Familial study of suicidal behavior among adolescents in Slovenia

The number of adolescents who attempt or complete suicide is increasing. Risk factors range from mental disorders, to problems at school, family problems, or difficulties in establishing relationships. A further important, and too often underestimated, risk factor for adolescent suicide is the presence of suicidal behavior in the adolescent's family. We investigated 184 high school adolescents in a region in Slovenia with a high suicide rate (30/100,000/year). They were questioned by means of an anonymous questionnaire about the presence of suicidal behavior in their relatives and about the presence of suicidal thoughts, plans, and acts in themselves. The results revealed that 13% of the adolescents studied had a relative who had attempted suicide and a further 9% of the adolescents had lost a relative due to suicide. About half of all females and almost a third of males had had suicidal thoughts (differences between sexes were statistically significant: chi2 = 6.13; p < .01). Attempted suicide among relatives was positively correlated with the presence of suicidal plans among adolescents (phi = 0.15; p < .05). This correlation proved to be even stronger and statistically more significant in men when we split the sample by gender. All variables (suicidal thoughts, suicidal plans, and suicide attempts) in the adolescent males positively correlated with attempted suicide among their relatives ((phi = 0.28, p < .01; phi) = 0.26, p < .05; phi = 0.34, p < .01; respectively). Our results speak in favor of a higher risk of suicidal behavior among adolescents with suicidal behavior in their families.     

Unemployment and suicidal behavior in a New Zealand birth cohort: a fixed effects regression analysis

This study examined the association between exposure to unemployment and suicidal behaviors (suicidal ideation and attempted suicide) in a birth cohort of New Zealand young adults using fixed-effects logistic and Poisson regression models. Data were gathered on unemployment and suicidal behaviors at annual periods from ages 16-25 years. At all ages increasing exposure to unemployment was associated with increased risks of suicidal ideation (p < .0001) and number of suicide attempts (p < .0001). Following adjustment for fixed effects and time-dynamic covariates, associations between unemployment and suicidal ideation reduced to marginal significance (p < .10), while the association between unemployment and suicide attempts was not statistically significant (p > .10). After adjustment, those experiencing 6 or more months of unemployment in a given year had odds of suicidal ideation that were 1.43 (95% CI: .96 to 2.16) times higher, and rates of suicide attempts that were 1.72 (95% CI: .89 to 3.32) times higher, than those who were not exposed to unemployment. Although unemployment was associated with moderate increases in risks of suicidal behaviors, much of this association was explained by confounding factors.     

Outcome of suicidal ideation and behavior in a young, help-seeking population over a 2-year period

Suicidal behavior is associated with negative outcomes, including completed suicide. This study examined the prevalence of suicidal behavior in a sample of referrals to a youth psychiatric service and investigated the stability of suicidality over 2 years. Of the 140 people (mean age 17.8) who were referred to a youth psychiatric service, 82 who were accepted for treatment (RA group) and 58 who were not accepted (RNA group) were assessed; 57% reported considering suicide and 39% reported attempting suicide in the 12 months prior to referral. Participants who reported suicidal ideation were significantly more likely than nonsuicidal participants to have multiple Axis I diagnoses and lower levels of functioning. At the 2-year follow-up there was a significant reduction in suicidality in the RA group, but not in the RNA group. In conclusion, suicidality is prevalent among young people referred to psychiatric services. Even brief contact with services results in a reduction in suicidality over 2 years.     

Effect of the broadcast of a television documentary about a teenager's suicide in Israel on suicidal behavior and methods

Portrayals of suicide in the media are controversial because they may impact on suicide rates and methods. The aim of this study was to analyze the effect of the broadcast of a television documentary wherein an adolescent girl is interviewed about her suicide plan and subsequently dies by suicide. National suicide rates during the 8 weeks prior to the program and the 4 weeks following it were compared to the same periods in the previous year. There was no significant difference in the rates of completed and attempted suicides before and after the program. There was a shift toward the method used in the film after the broadcast, but it was found to be nonspecific to that year. A significant decrease was noted in the mean age of suicide attempters in the last promotional week prior to the broadcast compared to the previous year (p = .032). These preliminary findings suggest that the repeated televised promotion of a documentary on suicide may raise the risk of suicide in vulnerable populations. Further investigations in bigger populations are needed.     

History of childhood abuse and neglect and suicidal behavior at hospital admission

Suicide is a major public health problem. Preventive measures have been sought by identifying risk factors. This study evaluates the association of childhood abuse and neglect with suicidal behavior at the time of psychiatric hospital admission. A total of 120 subjects (72 females; mean age 42.5 +/- 15.6 years old) admitted from August 2006 to July 2007 completed the Childhood Trauma Questionnaire (CTQ) to assess severity of exposure to childhood maltreatment. Thereof 62 (51.6%) patients presented with suicidal behavior at admission. Patients who had attempted suicide had significantly higher CTQ scores. Regression analysis indicated that shorter illness duration and severity of childhood maltreatment were predictors of suicidal behavior at admission. The study showed that inpatients of a psychiatric unit of a general hospital who experienced severe childhood abuse or neglect were significantly more likely to present with suicidal behavior. History of childhood maltreatment should be evaluated as an associated risk factor of suicidal behavior at admission of psychiatric inpatients.     

Elevated rates of suicidal behavior in gay, lesbian, and bisexual youth

Both clinical and epidemiological literature point to elevated rates of suicidal behaviors in gay, lesbian, and bisexual youth (GLBY). Recent North American and New Zealand studies of large populations (especially the US Youth Risk Behavior Surveys from several states) indicate that gay, lesbian, and bisexual adolescents (males in particular) can have rates of serious suicide attempts at least four times those of apparently heterosexual youth. There are various reasons why this figure is likely to be an underestimate. Reasons for these elevated rates of suicidal behavior include a climate of homophobic persecution in schools, and sometimes in family and community--values and actions that stigmatize homosexuality and that the youth who has not yet "come out" has to endure in silence.     

Definitions of suicidal behavior: lessons learned from the WHo/EURO multicentre Study

Based on the experience matured during the 15 years of the WHO/EURO Multicentre Study on Suicidal Behavior, this paper provides an excursus on main elements that characterize components for definitional needs. It describes the rationale for choosing the initial set of definitions within the study and the subsequent problems and developments. As a result, unifying terminologies are proposed.     

Gender and cultural patterns of suicidal behavior: young Hindustani immigrant women in the Netherlands

Patterns of suicidal behavior vary among cultures and along gender. Young Hindustani immigrant women attempt suicide four times more often than young Dutch women. This article explores multi-disciplinary explanations for suicidal behavior in this group. The interconnection of Durkheimian concepts of social integration and regulation with ecological insights into family relations and psychological and psychiatric theories on individual distress are relevant. It is suggested that young Hindustani women who display suicidal behavior possess certain personality and cognitive constellations that are interlocked with specific parenting styles in stressful family environments. These families are embedded in a context of moral transformations resulting from migration to a Western culture and may be facing difficulties accompanying the transitional processes encountered in the West, particularly those regarding gender roles. Durkheimian fatalistic and anomic suicides elucidate this. The Hindustani women who appear most at risk are those facing contradictory norms and overregulation, which prevent them from developing autonomy.     

Risk of suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in university students

The present paper investigates the risk of lifetime suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in a sample of 328 university students (41% male, 59% female). The response rate was 77% based on the total number of students registered for the relevant courses. A series of questions assessed lifetime suicide ideation, while problem solving and attitudes toward suicide were measured using the Self-Rating Problem Solving scale and four subscales of the Suicide Opinion Questionnaire, respectively (McLeavey, 1986; Domino et al., 1989). Almost one-third of the students surveyed had lifetime suicide ideation. Both genders were similar in terms of their suicide ideation history, problem solving, and attitudes toward suicidal behavior with the exception that male students were more in agreement with the attitude that suicidal behavior lacks real intent. Compared with 2% of nonideators and ideators, one in four planners reported that they would more than likely attempt suicide at some point in their life. Greater agreement with the attitude that suicidal behavior is normal was associated with significantly increased risk of being an ideator, as was poor problem solving and less agreement with the attitude that suicidal behavior is associated with mental illness.     

Predicting suicidal risk in a cohort of depressed children and adolescents

Background: In children and adolescents with a depressive disorder, predicting who will also go on to exhibit suicide-related behaviors (SRBs), including suicide attempt or self-harm, is a key challenge facing clinicians. Aims: To investigate the relative contributions of depressive disorder severity, hopelessness, family dysfunction, and perceived social support to the risk of suicide-related behaviors. Methods: This was a cross-sectional study of a group of 10-16-year-olds with major depressive disorders and dysthymic disorder. Results: Child-rated depressive disorder symptom severity emerged as the greatest predictor of risk. Hopelessness and family dysfunction were also significant predictors of SRBs. In combination these variables were strong predictors, accounting for 66% of the variance. This is a cross-sectional study design, rather than longitudinal, therefore risk prediction over time was not possible. Conclusions: Understanding the child and adolescents depressive disorder symptom severity from their perspective, their level of hopelessness, as well as their family context is critical in understanding the risk of SRBs. These findings may help to provide direction for targeted interventions to address these clinical risk factors.     

The determinants of teenage schooling in Jamaica: Rich vs. poor,females vs. males

The belief that schooling is an important way to reduce poverty and increase social mobility has lead to large government‐sponsored investment in education in developing countries. Jamaica has an impressive literacy and primary enrolment rate, yet the ability of its secondary school system to enhance social mobility and reduce inequality is limited. Regression results from a nationally representative household survey show that family background variables (parental education and income) are important determinants of secondary school enrolment, and income is the single most important determinant of enrolment in an ‘elite’ high school, with the impact being twice as large for females. Part of the income effect is shown to represent unobserved community heterogeneity. One conclusion is that the recent ‘cost‐sharing’ education policy of the Jamaican government, if applied selectively to the elite academic high schools, will fall disproportionately upon rich households.