Debora Ganz, Leo Sher
Columbia University and New York State Psychiatric Institute,
New York, New York, USA
Terror and Suicide. Hauppauge, New York: Nova Science Publishers, 2009, 167 pages.

The prevalence of Posttraumatic Stress Disorder (PTSD) in adolescence is higher than the prevalence of PTSD in adult populations. The prevalence of these factors is even higher among youth and adolescents exposed to terror. Such adolescents have also been found to present with other emotional disorders (particularly mood disorders), traumatic grief, childhood abuse, and/or a family or peer history of suicide. The reasons for and developments of the association between PTSD and suicidality in adolescence, however, remain unclear. Core biological changes contributing to PTSD affect emotion, arousal, perception of the self and the world, irritability, impulsivity, anger, aggression and depression. There is evidence that the aforementioned factors, as well as alcohol and other drug (AOD) use may act to moderate the influence of stressful life events, such as terror, and lead to eventual suicidality. Both PTSD and suicidality in adolescents have also been hypothesized to be a result of exposure to terror or other violence and negative coping styles. There are many treatment challenges for these populations, yet the most promising preventions and treatments include reductions in terror, suicide risk screenings, suicide education, Dialectical Behavioral Therapy (DBT), addressing associated coping mechanisms and prescribing anti-depressant and anti-anxiety medications. When prescribing medications physicians need to be careful to consider the weaknesses and strengths of each of the pharmacological options (specifically Serotonin Specific Reuptake Inhibitor’s (SSRI’s)) as they apply to adolescents presenting with PTSD and suicidality.