatment.Results The study revealed significant reductions in anxiety and improvements in overall functioning. Both parents and therapists reported the programme as acceptable. Notably, four out of six children (67%) no longer met the criteria for an anxiety diagnosis following the intervention and at follow-up.Conclusions These findings provide preliminary support for the effectiveness, acceptability, and practicality of this innovative CBT-SM approach in assisting young children in managing anxiety.
Topic The article focusses on the use coercion in acute psychiatric wards for children and adolescents in Norway.Purpose The purpose of this article is to provide insight into how coercion within a continuum of formal and informal coercion is embedded in psychiatric treatment of children and adolescents. This integrated focus on multiple forms of coercion is critical for raising professional awareness regarding the effects of coercion on children's wellbeing, trust in professionals and future access to mental health services.Sources Used The study is based on ethnographic fieldwork in three acute wards in Norway conducted in 2023-2024. The research is part of a larger mixed-methods study focusing on the complexities of coercion in Norwegian child and adolescent psychiatry, which in addition to fieldwork includes interviews and surveys with clinical staff and patients in 18 acute wards.Conclusion The study shows how formal and informal coercion is embedded in routine therapeutic practices in child and adolescent acute wards. Three forms of informal coercion are highlighted: misinformation or withholding information, the use of leverage to obtain treatment compliance, and the threat of formal coercion to secure treatment compliance. In clinical practice, the use of formal and informal coercion is interrelated. Children experience distress, frustration and exhibit forms of withdrawal when exposed to coercion. The study concludes that providing transparency in treatment activities and plans, listening to children's perspectives on treatment needs, and showing respect for their autonomy, also when they are admitted on parental consent, is vital for their wellbeing, recovery and future access to mental health care and other support systems.
INTRODUCTION:The widespread integration of digital technologies into adolescents' daily lives has raised concerns about potential behavioral correlates, including aggression. Although prior research suggests a relationship between technology use and aggressive behavior, results are mixed and often context-dependent. This study aimed to examine the association between information technology use and aggression among Turkish adolescents. METHODS:A descriptive cross-sectional study was conducted with 841 adolescents aged 11-14 years recruited from three public secondary schools in southeastern Turkey between February 3, 2025, and February 14, 2025. Data were collected using a sociodemographic questionnaire, the Information Technologies Usage Scale, and the Aggression Scale. Pearson correlation analyses and hierarchical multiple linear regression models were performed to examine associations between technology use and aggression, both before and after controlling for demographic and familial variables. RESULTS:Technology use was positively associated with aggression (r = 0.296, p < 0.001). In regression analyses, information technology use remained a significant predictor of aggression after adjustment for covariates (β = 0.235, p < 0.001), explaining a small proportion of variance. Among technology sub-dimensions, digital game playing and use of technological devices and applications were significantly associated with higher aggression scores, whereas virtual life preference was not. Longer daily technology use was also associated with higher aggression levels. CONCLUSION:Higher levels of technology engagement, particularly digital gaming and device use, were associated with increased aggression scores among adolescents, although the magnitude of these associations was small. Given the cross-sectional design, causal inferences cannot be drawn. The results highlight the importance of considering both the type and duration of technology use in adolescent behavioral research and underscore the need for longitudinal studies to clarify temporal relationships and underlying mechanisms.
OBJECTIVE:This scoping review assesses machine learning (ML)-based prediction models for autism spectrum disorder (ASD) in early childhood, with the aim of providing a technical and conceptual foundation for improving early ASD detection. METHODS:Relevant studies on ML-driven ASD prediction models were systematically retrieved from eight databases: PubMed, Embase, Web of Science Core Collection, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Database (CBM), Wanfang Data Knowledge Service Platform (WF), and VIP Chinese Science and Technology Journal Database. The scoping review methodology was strictly followed for data extraction and analysis. RESULTS:A total of 16 studies focusing on the application of diverse machine learning algorithms for ASD identification and prediction were included. Among these, 4 studies (25%) employed multiple algorithms for predictive modeling. The most frequently utilized algorithms were tree-based methods (7 studies, 44%), neural networks (NNs) (7 studies, 44%), support vector machines (SVMs) (5 studies, 31%), and regularized logistic regression (3 studies, 19%). Twelve studies (75%) reported Area Under the Curve (AUC) values, all exceeding the 0.7 threshold. Notably, 7 studies (44%) achieved excellent predictive performance with AUC values surpassing 0.9. CONCLUSIONS:ML-based models hold substantial promise for the early identification of ASD, which is critical for improving patient outcomes. Future research should focus on standardizing ML model frameworks, refining theoretical underpinnings to enhance practical applicability, and promoting clinical implementation following rigorous validation. These efforts will further enhance the accuracy and utility of such predictive models.
PROBLEM:Mental health stigma (MHS) presents a significant barrier to help-seeking and adversely affects the quality of life and support for adolescents with mental health difficulties, yet culturally adapted assessment tools for adolescents in China remain scarce. The objectives were to translate the Peer Mental Health Stigmatization Scale (PMHSS) into Chinese and evaluate its psychometric properties, including reliability and criterion validity. METHODS:The Chinese version of PMHSS (C-PMHSS) was developed through forward and backward translation, synthesis, comparison and cross-cultural debugging. Psychometric properties were evaluated in a stratified cluster sample of 530 adolescents (13-18 years). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed structural validity, while reliability was tested through Cronbach's alpha and test-retest correlations. FINDINGS:Factor analyzes confirmed a two-factor negative subscale (57.74% variance; χ²/df = 2.303, RMSEA = 0.071) and trifactorial positive subscale (70.32% variance; χ²/df = 2.143, RMSEA = 0.066). The C-PMHSS demonstrated strong internal consistency (α = 0.83) and test-retest reliability (r = 0.86). Significant MHS variations emerged across age, grade, and sex (p < 0.001). CONCLUSIONS:The C-PMHSS demonstrates robust psychometric properties, establishing itself as the first psychometrically validated Chinese instrument for early MHS identifying among adolescents. It holds promise for the early identification of adolescents with elevated mental health stigma and for guiding tailored interventions to reduce MHS and promote adolescent mental wellbeing.
PURPOSE:This study aimed to examine the relationship between primary school students' levels of privacy awareness and their knowledge of child sexual abuse, with particular attention to demographic and contextual factors including gender, socioeconomic status, and academic achievement. METHODS:A descriptive correlational research design was employed. The sample consisted of primary school students enrolled in public schools in Türkiye during the 2023-2024 academic year. Data were collected using validated measures of privacy awareness and child sexual abuse knowledge. Descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson correlation analysis, and multiple linear regression analysis were conducted to analyse the data. FINDINGS:The findings indicated that female students and older primary school students demonstrated significantly higher levels of both privacy awareness and knowledge of child sexual abuse. Students from higher socioeconomic backgrounds and those with higher academic achievement also showed greater awareness and knowledge. Overall, privacy awareness and sexual abuse knowledge were found to be at a moderate level but were strongly and positively correlated (r = 0.807, p < 0.01). Regression analysis further revealed that privacy awareness was a significant predictor of children's knowledge of sexual abuse (β = 0.819, p < 0.01). CONCLUSION:The results highlight the critical role of privacy awareness in enhancing children's protective knowledge against sexual abuse. Integrating systematic privacy education into primary school curricula may serve as an effective preventive strategy to strengthen children's self-protection skills and overall wellbeing.
BACKGROUND:Pediatric mental health crises are increasing in both frequency and severity, with restrictive measures such as restraint and seclusion (R/S) frequently used during episodes of acute behavioral escalation. Despite the known risks, there is limited evidence on pediatric-specific interventions, particularly those led or implemented by nurses, to reduce R/S. OBJECTIVES:This scoping review aimed to map the breadth and nature of evidence on nurse-led or nurse-implemented educational and practice interventions designed to reduce the use of restrictive measures in pediatric mental health settings among children 12 years or younger. DATA SOURCES:Guided by JBI methodology, Arksey and O'Malley's scoping review framework, and PRISMA-ScR reporting guidelines, comprehensive searches were conducted across MEDLINE, CINAHL, and PsycINFO. Studies published in English between 2014 and 2025 were screened. Eligible studies focused on nurses caring for children aged ≤ 12 years in inpatient, residential, or emergency psychiatric settings and reported on interventions aimed at reducing restrictive measures. CONCLUSIONS:Nine U.S.-based studies met inclusion criteria, primarily quality improvement and quasi-experimental in design. Interventions included trauma-informed care, simulation-based training, early warning assessment tools, and collaborative problem-solving approaches. Multimodal strategies emphasizing workforce development and cultural transformation were most effective. Notably, few interventions were nurse-initiated or included nursing perspectives during development. IMPLICATIONS FOR PRACTICE:Nurses play a critical role in preventing behavioral escalation and R/S use. Interventions tailored to the nursing role, supported by leadership, and embedded into organizational policy are essential. Future research should prioritize nurse-designed, pediatric-specific, and culturally responsive strategies to enhance safety and therapeutic care.
PURPOSE:Rural adolescents often lack access to mental health care along with increased rates of depression and suicide completion. While psychological strengths have been associated with positive outcomes globally, little is known regarding the prevalence of these indicators (hope, self-efficacy, resilience, optimism, and gratitude) among adolescents living in rural Texas. The purpose of this study was to describe how rural adolescents report their psychological strengths and examine the data for potential gender differences. DESIGN AND METHODS:A secondary analysis of cross-sectional data was performed on the RStudio platform using tests of central tendency and inferential statistics. RESULTS:There were 425 valid responses. Rural adolescents possessed indicators of psychological strengths at varying levels, with 16.9% reporting high resilience and 9.2% reporting high optimism. Males reported significantly greater levels of hope, self-efficacy, resilience, and gratitude with gender effect sizes ranging from 2% to 5%. PRACTICE IMPLICATIONS:Within school and community settings, nurses and adults who interact with rural adolescents should consider incorporating tailored strategies that promote growth of psychological strengths, with particular consideration for targeted screening and interventions for at-risk groups.
PROBLEM:Suicide remains one of the leading causes of death among adolescents. Adolescence is a critical developmental period marked by increased vulnerability to emotional and social stressors. Loneliness has gained recognition as a factor linked to poor mental health outcomes, including suicidal behaviors. However, its relationship with suicidal behaviors has not been thoroughly examined. METHODS:A secondary analysis was conducted using data from the 19th Korea Youth Risk Behavior Survey, which included responses from 52,880 adolescents aged 12-18 years, collected from August to October 2023. Associations between loneliness and suicidal behaviors were analyzed using complex sample multiple logistic regression. FINDINGS:Suicidal ideation, plans, and attempts were reported by 13.5%, 5.3%, and 3.2% of adolescents, respectively, with variations by socio-demographic, mental health, and problem behavior characteristics. 81.3% of adolescents reported loneliness, with 18.2% indicating they felt 'Often' or 'Always lonely.' Loneliness was significantly associated with all forms of suicidal behavior (p < 0.001); even after controlling for 19 covariates, adolescents with moderate or high loneliness had substantially higher odds of SI, SP, and SA compared to those with no loneliness. CONCLUSIONS:The significant association between loneliness and suicidal behaviors highlights the importance of incorporating loneliness assessments into adolescent suicide prevention strategies. Collaborative efforts involving schools, parents, and healthcare providers are critical to address risky behaviors and provide effective mental health support. Psychiatric mental health nurses can play a pivotal role in identifying at-risk youth, delivering therapeutic interventions, and coordinating care to reduce adolescent suicide risk.
