Assessing Suicidality in Adolescents

청소년의 자살 가능성에 대한 임상 평가

Objectives : To consider which questions are most useful clinically and to find a framework for assessment of suicidality or risk of suicide for adolescents. Methods : Authors reviewed and integrated both clinical works and researches about measures used to evaluate suicidal behaviors in adolescents. Results : The 'cascade approach' for assessment of suicidality was developed; the quality and quantity of 'distress' leads to an entry question to do with the 'quality of life' and whether it is worth living. These two questions lead to examinations of 'thoughts' which may lead to 'plans' which leads to 'threats' which then leads to 'deliberate self injury' and then on to a history of 'past suicide attempts'. Authors also suggested to use a summed score of cascade approach in clinical decisions and showed how to modify it up to different evaluation situations. Focusing on the good things helps not only to qualify suicidality but also to begin the search for solutions. Conclusion : In the clinical assessment process, while scales assist the clinician, there is nothing to supplant a sensitive clinical approach. The 'cascade approach' was proposed as a framework for assessing adolescents for suicidality.