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PACEs in Medical Schools

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Although the USPSTF in its publications and analyses recognizes that child abuse and neglect trauma strongly contributes to suicide ideation and completion, it does not recommend or endorse ACE screening or otherwise discuss it.

Suicide (Evidence Synthesis, Number 221, Screening for Depression, Anxiety, and Suicide Risk in Children and Adolescents: An Evidence Review for the U.S. Preventive Services Task Force)


" Suicide is the second leading cause of death among youth ages 10 to 19 years.

Although young children rarely attempt or die by suicide, they do reveal some preoccupation with death or suicide, either in talk or in play, and these themes are considered to signal major depression in preschool children and are a significant predictor of future suicidal ideation and other psychiatric disorders. More commonly, suicidal behaviors first emerge during later childhood and adolescence. Studies of Canadian and U.S. adolescents showed that the prevalence of attempts among ideators was 25.5 percent in the Canadian cohort and 33.9 percent in the U.S. cohort….The most substantial risk factors for youth suicide are adverse childhood experiences and mental
health disorders, including family history of suicide or mental health disorders, previous suicide attempts, life stressors such as interpersonal losses, legal or disciplinary problems, history of trauma, and parent-child conflict…. Major depression as a risk for suicide may have a different role in childhood versus adolescence. In one large epidemiologic sample, suicide attempts in children younger than age 13 years were
more strongly related to child maltreatment
compared with adolescents for whom suicide attempts were more strongly related to depression."

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