INTERVIEWING PREPUBERTAL CHILDREN ABOUT SUICIDAL IDEATION AND BEHAVIOR

Objective: Much of the literature on assessment of suicidal children h as focused on identifying risk factors associated with suicidal ideati on and behavior in this population. Unique problems encountered in int erviewing prepubertal children about suicidal ideation and behavior ar e examined in this paper. Method: Observations of problems encountered in interviewing prepubertal children about suicidal ideation and beha vior were gleaned in the context of interviews of children admitted to a child psychiatry inpatient unit and interviews of the parents of th ese children. Results: Unique problems include difficulties in assessm ent of suicidal intent, impact of cognitive development, particularly of the concept of death, interaction between current emotional state a nd memory of previous suicidal episodes, characteristics of play assoc iated with suicidal states, effects of parents' attitudes toward asses sment on information gathering, and the impact of certain risk factors on cognition and behavior during the interview. Conclusion: Interview ing children about suicidal ideation and behavior necessitates that th e clinician attend to multiple elements of the interview simultaneousl y. These interviews are further complicated by the stressful thoughts and feelings that can be raised in both clinician and child in reactio n to exploring the child's suicidal ideation and behavior. Additional research is needed to refine the process of reliable interviewing of c hildren about suicidal ideation and behavior and to develop instrument s both to quantitate the different elements of these interviews and to guide the clinicians conducting them.