What is pica?

July 2005

Are Hispanic adolescent girls at higher risk of suicidal ideation and attempts than their male counterparts or African American and Caucasian youth?

According to former Surgeon General David Satcher (1999), suicidal ideation and attempts are at crisis levels among adolescents. Youth who are at the highest risk of committing suicide are those who have multiple stressors and are involved in multiple systems, which describes many children involved in our system of care communities. According to Health, United States, 2004, an annual report on trends in health statistics, Hispanic adolescent girls are significantly more likely to consider suicide, attempt suicide, and sustain an injury as a result of a suicide attempt than their male counterparts. This is also true when compared to African American and Caucasian youth. Various psychosocial explanations have been offered to account for this disparity, including sex role socialization, acculturation, social and linguistic isolation, and depression (Gibbs & Huang, 2003).

Interpersonal psychotherapy (IPT) can be a very effective non-psychopharmacological intervention in the treatment of Hispanic girls, especially if depression is a factor in their suicidal ideations and attempts—and it usually is. Additionally, IPT addresses some of the other issues that many of these girls face. Latino youth in the U.S. and Puerto Rico have been included in IPT studies (Hibbs & Jensen, 1996).

IPT is a short-term psychotherapy approach that has as its premise that unipolar, nonpsychotic depression can be explained by problems in interpersonal relationships. The primary goals of IPT are to identify and treat the depressive symptoms and identify the problem areas associated with the onset of the depression. IPT focuses on the patient’s present and future and on the resolution of problems and disputes. The four primary problem areas targeted by IPT are (1) grief, (2) interpersonal disputes, (3) role transitions, and (4) interpersonal deficits—social isolation, socially unfulfillment, and chronic depression. These are all issues that are often part of adolescent development. In IPT there are 12 weekly sessions that are divided into approximately three groups of 4 sessions each. Initial sessions (1 to 4) aim to obtain information about the symptoms of the youth's depression and its development; educate the youth, family, and if appropriate, the teacher about depression; explain what IPT is; evaluate interpersonal relationships; identify main problems; and with input from the youth and family, establish a treatment plan that includes a clear description of what is expected of the youth, family, and provider. The intermediate sessions (5 to 8) are aimed at helping the youth work on the selected interpersonal problem, monitor depressive feelings, and facilitate a positive therapeutic relationship. Assertiveness and relaxation trainings and role play exercises are often included during this period. During the last 4 sessions (9 to 12), termination is discussed, feelings related to separation are acknowledged, the course of treatment and symptoms are reviewed, and the patient's interpersonal competence is recognized.

Manuals for this treatment can be obtained by contacting Laura Mufson, Ph.D. at Columbia University in New York and Jeannette Rossello, Ph.D. at the University of Puerto Rico.

References

U.S. Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: Author.

National Center for Health Statistics (2004). Chartbook on Trends in the Health of Americans. Health, United States, 2004. Hyattsville, Maryland: Author.

Gibbs, J. T. & Huang, L. N. (2003) Children of Color: Psychological Interventions with Culturally Diverse Youth New York: Jossey-Bass.

Hibbs, E. D. & Jensen, P. S. (1996). Psychosocial Treatments for Child and Adolescent Disorders: Empirically Based Strategies for Clinical Practice. Washington, D.C., American Psychological Association.

Technical Assistance Partnership for Child and Family Mental Health

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	July 2005 Are Hispanic adolescent girls at higher risk of suicidal ideation and attempts than their male counterparts or African American and Caucasian youth? According to former Surgeon General David Satcher (1999), suicidal ideation and attempts are at crisis levels among adolescents. Youth who are at the highest risk of committing suicide are those who have multiple stressors and are involved in multiple systems, which describes many children involved in our system of care communities. According to Health, United States, 2004, an annual report on trends in health statistics, Hispanic adolescent girls are significantly more likely to consider suicide, attempt suicide, and sustain an injury as a result of a suicide attempt than their male counterparts. This is also true when compared to African American and Caucasian youth. Various psychosocial explanations have been offered to account for this disparity, including sex role socialization, acculturation, social and linguistic isolation, and depression (Gibbs & Huang, 2003). Interpersonal psychotherapy (IPT) can be a very effective non-psychopharmacological intervention in the treatment of Hispanic girls, especially if depression is a factor in their suicidal ideations and attempts—and it usually is. Additionally, IPT addresses some of the other issues that many of these girls face. Latino youth in the U.S. and Puerto Rico have been included in IPT studies (Hibbs & Jensen, 1996). IPT is a short-term psychotherapy approach that has as its premise that unipolar, nonpsychotic depression can be explained by problems in interpersonal relationships. The primary goals of IPT are to identify and treat the depressive symptoms and identify the problem areas associated with the onset of the depression. IPT focuses on the patient’s present and future and on the resolution of problems and disputes. The four primary problem areas targeted by IPT are (1) grief, (2) interpersonal disputes, (3) role transitions, and (4) interpersonal deficits—social isolation, socially unfulfillment, and chronic depression. These are all issues that are often part of adolescent development. In IPT there are 12 weekly sessions that are divided into approximately three groups of 4 sessions each. Initial sessions (1 to 4) aim to obtain information about the symptoms of the youth's depression and its development; educate the youth, family, and if appropriate, the teacher about depression; explain what IPT is; evaluate interpersonal relationships; identify main problems; and with input from the youth and family, establish a treatment plan that includes a clear description of what is expected of the youth, family, and provider. The intermediate sessions (5 to 8) are aimed at helping the youth work on the selected interpersonal problem, monitor depressive feelings, and facilitate a positive therapeutic relationship. Assertiveness and relaxation trainings and role play exercises are often included during this period. During the last 4 sessions (9 to 12), termination is discussed, feelings related to separation are acknowledged, the course of treatment and symptoms are reviewed, and the patient's interpersonal competence is recognized. Manuals for this treatment can be obtained by contacting Laura Mufson, Ph.D. at Columbia University in New York and Jeannette Rossello, Ph.D. at the University of Puerto Rico. References U.S. Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: Author. National Center for Health Statistics (2004). Chartbook on Trends in the Health of Americans. Health, United States, 2004. Hyattsville, Maryland: Author. Gibbs, J. T. & Huang, L. N. (2003) Children of Color: Psychological Interventions with Culturally Diverse Youth New York: Jossey-Bass. Hibbs, E. D. & Jensen, P. S. (1996). Psychosocial Treatments for Child and Adolescent Disorders: Empirically Based Strategies for Clinical Practice. Washington, D.C., American Psychological Association.