American Express to Cut 5,400 Jobs


LOS ANGELES (AP) — American Express Co. said Thursday that it will slash about 5,400 jobs, mainly in its travel business, as it seeks to cut costs and transform its operations as more of its customers shift to online portals for booking travel plans and other needs.


The job cuts will be partly offset by jobs that the company expects to add this year.


American Express said the jobs eliminated will span employee seniority levels and divisions worldwide, but will primarily involve positions that do not directly generate revenue for the company.


All told, the company anticipates that staffing levels will end up between 4 and 6 percent lower this year than in 2012. The company currently has 63,500 employees.


"Against the backdrop of an uneven economic recovery, these restructuring initiatives are designed to make American Express more nimble, more efficient and more effective in using our resources to drive growth," said CEO Kenneth Chenault.


Shares slipped 29 cents to $60.50 in after-hours trading. They ended regular trading up 53 cents at $60.79.


American Express said it will book an after-tax charge of $287 million due to the restructuring. It's also recording $212 million in expenses related to reward points for its cardholders and roughly $95 million in customer reimbursements and other costs.


The combined charges will reduce American Express' fourth-quarter net income by 46 percent from a year earlier.


The company projects net income of $637 million, or 56 cents per share, compared with net income of $1.2 billion, or $1.01 per share, in the same quarter of 2011.


Excluding one-time items, fourth-quarter 2012 earnings amount to $1.2 billion, or $1.09 per share, ahead of analysts' consensus forecast of $1.06 per share, according to FactSet.


Revenue rose 5 percent to $8.1 billion. Analysts expected $8.01 billion.


The company is scheduled to report full results next Thursday.


Overall American Express has done well after the recession, as upscale shoppers have spent freely. That's because Amex cardholders are in general about a third more affluent than other credit card holders.


Through the first nine months of 2012, revenue grew 5 percent, while net income rose 3 percent.


Spending by cardholders jumped 8 percent in the fourth quarter, despite some softening early in the period due to Superstorm Sandy, the company said.


Chenault noted that, since the recession, American Express has been consistently gaining market share.


Despite that success, he said the company must embrace new technologies, become more efficient and position itself to invest in growth opportunities in a marketplace that's increasingly becoming defined by consumers' use of the Internet and mobile technology.


To that end, American Express' restructuring plan calls for overhauling its travel business to cut costs and invest in ways to cater to a growing volume of customers turning to online and automated tools to make their travel arrangements.


"One outcome of this ongoing shift to online is that we can serve a growing customer base with lower staffing levels," Chenault said during a call with analysts.


The company also will reconfigure its cardholder servicing and collections operations to focus more on online and mobile, rather than telephone and mail.


"The overall restructuring program will put us in a better position as we seek to deliver strong results for shareholders and to maintain marketing and promotion investments at about 9 percent of revenues," Chenault said.


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Venezuelan Court: Chávez Swearing-In Can Be Postponed



CARACAS, Venezuela (AP) — Venezuela's foreign minister is hosting a meeting with leaders from 19 Latin American and Caribbean nations.


Nicolas Maduro plans to discuss issues related to Petrocaribe, a pact that has boosted the South American nation's influence in the region.


Venezuela created Petrocaribe in 2005 to sell fuel to member countries at preferential terms and help finance oil infrastructure projects.


Visiting leaders and foreign ministers are expected to attend an event Thursday to show their support for President Hugo Chavez.


Chavez is currently in Cuba recovering from cancer-related surgery.


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Go Ahead, Keep Being Mean to Celebrities on Twitter






We realize there’s only so much time one can spend in a day watching new trailers, viral video clips, and shaky cell phone footage of people arguing on live television. This is why every day The Atlantic Wire highlights the videos that truly earn your five minutes (or less) of attention. Today:  


RELATED: The Honey Boo Boo Nature Special; Everyone’s Favorite Sleepwalking Mom






We usually don’t condone being an impolite jerk to anyone, especially on social media. But we kind of make an exception because, well, if everyone was nice to everyone all of a sudden, we’d run out of fun Jimmy Kimmel segments where celebrities read their tweets:


RELATED: Ai Weiwei’s ‘Gangnam Style’ Isn’t Bad


RELATED: So Which Boyfriend Is Taylor Swift Singing About Now?


Oh man, this giant squid is like the most famous sea creature celebrity of the moment. And yes, it’s way freakier in motion:


RELATED: Katie Holmes Goes Bust on Broadway


RELATED: Justin Bieber is Coming to Town


So fine, this is sort of bending the rules per se because this isn’t really a video-video. It’s the Game of Thrones introduction with beatboxing by the Stark children. 


And finally, here is one minute of a man singing all the songs involving the word “baby.” And in case you were wondering, yes, Justin Bieber is officially in the Baby Pantheon of Music. 


Social Media News Headlines – Yahoo! News





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Steroids fallout: No BB Hall for Bonds, Clemens


NEW YORK (AP) — No one was elected to the Hall of Fame this year. When voters closed the doors to Barry Bonds, Roger Clemens and Sammy Sosa, they also shut out everybody else.


For only the second time in four decades, baseball writers failed to give any player the 75 percent required for induction to Cooperstown, sending a powerful signal that stars of the Steroids Era will be held to a different standard.


All the awards and accomplishments collected over long careers by Bonds, Clemens and Sosa could not offset suspicions those feats were boosted by performance-enhancing drugs.


Voters also denied entry Wednesday to fellow newcomers Craig Biggio, Mike Piazza and Curt Schilling, along with holdovers Jack Morris, Jeff Bagwell and Lee Smith.


Among the most honored players of their generation, these standouts won't find their images among the 300 bronze plaques on the oak walls in Cooperstown, where — at least for now — the doors appear to be bolted shut on anyone tainted by PEDs.


"After what has been written and said over the last few years I'm not overly surprised," Clemens said in a statement he posted on Twitter.


Bonds, Clemens and Sosa retired after the 2007 season. They were eligible for the Hall for the first time and have up to 14 more years on the writers' ballot.


"Curt Schilling made a good point, everyone was guilty. Either you used PEDs, or you did nothing to stop their use," Hall of Famer Mike Schmidt said in an email to The Associated Press after this year's vote was announced. "This generation got rich. Seems there was a price to pay."


Biggio, 20th on the career list with 3,060 hits, appeared on 68.2 percent of the 569 ballots, the highest total but 39 votes shy. The three newcomers with the highest profiles failed to come close to even majority support, with Clemens at 37.6 percent, Bonds at 36.2 and Sosa at 12.5.


Other top vote-getters were Morris (67.7), Jeff Bagwell (59.6), Piazza (57.8), Tim Raines (52.2), Lee Smith (47.8) and Schilling (38.8).


"I'm kind of glad that nobody got in this year," Hall of Famer Al Kaline said. "I feel honored to be in the Hall of Fame. And I would've felt a little uneasy sitting up there on the stage, listening to some of these new guys talk about how great they were. ... I don't know how great some of these players up for election would've been without drugs. But to me, it's cheating."


At ceremonies in Cooperstown on July 28, the only inductees will be three men who died more than 70 years ago: Yankees owner Jacob Ruppert, umpire Hank O'Day and barehanded catcher Deacon White. They were chosen last month by the 16-member panel considering individuals from the era before integration in 1947.


"It is a dark day," said Jose Canseco, the former AL MVP who was among the first players to admit using steroids. "I think the players should organize some type of lawsuit against major league baseball or the writers. It's ridiculous. Most of these players really have no evidence against them. They've never tested positive or they've cleared themselves like Roger Clemens."


It was the eighth time the BBWAA failed to elect any players. There were four fewer votes than last year and five members submitted blank ballots.


"With 53 percent you can get to the White House, but you can't get to Cooperstown," BBWAA secretary-treasurer Jack O'Connell said. "It's the 75 percent that makes it difficult."


There have been calls for the voting to be taken away from the writers and be given to a more diverse electorate that would include players and broadcasters. The Hall says it is content with the process, which began in 1936.


"It takes time for history to sort itself out, and I'm not surprised we had a shutout today," Hall President Jeff Idelson said. "I wish we had an electee. I will say that, but I'm not surprised given how volatile this era has been in terms of assessing the qualities and the quantities of the statistics and the impact on the game these players have had."


Bonds, baseball's only seven-time Most Valuable Player, hit 762 home runs, including a record 73 in 2001. He was indicted on charges he lied to a grand jury in 2003 when he denied using PEDs but a jury two years ago failed to reach a verdict on three counts he made false statements and convicted him on one obstruction of justice count, finding he gave an evasive answer.


"It is unimaginable that the best player to ever play the game would not be a unanimous first-ballot selection," said Jeff Borris of the Beverly Hills Sports Council, Bonds' longtime agent.


Clemens, the only seven-time Cy Young Award winner, is third in career strikeouts (4,672) and ninth in wins (354). He was acquitted last year on one count of obstruction of Congress, three counts of making false statements to Congress and two counts of perjury, all stemming from his denials of drug use.


"To those who did take the time to look at the facts," Clemens said, "we very much appreciate it."


Sosa, eighth with 609 home runs, was among those who tested positive in MLB's 2003 anonymous survey, The New York Times reported in 2009. He told a congressional committee in 2005 that he never took illegal performance-enhancing drugs.


Since 1961, the only years the writers didn't elect a candidate had been when Yogi Berra topped the 1971 vote by appearing on 67 percent of the ballots cast and when Phil Niekro headed the 1996 ballot at 68 percent — both got in the following years. The other BBWAA elections without a winner were in 1945, 1946, 1950, 1958 and 1960.


Morris will make his final ballot appearance next year, when fellow pitchers Greg Maddux and Tom Glavine are eligible for the first time along with slugger Frank Thomas.


"Next year, I think you'll have a rather large class, and this year, for whatever reasons, you had a couple of guys come really close," Commissioner Bud Selig said at the owners' meetings in Paradise Valley, Ariz. "This is not to be voted to make sure that somebody gets in every year. It's to be voted on to make sure that they're deserving. I respect the writers as well as the Hall itself. This idea that this somehow diminishes the Hall of baseball is just ridiculous in my opinion."


Players' union head Michael Weiner called the vote "unfortunate, if not sad."


"To ignore the historic accomplishments of Barry Bonds and Roger Clemens, for example, is hard to justify. Moreover, to penalize players exonerated in legal proceedings — and others never even implicated — is simply unfair. The Hall of Fame is supposed to be for the best players to have ever played the game. Several such players were denied access to the Hall today. Hopefully this will be rectified by future voting."


The BBWAA election rules say "voting shall be based upon the player's record, playing ability, integrity, sportsmanship, character, and contributions to the team(s) on which the player played."


An Associated Press survey of 112 eligible voters conducted in late November after the ballot was announced indicated Bonds, Clemens and Sosa would fall well short of 50 percent. The big three drew even less support than that as the debate raged over who was Hall worthy.


Voters are writers who have been members of the BBWAA for 10 consecutive years at any point.


BBWAA president Susan Slusser of the San Francisco Chronicle said she didn't vote for Bonds, Clemens or Sosa.


"The evidence for steroid use is too strong," she said.


As for Biggio, "I'm surprised he didn't get in."


Mark McGwire, 10th on the career home run list with 583, received 16.9 percent on his seventh try, down from 19.5 last year. He got 23.7 percent in 2010 — a vote before he admitted using steroids and human growth hormone.


Rafael Palmeiro, among just four players with 500 homers and 3,000 hits along with Hank Aaron, Willie Mays and Eddie Murray, received 8.8 percent in his third try, down from 12.6 percent last year. Palmeiro received a 10-day suspension in 2005 for a positive test for performance-enhancing drugs, claiming it was due to a vitamin vial given to him by teammate Miguel Tejada.


MLB.com's Hal Bodley, the former baseball columnist for USA Today, said Biggio and others paid the price for other players using PEDs.


"They got caught in the undertow of the steroids thing," he said.


Bodley said this BBWAA vote was a "loud and clear" message on the steroids issue. He said he couldn't envision himself voting for stars linked to drugs.


"We've a forgiving society, I know that," he said. "But I have too great a passion for the sport."


NOTES: There were four write-in votes for career hits leader Pete Rose, who never appeared on the ballot because of his lifetime ban that followed an investigation of his gambling while manager of the Cincinnati Reds. ... Two-time NL MVP Dale Murphy received 18.6 percent in his 15th and final appearance. ... At the July 28 ceremonies, the Hall also will honor Lou Gehrig and Rogers Hornsby among a dozen players who never received formal inductions because of restrictions during World War II. ... Piazza has a book due out next month that could change the view of voters before the next election.


___


AP Sports Writers Dan Gelston, Mike Fitzpatrick, John Marshall and Ben Walker contributed to this report.


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Americans Under 50 Fare Poorly on Health Measures, New Report Says





Younger Americans die earlier and live in poorer health than their counterparts in other developed countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health and longevity in the United States.




Researchers have known for some time that the United States fares poorly in comparison with other rich countries, a trend established in the 1980s. But most studies have focused on older ages, when the majority of people die.


The findings were stark. Deaths before age 50 accounted for about two-thirds of the difference in life expectancy between males in the United States and their counterparts in 16 other developed countries, and about one-third of the difference for females. The countries in the analysis included Canada, Japan, Australia, France, Germany and Spain.


The 378-page study by a panel of experts convened by the Institute of Medicine and the National Research Council is the first to systematically compare death rates and health measures for people of all ages, including American youths. It went further than other studies in documenting the full range of causes of death, from diseases to accidents to violence. It was based on a broad review of mortality and health studies and statistics.


The panel called the pattern of higher rates of disease and shorter lives “the U.S. health disadvantage,” and said it was responsible for dragging the country to the bottom in terms of life expectancy over the past 30 years. American men ranked last in life expectancy among the 17 countries in the study, and American women ranked second to last.


“Something fundamental is going wrong,” said Dr. Steven Woolf, chairman of the Department of Family Medicine at Virginia Commonwealth University, who led the panel. “This is not the product of a particular administration or political party. Something at the core is causing the U.S. to slip behind these other high-income countries. And it’s getting worse.”


Car accidents, gun violence and drug overdoses were major contributors to years of life lost by Americans before age 50.


The rate of firearm homicides was 20 times higher in the United States than in the other countries, according to the report, which cited a 2011 study of 23 countries. And though suicide rates were lower in the United States, firearm suicide rates were six times higher.


Sixty-nine percent of all American homicide deaths in 2007 involved firearms, compared with an average of 26 percent in other countries, the study said. “The bottom line is that we are not preventing damaging health behaviors,” said Samuel Preston, a demographer and sociologist at the University of Pennsylvania, who was on the panel. “You can blame that on public health officials, or on the health care system. No one understands where responsibility lies.”


Panelists were surprised at just how consistently Americans ended up at the bottom of the rankings. The United States had the second-highest death rate from the most common form of heart disease, the kind that causes heart attacks, and the second-highest death rate from lung disease, a legacy of high smoking rates in past decades. American adults also have the highest diabetes rates.


Youths fared no better. The United States has the highest infant mortality rate among these countries, and its young people have the highest rates of sexually transmitted diseases, teen pregnancy and deaths from car crashes. Americans lose more years of life before age 50 to alcohol and drug abuse than people in any of the other countries.


Americans also had the lowest probability over all of surviving to the age of 50. The report’s second chapter details health indicators for youths where the United States ranks near or at the bottom. There are so many that the list takes up four pages. Chronic diseases, including heart disease, also played a role for people under 50.


“We expected to see some bad news and some good news,” Dr. Woolf said. “But the U.S. ranked near and at the bottom in almost every heath indicator. That stunned us.”


There were bright spots. Death rates from cancers that can be detected with tests, like breast cancer, were lower in the United States. Adults had better control over their cholesterol and high blood pressure. And the very oldest Americans — above 75 — tended to outlive their counterparts.


The panel sought to explain the poor performance. It noted the United States has a highly fragmented health care system, with limited primary care resources and a large uninsured population. It has the highest rates of poverty among the countries studied.


Education also played a role. Americans who have not graduated from high school die from diabetes at three times the rate of those with some college, Dr. Woolf said. In the other countries, more generous social safety nets buffer families from the health consequences of poverty, the report said.


Still, even the people most likely to be healthy, like college-educated Americans and those with high incomes, fare worse on many health indicators.


The report also explored less conventional explanations. Could cultural factors like individualism and dislike of government interference play a role? Americans are less likely to wear seat belts and more likely to ride motorcycles without helmets.    


The United States is a bigger, more heterogeneous society with greater levels of economic inequality, and comparing its health outcomes to those in countries like Sweden or France may seem lopsided. But the panelists point out that this country spends more on health care than any other in the survey. And as recently as the 1950s, Americans scored better in life expectancy and disease than many of the other countries in the current study.


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Solis Stepping Down as Labor Secretary





WASHINGTON – Secretary of Labor Hilda L. Solis announced on Wednesday that she was stepping down, becoming the latest woman to leave President Obama’s cabinet at a time when his personnel choices are drawing scrutiny for their lack of female candidates.




Ms. Solis, a former congresswoman from California, told colleagues in an e-mail that she had submitted her resignation letter to Mr. Obama Wednesday afternoon.


She said she had decided to step down after consulting family members and friends. Associates of Ms. Solis, who is 55 and was born in Los Angeles, said she was likely to run for a seat on the Los Angeles County Board of Supervisors.


In a statement, Mr. Obama said, “Secretary Solis has been a critical member of my economic team as we have worked to recover from the worst economic downturn since the Great Depression and strengthen the economy for the middle class.”


Ms. Solis was praised by labor unions for working to enforce workplace regulations and occasionally criticized for not being responsive to business interests. Among her biggest campaigns was cracking down on farmers who employ children or underpaid workers.


Ms. Solis, who was never viewed as part of Mr. Obama’s inner core of advisers, prided herself on going to bat for the nation’s recession-battered workers, especially those on the lower end. Many Hispanic workers looked to her as their champion – she focused, for instance, on the high fatality rate for Hispanic workers.


She made the department more aggressive in ferreting out rules violations involving the minimum wage, overtime and other issues. Last year the Labor Department collected more back pay for wage violations than in any previous year, more than $280 million on behalf of 300,000 workers.


Under her, the Labor Department incurred the coal industry’s wrath by focusing on mine safety violations after the Upper Big Branch disaster, a West Virginia coal mine explosion in 2010 that killed 29 workers.


She is one of two Hispanic members of the cabinet, with Ken Salazar, the interior secretary, and was one of a handful of women, along with Secretary of State Hillary Rodham Clinton; Lisa P. Jackson, the administrator of the Environmental Protection Agency; Janet Napolitano, the secretary of homeland security; Susan E. Rice, the ambassador to the United Nations; and Kathleen Sebelius, the secretary of health and human services, who has cabinet status.


Ms. Jackson has announced her resignation, and Mrs. Clinton is to be succeeded by Senator John Kerry.


Mark Landler reported from Washington, and Steven Greenhouse from New York.



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Venezuelan Government: Hugo Chávez to Miss Scheduled Swearing-In


Ramon Espinosa/Associated Press


Venezuelan embassy workers hold up a framed image of ailing President Hugo Chávez.





CARACAS (Reuters) - Venezuelan President Hugo Chavez will miss Thursday's scheduled swearing-in ceremony for his third term due to health problems, the government said in a letter to Congress read out on Tuesday.


Chavez has not been heard from since undergoing his fourth cancer surgery in Cuba on December 11, and officials have described his condition as delicate.


(Reporting by Brian Ellsworth; Editing by Sandra Maler)


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James Franco Does His Best Justin Bieber






We realize there’s only so much time one can spend in a day watching new trailers, viral video clips, and shaky cell phone footage of people arguing on live television. This is why every day The Atlantic Wire highlights the videos that truly earn your five minutes (or less) of attention. Today:  


RELATED: All We Want for Christmas Is Jimmy Fallon and Mariah Carey Singing to Us






Remember when Justin Bieber was struggling for relevance and James Franco was the super serious, super educated actor destined for greatness? Well, Franco clearly doesn’t want you to:


RELATED: Dating Is Just So Depressing


RELATED: A Dubstep Birthday for Michael Jackson and One Soggy Koala


So what do you do when someone gets their dream wedding ruined by a doomed hot-air balloon ride? Well, if you’re the Today show, you make a macabre Wedding Crashers joke: 


RELATED: Ai Weiwei’s ‘Gangnam Style’ Isn’t Bad


RELATED: ‘What Makes You Beautiful’ Gets Beautiful


Here’s perhaps one of the better arguments against that trillion-dollar coin, courtesy of Homer Simpson and company:


And this guy seems pretty down on the squandered opulence of cruise ships:


Wireless News Headlines – Yahoo! News





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Jaguars hire Falcons' Caldwell as general manager


JACKSONVILLE, Fla. (AP) — The Jacksonville Jaguars have agreed to hire Atlanta director of player personnel David Caldwell as general manager, charging him with turning around one of the league's worst teams.


His first move will be deciding the fate of coach Mike Mularkey.


Owner Shad Khan tabbed Caldwell on Tuesday, a day after a third interview. FoxSports.com first reported the hire, saying the two sides are negotiating financial terms.


Caldwell is now expected to make a decision on Mularkey, who went 2-14 in his first season in Jacksonville and has lost 20 of his last 23 games as a head coach.


Khan gave Mularkey's assistants permission to search for other jobs last week, an indication that he doesn't expect to retain Mularkey or his staff.


Then again, Caldwell and Mularkey have a relationship stemming from their time in Atlanta.


Before becoming the Falcons' director of player personnel in 2012, Caldwell spent four seasons as Atlanta's director of college scouting — the same four years Mularkey served as offensive coordinator. Caldwell replaced Les Snead, who was hired as St. Louis' general manager last offseason.


"He's a great guy, a great family man, does a good job," Mularkey said of Caldwell last month. "He had some experience in Indy before he got to Atlanta, and I thought he did a good job up there. ... I thought that (he would become a GM) when I worked with him, that he was heading in that direction."


Caldwell was part of an Atlanta front office that drafted quarterback Matt Ryan, linebackers Curtis Lofton and Sean Witherspoon, offensive tackle Sam Baker, safety William Moore, receiver Julio Jones and running back Jacquizz Rodgers.


He doesn't inherit as much talent in Jacksonville, but the Jaguars have the No. 2 pick in April's draft and plenty of room under the salary cap to make moves. And coming off the worst season in franchise history, it won't take much to show improvement.


Khan fired general manager Gene Smith last week, parting ways with the guy who built a team that failed to make the playoffs the last four seasons.


Smith had been with the team since its inception in 1994, working his way up from regional scout to general manager. He had been GM since 2009, compiling a 22-42 record. Not one player he acquired made the Pro Bowl, though.


Smith changed the way Jacksonville approached personnel moves. He made character as important as ability, but it never paid off the way he envisioned.


Finding talent was the main issue.


Smith whiffed on offensive tackle Eben Britton (39th overall pick in 2009), defensive tackle Tyson Alualu (10th pick in 2010) and quarterback Blaine Gabbert (10th pick in 2011). Smith traded up to select Gabbert even though several teams with quarterback needs passed on the former Missouri starter.


Smith's most controversial act came in April, when he chose punter Bryan Anger in the third round (70th pick). Anger was terrific as a rookie, but adding him never seemed like the best call for a team that needed talent and depth at so many other positions.


Equally alarming for Khan had to be Smith's penchant for overpaying in free agency: Torry Holt, Aaron Kampman, Paul Posluszny, Clint Session, Dawan Landry, Laurent Robinson and Aaron Ross.


Smith did hit on some players, including left tackle Eugene Monroe (eighth pick in 2009), cornerback Derek Cox (73rd pick in 2009) and receivers Cecil Shorts (114th pick in 2011) and Justin Blackmon (fifth pick in 2012). But none of those starters has become a star. And Smith gave up a second-round pick to get Cox and a fourth-rounder to trade up and get Blackmon.


___


Online: http://pro32.ap.org/poll and http://twitter.com/AP_NFL


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Gaps Seen in Therapy for Suicidal Teenagers


Most adolescents who plan or attempt suicide have already gotten at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled teenagers, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.


The study in the journal JAMA Psychiatry found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.


The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems that include attention-deficit and eating disorders, as well as alcohol and drug abuse.


The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and about a third of them had made a suicide attempt, usually within a year of having the idea.


Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference.


The study suggests that effective treatment for severely suicidal teenagers must address not just mood disorders, but also behavior problems that can lead to impulsive acts, experts said. According to the Centers for Disease Control and Prevention, 1,386 people between the ages of 13 and 18 committed suicide in 2010, the latest year for which numbers are available.


“I think one of the take-aways here is that treatment for depression may be necessary but not sufficient to prevent kids from attempting suicide,” said Dr. David Brent, a professor of psychiatry at the University of Pittsburgh, who was not involved in the study. “We simply do not have empirically validated treatments for recurrent suicidal behavior.”


The report said nothing about whether the therapies given were state of the art, or carefully done, said Matt Nock, a professor of psychology at Harvard and the lead author; and it is possible that some of the treatments prevented suicide attempts. “But it’s telling us we’ve got a long way to go to do this right,” Dr. Nock said. His co-authors included Ronald C. Kessler of Harvard, and researchers from Boston University and Children’s Hospital Boston.


Margaret McConnell, a consultant in Alexandria, Va., said that her daughter Alice, who killed herself in 2006, at the age of 17, was getting treatment at the time. “I think there might have been some carelessness in the way the treatment was done,” Ms. McConnell said, “and I was trusting a 17-year-old to manage her own medication; we found out after we lost her that she wasn’t taking it regularly.”


In the study, researchers surveyed 6,483 adolescents from the ages of 13 to 18 and found that 9 percent of male teenagers and 15 percent of female teenagers experienced some stretch of having persistent suicidal thoughts. Among girls, 5 percent made suicide plans and 6 percent made at least one attempt (some were unplanned).


Among boys, 3 percent made plans and 2 percent carried out attempts – which tended to be more lethal than girls’ attempts.


(Suicidal thinking or behavior was virtually unheard-of before age 10.)


Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.


Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias, or generalized anxiety disorder. Those with an added behavior problem – attention-deficit disorder, substance abuse, explosive anger – were more likely to act on thoughts of self-harm, the study found.


Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.


One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and attempts in people with so-called borderline personality disorder, who are highly prone to self-harm, among others.


But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments – talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use – was more effective that regular therapies.


“But that’s just one study, and it’s small,” Dr. Brent said. “We can treat components of the overall problem, but that’s about all.”


Ms. McConnell said that her daughter’s depression seemed mild and that there was no warning that she would take her life. “I think therapy does help a lot of people, if it’s handled right,” she said.


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