Suicide and Youth

The problem of suicide among young people is increasing at phenomenal rates. More young people die by suicide than from cancer and heart ailments combined. More than 4,000 young suicides are recorded each year, but no one knows how many suicide attempts fail. This article examines the problem of adolescent suicide and suicide attempts in relation to cultural factors, sex differences, and probable causes. Case studies help to identify symptomatic behavior. The importance of parents, teachers, and counselors in becoming alert to conflict and stress situations in youths is delineated. Community and school responsibility for leading youth to self-understanding and self-direction is crucial, and the article suggests several means of prevention through mental health and moral responsibility.     

Adolescent Development and Youth Suicide

The adolescent years, being a period of unique developmental changes, are of great interest in understanding suicidal behavior. The occurrence of completed suicide by age in 1-year age groups in adolescence and young adulthood was studied via official Finnish mortality statistics and the population statistics. Suicide rates increased sharply by age during adolescence, starting somewhat earlier among boys than among girls. During the periods of rapidly rising and high suicide rates in the 1970s and 1980s among boys, the increase in suicide rates started at a younger age than during a spell of lower rates in the 1960s.     

Factor structure of Calhoun's Youth Suicide Scale

To assess the factor structure of Calhoun's Youth Suicide Scale (YSS), 191 consenting undergraduates in one sample and 240 consenting undergraduates in a second sample wee given the YSS during class. From the second sample, 152 subjects also took the YSS a second time about 1 month later. In the first sample, three factors, which accounted for 50.0% of the variance, emerged. They were: How the Parents were Viewed (in terms of psychological disturbance, likability, and blame); Expected Responses to the Bereaved Family (terms of tension and sympathy); and Empathy with Parents (whether the newspaper was viewed as correct in reporting the cause of death, how long parents were expected to grieve, and whether parents were expected to be liked). In the second sample, the same three factors emerged (accounting for 55.5% of the variance), with the exception of one item on Factor 3: expecting to like the parents. Congruence coefficients between the three factors in the two samples were .98, .94, and .78, respectively. Reliability correlations on individual items ranged from a low of .30 to a high of .61. These results indicate that the YSS is valid, stable, and moderately reliable for assessing reactions to youth suicide; thus, it would be a viable instrument for use in future research on reactions to suicide.     

Factor Structure of Calhoun's Youth Suicide Scale

To assess the factor structure of Calhoun's Youth Suicide Scale (YSS), 191 consenting undergraduates in one sample and 240 consenting undergraduates in a second sample wee given the YSS during class. From the second sample, 152 subjects also took the YSS a second time about 1 month later. In the first sample, three factors, which accounted for 50.0% of the variance, emerged. They were: How the Parents were Viewed (in terms of psychological disturbance, likability, and blame); Expected Responses to the Bereaved Family (terms of tension and sympathy); and Empathy with Parents (whether the newspaper was viewed as correct in reporting the cause of death, how long parents were expected to grieve, and whether parents were expected to be liked). In the second sample, the same three factors emerged (accounting for 55.5% of the variance), with the exception of one item on Factor 3: expecting to like the parents. Congruence coefficients between the three factors in the two samples were .98, .94, and .78, respectively. Reliability correlations on individual items ranged from a low of .30 to a high of .61. These results indicate that the YSS is valid, stable, and moderately reliable for assessing reactions to youth suicide; thus, it would be a viable instrument for use in future research on reactions to suicide.     

Confucianism and Youth Suicide in Rural China

This study examined the relationship between core Confucian ethics and suicide. We used a proxy sample of youths randomly selected from rural areas of three provinces in China. The proxy sample consisted of 382 completed suicides and 414 community living controls, all aged 15–34 years. Logistic regression analyses showed that among the Chinese youths (1) the Confucian ethic of filial piety was negatively associated with suicide; (2) the Confucian ethic of harmony moderated the estimated net effect of negative life events on suicide; and (3) the Confucian ethic of female subordination was positively linked with suicide. We also discussed implications of our study for future research.     

Youth Suicide Intervention Using the Satir Model

Youth suicide is a social issue that needs serious consideration among families, therapists and helping professionals. This article presents an actual case of a youth who completed suicide, and discussion of the hypothetical Satir model treatment of this youth while alive. The Satir model has numerous interventions that have current applications toward dealing with suicidal youth in a humanist and hopeful way, fostering youths' desire to live and to become more positively involved in their lives. In the past, Satir focused on coping stances in communication, and now the coping stances give a deeper understanding into the internal world.     

Change Pathways in Indigenous and Nonindigenous Youth Suicide

Multivariate dynamic relationships among suicide attempts, anxiety and/or depressive symptoms, hope, and help‐seeking were examined across time in Native Hawaiian and non‐Hawaiian adolescents, using data from a 5‐year longitudinal cohort study (N = 7,317). The rate of suicide attempts decreased over time, but this reduction was significantly less among Native Hawaiian youth than their non‐Hawaiian peers. There were also significant differences between groups in hope and help‐seeking, with Native Hawaiian youth increasing help‐seeking and decreasing hope to a greater degree. Youth‐centered, cultural approaches to suicide prevention are essential in enhancing well‐being in indigenous communities.     

The Vulnerability of Young Japanese Women and Suicide

ABSTRACT: Young Japanese females had the highest suicide rate in the world until the end of the 1960s, and it is still extremely high. This paper attempts to explain this phenomenon primarily in terms of vulnerability—in their personalities, social conditions, and role conflicts. Concomitant psychological traits and social conditions are discussed. The cultural conflict of young Japanese women is explicated in terms of psychological and historical information. In addition, the reasons for the differences between the suicide rates among females in the Tokyo area and the Kyoto-Osaka area are explored largely in terms of concepts relating to authoritarianism and its correlates.     

Investigating Correlates of Suicide Among Male Youth: Questioning the Close Affinity Between Suicide Attempts and Deaths

This study was based on a sample of male high school students who completed National Longitudinal Adolescent Health Surveys in 1994, 1995, and 2001. We studied these students prospectively, comparing those who later died by suicide (n = 21) with those who were still living (n = 10,101). We employed chi‐square and analysis of variance tests for statistical significance between suicide decedents and living respondents. Results showed suicide decedents were more likely to have experienced the suicide loss of another family member, to have been expelled from school, to have engaged in more delinquent actions including fighting, and to have greater involvement with the criminal justice system. Although one might have expected suicide casualties to have exhibited a greater amount of suicidal thoughts, attempts, and higher incidences of suicidality among their friends, our analyses did not find that these factors were associated with actual suicides. Should these findings be replicated, this would point to a need to refine youth suicide risk assessments. Collecting life histories, as well as identifying patterns of delinquency and fighting, may serve as more potentially fruitful means for assessing genuine suicide risk than some traditional risk assessment methods.z     

Strain,Emotion, and Suicide Among American Indian Youth

In this article, we test the utility of Agnew's general strain theory to explain suicidal behaviors among American Indian youth. Data from 721 American Indian adolescents from the Midwest and Canada were collected in partnership with participating reservations/reserves and a research team. We investigate the effects of strains/stressors on suicide, including tests of mediating effects of negative emotions on relationships between stressors and suicidality. We found that several strains/stressors were related to suicidality, including coercive parenting, caretaker rejection, negative school attitudes, and perceived discrimination. We also found that depressive symptoms and anger mediated the effects of several key predictors of suicidality. We discuss the theoretical and policy implications of our work for the general strain theory and for American Indian suicide in general.     

Awareness Effects of a Youth Suicide Prevention Media Campaign in Louisiana

Research on the efficacy of mediated suicide awareness campaigns is limited. The impacts of a state‐wide media campaign on call volumes to a national hotline were analyzed to determine if the advertisements have raised awareness of the hotline. We use a quasi‐experimental design to compare call volumes from ZIP codes where and when the campaign is active with those where and when the campaign is not active. Multilevel model estimates suggest that the campaign appears to have significantly and substantially increased calls to the hotline. Results from this study add evidence to the growing public health literature that suggests that mediated campaigns can be an effective tool for raising audience awareness.     

Caregiver Strain and Youth Suicide Attempt: Are They Related?

There are scant data documenting the relationship between caregiver strain and suicidal behavior among youth. This study includes data from the caregivers of 1,854 youth who received services through the Comprehensive Community Mental Health Services for Children and Their Families Program. Caregiver strain, family functioning, and youth functional impairment were assessed with the Caregiver Strain Questionnaire, Family Life Questionnaire, and Columbia Impairment Scale. Caregivers of suicidal and nonsuicidal youth differed in subjective internalizing strain (e.g., worry and guilt) and objective strain (e.g., constraints on activities). Differences in objective strain persisted even after controlling for family life and youth functional impairment.     

Youth Suicide Deaths: Investigation of Clinical Predictors in a Statewide Sample

Death by suicide is a significant cause of mortality among youth. However, there is limited information on the demographic and clinical factors associated with youth suicide deaths. The objective of this study was to link large statewide databases to describe demographic, clinical, and cause of death characteristics among youth who died by suicide. We examined 1,218 decedents under age 26 who died by suicie between 2000 and 2014. Eighteen died before age 12, 53 died between ages 12 and 14, 292 died between ages 15 and 18, and 855 died between ages 19 and 25. Most were male (83%), and firearm was most common cause of death; 28% previously attempted suicide, 31% had a mental health diagnosis, and 17% were prescribed psychotropic medication. Younger children died by hanging/smothering (89% of all 7‐ to 11‐year olds), and overdose/poisoning increased progressively with age. Adolescents had a higher proportion of females than young adults (23% vs. 14%, p  = .002). Combining data from the medical examiner and large hospital systems allows examination of youth suicide from a developmental perspective. Differences between age groups included gender, method, diagnosed mental illness, and diagnosis of attention deficit hyperactivity disorder. These data point to missed opportunities for effective interventions for specific developmental stages.     

Youth Suicide: The Knowledge and Attitudes of Australian Teachers and Clergy

This is the first study of the suicide-related knowledge and attitudes of teachers and clergy in Australia. These professional groups have been identified as “gatekeepers” who might serve as a first line of assistance for distressed young people. Such gatekeepers, along with medical and mental health professionals, have a vital role to play in the prevention of youth suicide, of which Australia has the highest rates in the world. This research confirmed that high numbers of teachers and clergy have been approached by suicidal young persons. However, their gatekeeping role may be compromised by a low level of knowledge about signs of suicide risk, which was found even among those who had taken courses in suicide or death and dying or who had personally known someone who suicided. Suicidal behavior was found to be generally regarded as unacceptable, especially by those with a high religious commitment. Further educational efforts about suicide risk identification and prevention seem to be needed for both teachers and clergy; it will be important for such education to take into account attitudinal issues and how these might affect communication with young suicidal people.     

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.     

Psychodynamics of Suicide in Lesbian,Gay, Bisexual,or Transgender Youth

Lesbian, gay, bisexual, and transgender (LGBT) youth are a vulnerable population at high risk of suicide and, as such, benefit from an informed psychotherapeutic approach to treatment. While it is clear that sexual orientation and gender identity are independent dimensions from psychopathology, LGBT youth are frequently marginalized and may face unique challenges with self-acceptance and identification with peers, family, and society, increasing risk of social isolation, which in turn increases vulnerability to anxiety, mood disorders, substance use, and suicide. We elaborate on the common phenomenon of ambivalent repression of the sexual self in adolescents associated with intertwined themes frequently expressed in suicidal lesbian, gay, transgender, bisexual, and queer patients on the inpatient adolescent unit: anger directed toward internal and external objects; desire for self-punishment, atonement, and possibly rebirth; and desperation and desire to escape psychic pain. We enhance our discussion with case examples and practical therapeutic considerations that emerge from these themes that can be harnessed across treatment settings.     

Reducing Suicide Potential Among High-Risk Youth: Tests of a School-Based Prevention Program

This study tested the efficacy of a school-based prevention program for reducing suicide potential among high-risk youth. A sample of 105 youth at suicide risk participated in a three-group, repeated-measures, intervention study. Participants in (1) an assessment plus 1-semester experimental program, (2) an assessment plus 2-semester experimental program, and (3) an assessment-only group were compared, using data from preintervention, 5-month, and 10-month follow-up assessments. All groups showed decreased suicide risk behaviors, depression, hopelessness, stress, and anger; all groups also reported increased self-esteem and network social support. Increased personal control was observed only in the experimental groups, and not in the assessment-only control group. The potential efficacy of the experimental school-based prevention program was demonstrated. The necessary and sufficient strategies for suicide prevention, however, need further study as the assessment-only group, who received limited prevention elements, showed improvements similar to those of the experimental groups.     

14 Culture and Suicide: From a Japanese Psychiatrist's Perspective

There have been numerous papers focusing on culture and suicide, but it seems that they have often emphasized cultural differences excessively, thus running the risk of increasing prejudice toward different cultures and reinforcing overgeneralizations. From my albeit limited knowledge and experience, it appears that there are more similarities than differences in suicide among various cultures. Most cases of suicide reflect complex human factors that are found universally among cultures. Despite the fact that some cultural differences in suicide admittedly exist in different societies and that these are important, they cannot explain every aspect of suicide. This article explains how I, as a Japanese psychiatrist, diagnose and treat suicidal patients against the backgrounds of Japanese culture by presenting my way of thinking in daily practice in order to show similarities and differences that exist in Japanese suicide, treatment, and prevention.