The purpose of the present study is to examine the psychosocial determinants of two of the most serious forms of adolescent self-destructive behavior encountered in the hospital setting: suicidal ideation and/or behavior and non-adherence with medical treatment. The study will assess two clinical samples of 13-17 y.o. adolescent inpatients admitted for a) psychiatric assessment (100 subjects) or b) diabetic regulation (60 subjects). Data from these two clinical samples will be used to examine the relationship of suicidality and diabetic non-adherence to 1) psychiatric diagnosis and symptoms and personality and family variables and 2) self-care attitudes and behaviors. The hypothesis will be tested that self-care attitudes and behaviors add to the power of demographic, psychopathologic, and family variables to predict suicidality or diabetic non-adherence in the respective clinical groups. An underlying perspective of the study is that failure to develop the capacity for autonomous bodily self-care in adolescence is an important element in various forms of adolescent self-destructive behavior (including suicide attempts and medical non-adherence). A written Self-Care Attitudes and Behaviors Questionnaire (SCAQ) will be used to assess subjects' positive preventive health and hygiene practices, risk behaviors, and perceived parental attitudes towards the physical care of the child. In order to refine the construct of self-care attitudes and behaviors and its measurement, the study will evaluate the internal consistency of the SCAQ and its convergent and discriminant validity with respect to measures of specific psychopathology and other health-behavior related variables. Comparison data on the SCAQ will be obtained from a community sample of adolescents recruited from an ongoing epidemiologic study. Concurrent psychosocial data, including psychiatric symptoms and diagnoses will also be available for these community subjects.
