James Donaldson on Mental Health - Staying in unhappy marriages and mental health of children and adolescents: A large-scale cross-sectional study in China

Juan Wang, Yuqian He, Xuemei Li, Ziqian Wei, Xiaopeng, Yinzhe Wang, Tingting Lei, Dan Zhu, Xinyu Zhou

Highlights

- •About 34.56% to 41.56% of parents in unhappy relationships continue their marriage
- •Children and adolescents whose parents had an unhappy relationship but were not divorced experience more depressive and anxiety symptoms, non-suicidal self-injury (NSSI), and suicide risk than other peers, including those whose parents had unhappy-relationship and divorced.
- •The results were robust regardless of whether the interparental relationship was perceived by the students or self-reported by the parents

Abstract

Background

Some couples remain married despite being unhappy, for the sake of their children and adolescents. However, children and adolescents in families with unhappy marriages may be chronically expose to parental conflict, potentially increasing the risk of mental health problems more than divorce itself. Although plausible, this hypothesis has rarely been empirically tested using representative data.

Methods

This large-scale cross-sectional study involved 96,431 parent-child dyads in Chongqing, China. Participants were divided into seven groups based on parental marital status and interparental relationships. Mental health problems, including depressive and anxiety symptoms, non-suicidal self-injury (NSSI) and suicide risk, was evaluated within dyads. Multivariate logistic regression was conducted to compare the risk of mental health problems among different groups.

Results

About 34.56?% to 41.56?% of parents in unhappy relationships continue their marriage. Children and adolescents in the unhappy-relationship-not-divorced parents group had higher odds of depressive and anxiety symptoms, NSSI and suicide risk compared to their peers in other groups, including those with divorced parents across different levels of interparental relationships. These findings were consistent regardless of whether the interparental relationship was reported by children and adolescents or the parents.

Conclusions

Public awareness should be raised that divorce may not be the worst option when parents are in an unhappy relationship, at least when considering the potential association with their child and adolescent mental health.

Introduction

Mental health problems in children and adolescents are major contributors to the global burden of disease (Merry et al., 2020), impacting an estimated 10–20?% of this age group wolrdwide (Fazel et al., 2014). Mental health problems in children and adolescents are associated with various later adverse outcomes, including developing mental disorders in adulthood (Calvete et al., 2019), suicide risk (Fergusson et al., 2005), problems in social functioning (Semkovska et al., 2019), and poor physical and mental health (Jamet et al., 2024). Therefore, identifying risk factors and taking preventive measures to avoid significant disease burdens becomes increasingly important.

Increasing evidence suggests that parents' marriage is an important risk factor for mental health of children and adolescents. Most previous studies have focused on the marital status, like divorce, which may be associated with a high risk of child and adolescent mental health problems, such as depression, anxiety (Tullius et al., 2022), non-suicidal self-injury (NSSI) (F. Wang et al., 2021) and even suicide risk (Dube et al., 2001). However, some researchers have proposed that the poor marital quality of parent may has a more detrimental effect for children and adolescents than divorce (Brand et al., 2019). According to the family system theory, negative feelings from the marital subsystem could “spill over” to the parent-child subsystem and increase the risk of child and adolescent mental health problems (Erel and Burman, 1995; Stroud et al., 2015). Marital quality represents the valence of parental interaction (positive or negative), whereas marital status reflects the duration of the valence (divorce, short term; in marriage, long term). The family climate is usually oppressive and conflictual when parents are in an unhappy relationship (Harold and Sellers, 2018). The longer the child is immersed in such an atmosphere, the greater harm of the ‘spill-over effect’ (Kalmijn, 2015). Therefore, divorce may associate with the mental health problems of children and adolescents from families with positive relationships but it did not harm or even benefit the mental health of children and adolescents from families with negative relationships (Amato et al., 1995; Hanson, 1999).

However, epidemiological studies on the relationships between parents' marriage and the risk of child and adolescent depressive symptoms may not be valid enough to support the theory (Hanson, 1999). Most of studies only focused on one side of the marital status and qualities (O'Hara et al., 2019) and therefore could not directly answer whether divorce or non-divorce was worse for the risk of child and adolescent mental health problems at the same level of unhappy relationships. Second, dependent indicators in previous studies mainly focused on school adjustment and general feelings rather than direct indicators of psychiatric scales. Therefore, it remains unclear whether an unhappy marriage is associated with severe mental health problems, such as NSSI and suicide risk (Boduszek et al., 2021; Racine et al., 2021). Third, interparental relationship quality was usually self-reported by parents, but children's feelings may differ from their parents' perceptions, which may be more closely related to children's own mental health outcomes (Clements et al., 2014). Finally, previous studies were mainly conducted in a Western setting. Unlike individualism in Western countries, Chinese culture stresses sacrificing individual interests for the group benefits (Sun, 1991). Perhaps more Chinese parents would sacrifice their own happiness for the sake of their children. Therefore, clarifying how parental marital status and relationship quality relate to children's mental health problems in China is essential for parents' marriage decisions.

To help answer whether parents should stay in a terrible marriage for the sake of their children, the present study has categorized children into different groups based on their parental marital status (i.e., non-divorce, divorce or separation, remarried) and relationship quality (i.e., happy, so-so, unhappy) reported by the parent and the child, respectively. And then, comparing the risks of mental health problems (i.e., depressive symptoms, anxiety symptoms, NSSI, and suicide risk) in different groups. We hypothesize that children whose parents chose to maintain an unhappy marriage have the highest likelihood of developing mental health problems compared to children in other parental situations.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Data source and participants

This study was part of a baseline investigation of a large cohort study aimed at assessing the mental health status of children in Chongqing, China. The Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (2020–890) approved this study. Participants were recruited from all students in grades three through twelve in all primary and secondary schools (n?=?262) in Chongqing municipality spanning between September and December 2021. School officials were informed of

Results

Demographic characteristics and grouping results based on parental marital status and relationship quality are summarized in Table 1, Table 2. The educational levels of parents varied widely: 17.55?% of fathers and 22.46?% of mothers had completed primary school or less; 49.52?% of fathers and 45.55?% of mothers had completed middle school; 18.55?% of fathers and 18.01?% of mothers had completed secondary school; 12.93?% of fathers and 13.67?% of mothers held a bachelor's degree; and only

Discussion

To help answer whether children and adolescents whose parents maintained a marriage with an unhappy relationship have a higher risk of developing mental health problems, the current study compared the odds of depressive symptoms, anxiety symptoms, NSSI, and suicide risk of children and adolescents whose parents maintained a marriage with an unhappy relationship and those from other types of families. Results supported our hypotheses. Regardless of whether parental relationship quality was

Conclusions

Using a large-scale sample of parent-child dyad, this study revealed that children and adolescents whose parents maintain a marriage with an unhappy relationship had higher risks of depressive symptoms, anxiety symptoms, NSSI, and suicide risk, than children and adolescents with other parents, including those whose parents divorced and kept unhappy relationships. Such findings may not only challenge the knowledge of parents who endure an unhappy marriage for the sake of loving their offspring

https://standingabovethecrowd.com/james-donaldson-on-mental-health-staying-in-unhappy-marriages-and-mental-health-of-children-and-adolescents-a-large-scale-cross-sectional-study-in-china/

Bolstering self-critical children who tend to talk themselves down

Writer: Katherine Martinelli

Clinical Expert: Rachel Busman, PsyD, ABPP

https://www.youtube.com/watch?v=yE6I0Zcywxw&t=8s

What You'll Learn

- Why might kids say bad things about themselves?

- What can parents do to help kids who are hard on themselves?

All kids say bad stuff about themselves sometimes. But when their inner voice keeps saying bad things, it can have a negative effect on them.

Children who expect a lot of themselves may be prone to negative self-talk. For older kids, saying things like, “I’m so stupid” or, “I’m so fat” can be a way of protecting themselves from social pressure. They may say bad things about themselves before someone else does it. And kids who are being bullied may start to believe the bad things other kids say about them and start saying them too.

While some kids may do this as a way of getting attention, others do it because they’re not good at bouncing back when something bad happens. They also might not want to try new or hard things.

Parents should take negative self-talk seriously when it starts to happen a lot and causes problems with school or friends. Also watch out if your child stops eating or sleeping well or complains about feeling sick a lot and doesn’t want to go to school. This could mean your child is depressed.

Parents can help. Really listen to your child and show that you care how they feel. Try not to be overly cheery when they share a concern. When you catch yourself being negative, correct yourself. For example, if you burn something and blurt out, “I’m a terrible cook,” correct that. Say, “Actually I’m a pretty good cook. Everyone makes mistakes.” Check in with your child’s teachers, too.

If your child keeps saying bad things about themselves, seems to be depressed or has other changes in their behavior, it makes sense to talk to mental health professional.

We hear kids say negative things about themselves all the time: “I’m so stupid!” “Nobody likes me.” And, of course, “I’m fat.” Or “I’m ugly.” Sometimes these things are throwaway lines, or fishing for reassurance. They may be harmless. But what experts call negative self-talk can also reflect an unhealthy tendency in kids to think the worst of themselves, and that can lead to — or be a sign of — something more serious.

What is self-talk?

Self-talk is essentially our inner monologue, explains Rachel Busman, PsyD, a clinical psychologist. It can be a way of narrating what is happening around you, practicing language, and guiding yourself through a task.

While self-talk is often constructive, it can also go the other way. We all engage in self-critical behavior from time to time, and it isn’t an immediate cause for concern. But it’s useful to think about why your child might be talking themselves down, and when it might reflect a problem.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Globalized thinking

Kids often make statements about themselves that reflect “all or none thinking,” explains Lisa Brown, PsyD, a private practitioner and psychologist at the Rodeph Sholom Day School in New York. For example, when a child doesn’t do well in one soccer game and exclaims, “I stink at soccer!” When this kind of globalized thinking persists, she says, it “can affect how children think and feel about themselves in general.”

Perfectionism

“Children who set impossibly high standards for themselves,” says Dr. Brown, “are prone to engage in negative self-talk.” These perfectionists can be so hard on themselves that they run themselves down trying to reach their goals.

Too cool for school

Sometimes the self-deprecating “I’m so going to fail that test!” or “I’m so fat!” can be a form of social protection. For older kids in particular, “the social sphere becomes really important,” says Dr. Busman. In certain social circles it may not be cool to be smart, and obsessing over appearances may be a way to fit in with the popular kids. Or maybe the child is trying to beat others to the punch by making negative statements first.

Attention-seeking

“Sometimes,” says Dr. Brown, “children may engage in negative self-talk, verbalized out loud, in an attempt to manipulate others or in an effort to get attention.” For example a child may try to guilt parents by talking about what a horrible child they are and how they deserve to be punished.

Lack of resilience

In some cases, self-critical thought can be an indication of lack of resilience. “If children regularly respond to disappointments with negative self-talk that is out of proportion to the particular disappointments,” says Dr. Brown, “this can lead to avoiding certain experiences as well as a lack of motivation to persevere in the face of difficulties.”

Bullying

If a child is being picked on, it can be easy for them to internalize the insults aimed at them. Shawna Palomo, mom to a 17-year-old daughter, says her daughter’s negative self-talk emerged when she was 13. “They made fun of her,” recalls Palomo. “After a while, she would believe all the bad stuff her classmates were saying about her. She would always say how ugly she was.” Her daughter complained that her lips and nose were too big, her hair too curly. “It’s hard watching your child battle these demons,” laments Palomo.

When is it a problem?

In isolation, negative self-talk is natural and not cause for concern. But it can also be evidence of low self-esteem, a learning disability, anxiety, or depression. Dr. Busman offers these signs to look out for:

- The negative self-talk is persistent and pervasive.

- It is not based in reality. For example, your son gets invited to play dates but still frets that no one likes him, or he always aces spelling tests but remains anxious that he will fail.

- It is impacting a child’s relationships or schoolwork.

- Your child’s eating and/or sleeping patterns have changed.

- They’re making persistent, vague “I don’t feel well” statements in the absence of physical symptoms.

Palomo noticed many of these signs in her daughter as the negative self-talk led to depression. “She would not care about her appearance, then it went to the extreme where her appearance was all she cared about.” She didn’t do her homework, lost weight, and wanted to stay in bed all day.

What parents can do to help

Here are some ways to free children from negative thinking and steer them away from destructive self-talk:

Listen and validate

It can be tempting to ignore it when a kid first expresses negative feelings, but Dr. Busman says she “would recommend never just brushing off those kinds of comments, even if they’re kind of silly or not based in any reality.” Instead, offer a safe place for your child to come with concerns and try to find out what is going on.

Offer a realistic approach

Both Dr. Busman and Dr. Brown advise against battling critical self-talk with overly optimistic “positive thinking,” and recommend a more realistic approach. So if a child says they’re sure no one will talk to them on their first day at a new school, you don’t want to say, “The first day of school is going to be great and you’re going to make a million friends.” Instead, you might offer: “The first day of school might be a bit scary, but as you settle in you will likely make friends and grow to love it.”

Put it in context

Dr. Brown notes that adults can help by talking with kids in a way that “contextualizes their experience” and offers a “broader perspective.” Help them identify specifically what upset them, she explains, or made them make such a self-critical statement, and acknowledge that one bad experience doesn’t equate being the worst at something.

Model realistic and positive self-talk

Try to stop saying self-critical things about yourself, too. Don’t fixate on mistakes you’ve made, or worry out loud about your weight. We want to model positive self-esteem for our children. Dr. Busman also suggests offering stories from your own life to relate to your child. “Whether it’s an embellished example or entirely factual,” she says, “you’re modeling non-anxious coping and more realistic self-talk.”

Correct the record

Dr. Brown also notes catching yourself in the midst of making a negative statement can create a valuable teachable moment. Say you burn something and yell in frustration, “I’m a terrible cook!” Continue the conversation in front of your child with something like “actually, I’m a pretty good cook most of the time, I just messed up this dish but I’m not going to let that stop me from cooking in the future.”

Touch base with school

If your child is in school, check in with their teachers about what you’re hearing. Getting their perspective can help you see a more complete picture. Dr. Busman notes that this kind of information can also be useful later should you end up having a professional evaluation.

Seek professional help

If the behavior is persistent and negatively impacting your child’s life, or if it’s linked to other troubling shifts in mood and behavior it might be time to obtain a diagnostic evaluation to help determine what is causing the problem. Dr. Busman calls this a “mental health check-up,” and it can help pinpoint what is going on and how it can be treated.

Frequently Asked Questions

Why would kids say bad things about themselves?

Kids might say bad things about themselves — negative self-talk — for different reasons. They might have high expectations for themselves, or they might be getting bullied and starting to believe what the bully is saying to them. Others do it because they’re not good at bouncing back when something bad happens.

When should parents be concerned about a kid saying bad things about themselves?

What can negative self-talk be a sign of? https://standingabovethecrowd.com/?p=16222

James Donaldson on Mental Health - What parents can do to save kids from suicide in a world full of pressure, anxiety

Dr. Eva Szigethy

- Suicide attempts are increasing among children 10 to 14.
- Stressors like academic pressure, social media, and mass violence contribute to declining youth mental health.
- Parents are encouraged to monitor screen time, communicate openly about mental health, and seek professional help if needed.
- Integrating mental health services into pediatricians' offices and school health centers can help identify issues earlier.

Suicide risk for kids and teens is real … and it’s frightening. Most teens and young adults who attempted or completed suicide used to be in the 15- to 30-year age range. Now, we are seeing more kids attempt suicide between ages 10 and 14.

Kids are under more stress than ever before

Today’s kids feel pressure to excel in school and sports, often at young ages. Their packed after-school and summer schedules leave little time for unstructured play. Mass violence, societal unrest and natural disasters can add to their anxiety. Additionally, the COVID-19 pandemic had a lasting impact on how kids learned and socialized.

Kids cannot handle everything that is on the news and social media if there aren’t filters. As a parent, it is important to monitor your kids’ access – what they watch, how and with whom they engage, and how much time they spend online.

Social media and artificial intelligence (AI) chatbots also threaten adolescent mental health. Cyberbullying or things kids are prodded to do online can result in an emotional trigger that throws a switch in their developing brains. Kids are impulsive, and when they are in distress, ending their life seems like the best idea.Need a news break? Check out the all new PLAY hub with puzzles, games and more!

How to protect your child from suicidal ideation

Warning signs can vary, but they may include changes in appearance or personal hygiene; social withdrawal and a drop in grades; risky activities including drinking, drugs or unsafe sex; and self-harm behaviors such as cutting.

Communication is key to any good parent and child relationship, but especially if your child or teen struggles with their mental health. A common misperception is that talking to your child about suicide pushes them to try it. That is not true. It is OK to ask if they have thoughts of hurting themselves. If you are not comfortable having that conversation, get help from your child’s primary care provider or a pediatric mental health professional.

When I was a child, we played outside. We did not have smartphones and tablets, so we were not glued to devices. Our kids – and our nation as a whole – could benefit from families spending more quality time together. As simple as it seems, playing at the park or exploring nature on a hike will help you connect with your kids. Designate meals as media-free time without devices – for you and your children.

Your mental health is important, too. According to the U.S. Surgeon General's Advisory on the Mental Health and Well-Being of Parents, 48% of parents say their stress is “completely overwhelming” most days. If you are depressed or dealing with mental health issues, please seek help. Especially if you have young kids, as their decision making is influenced by their role models and what they see around them. Kids’ brains are not equipped to handle the constant influx of danger signals from their environment.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

When kids don’t have access to help, they can die by suicide

One in every five children has a mental health issue, and half of those problems begin before age 15. It is critical to improve access to mental health resources for kids and teens. One way we can do this is with “behavioral health integration.” With this approach, mental health experts are embedded at medical care facilities such as a pediatrician’s office or school-based health center. These collaborations are proven to identify a child’s mental health issues earlier; improve the child’s comfort level by receiving care in a trusted and familiar setting; make mental health care easier for families to access; and enhance the care coordination between the primary care and mental health providers.

Resources are also essential for families: gun locks, lock boxes and educational materials about safe gun storage. If we can create some “distance” between a child’s impulsive suicidal thoughts and prevent them from having access to lethal means, we can save lives. By preventing the suicidal act and getting kids the care they need, we can help them go from surviving to thriving.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-what-parents-can-do-to-save-kids-from-suicide-in-a-world-full-of-pressure-anxiety/

Sophia Friesen - Science communications manager, University of Utah Health

Among friends and family of those who die by suicide, a common refrain is: I didn’t know.

While some people who die by suicide have prior attempts, about half of people who die by suicide have no documented suicidal thoughts or behaviors, nor do they have known psychiatric conditions associated with suicide risk, like depression. They have no previous clear indicators that they might be at risk at all.

A new genetic study at the University of Utah found that people in this group of unexpected suicides aren’t just flying under the clinical radar via lower access to psychiatric services—their underlying risk factors may be fundamentally different.

The research found that people who die by suicide without prior non-fatal suicidal thoughts or behaviors have fewer psychiatric diagnoses and also fewer underlying genetic risk factors for psychiatric conditions compared to people who had shown these warning signs before dying by suicide. 

“There are a lot of people out there who may be at risk of suicide where it’s not just that you’ve missed that they’re depressed, it’s likely that they’re in fact actually not depressed,” said Hilary Coon, professor of psychiatry in the Spencer Fox Eccles School of Medicine and first author on the study. “That is important in widening our view of who may be at risk. We need to start to think about aspects leading to risk in different ways.”

The results, published in JAMA Network Open, upend conventional beliefs about suicide risk and suggest new approaches to help save lives.

Uncovering hidden risk

Other research had shown that people who die by suicide without prior known suicidality are less likely to have psychiatric diagnoses, such as depression, compared to people with documented suicidal thoughts or behaviors. But nobody knew the root cause of this difference. Maybe, researchers thought, people without known suicidality are still just as depressed or anxious—they’re just undiagnosed.

But Coon’s team was surprised to find that this isn’t the case. Instead, they found that this group has different genetic risk factors from people with known suicidality. By comprehensively analyzing anonymized genetic data from more than 2,700 people who died by suicide, the researchers found that people without prior suicidality tend to have fewer genetic risk factors for several psychiatric conditions, including major depressive disorder, anxiety, Alzheimer’s disease and PTSD.

The genetic data also suggests that this group isn’t any more likely than the general population to have milder conditions, like depressed mood and neuroticism. This means that conventional wisdom on how to reduce suicide may need to be rethought.

“A tenet in suicide prevention has been that we just need to screen people better for associated conditions like depression,” Coon explainedipa. “And if people had the same sort of underlying vulnerabilities, then additional efforts in screening might be very helpful. But for those who actually have different underlying vulnerabilities, then increasing that screening might not help for them.”

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Helping those most at risk for suicide

Figuring out how to find and treat these “hidden” at-risk individuals is a major focus of Coon’s upcoming research. Previous studies with clinical data have shown potential links between suicide risk and hard-to-treat conditions like chronic pain. Coon is also investigating how other physical disorders, such as inflammation and respiratory conditions, may impact suicide risk. Her work will also focus on traits that may confer resilience to suicide.

Coon emphasizes that, on their own, individual genetic risk factors related to suicide have very small effects on risk, and there’s no single gene—or combination of genes—that causes suicide. Environmental and societal contexts are crucial contributors to risk, and understanding the interplay between the environment and underlying biology will be essential to discovering who’s at risk.

“We hope our work will begin to define subsets of individuals at risk, and also the contexts in which these risk characteristics may be important,” Coon said. “If people have a certain type of clinical diagnosis that makes them particularly vulnerable within particular environmental contexts, they still may not ever say they’re suicidal. We hope our work may help reveal traits and contexts associated with high risk so that doctors can deliver care more effectively and specifically. ”

Better identification of at-risk individuals will help people get the care they need. https://standingabovethecrowd.com/?p=16219

James Donaldson on Mental Health - Many who die by suicide aren’t depressed, genetic research suggests

Sophia Friesen - Science communications manager, University of Utah Health

Among friends and family of those who die by suicide, a common refrain is: I didn’t know.

While some people who die by suicide have prior attempts, about half of people who die by suicide have no documented suicidal thoughts or behaviors, nor do they have known psychiatric conditions associated with suicide risk, like depression. They have no previous clear indicators that they might be at risk at all.

A new genetic study at the University of Utah found that people in this group of unexpected suicides aren’t just flying under the clinical radar via lower access to psychiatric services—their underlying risk factors may be fundamentally different.

The research found that people who die by suicide without prior non-fatal suicidal thoughts or behaviors have fewer psychiatric diagnoses and also fewer underlying genetic risk factors for psychiatric conditions compared to people who had shown these warning signs before dying by suicide. 

“There are a lot of people out there who may be at risk of suicide where it’s not just that you’ve missed that they’re depressed, it’s likely that they’re in fact actually not depressed,” said Hilary Coon, professor of psychiatry in the Spencer Fox Eccles School of Medicine and first author on the study. “That is important in widening our view of who may be at risk. We need to start to think about aspects leading to risk in different ways.”

The results, published in JAMA Network Open, upend conventional beliefs about suicide risk and suggest new approaches to help save lives.

Uncovering hidden risk

Other research had shown that people who die by suicide without prior known suicidality are less likely to have psychiatric diagnoses, such as depression, compared to people with documented suicidal thoughts or behaviors. But nobody knew the root cause of this difference. Maybe, researchers thought, people without known suicidality are still just as depressed or anxious—they’re just undiagnosed.

But Coon’s team was surprised to find that this isn’t the case. Instead, they found that this group has different genetic risk factors from people with known suicidality. By comprehensively analyzing anonymized genetic data from more than 2,700 people who died by suicide, the researchers found that people without prior suicidality tend to have fewer genetic risk factors for several psychiatric conditions, including major depressive disorder, anxiety, Alzheimer’s disease and PTSD.

The genetic data also suggests that this group isn’t any more likely than the general population to have milder conditions, like depressed mood and neuroticism. This means that conventional wisdom on how to reduce suicide may need to be rethought.

“A tenet in suicide prevention has been that we just need to screen people better for associated conditions like depression,” Coon explainedipa. “And if people had the same sort of underlying vulnerabilities, then additional efforts in screening might be very helpful. But for those who actually have different underlying vulnerabilities, then increasing that screening might not help for them.”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Helping those most at risk for suicide

Figuring out how to find and treat these “hidden” at-risk individuals is a major focus of Coon’s upcoming research. Previous studies with clinical data have shown potential links between suicide risk and hard-to-treat conditions like chronic pain. Coon is also investigating how other physical disorders, such as inflammation and respiratory conditions, may impact suicide risk. Her work will also focus on traits that may confer resilience to suicide.

Coon emphasizes that, on their own, individual genetic risk factors related to suicide have very small effects on risk, and there’s no single gene—or combination of genes—that causes suicide. Environmental and societal contexts are crucial contributors to risk, and understanding the interplay between the environment and underlying biology will be essential to discovering who’s at risk.

“We hope our work will begin to define subsets of individuals at risk, and also the contexts in which these risk characteristics may be important,” Coon said. “If people have a certain type of clinical diagnosis that makes them particularly vulnerable within particular environmental contexts, they still may not ever say they’re suicidal. We hope our work may help reveal traits and contexts associated with high risk so that doctors can deliver care more effectively and specifically. ”

Better identification of at-risk individuals will help people get the care they need.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-many-who-die-by-suicide-arent-depressed-genetic-research-suggests/

James Donaldson on Mental Health - How to Help Kids Who Are Too Hard on Themselves

Bolstering self-critical children who tend to talk themselves down

Writer: Katherine Martinelli

Clinical Expert: Rachel Busman, PsyD, ABPP

https://www.youtube.com/watch?v=yE6I0Zcywxw&t=8s

What You'll Learn

- Why might kids say bad things about themselves?
- What can parents do to help kids who are hard on themselves?

All kids say bad stuff about themselves sometimes. But when their inner voice keeps saying bad things, it can have a negative effect on them.

Children who expect a lot of themselves may be prone to negative self-talk. For older kids, saying things like, “I’m so stupid” or, “I’m so fat” can be a way of protecting themselves from social pressure. They may say bad things about themselves before someone else does it. And kids who are being bullied may start to believe the bad things other kids say about them and start saying them too.

While some kids may do this as a way of getting attention, others do it because they’re not good at bouncing back when something bad happens. They also might not want to try new or hard things.

Parents should take negative self-talk seriously when it starts to happen a lot and causes problems with school or friends. Also watch out if your child stops eating or sleeping well or complains about feeling sick a lot and doesn’t want to go to school. This could mean your child is depressed.

Parents can help. Really listen to your child and show that you care how they feel. Try not to be overly cheery when they share a concern. When you catch yourself being negative, correct yourself. For example, if you burn something and blurt out, “I’m a terrible cook,” correct that. Say, “Actually I’m a pretty good cook. Everyone makes mistakes.” Check in with your child’s teachers, too.

If your child keeps saying bad things about themselves, seems to be depressed or has other changes in their behavior, it makes sense to talk to mental health professional.

We hear kids say negative things about themselves all the time: “I’m so stupid!” “Nobody likes me.” And, of course, “I’m fat.” Or “I’m ugly.” Sometimes these things are throwaway lines, or fishing for reassurance. They may be harmless. But what experts call negative self-talk can also reflect an unhealthy tendency in kids to think the worst of themselves, and that can lead to — or be a sign of — something more serious.

What is self-talk?

Self-talk is essentially our inner monologue, explains Rachel Busman, PsyD, a clinical psychologist. It can be a way of narrating what is happening around you, practicing language, and guiding yourself through a task.

While self-talk is often constructive, it can also go the other way. We all engage in self-critical behavior from time to time, and it isn’t an immediate cause for concern. But it’s useful to think about why your child might be talking themselves down, and when it might reflect a problem.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Globalized thinking

Kids often make statements about themselves that reflect “all or none thinking,” explains Lisa Brown, PsyD, a private practitioner and psychologist at the Rodeph Sholom Day School in New York. For example, when a child doesn’t do well in one soccer game and exclaims, “I stink at soccer!” When this kind of globalized thinking persists, she says, it “can affect how children think and feel about themselves in general.”

Perfectionism

“Children who set impossibly high standards for themselves,” says Dr. Brown, “are prone to engage in negative self-talk.” These perfectionists can be so hard on themselves that they run themselves down trying to reach their goals.

Too cool for school

Sometimes the self-deprecating “I’m so going to fail that test!” or “I’m so fat!” can be a form of social protection. For older kids in particular, “the social sphere becomes really important,” says Dr. Busman. In certain social circles it may not be cool to be smart, and obsessing over appearances may be a way to fit in with the popular kids. Or maybe the child is trying to beat others to the punch by making negative statements first.

Attention-seeking

“Sometimes,” says Dr. Brown, “children may engage in negative self-talk, verbalized out loud, in an attempt to manipulate others or in an effort to get attention.” For example a child may try to guilt parents by talking about what a horrible child they are and how they deserve to be punished.

Lack of resilience

In some cases, self-critical thought can be an indication of lack of resilience. “If children regularly respond to disappointments with negative self-talk that is out of proportion to the particular disappointments,” says Dr. Brown, “this can lead to avoiding certain experiences as well as a lack of motivation to persevere in the face of difficulties.”

Bullying

If a child is being picked on, it can be easy for them to internalize the insults aimed at them. Shawna Palomo, mom to a 17-year-old daughter, says her daughter’s negative self-talk emerged when she was 13. “They made fun of her,” recalls Palomo. “After a while, she would believe all the bad stuff her classmates were saying about her. She would always say how ugly she was.” Her daughter complained that her lips and nose were too big, her hair too curly. “It’s hard watching your child battle these demons,” laments Palomo.

When is it a problem?

In isolation, negative self-talk is natural and not cause for concern. But it can also be evidence of low self-esteem, a learning disability, anxiety, or depression. Dr. Busman offers these signs to look out for:

- The negative self-talk is persistent and pervasive.
- It is not based in reality. For example, your son gets invited to play dates but still frets that no one likes him, or he always aces spelling tests but remains anxious that he will fail.
- It is impacting a child’s relationships or schoolwork.
- Your child’s eating and/or sleeping patterns have changed.
- They’re making persistent, vague “I don’t feel well” statements in the absence of physical symptoms.

Palomo noticed many of these signs in her daughter as the negative self-talk led to depression. “She would not care about her appearance, then it went to the extreme where her appearance was all she cared about.” She didn’t do her homework, lost weight, and wanted to stay in bed all day.

What parents can do to help

Here are some ways to free children from negative thinking and steer them away from destructive self-talk:

Listen and validate

It can be tempting to ignore it when a kid first expresses negative feelings, but Dr. Busman says she “would recommend never just brushing off those kinds of comments, even if they’re kind of silly or not based in any reality.” Instead, offer a safe place for your child to come with concerns and try to find out what is going on.

Offer a realistic approach

Both Dr. Busman and Dr. Brown advise against battling critical self-talk with overly optimistic “positive thinking,” and recommend a more realistic approach. So if a child says they’re sure no one will talk to them on their first day at a new school, you don’t want to say, “The first day of school is going to be great and you’re going to make a million friends.” Instead, you might offer: “The first day of school might be a bit scary, but as you settle in you will likely make friends and grow to love it.”

Put it in context

Dr. Brown notes that adults can help by talking with kids in a way that “contextualizes their experience” and offers a “broader perspective.” Help them identify specifically what upset them, she explains, or made them make such a self-critical statement, and acknowledge that one bad experience doesn’t equate being the worst at something.

Model realistic and positive self-talk

Try to stop saying self-critical things about yourself, too. Don’t fixate on mistakes you’ve made, or worry out loud about your weight. We want to model positive self-esteem for our children. Dr. Busman also suggests offering stories from your own life to relate to your child. “Whether it’s an embellished example or entirely factual,” she says, “you’re modeling non-anxious coping and more realistic self-talk.”

Correct the record

Dr. Brown also notes catching yourself in the midst of making a negative statement can create a valuable teachable moment. Say you burn something and yell in frustration, “I’m a terrible cook!” Continue the conversation in front of your child with something like “actually, I’m a pretty good cook most of the time, I just messed up this dish but I’m not going to let that stop me from cooking in the future.”

Touch base with school

If your child is in school, check in with their teachers about what you’re hearing. Getting their perspective can help you see a more complete picture. Dr. Busman notes that this kind of information can also be useful later should you end up having a professional evaluation.

Seek professional help

If the behavior is persistent and negatively impacting your child’s life, or if it’s linked to other troubling shifts in mood and behavior it might be time to obtain a diagnostic evaluation to help determine what is causing the problem. Dr. Busman calls this a “mental health check-up,” and it can help pinpoint what is going on and how it can be treated.

Frequently Asked Questions

Why would kids say bad things about themselves?

Kids might say bad things about themselves — negative self-talk — for different reasons. They might have high expectations for themselves, or they might be getting bullied and starting to believe what the bully is saying to them. Others do it because they’re not good at bouncing back when something bad happens.

When should parents be concerned about a kid saying bad things about themselves?

What can negative self-talk be a sign of?

https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-to-help-kids-who-are-too-hard-on-themselves-2/

A review of 467 studies also points out that, instead of alleviating feelings of fear and anxiety, weapons increase them, as well as exacerbating controlling behaviors and causing domestic violence

Photo by Pixabay on Pexels.com

In addition to posing physical and life risks, access to firearms has an impact on mental health. It increases suicides, intensifies psychological fragility, and amplifies violence. This is the conclusion of a study published in the September issue of the scientific journal Harvard Review of Psychiatry.

The study was led by researchers from the Institute of Psychiatry at the University of São Paulo’s Medical School (FM-USP) in Brazil. The researchers conducted a systematic review of 467 studies from various countries published up to March 2023. Most of the studies – 81% (378) – were conducted in the United States; 6% were conducted in Western Europe; 4% in Australia; and 3% in Canada. The rest were conducted in other regions.

The analysis explored the links between access to firearms, aggressive behavior, substance use and abuse, social and domestic violence, and their influence on mental health. Three psychological mechanisms related to these factors were identified.

The first is that weapons facilitate impulsive acts in times of crisis or distress. Suicide was the main outcome, appearing in 284 studies (61% of the total). The analysis showed that the presence of a firearm in a home increases the risk of suicide three to fivefold, regardless of the individual’s previous mental health status. When firearms are stored safely, this risk decreases but remains high.

A second mechanism is that the weapon acts as a kind of “psychological amplifier,” exacerbating certain mental health conditions. Rather than alleviating feelings of fear and anxiety, the weapon exacerbates them, leading to aggression. Additionally, it exacerbates the symptoms of trauma in individuals exposed to armed violence, creating a feedback loop that intensifies suffering rather than alleviating it.

Finally, the weapon serves as a symbol that transforms power dynamics and perceptions of vulnerability. This exacerbates controlling behaviors and leads to cases of social and domestic violence.

“Understanding that everyone is susceptible to human frailties, the possibility of having highly lethal tools available in the hands of the general population, instead of increasing the sense of security and protection and improving the individual’s emotional regulation, ends up having the opposite effect, as we see in studies. It highlights emotional weaknesses, increases feelings of fear and aggression, and leads to an increase in cases of harassment and violence,” explains Rodolfo Furlan Damiano, a psychiatrist and the corresponding author of the article, to Agência FAPESP.

Damiano and Eurípedes Constantino Miguel Filho, a professor at the USP Medical School, coordinate the Program for Education, Research and Care in Treatment-Resistant Depression, Self-Injury, and Suicidality (Pro-DRAS). Damiano has the support of FAPESP through a postdoctoral fellowship for a project seeking to provide information on the effectiveness and feasibility of rapid interventions for suicide prevention.

Last year, Damiano coordinated another study that mapped risk and protective factors for suicidal behavior. The study showed that people with impulse control disorders (ICDs) are at risk (read more at agencia.fapesp.br/53522). 

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Screening of studies

The review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline, a set of 27 items that systematizes the collection and extraction of data for this type of research.

The review began with a database of 3,930 articles from PubMed, Scopus, Web of Science, and PsycInfo. The screening protocol prioritized studies in criminology, public health, and sociology with direct outcomes and/or proven implications for psychological factors. This resulted in 467 articles addressing gun ownership, violence, policies, and their effects on mental health.

“The idea for this work arose from the link between suicide and firearms, but we realized that it could be something more comprehensive. When it comes to access to weapons, the discussion is always related to the issue of public safety. Our goal with the research wasn’t to deal with this sphere, but rather with mental health, which is an important and little-discussed issue,” Damiano explains.

In their conclusions, the scientists suggest adopting public policies that incorporate health-related scientific evidence.

“This review highlights the urgent need for comprehensive policies that address access to firearms, tackle the social determinants of the harm they cause, and promote mental health interventions. An integrated approach that considers these individual and social factors is essential to mitigate the complex psychological pathways through which they affect different populations,” the authors write in the article.

The situation in Brazil

Despite the small research sample size in Brazil, Damiano says the results are applicable to the country’s reality. “We’re dealing with mental health and the human impact, which can be extrapolated,” the psychiatrist says.

In Brazil, the purchase of firearms – both permitted and restricted caliber – is subject to a series of rules and requires authorization from federal agencies such as the Federal Police and the Army. In addition to being at least 25 years old, applicants must present a clean criminal record and prove their technical ability and psychological aptitude to handle firearms.

Despite the slowdown in growth since 2018, the number of registered firearms in Brazil increased by 3.2% between 2023 and 2024, reaching a total of 2,154,000 registrations in the National Firearms Registry System (SINARM), which is managed by the Federal Police. This information can be found in the 2025 Brazilian Public Security Yearbook. 

Damiano says he intends to continue the review work, focusing on laws that restrict access to firearms.

Photo by Pixabay on Pexels.com https://standingabovethecrowd.com/?p=16217