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1 !"#$% 1!"# 1! 2,* 1,3 1(Child and Adolescent Behaviors in Long-Term Evolution CABLE) 2001!"#$%!&'()*+,-!"#!$(!"#)!(!"#)18!"#$%&'2,075!"1,652!"#1,841!"#$%&'()*!"#$%&'!"#$%&'(19.77%!"#$%(26.63%)!(12.18%)2!"#$ 1!"#$%&'()* '2342.!"#$%&'()*+,-.!"#$%&3.!"#$%&'()*+,-./4.!"#$%&'( !"#$%&'()*+,-!"#$%&'(! (6) )!"#$%&'(&)*&+,-.&/ !"#$%[1]!"#$!"#$%&'()*+1997!"#$%&'()1999!"!"#$%1524!"#$%![2]2001!"#$24 1!"#$%&'#(&')*+,-./0 2!"#$#%&'()*+, 3!"#$%&'()*"#+ *!"!"112!"#$%&' %[2]!"#$%&'!"#$!"#$%&'#()*+ (suicide/suicidal ideation)!" (suicide/suicidal attempt)!"# (committed / completed suicide)![3,4]!"#$%&' (")*+,-. "#!"#$%&'(!")*+#,-!"#$%&'()!%*+,!!"#$%&'()*+$,-.!"#$%&'()*+,-.!"# %[5-7]!"#$!"#$%&'()*+,-[7,8]! 2005, Vol.24, No.6 471

2 !"#$!%!&!"!"#$%&!"#$%&'()*+,-.!"#$%(Children and Adolescent Behaviors in Long-term Evolution CABLE)[12,13]2001!"#$%&!"#$%&'()*+,-. /!"#$%&'()*+,-.%/!"#$ "%(!"#) (!"#)!"#$%&!"#$%&'()*+,-."/!"#$%&'!(#$%&)*!!1998!"#$%&'() 16.7%[9]!"#$%2000!"#$%&8.2%[7]!"#$ [4]!"#$%&'()*+,-!"#$%&'()*+,-!"#$%&'()*+%,-./!"MedlinePsycINFO!" (98.0%)!"#$%&'(!"(2.0%)!"#$%&!"#$%&'()*+,-!"#$%&!'()"#*+,-. [6,7,10]!"#$ %&'()*!"#$%&'()*+,-.!"#$%&(1)!"#$%&!"#$%&'((2)!"# [11]!"#$%&'()*+,-.!"!"#$%&'()*+,-./!"#$%&'()*+,- CABLE!"#$%&(cohort)!"#$%&'( )*+,-!"#$%&'()*+CABLE 2001!"#$%&'()*+,!"#$%&'$()3,612!"#$%&'()2,125!" & 2,075!"#97.6%!"#$!"#$%&'( )*&+,!"#$%&'()1,652!" 1,841!"#$%&'!!"#$%&[11]!"#!"#$%&'()*+,-%.!"#$%&' ()!"#$%&'()*+,-.!"#$%&'()*+,-,.&/ (!"#$)!"#$CDC 1991!"#$%&'Youth Risk Behavior Surveillance System[14]!"#$%&'()*+,-'./01!"#$ %&'()*+, %+!"#$%&'()*+!,"#$ %0!"#$%&'!()*!"+',!"#$%&'()*+,-.+/!"#$%&'()*+,- () 1.!"#$%&!"#$%&'(")*+,'-. 1!"#$%&'(!)*+,-./!"#$%&'(1!"#$2!"#$3!"#$%4!"#!"#$%&'()*+,'-./!"#$%&' ()*!"#$%&'()*(+,-( 472! 2005, Vol.24, No.6

3 !"#$% "!"#$%&'((1!"#2!"#$%&'()*3!"#!"#4!"#$%&'()5!"#$%&')!"#$%&!"#$%!&'#()*+,-.! 2.!"#$!"#$%&'()$*%&+!"#$%&'1!"#$2!"#3!"#$%&'()*+, 1!"#$%&'()*+,#-$%.!"#$%&'(")*+!"#$%!"#$%&'()*+,-!")*!"#$%$&'!"#%()*+,-!"#$%&'(&)*+,-./0!"#$%&!"#$%&'()*+',#-!"#$%&'()*+,-./01 1!"#$%&'()#$%*+,-./!"#$%&'()*+,-./!!"#$%&'()*+,*-./0!"#$%&'()*+!"#$%&'()*+,-./! 2005, Vol.24, No.6 473

4 !"#$!%!&!"#$%&'()*+,#$%-./!"#$%&'()*+,-!"#$!"#$%&'()*+,-!"#%!"#$%&'()#*+,-./0 1!"#$%&'()*+, -./ 3.!"#$!"#$%& '()*%& +,!!"#$%&'()*!+,-./$0!"#$%&'()'*+,-./0!"#$%&'()*+,-. (1!"2!"3!"4 5!)!"#$%&'!"#$!"#16!"#$%&'(!"#$%&'()%*!+,-.!"#$%&'#()*+,-./!"#$%&'()!"*+!"#$%&'()*+%,-./0!"#$%&'(&)*+,-./!!"#$%&!'()*!"#$%&'(!"#$%&'()*+,-'./0!"#$%&"'()*+,-.!"#$%!&'()*+,-./!"#$%&'(!) *+#$% 1 1-0!"#$%&'() 4.!"#!"#$%&'(!")*%!"#$%&'()*+!,-./ 1!"# $!%&'()*+,!-.!"#$%&'(!)#*+,-./0 1!"#$%&'()!"#$%&'()*+,-'.!"#$%&'()*+!,-$./0!"#$%&'()*"#$+,-.!"#$%&"'()*+,-./%!"#$%&'()*+!"#$%&'!"()*+,-!"#$%&'()*+,(-../ ()!"#$%&'()*+#$!"#$%#&!"'(!)*+,- "!"#$%&'()*+,-./0 1!"#$%&'()*+!",-&!"#$%&'()*+,-$%&./ 1!"#$%&'()*+, 5.!"#$!"#$%&'( )*+,-!"#$%&'()!*+,-./0 474! 2005, Vol.24, No.6

5 !"#$%!"#$%&'()*+,!-./0 1 WHO1983!"#$%&'Health Behavior in School-aged Children[15]!"# ()!"#$"!"#$%&'()( Cronbach's α )!"#$%&'()*!"#$%Cronbach's α 0.74!"#0.70!"#$%0.75!"#$%0.65!"#$%0.83!"#$%&'(0.75!"#CABLE!10 1!"#$%&'()*+,-. (Exploratory Factor Analysis)!"#$ (Confirmatory Factor Analysis)!"#!"#$%&'()*+,-.()!"#$%&'()*+,-$.!"#$%&'()*(+,-./ X 2 /df5 GFAAGFA0.90 RMSEA0.05!"#$%&'(!"#$%&'()*+,-./!"#$!!"#$%&'()$%&*(+,-.! "#$%&'()*+,-./0!"#$%#&'()*+,-./!"#$%&'!"#$%&'()*+,!"#$%&'()*LISREL 8.52!"#$%&SAS! 8.1!"#$%&'!"()*+,-!Z!"#$%&'()*+,!"#$(stepwise logistic regression procedure)!"#$%&'()*+,!"#$%&'()&*+,( )(1)!"#$%&'()*+, (main effects)(2)!"#$%&'()!"#$%&'()*+,&'-."!"#$%&'()*+,-./ (3)!"#$%&'()*+,-. 2,074!"#$%&'()*+,-. 1,089985!"#!$%1, !!19.77%!"#!"#$%&'()*+,-.!"#$%&'( 19.11% 20.48%)!"#$(26.63%)! (12.18%)!"#$%&'()!"#$%&'26.65%26.60% 10.98%13.52%!"#$%&!"#!"#$%&'()() 23.81%!"#$%&'()*+,-!"#$%&'(8.57%)!"# 8.87%8.25%!"#$%&'!"#$%&'()*+,23.24% 24.47%!"#$%&'()*+,-!"#$!"#$%&'()*+,-!"#$%&'()*!+,-.!"#$%&'()*+)",-. (reduced model)!"#$%&'(!"#$%&"'()*+",-.!"#$%#&'()#*+,-.!"#80%!"#$%&'( (!"#$3.04)!"#$%&'!"#$%&'()"#$*+,-! 2005, Vol.24, No.6 475

6 !"#$!%!&!"#$%&$'()*!"!"#$!"#$ a!"! Cronbach's α X 2 /df GFI AGFI RMSEA 1.!"#$(n2048) % !"#$%(n2046) % !"#$%(n2056) % !"#(n2055) % !"#(n2061) % !"#$%(n2061) % :!! (n559) (n530) (n1089) (n519) (n466) (n985) (n1078) (n996) (n2074) (%) ! X X X ! X X 2!"#$ p !!!! (n834) (n800) (n1634) (n981) (n846) (n1827) (%) ! Z12.03! X X Z Z! X 2!"#$ p0.001 ax 2 /df5gfaagfa0.90rmsea0.05!"#$!"#$%&'()*+,-!"#$%&' ()*+,&!!"#$%&'()%*+,-./!"#$%!&'()!*+,-!"#$%&'()()*+,!"#$%&'()%*+,-.!"#$%&'($)*+,-./!"#$%&'()*+,-./!"#$%c0.83!"#!"#$%&'()*!"+#,-!"#$%&'()*$+,-./!"#$%&'()*+#,-./ 476! 2005, Vol.24, No.6

7 !"#$% ! (n1279) (n1279) (n675) (n604) (!"#) (!"#$%&') (!"#) (!"#) 95%! p 95%! p 95%! p 95%! p!" 1. (/) 1.80 (1.28,2.53) 0.80 (0.18,3.55) 5.52 (2.76,11.07) 2.! ( / ) 3.04 (2.11,4.40) 5.70 (3.21,10.13) ! 1.50 (1.29,1.75) 1.54 (1.32,1.81) 1.50 (1.19,1.89) 1.63 (1.32,2.02) 4.! 1.27 (1.18,1.36) 1.25 (1.16,1.34 ) 1.30 (1.19,1.41) 1.28 (1.14,1.43) 5.!" 1.13 (1.05,1.21) 1.05 (0.95,1.15) 1.15 (1.06,1.25) **!" 1.! 1.06 (1.01,1.10) ** 1.06 (1.01,1.10) * 1.15 (1.07,1.24) 2.!"#$% 1.11 (1.06,1.17) 1.11 (1.06,1.17) 1.28 (1.17,1.40) 3.!"# 0.94 (0.89,0.99) * 4.!"# 0.95 (0.91,0.99) * 0.94 (0.90,0.99) * 5.!"#$% 2.18 (1.11,4.26) *!" 1. *! (0.17,0.72) ** 2. *!" (1.03,1.33) *!"#$ 1. Likelihood ratio (p0.0001) (p0.0001) (p0.0001) (p0.0001) 2. c Hosmer and Lemeshow (p0.25) 8.84 (p0.36) (p0.03) 8.03 (p0.43)!" *p0.05**p0.01p !"#$! 2005, Vol.24, No.6 477

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p0.01 p ! 2005, Vol.24, No.6

9 !"#$%!"CABLE!"#$%&'(!"#$%&'()*"+,(-.!"#$%&'(Negy[17]!!"#$%&(The Child's Theories Concerning Death)9!"#$%&'( 1!"#$%&'()*+",-.!"#$ %&'()*+,-./!"#$%&!"#$%&'()*+,-.!"!"#$%&'()*+,-.!"![22,23]!"#$%&'!"#$%!&'()*&+,-.!"#$%&'()*'+,-.!"#$%&'()*+*,-*.!"#$%&'()*+!"#$%&'()*+,-.!"#$%&'()*+,-. 1!"[19-24]!"#$%&'(!"#$%&'()*+,!-./!"#$%&'()*+,-[20,25, 26]!"#$%&'( )*+,-!"#$%&'()%*+,-./(0!"#$%&'()"*+,-.! 1 1!"#$%&'()*+,-.!"#$%&'()*+),-./ & 1!"#$%&'"#()*+,-$!"#$%&'()!"#$%&'()*+,-.!"#$%&'()*!+,-./!"#$%&'([16,26]!"!"#$%&'()* +,-./!"#$%&'!()*+,-.!"#$%&'()*+, -.!!"#$%&'()*+,-#.!"#$%&'()*!+,-./!"#$%&'()*+,-!"#$%& '()*+,-!"#$%&'()* #$%&' 1!!"#$%&'()*+, !"#$%&'()*+,- 1!"#$%&'()*+, - 1! 2005, Vol.24, No.6 479

10 !"#$!%!&!"#$%&'()!"#*+,-. 1!"#$%&'()*+,!"-.!"#$%&'()*+,-'(.!"#$%&'()*+, -./!"#$%&'()*+,-.()!!"!"#$%&'()*+,-.!"!"#$%&'()*+(!"#$)!"#$%&'(!"#$%[22,27-29]!"#$ ' "!"#$%&'()"*+,-.!"#$%&!'()*+,-).!"# $%&'()*+,&-!"#$%&'()*&'[22,28]!"#$%&'()*+,-.'/!"#$%&'()*+!"#$%&'()*+,-!"#$%&'()*+,- [4, 11,13,30]!"#$%&'()*+,!"#$%&'()! $*+%!"#$%&'()*+,-./"!"#$%&'()*+,-./!!"#$%&'()*+,-.!"#$%&'()*+,-.)/!"#$%&'()*+',-./!"#$%&'()!"#$%&'()*+,&-!"#$%&'()*+,!-./!"#$%&'()*#+,-./ 1!"#$%&'()*+,-.!"!"#$%&'()*+!"#$%&'((p! )!"#$%&'()*+!!"#$%&' ()*+,!"#$%&'()*+$,-./!(Children and Adolescent Behaviors in Long-term Evolution CABLE!"HP-090-SG-03)!"#$!"#$! 1. WHO. The World Health Report 2001: Mental Health: New Understanding, New Hope. Genava: WHO, 2001; !"#$%&'()*+,-.*/,!"0!"#$%&'() ! 2005, Vol.24, No.6

11 !"#$% 3. Beskow J. Suicide in mental disorder in Swedish men. Acta Psychiatr Scand Suppl 1979;277: !"#$%&'()*( Lewinsohn PM, Rohde P, Seeley JR. Psychosocial risk factors for future adolescent suicide attempts. J Consult Clin Psychol 1994;62: Brent DA. Risk factors for adolescent suicide and suicidal behavior: mental and substance abuse disorders, family environmental factors, and life stress. Suicide Life-threat Behav 1995;25: Wichstrom L. Predictors of adolescent suicide attempts: a nationally representative longitudinal study of Norwegian adolescents. J Am Acad Child Adolesc Psych 2000;39: Diekstra RFW, Kienhorst CWM, DeWilde EJ. Suicide and suicidal behavior among adolescent. In: Rutter M, Smith DJ eds. Psychosocial Disorders in Young People: Time Trends and Their Causes. Chichester, England: Wiley,1995; ! "#$%&'()*+,-./ /12/ Shafii M, Carrigan S, Whittinghill JR, Derrick A. Psychological autopsy of completed suicide in children and adolescents. Am J Psychiatr 1985;142: Bronfenbrenner U. The ecology of human development: experiments by nature and design. Cambridge, Mass.: Harvard University Press, !"# $% &'( )*+,CABLE (Child and Adolescent Behaviors in Long-Term Evolution) Annual Report 2001!"#$%&!"#$ Yen LL, Chen L, Lee SH, Hsiao C, Pan LY. Child and adolescents behavior in long-term evolution (CABLE): a school-based health lifestyle study. Promot Educ 2002; (suppl 1): National Center for Chronic Disease Prevention and Health Promotion. Youth Risk Behavior Surveillance System (YRBSS). (cited 2004/5)Available from: URL: World Health Organization. Health Behavior in Schoolaged Children (HBSC). (cited 2004/5)Available from: URL: Hesketh T, Ding QJ, Jenkins R. Suicide ideation in Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 2002;37: Nagy M. The child's theories concerning death. J Genet Psychol 1948;73: Garrison CZ, Jackson KL, Addy CL, McKeown RE, Waller JL. Suicidal behaviors in young adolescents. Am J Epidemiol 1991;133: Sorenson SB, Rutter CM. Transgenerational patterns of suicide attempt. J Consult Clin Psychol 1991;59: de Man AF, Leduc CP, Labreche-Gauthier L. Correlates of suicide ideation in French-Canadian adults and adolescents: a comparison. J Clin Psychol 1992;48: de Man AF, Leduc CP. Suicidal ideation in high school students: depression and other correlates. J Clin Psychol 1995;51: !" &123!"#$%&'() Leikin JB, Morris RW, Warren M, Erickson T. Trends in a decade of drug abuse presentation to an inner city ED. Am J Emerg Med 2001;19: Sayar K, Bozkir F. Predictors of Suicide Intent and Lethality in a Sample of Adolescent Suicide Attempters. Yeni Symposium 2004;42: Adams DM, Overholser JC, Lehnert KL. Perceived family functioning and adolescent suicidal behavior. J Am Acad Child Adolesc Psych 1994;33: Wagner BM, Cohen P. Adolescent sibling differences in suicidal symptoms: the role of parent-child relationships. J Abnorm Child Psychol 1994;22: Hollis C. Depression, family environment, and adolescent suicidal behavior. J Am Acad Child Adolesc Psych 1996;35: &' ! 2005, Vol.24, No.6 481

12 !"#$!%!& Ever having suicide ideation among the 4 th graders in northern Taiwan and its correlates YI-CHEN CHIANG 1, SHIAO-CHI WU 2,*, LEE-LAN YEN 1,3 Objectives: The purposes of this study were to realize the rate of children in 4 th grade who had ever had suicide ideation and to investigate the correlates of this. Methods: Data were obtained from a longitudinal study, Child and Adolescent Behaviors in Long-term Evolution (CABLE), which was conducted in The sample involved 2,075 fourth graders, 1,652 fathers and 1,841 mothers in northern Taiwan. Results: It was found that the prevalence of ever having suicide ideation among children was 19.77%. The rate in Taipei City was more than twofold that of Hsin- Chu County (26.63% vs %). Results of the stepwise logistic regression procedure showed that resident area, substance use, depression, social loneliness, mother's age, parental punishment and family support were the significant variables related to ever having suicide ideation include. It also showed that there is significant disparity between children living in urban and rural area. Conclusions: In order to prevent suicide ideation arising among children, parents and teachers should pay more attention to children's problem behaviors and emotion status. Children need greater family support and appropriate punishment. Those who have suicide ideation should be screened as early as possible. Life education and social skills are suggested in primary schools. (Taiwan J Public Health. 2005;24(6): ) Key Words: suicide ideation, children, depression, social loneliness, urban and rural disparity 1 Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan, R.O.C. 2 Institute of Health and Welfare Policy, College of Medicine, National Yang-Ming University, No. 155, Li-Long St., Sec. 2, Shih-Pai, Taipei, Taiwan, R.O.C. 3 Division of Health Policy Research, National Health Research Institutes, Taipei, Taiwan, R.O.C. * Correspondence author. scwu@ym.edu.tw Received: May 26, 2004 Accepted: May 6, ! 2005, Vol.24, No.6

Adjustment disorder and the course of the suicidal process in adolescents

Journal of Affective Disorders 87 (2005) 265 270 Research report Adjustment disorder and the course of the suicidal process in adolescents Gwendolyn Portzky*, Kurt Audenaert, Kees van Heeringen Unit for