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(Pediatrics in Review. 2006;27:e36-e41.)
© 2006 American Academy of Pediatrics

Assessing the Potential for Violent Behavior in Children and Adolescents


Russell Copelan, MD*
 * Attending Emergency Psychiatrist, Department of Neurosciences, Memorial Hospital, Colorado Springs, Colo

The first 300 words of the full text of this article appear below.


   Introduction
 
Suicide and homicide in children and adolescents, both reasonably foreseeable and preventable events, are terrible losses for families and represent significant public health concerns. The realization that violence can occur anywhere has had a traumatizing impact on schools and communities nation- and worldwide. Violence is a dynamic and complex public health issue that affects millions of children and their families.

Suicide and aggression can occur across the entire spectrum of psychiatric disorders, which emphasizes the need for an organized, systematic assessment. These linked behaviors are best conceptualized as occurring on a final common pathway. Management of violent behavior depends on the stage of the destructive process as well as on the speed of progression. Differentiating the progressive, scalable risk factors that suicidal and homicidal phenomena have in common has important clinical consequences.

No standard of care exists for the prediction of child and adolescent suicide and homicide. However, a standard of care does exist that requires primary care physicians, nurses, physician assistants, and other medical and mental health professionals to assess risk adequately when clinically indicated. Although adequate assessment lacks definitional clarity, performing systematic violence risk assessments that inform treatment more than meets the standard of care and may improve quality of care substantially. Suicide and homicide, although not predictable on the basis of a "simply sufficient" interview, can be anticipated reasonably by assessing specific time-related factors.


   Prevalence of Child and Adolescent Violence
 
Millions of children each year are exposed to acts of violence, and the numbers appear to be increasing. Concurrently, the number of children who have committed acts of violence also has increased.

Over the last 30 years, the incidence of adolescent suicide has increased markedly. Approximately 3 million youths were at risk for suicide in 2000, and 37% of those at risk attempted to kill themselves. Among adolescents 15 to 24 years of . . . [Full Text of this Article]






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