Gender and History of Suicidality: Are These Factors Related to U.S. College Students’ Current Suicidal Thoughts,Feelings, and Actions?

Gender and history of suicidality (HS vs. NoHS) were related to current symptoms of depression, reasons for living, and reports of self-destructive and life-threatening behavior in a college student sample. Overall, college men reported engaging in more life-threatening and potentially suicidal behavior than college women on the Life Attitudes Schedule (LAS). No gender effects were obtained on the symptoms of depression and reasons for living measures. Results suggest that the LAS may be a particularly effective way to identify college students at risk for self-destructive and suicidal behavior. As expected, HS individuals were more depressed, had fewer reasons for living, and reported engaging in more current suicidal and life-threatening behavior than NoHS participants. However, gender and history of suicidality were found to interact. NoHS women reported avoiding a variety of injury-producing and health-diminishing behaviors that were common for all other groups of college students. Meanwhile, HS women endorsed fewer current reasons for living than did NoHS women, NoHS men, and NoHS men. These findings were interpreted both with regard to cultural and gender-specific expectations for the expression of self-destructive, suicidal, and life-threatening behavior. Implications for the prevention of college women's and men's suicidal behavior were also noted.     

Gender Differences in the Suicide-Related Behaviors of Adolescents and Young Adults

Gender differences in suicide-related behaviorswere examined in an older adolescent and a young adultsample (primarily Caucasian). Suicide-related behaviorswere assessed by the Life Attitudes Schedule (LAS) as well as by measures of depressivesymptomatology and hopelessness. The LAS measures a broadcontinuum of potentially life-diminishing orlife-enhancing behaviors. There are four LAScontent-category subscales: overtly suicidal and death-related,self-related, risk and injury-related, and health-relatedbehaviors. As hypothesized, in both samples, genderdifferences in the expression of suicide-related behaviors were obtained. Males from both samplesendorsed substantially more risk-taking andinjury-producing behaviors than females. Males in bothsamples also reported more negative health-relatedbehaviors than females. In contrast, females reported moresymptoms of depression than males. Hopelessness scoresonly differentiated male and female young adults; maleand female adolescents did not differ significantly on the hopelessness measure. These findings areprimarily discussed in terms of gender-role socializationtheory. Implications for the treatment of suicidality aredrawn.     

Risk of suicidal ideation in adolescents with both self-asphyxial risk-taking behavior and non-suicidal self-injury

This study examined adolescent participation in self-asphyxial risk-taking behaviors (SAB), sometimes known as the "choking game," and its relationship with other adolescent risk behaviors, including non-suicidal self-injury (NSSI). Researchers proposed that participation in SAB and NSSI would be associated with suicidal behavior, disordered eating, and substance use. Using a large community-based sample, results revealed preliminary associations between SAB and other risk-taking behaviors. Adolescents who had engaged in both SAB and NSSI reported more concurrent risk behaviors than adolescents who participated in only one of the behaviors or neither behavior. Results indicate that greater awareness of SAB is important, and continued research can evaluate the possible link between the behavior and risk for suicide.     

The role of affect in suicidal thoughts and behaviors

Risk factors, theoretical explanations, and treatment suggestions for suicidal behaviors have historically focused largely on cognitions, but a more comprehensive picture may be provided by examining the role of affect in suicidal thoughts and behaviors. In the current study the link between affect and suicide within the theoretical framework of the circumplex model was examined empirically. Data from 104 participants demonstrated that both positive and negative affect are related to suicidal thoughts and behaviors, and that affect provided additional information about suicidality over and above the cognitive variable of hopelessness. The findings support that suicidal risk assessment may be enhanced by evaluating both hopelessness and affect, and that negative affect, in particular, is important to address in the treatment of suicidal individuals.     

Current suicide proneness and past suicidal behavior in adjudicated adolescents

Youth recently assigned to probation (n = 233) were assessed for current suicide proneness, depression, and hopelessness, as well as for recent suicide ideation, previous suicide ideation, or suicide attempt(s). The Life Attitudes Schedule-Short Form (LAS-SF) was used to assess suicide proneness. As per the LAS-SF, suicide proneness was defined broadly to include current engagement in overtly suicidal behavior as well as in risk-taking and potentially injury-producing behaviors, coupled with a lack of engagement in health and safety behaviors, or self-enhancement behaviors. As expected, current suicide proneness was significantly associated with a history of suicide ideation and attempts, recent ideation, and current depression and hopelessness for adjudicated youth. Gender differences were obtained between the strength of the association between suicide proneness and depressive symptoms. A subgroup of adjudicated youth (n = 39) was then interviewed about their suicidal behaviors. Among other things, these youth indicated that the majority of their previous suicide attempts were committed impulsively.     

Personality and risk-taking: common biosocial factors

The first part of this article describes a study of the relationships between personality and risk-taking in six areas: smoking, drinking, drugs, sex, driving, and gambling. The participants, 260 college students, were given self-report measures of risky behaviors in each of the six areas and the Zuckerman-Kuhlman five-factor personality questionnaire. Generalized risk-taking (across all six areas) was related to scales for impulsive sensation seeking, aggression, and sociability, but not to scales for neuroticism or activity. Gender differences on risk-taking were mediated by differences on impulsive sensation seeking. The second part discusses biological traits associated with both risk-taking and personality, particularly sensation seeking, such as the D4 dopamine receptor gene. the enzyme monoamine oxidase, and augmenting or reducing of the cortical evoked potential. Comparative studies show relationships between biological markers shared with other species and correlated behaviors similar to sensation seeking in humans. A biosocial model of the traits underlying risk-taking is presented.     

Pathways to suicidal behaviors in childhood

Path analyses were applied to test a model that includes internalizing and externalizing behavior problems as predictors of suicidal behaviors in children. Parents of an inpatient sample of boys (N=87; M age=9.81 years) rated the frequency of suicidal ideation and completed standardized measures of behavior problems. Blind raters rated the severity of the children's suicidal behaviors. Results revealed a significant direct effect for suicidal ideation on suicide attempt and for depressive symptoms on suicidal ideation. There was also a significant indirect path from impulsivity to suicidal ideation through aggressive and depressive symptoms. Clinical implications are discussed.     

The Life Attitudes Schedule Short Form: An Abbreviated Measure of Life-Enhancing and Life-Threatening Behaviors in Adolescents

An abbreviated version of the Life Attitudes Schedule (LAS) was developed, consisting of 24 items, each representing one cell of the original LAS theoretical matrix (4 content categories × 2 behavior types × 2 valence). Items were retained on the basis of high correlations with LAS total score and low correlations with gender. Psychometric properties of the LAS Short Form were robust and the Short Form total score correlated .93 with the original LAS total score. As with the original LAS, boys reported more injury-related behaviors than girls. Future research and clinical directions are suggested.     

Transgender youth and life-threatening behaviors

Sexual minority status is a key risk factor for suicide among lesbian, gay, and bisexual youth; however, it has not been studied among transgender youth. Fifty-five transgender youth reported on their life-threatening behaviors. Nearly half of the sample reported having seriously thought about taking their lives and one quarter reported suicide attempts. Factors significantly related to having made a suicide attempt included suicidal ideation related to transgender identity; experiences of past parental verbal and physical abuse; and lower body esteem, especially weight satisfaction and thoughts of how others evaluate the youths' bodies. Sexual minority status is a key risk factor for life-threatening behaviors among transgender youth.     

Self-concealment and suicidal behaviors

Understanding self-concealment, the tendency to actively conceal distressing personal information from others, may be important in developing effective ways to help individuals with suicidal ideation. No published study has yet assessed the relation between self-concealment and suicidal behaviors. Additionally, most self-concealment research has been conducted solely with younger adults. The relation between self-concealment and depressive symptoms among older adults (age 65 and older), and between self-concealment and suicidal behaviors among both younger (college student) and older adults, was investigated in this study. As predicted, self-concealment was significantly related to suicidal behaviors in younger adults. Furthermore, self-concealment was significantly related to depressive symptoms in older adults. Interestingly, the association between self-concealment and suicidal behaviors in this age group was not significant.     

The effects of risk-glorifying media exposure on risk-positive cognitions, emotions, and behaviors: a meta-analytic review

In recent years, there has been a surge in the quantity of media content that glorifies risk-taking behavior, such as risky driving, extreme sports, or binge drinking. The authors conducted a meta-analysis involving more than 80,000 participants and 105 independent effect sizes to examine whether exposure to such media depictions increased their recipients' risk-taking inclinations. A positive connection was found for overall, combined risk taking (g=.41); as well as its underlying dimensions: risk-taking behaviors (g=.41), risk-positive cognitions and attitudes (g=.35), and risk-positive emotions (g=.56). This effect was observed across varying research methods (experimental, correlational, longitudinal); types of media (video games, movies, advertising, TV, music); and differing risk-related outcome measures (e.g., smoking, drinking, risky driving, sexual behavior). Multiple moderator analyses revealed 2 theoretically new boundary conditions for sociocognitive models. First, the effect was stronger for active (i.e., video games) than for passive (e.g., film, music) exposure to risk-glorifying media content. Second, the effect was stronger when there was a high degree of contextual fit between the media content and type of risk-taking measure. The theoretical, practical, and societal implications of the present research synthesis are discussed.     

Psychopathology of adolescent suicide: hopelessness, coping beliefs, and depression

Two studies of adolescents examined the relation of several cognitive variables and depression to suicide-related behaviors. Study 1 compared hopelessness and depression in 281 high school students. Unlike research with adults, depression was significantly related to suicidal behaviors, even after hopelessness was statistically controlled. When depression was controlled, hopelessness was unrelated to suicidal behaviors for boys and only modestly related for girls. Study 2 examined depression, hopelessness, survival-coping beliefs, fear of social disapproval, and social desirability in relation to suicidal behaviors in 53 male juvenile delinquents. Again, hopelessness did not account for a significant proportion of the variance in suicide. Depression was uniquely related to past suicide attempts. Survival-coping beliefs were associated with self-predicted future suicide and other suicidal behaviors. Survival-coping beliefs are discussed as a cognitive buffer to suicidal ideation in adolescence.     

Iowa Gambling Task performance and executive function predict low-income urban preadolescents’ risky behaviors

This study examines preadolescents’ reports of risk-taking as predicted by two different, but related inhibitory control systems involving sensitivity to reward and loss on the one hand, and higher order processing in the context of cognitive conflict, known as executive functioning (EF), on the other. Importantly, this study examines these processes with a sample of inner-city, low-income preadolescents and as such examines the ways in which these processes may be related to risky behaviors as a function of children’s levels of both concurrent and chronic exposure to household poverty. As part of a larger longitudinal study, 382 children (ages 9–11) provided a self-report of risky behaviors and participated in the Iowa Gambling Task, assessing bias for infrequent loss (preference for infrequent, high magnitude versus frequent, low magnitude loss) and the Hearts and Flowers task assessing executive functioning. Results demonstrated that a higher bias for infrequent loss was associated with higher risky behaviors for children who demonstrated lower EF. Furthermore, bias for infrequent loss was most strongly associated with higher risk-taking for children facing highest levels of poverty. Implications for early identification and prevention of risk-taking in inner-city preadolescents are discussed.     

亲子关系对青少年冒险行为的影响:有调节的中介模型

为探讨亲子关系对青少年冒险行为的影响机制,采用亲子关系问卷、同伴群体特征问卷及冒险行为问卷对山东省日照市三所普通中学的1275名初一到高三学生进行调查。结果发现：（1）父母支持与亲子冲突、不良同伴交往及冒险行为均呈负相关,亲子冲突与不良同伴交往、冒险行为均呈正相关,不良同伴交往与冒险行为呈正相关;（2）父母支持显著负向预测冒险行为,亲子冲突显著正向预测冒险行为,且两者的预测作用都可以通过不良同伴交往的中介作用实现;（3）在亲子冲突影响冒险行为这一模型中,不良同伴交往起中介作用,且中介的后半路径受性别调节,具体表现为：与女生相比,男生结交不良同伴会参与更多冒险行为。结果提示,不良亲子关系和不良同伴交往都是青少年冒险行为的重要预测因素,且不良亲子关系可以通过影响同伴交往影响青少年冒险行为。此外,在这一过程中,存在性别差异,当亲子冲突较多时,尤其应当关注男孩的同伴交往情况。     

Associations between delinquency and suicidal behaviors in a nationally representative sample of adolescents

Suicide was the second leading cause of death for 14-17 years olds in 2002. Prior studies indicate that suicidal behaviors are especially common among juvenile delinquents, yet this association has not been examined in a national sample. The 2003 Youth Risk Behavior Surveillance System was used to examine associations between suicidal behaviors and delinquency in a nationally representative sample of 14-17 year olds. Results indicated that delinquent adolescents were more likely to have seriously considered suicide (adjusted odds ratio [AOR] = 5.44), made a suicide plan (AOR = 4.90), attempted suicide (AOR = 10.08), and required medical treatment after attempting suicide (AOR = 14.61) compared to their nondelinquent counterparts. Delinquency was significantly related to suicidal behaviors for boys and girls, but the magnitudes of effects were larger for girls. This finding suggests that delinquent youth, particularly delinquent girls, should be targeted in interventions to reduce suicidal behaviors.     

Diagnosis of Youth At-Risk for Suicide,Pregnancy, and Drug and Alcohol Abuse

The intent of this paper is to overview three selected subgroups of at-risk youth. These subgroups are: suicidal adolescents, pregnant teenagers, and drug and alcohol abusers. Alternatives to traditional diagnostic procedures will be examined from the perspective of determining whether they can effectively and efficitently provide information necessary to develop a client management plan. A continuing diagnostic process providing the data base for a client information system is proposed. Such diagnostic practices can promote the early recognition of at-risk behaviors, thus increasing the general awareness, or early recognition, that may be crucial to preventive efforts. Discussion is provided for the use of the term at-risk. In this paper, the term is used to mean more than an adolescent who is simply at academic risk and prone to dropping out (being stopped or pushed out) of school. As used here, the at-risk group includes a number of students who are not only failing academically, but display unwanted social-personal behaviors, leading to possible adjudication or requiring community based support services, while some may even be in life-threatening circumstances.     

The mediating roles of anxiety depression, and hopelessness on adolescent suicidal behaviors

The purpose of this study was to explore the roles of anxiety, depression, and hopelessness as mediators between known risk factors and suicidal behaviors among 1,287 potential high school dropouts. As a step toward theory development, a model was tested that posited the relationships among these variables and their effects on suicidal behaviors. Structural equation models, estimated separately by gender, revealed support for the model, and substantial similarities between males and females. The results showed direct effects of depression and hopelessness on suicidal behaviors for males, and direct effects of hopelessness, but not depression, for females. For both males and females, anxiety was directly linked to depression and hopelessness; drug involvement had both direct and indirect effects on suicidal behavior. As hypothesized, lack of family support showed indirect influences on suicidal behaviors through anxiety for both males and females. The results have important implications for future model development regarding adolescent suicidal behaviors.     

Thought suppression and self-injurious thoughts and behaviors

This study proposes and tests a theoretical model suggesting that the propensity to suppress unwanted thoughts is associated with an increased presence and frequency of self-injurious thoughts and behaviors (SITB). In the model, propensity to suppress unwanted thoughts is hypothesized to be a cognitive mediator of the relationship between emotional reactivity and SITB, and is expected to be related to the extent to which SITB is initiated to escape from aversive emotions. Results of this cross-sectional study of adolescents (N=87) revealed that the self-reported propensity to suppress unwanted thoughts is associated with the presence and frequency of non-suicidal self-injury (NSSI), suicidal ideation, and suicide attempts. Furthermore, thought suppression partially mediates the relationship between emotional reactivity and the frequency of NSSI and suicidal ideation. Finally, adolescents with a higher tendency to suppress unwanted thoughts report engaging in NSSI in order to reduce aversive emotions rather than for social communication. Results are discussed within the framework of the negative reinforcement function of SITB.     

Environmental factors in suicide in long-term care facilities.

One major purpose of this study was to identify environmental factors related to suicide in long-term care facilities. Questionnaires were mailed to a random sample of administrators at 1,080 facilities. Information was collected on facility characteristics, overt suicide, and intentional life-threatening behavior. Chi-square analyses revealed 4 environmental characteristics related to suicidal behavior and deaths from suicide: staff turnover, size, auspices, and per diem cost. More suicides occurred in larger facilities and facilities with higher staff turnover. Religious or "other" facilities experienced more suicidal deaths than public or private facilities; facilities charging less experienced more deaths.     

Predicting self-damaging and suicidal behaviors in female borderline patients: reasons for living, coping, and depressive personality disorder.

The aims of this study are to examine (1) whether reasons for living predict self-damaging and suicidal behaviors, (2) the associations of reasons for living with coping strategies and depressive personality disorder (PD), and (3) the unique predictive validity of reasons for living in a multivariate predictor model. Reasons for living (RFL), coping strategies, and depressive personality disorder were measured at baseline in 38 patients who met DSM-IV criteria for borderline personality disorder (BPD). Frequency of self-damaging and suicidal behaviors in the 6-month period following baseline was measured prospectively at 3- and 6-month follow-ups. The RFL has only one subscale that predicts parasuicidal behaviors (i.e. Survival and Coping Beliefs [SCB]). Participants who scored low on this subscale were 6.8 times more likely to exhibit self-damaging and suicidal behaviors in the follow-up period than their high-scoring counter-parts. However, SCB was substantially correlated with the coping strategies "reassuring thoughts," "active coping," and "palliative reaction pattern," as well as with depressive personality traits. In a multivariate model, the predictive power of SCB appeared to be accounted for by reassuring thoughts and depressive PD. Coping scales might be preferable over the RFL as a predictor of self-damaging and suicidal behaviors in borderline patients.