Young adults' support strategies when peers disclose suicidal intent

In response to the growing suicide rate among adolescents and young adults, researchers have noted the importance of peer responses to suicidal disclosures in this population. The most adaptive response is to inform a responsible adult about the suicidal peer, but existing data indicate that most adolescents and young adults choose to talk to the peer on their own. The present study examined whether young adults' own history of suicidal ideation, gender, social history with suicide, and ambiguity of the disclosure would predict their response to a hypothetical suicidal peer. The data revealed significant effects of ambiguity and participants' suicidal ideation on the confidants' response strategy. The confidants' experience with others' attempted or completed suicides increased their likelihood of saving they would tell an authority, whereas their own history of ideation or attempts reduced the likelihood of that response. These effects were most pronounced when the hypothetical peer's suicidal intent was not completely clear, which may often be the case in disclosures by suicidal adolescents. Youth and young adults should be encouraged to inform adults about suicidal peers, particularly those who have been suicidal themselves previously, and who may resist that strategy. It is postulated that these particular peers may be more easily convinced to respond in this manner if they could be involved in the intervention with their suicidal peer.     

Conversational skills for autistic adolescents: An autistic peer as prompter

In this study, an autistic youth served as peer prompter for three other autistic adolescents. The peer prompter encouraged the other boys to talk about sports, a topic frequently discussed by typical teenagers. A multiple-baseline design across participants was used to assess the effectiveness of the peer-prompting procedure. During baseline, the youth rarely talked about sports, although all three had previously completed a sports-appreciation class and had displayed large pre-to-post gains on a paper-and-pencil test. During intervention, when a peer prompted sports discussions, all three youth engaged in much more sports-related conversation. Generalization measures indicated that: (1) the youth engaged in sports discussions in groups, as well as in the dyads that characterized the training situation; (2) they talked about sports in a setting other than the training setting; (3) they discussed sports with their peers when an unfamiliar teacher was present; and (4) they continued to discuss sports when training tapes and behavioral contracts between the teacher and the peer prompter were withdrawn. Previously, it has been common to use nonhandicapped or less-handicapped peers as tutors; this study demonstrates that an autistic youth may also effectively serve as a prompter who assists his schoolmates in acquiring conversational skills that contribute to their normalization.     

Youth suicide risk and sexual orientation

Using a broad suicide risk assessment (suicidal ideation, hopelessness, hostility) with 100 youth ages 17 to 19, this study examined the relationship between sexual orientation and youth suicide risk. Participants were compared across sexual orientation, as well as level of perceived external support, which may be a mitigating variable in suicide risk. The suicide risk demonstrated by sexual minorities in this study was no greater than that of their heterosexual peers. Youth who reported more external support demonstrated lower overall suicide risk and, specifically, lower levels of hostility, hopelessness, and suicidal ideation. The results indicated that suicide risk is not determined by demographic criteria alone, and may be influenced by psychosocial variables, such as support.     

Suicide method runs in families: a birth certificate cohort study of adolescent suicide in Taiwan

Suicide method used by adolescents was examined to determine if it was the same as that employed by their suicidal parents. Six hundred eighty adolescents completed suicide between 1997 and 2007, of whom 12 had parents who had previously died by suicide. The suicide method used by these adolescents was compared with that employed by their suicidal parent and that of a matched peer control adolescent with no exposure to parental suicide and living in the same area. In 10 of the 12 suicidal parent-adolescent dyads, the same suicide method was employed by parent and adolescent. Of seven adolescents whose age at parental suicide was 15 years or above, six used the same suicide method as their suicidal parent had. On the contrary, of 12 exposure-nonexposure suicidal adolescent dyads, the same method was used in only four. Adolescents exposed to parental suicide are more likely to use the suicide method employed by their suicidal parents than the method used by adolescent peers with no exposure to parental suicide.     

Suicidal behavior among youth with severe emotional disturbance

The purpose of this study was to replicate an investigation of risk behaviors associated with suicidal behavior in public high school students, in a population of high school age youth with severe emotional disturbance (SED). Subjects for the study were clients of the South Carolina Continuum of Care (COC) (N=83). Information on suicidal thoughts and acts, aggressive behaviors, substance use and physical recklessness was gathered using a modified version of the self-report National Youth Risk Behavior Survey. Four percent of the youth reported seriously considering suicide, 8% reported planning how they would attempt suicide, 10% reported actually attempting suicide at least once, and 6% reported attempts requiring medical treatment Of the 13 youth who reported attempting suicide, four (31%) did not report planning an attempt. All suicidal behaviors except thoughts occurred more in girls than boys with SED. Alcohol and illicit drug use were associated with suicidal behavior, with larger odds ratios for attempts than for thoughts/plans. Youth with SED who use alcohol and illicit substances are particularly at risk of suicidal behavior. A high index of suspicion is appropriate when evaluating suicidal risk in girls with SED, especially in the presence of known alcohol or substance use.Continuum of Care for Emotionally Disturbed Children Division, S. C. Office of the Governor.     

The Impact of Exposure to Peer Suicidal Self‐Directed Violence on Youth Suicidal Behavior: A Critical Review of the Literature

There is considerable evidence that being exposed to the suicide or suicidal behavior of another can increase the risk for suicide. Significant relationships between media coverage and youth suicide have been documented in the professional literature. Exposure to familial suicidal behavior has also been established as a risk factor for youth suicidal behavior; However, peer suicide exposure is not as clear cut as research results in this area have been mixed. In the current paper the empirical literature focused on the associations between exposure to peer suicides and suicide attempts and youth suicidal behavior is critically reviewed. Effect sizes were computed for each of the 23 studies included in the review to allow for cross‐study comparisons. The results demonstrate that having a friend or acquaintance attempt suicide is significantly related to risk for suicidal thoughts and behavior. However, the support for the relationship between the suicide of a peer and youth suicidal behavior was less consistent. Implications for clinical practice and suicide postvention as well as areas of future research are discussed.     

University Students' Perceived Self‐Efficacy in Identifying Suicidal Warning Signs and Helping Suicidal Friends Find Campus Intervention Resources

Currently, suicide is the third leading cause of death among youth 18 to 24 years of age and the second leading cause of death on college campuses. A sample of students (N = 1,019) from three midwestern universities were surveyed regarding their perceived self‐efficacy in identifying suicide warning signs and campus suicide intervention resources. The results indicated that 11% strongly believed they could recognize a friend at suicidal risk, while 17% strongly believed they could ask a friend if he or she was suicidal. Students who had received high school suicide prevention education and who had ever had a family member or friend express suicidal thoughts to them were those most confident in recognizing a friend at risk, asking a friend if he/she is suicidal, and helping a friend to see a counselor. Most (71%) were not aware of on‐campus help resources. These findings underscore the importance of suicide prevention education throughout the high school and college years.     

Youth suicide risk factors and attitudes in New York and Vienna: a cross-cultural comparison

The prevalence of suicide risk factors and attitudes about suicide and help-seeking among New York and Viennese adolescents were compared in order to explore possible cross-cultural differences. Viennese adolescents exhibited higher rates of depressive symptomatology than their New York counterparts and had more first-hand experience with suicidal peers. More attribution of suicide to mental illness was reported in Vienna; yet Viennese youth were less likely than New York adolescents to recognize the seriousness of suicide threats. Help-seeking patterns of Viennese adolescents were influenced by their setting a high value on confidentiality. These cross-cultural differences may reflect the limited exposure of Austrian youth to school-based suicide prevention programs. The findings highlight the need of taking the sociocultural context into consideration in the planning of youth suicide prevention strategies.     

Peer isolation and drug use among white non-Hispanic and Mexican American adolescents.

The social-emotional characteristics and drug-use patterns of adolescents who reported having no friends (i.e., isolates) were compared to those of adolescents in drug-using and non-drug-using peer groups. Adolescents who did not have drug-using peers reported the lowest drug use and those with drug-using peers had the highest drug use, with adolescents who were isolated falling in between. Isolated youth reported more shyness, greater feelings of alienation, and lower social acceptance than did those in the other groups. Isolated youth also reported more anger and depression than did youth with non-drug-using peers, but less anger and equivalent depression when compared to adolescents with drug-using peers. Results are discussed in terms of social-emotional characteristics of isolated youth and risk/protective factors.     

Activity involvement among suicidal and nonsuicidal high-risk and typical adolescents

The purpose of this study was to compare weekly activities among four groups of randomly selected high-risk and typical high school students: (1) potential dropouts at suicide risk, (2) typical youth at suicide risk, (3) potential dropouts not at suicide risk, and (4) typical youth not at suicide risk. Of the 1,286 participants, 39.4% of the high-risk and 30.1% of typical high school students screened in at suicide risk. Weekly activity comparisons across the four groups showed that suicide-risk adolescents, regardless of potential dropout status, engaged in more solitary activities on weekdays and weekends than did their nonsuicide risk peers. High-risk potential dropout youth engaged in less homework and more social activities during weekdays and weekends than did the typical high school students. These results provide important insight into the weekly activity involvement of at-risk youth while helping to gain a better understanding of suicide-risk adolescents. Implications of these findings are discussed for identifying youth at risk for suicidal behavior and for prevention programming.     

The Use of Simulations to Assess the Impact of an Adolescent Suicide Response Curriculum

This study employed simulations of encounters with suicidal peers to assess the impact of classroom suicide response lessons. Students were asked to anonymously write how they would respond, and how concerned they would be in regard to two vignettes of troubled peers. On the posttest, students who had participated in the classes provided significantly more “tell an adult” responses than those in the control group, whereas no differences existed between the groups on the pretest. On both the pretest and posttest, all students expressed greater concern on the unambiguous vignette (student said that he has been thinking about killing himself) than on the ambiguous vignette (student wrote an essay about final decisions); and, overall, females expressed greater concern than males. These results provide evidence for the efficacy of the classes and the utility of the simulations for assessing their impact.     

An investigation of psychopathology in nonreferred suicidal and nonsuicidal adolescents

This investigation examined self-reported psychopathology in a school-based sample of 456 suicidal and nonsuicidal adolescents. The sample consisted of four groups: three at-risk for suicidal behavior based on current suicidal ideation as assessed by the Suicidal Ideation Questionnaire (SIQ; Reynolds, 1988), past suicide attempts, or both; and one nonsuicidal comparison group. Psychopathology was examined using ten scales from the Adolescent Psychopathology Scale (APS; Reynolds, 1998a) including: Major Depression, Conduct Disorder, Substance Abuse, Schizophrenia, Adjustment Disorder, Anorexia Nervosa, Borderline Personality Disorder, Obsessive-Compulsive Personality Disorder, Schizotypal Personality Disorder, and Avoidant Personality Disorder. Analyses were conducted separately for males and females using a MANOVA design that examined psychopathology severity among the four groups. Adolescents who engaged in past or current suicidal behavior had higher psychopathology severity scores compared to their nonsuicidal peers. Males with current suicidal thoughts who had attempted suicide had the highest levels of psychopathology severity compared to males in the other three groups. Females with a past suicide attempt or current suicidal ideation had higher psychopathology severity scores compared to nonsuicidal females. Results show greater psychopathology in school-based adolescents who have engaged in past and/or current suicidal behavior. The need for clinicians and mental health professionals working with at-risk youth to focus on concurrent psychopathology along with suicidal behavior is discussed.     

Student recognition of and response to suicidal peers

ABSTRACT: A survey of 1,131 university freshmen revealed that they were able to recognize suicidal behavior in their peers, but were unsure of a helpful response to make to them. A model of self-efficacy, emotional comfort, knowledge of a helpful response, and knowledge of suicidal behavior predicted a student's intention to ask a suicidal peer directly, “Are you thinking about killing yourself?” (R² = .38). Results of the study suggest that suicide prevention programs for adolescents should include educational experiences such as modeling, skill training, and role playing to increase self-efficacy and emotional comfort in affect-laden situations.     

Children's peer selection: experimental examination of the role of self-perceptions

Although previous studies have examined characteristics of children selected as friends, little research has examined the role played by characteristics of the selecting child. In 2 experimental studies that examined the role of self-perceptions in peer selection, participants (91 seventh graders in Study 1 and 83 third graders in Study 2) viewed various evaluations of themselves. Participants either believed evaluations were written by unfamiliar peers (Study 1) or were asked to imagine that the views of puppets were views of unfamiliar peers (Study 2). Participants were asked to select the peers they wished to meet and interact with. When evaluations were related to specific competence domains, 7th graders preferred positive peers to negative peers, whereas 3rd graders selected peers who viewed them as they viewed themselves. When evaluations were related to global self-worth, children's selections were unrelated to views of their own global worth. Selection of a globally negative peer was associated with attachment-insecurity/maternal-rejection and depressive symptoms.     

Psychosocial Correlates of Suicide Attempts Among Junior and Senior High School Youth

Three groups of junior and senior high schools students (total N = 1050) recruited in rural counties of a mid-Atlantic state–those who had made a prior suicide attempt, those reporting high levels of depressed mood or suicidal ideation, and those who were not depressed or suicidal – were compared with regard to their reports of a number of potential risk factors for suicidal behavior. Adolescents with a history of a suicide attempt reported more frequent stresses related to parents, lack of adult supports outside of the home, police, and sexuality (i.e., concerns about pregnancy, pressure to have sex, getting sexually transmitted diseases), compared with both depressed/suicide ideators and nondepressed adolescents. Suicide attempters were also more likely than the other adolescents to report that they were physically hurt by a parent, that they ran away from home, that they lived apart from both parents, and that they knew someone who had completed suicide. Results are discussed in the context of prior studies of adolescent suicidal behavior in community and clinical samples.     

Suicide and prostitution among street youth: a qualitative analysis

This study presents the results of a qualitative analysis of the narratives of 29 street youth in which they describe their experiences with, and understanding of, suicide. A history of attempted suicide was reported by 76% of the participants and the analysis revealed themes of isolation, rejection/betrayal, lack of control, and most centrally, low self-worth as forming the basis of their experiences concerning suicide. Additionally it was found that trading sex, in which most participants had been or were currently involved, was linked with their suicidal experiences and may account for the high attempt rate. Finally, variables related to suicide were found that have not been examined previously in the literature on street youth, including loss of control, assault during prostituted sex, drug abuse as a "slow suicide," and breakups in intimate relationships.     

Young adults' reactions to gay and lesbian peers who became suicidal following "coming out" to their parents

Rates of nonfatal suicidal behavior among gay and lesbian youth surpass those recorded among their heterosexual peers. A frequently cited precipitant of gay and lesbian nonfatal suicidal behavior is the turmoil associated with coming out to one's family. This study investigated young adults' attitudes toward peers who engaged in suicidal behavior after coming out and being rejected by their parents, and compared them with attitudes toward persons who had become suicidal in response to other stressors (a physical illness, a relationship loss, or an academic failure). Our goal was to explore whether young persons hold beliefs that may encourage lesbian and gay suicidal behavior. We found that gays and lesbians who engaged in suicidal behavior following coming out were not viewed in particularly forgiving or empathic ways, as was the case for persons who became suicidal following an incurable illness. All suicidal persons were perceived as relatively feminine. At the same time, suicidal males were rated as more masculine if they engaged in suicidal behavior because of an academic failure or a physical illness, while suicidal females were viewed as more masculine only if their suicidal behavior followed an academic failure. Finally, we found that both respondent sex and respondent gender-identity influenced evaluations of suicidal persons. Building on these findings, future research should explore attitudes toward the permissibility of a suicidal decision by lesbian and gay persons.     

Turkish Imams’ Experience with and Their Attitudes Toward Suicide and Suicidal Persons

This study investigated the experience with and attitudes toward suicide and suicidality in 70 consenting imams serving in mosques in the province of Aydin which is located at the southwest part of Turkey. A self-report questionnaire was used to collect the data. Attitudes of imams to suicide and suicidality were compared with attitudes of male university students. Only 4 imams (5.7 %) reported having had suicidal thoughts in past, and none reported having attempted suicide. Almost 50 % said that someone in communities they serve has commited suicide and nearly 40 % reported leading funeral ceremony for someone who committed suicide. Majority of imams (64.3 %) were of the opinion that a funeral ceremony should be arranged for people who suicide and 87.1 % were of the opinion that people who suicide can be buried in a common cemetery, but only 21.4 % said that someone who attempted suicide can be appointed as imam. Compared to male medical students, imams saw suicide as an unacceptable option and those engaging in suicidal behavior to be punished after death. But they displayed socially accepting and helping reactions to an imagined close friend who attempted suicide. Therefore, it was concluded that imams might exhibit preventive reactions to suicide when they offer counseling for persons from their congregations during times of suicidal crises.     

Religiosity,Meaning in Life and Suicidal Tendency Among Jews

The study examines the impact that meaning in life, or lack thereof, has on suicidal tendencies among youth, as well as the nexus between level of religiosity, meaning in life and suicidal tendencies. Subjects were 450 students from both Jewish religious and Jewish secular schools aged 15–18. Findings: a significant and negative correlation was found between a sense of meaning in life and suicidal tendencies, beyond gender or level of religiosity. In addition, no difference was found in level of suicidal tendency between Jewish religious and Jewish secular youth; however, among Jewish religious teens, a lower level of depression was reported in comparison with their secular peers. The study therefore concludes that meaning in life is the dominant variable in minimizing suicidal tendencies among youth. The results of this study may promote the establishment of prevention, intervention and therapy plans, especially in the age range that is crucial for suicide. Such programs should be based upon finding meaning in life.     

Risk and Protective Factors that Distinguish Adolescents Who Attempt Suicide from Those Who Only Consider Suicide in the Past Year

Data from the 2010 Minnesota Student Survey was analyzed to identify risk and protective factors that distinguished adolescents across three groups: no suicidality, suicidal ideation only, and suicide attempt. The population‐based sample included 70,022 students in grades 9 and 12. Hopelessness and depressive symptoms emerged as important risk factors to distinguish youth who reported suicidal ideation or behavior from those without a history of suicidality. However, these factors were not as important in differentiating adolescents who attempted suicidal from those who considered suicide but did not act on their thoughts. Instead, for both genders, self‐injury represented the most important factor to distinguish these youth. Other risk factors that differentiated the latter groups, but not the former groups, for males were dating violence victimization and cigarette smoking, and for females was a same‐sex sexual experience. Running away from home also seemed to increase the risk of a suicide attempt among youth in this study. Parent connectedness and academic achievement emerged as important protective factors to differentiate all the groups, yet neighborhood safety appeared to protect against the transition from suicidal thoughts to behavior. Findings from this study suggest risk and protective factors practitioners should target in clinical assessments and intervention programs to help prevent suicidal behavior among youth at greatest risk.