A Longitudinal Investigation of Depression,Hopelessness, Social Support,and Major and Minor Life Events and Their Relation to Suicidal Ideation in Adolescents

The longitudinal relationship of psychological and social-environmental factors with adolescent suicidal ideation over a 1-year-period was examined in a sample of 374 high school students. Students were assessed twice over a 1-year period with measures of depression, hopelessness, major negative life events, daily hassles, social support, and suicidal ideation. At the initial assessment, daily hassles and negative life events for males and social support and depression for females were significant factors related to suicidal ideation levels 1 year later. Changes in depression and hopelessness were significantly related to changes in suicidal ideation over the 1 year interval for males and females. Differences found between males and females in the relationship of psychological and social-environmental variables with suicidal ideation supports the need to examine gender specific relationships when conducting research on suicidal behavior in adolescents.     

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.     

Prospective Study of Major Loss Life Events and Risk for Suicidal Thoughts and Behaviors Among Adolescents and Young Adults

This prospective, naturalistic study examined the association between major loss life experiences, other psychiatric risk factors (depression, hopelessness, and anxiety), and suicidal thoughts and behaviors (STBs) among adolescents followed through young adulthood for up to 14 years. Major loss life events were related to subsequent increases in STBs. Major loss life events were primarily related to increases in suicide ideation in the presence of lower levels of other risk factors. There was a bidirectional relationship between major losses and other risk factors. Implications for the association between loss experiences, other risk factors, and future STBs are discussed.     

Are Reports of Life Event Stress among Suicidal Youth Subject to Cognitive Bias?

Severity of depressive symptoms, hopelessness, and suicidal ideation were examined to determine whether they were significantly associated with the accuracy of suicidal adolescents' ratings of stressful life events. The sample included 130 inpatient adolescents who endorsed suicide‐related behaviors. Stress interviews were administered, and the severity of stressful events was rated separately by adolescents and an independent team. A residualized cognitive bias score was created by regressing adolescents' severity ratings to the independent team's severity ratings of the same events. Depressive symptoms, but not hopelessness or suicidal ideation, were significantly associated with cognitive bias scores. A negative cognitive bias in adolescents' reports of life stress may be present at higher levels of depression relative to minimal levels of depression. Further research on the relations between stress and suicide‐related behaviors is encouraged to include independent ratings of stress severity.     

Positive and Negative Expectations of Hopelessness as Longitudinal Predictors of Depression,Suicidal Ideation,and Suicidal Behavior in High‐Risk Adolescents

The relationship between hopelessness and depression in predicting suicide‐related outcomes varies based on the anticipation of positive versus negative events. In this prospective study of adolescents at elevated risk for suicide, we used two Beck Hopelessness Scale subscales to assess the impact of positive and negative expectations in predicting depression, suicidal ideation, and suicidal behavior over a 2‐ to 4‐year period. In multivariate regressions controlling for depression, suicidal ideation, and negative‐expectation hopelessness, positive‐expectation hopelessness was the only significant predictor of depressive symptoms and suicidal behavior. Clinical interventions may benefit from bolstering positive expectations and building optimism.     

Depression, hopelessness, and self-esteem: accounting for suicidality in adolescent psychiatric inpatients

The present study was designed to examine depression, hopelessness, and self-esteem as related to suicidal behavior in three groups of depressed adolescent psychiatric inpatients. Depressed adolescents who had never attempted suicide were compared to depressed adolescents who had attempted suicide once and to depressed adolescents who had attempted suicide on several different occasions. Results showed that suicidal adolescents experienced significantly greater depression and hopelessness than did the nonsuicidal adolescents. However, all three groups of depressed adolescents reported similar low levels of self-esteem. Measures of depression and hopelessness were useful in classifying the adolescents based on their suicidal behavior. Results suggest that the treatment of suicidal adolescents could benefit from strategies that focus on reducing feelings of depression and hopelessness.     

Purpose in life and reasons for living as mediators of the relationship between stress,coping, and suicidal behavior

Positive psychological factors that help protect vulnerable persons from suicidal behavior are vital in understanding resiliency and suicide prevention. The purpose of the current study was to examine whether positive factors (including purpose in life, reasons for living, and coping styles) mediate the relationship between stressful life events and suicidal behaviors among 416 college student volunteers. Reasons for living inversely predicted suicidal behavior and thoughts directly as well as indirectly via an inverse relationship with depression. Purpose in life indirectly predicted suicidal behavior and thoughts via an inverse effect on depression, whereas emotion-focused coping indirectly predicted suicidal behavior and thoughts both through an effect on depression and an inverse effect on reasons for living. In addition, avoidant coping indirectly predicted suicidal behavior via a direct, positive effect on reasons for living. Reasons for living and emotion-oriented coping had the largest effects in the model. Results of this study underscore the importance of augmenting reasons for living and purpose in life among suicidal or potentially suicidal persons.     

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.     

Loneliness under assault: Understanding the impact of sexual assault on the relation between loneliness and suicidal risk in college students

The present study sought to examine for how loneliness and sexual assault are involved in predicting suicidal risk (viz., hopelessness & suicide probability) in a sample of 334 college students. Specifically, we were interested in examining whether sexual assault may play an additive as well as interactive role in the prediction of suicidal risk above and beyond loneliness. Results from regression analyses indicated that both loneliness and sexual assault were important and unique predictors of suicidal risk in students. Moreover, consistent with expectations, we found support for a Loneliness × Sexual Assault interaction in predicting both hopelessness and suicide probability. Inspection of the interactions indicated that the highest levels of suicidal risk were present for lonely students who had experienced some form of sexual assault. Some important implications of the present findings are discussed.     

Validation of the reasons for living inventory in general and delinquent adolescent samples

Two studies are reported that discuss the validation of an adult suicide prediction questionnaire for use with adolescents. The Reasons for Living Inventory (RFL; Linehan, Goodstein, Nielsen, & Chiles, 1983) was slightly modified and administered to two samples of adolescents: one from a general high school population and one from a population of juvenile delinquents receiving psychological treatment in a correctional facility. As with adults, adolescents who reported more reasons for staying alive were less apt to report past or recent suicidal thoughts or behaviors. Evidence of convergent validity emerged via correlations of RFL subscales with depression, hopelessness, and other suicide inventories. Evidence of discriminant validity emerged in that correlations with social desirability were not large. Evidence of construct validity emerged in that the RFL subscales related to suicidal thoughts and behaviors over and above depression and hopelessness. Differences between general and delinquent adolescents' reasons for living are discussed.Special gratitude is due to the Indiana Department of Corrections and the Penn-Harris-Madison Public School System for their cooperation and assistance in data collection for this project.     

Gender differences in the psychosocial correlates of suicidal ideation among adolescents.

Gender differences in the psychosocial correlates of suicidal ideation were studied. A sample of 613 high school students (ages 14-19) completed measures of suicidal ideation, depression, hopelessness, life stress, loneliness, alcohol and drug use, and reasons for living. The results of a discriminant function analysis indicated that males reported higher loneliness and substance abuse scores than females whereas females reported greater suicidal ideation, depression, and reasons for living. The results of multiple regression analyses found that, although the same four variables, depression, hopelessness, substance abuse, and few reasons for living emerged as significant predictors of suicidal ideation in both samples, the predictive equation accounted for more of the variance in ideation scores in females (57%) than in males (46%). In a final analysis a discriminant function analysis of the subscales of the reasons for living inventory revealed that females have a greater fear of death and injury whereas males have a greater fear of social disapproval over having suicidal thoughts. This may account for the greater rate of suicide completing among males. Fear of social disapproval, more anger and impulsivity, and less help-seeking behavior among males are offered as potential variables to explain the observed gender differences.     

Positive life events, attributional style, and hopefulness: testing a model of recovery from depression

A model of a recovery process from depression that is compatible with the hopelessness theory of depressive onset is proposed. This model predicts that depressives who have an enhancing attributional style for positive events (i.e., make global, stable attributions for such events) will be more likely to regain hopefulness and, thereby, recover from depression, when positive events occur. This prediction was tested by following a group of depressed college students longitudinally for 6 weeks. Although neither positive events alone nor attributional style alone predicted reduction in hopelessness, depressives who both showed the enhancing attributional style for positive events and experienced more positive events showed dramatic reductions in hopelessness which were accompanied by remission of depressive symptoms. Thus, attributional style for positive events may be a factor that enables some depressives to recover when positive events occur in their lives.     

Psychache and suicidality in adult mood disordered outpatients in Brazil

Shneidman (e.g., 1998) has theorized that psychache--general psychological and emotional pain that reaches intolerable intensity--is an important suicide-related variable, and indeed, represents a source of suicidal behavior. This conceptualization, while prominent and clinically and intuitively appealing, has received relatively little empirical scrutiny. In this study, we determined whether an index closely related to psychache, psychological quality of life, would display a special and resilient association to suicidality among 60 adult psychiatric outpatients in Brazil. All patients underwent structured clinical interviews and completed various clinical and quality-of-life measures. We found that the association between psychological quality of life and suicidality remained, even when depression, hopelessness, and other domains of quality of life were controlled. Psychache appears to deserve its place among key suicide-related variables, and deserves the attention of clinicians working with suicidal people.     

Cognitive vulnerability to depression, rumination, hopelessness, and suicidal ideation: multiple pathways to self-injurious thinking

In order to advance the detection and prevention of suicide, recent research has focused on predictors of suicidal ideation and behavior such as negative cognitive styles, dysfunctional attitudes, hopelessness, and rumination. In this study the relationships among these risk factors in the context of the Attention Mediated Hopelessness (AMH) theory of depression are examined. One hundred and twenty-seven undergraduates in the Cognitive Vulnerability to Depression (CVD) project were followed for 2.5 years. The CVD project followed initially nondepressed freshmen, at either high or low cognitive risk for depression, in order to predict onsets and recurrences of depressive disorders. The presence and duration of suicidal ideation were predicted prospectively by rumination and hopelessness, and hopelessness partially mediated the relationship between rumination and ideation and fully mediated the association between rumination and duration of suicidality. Further, rumination mediated the relationship between cognitive vulnerability and suicidal ideation.     

Stress, self-esteem, and suicidal ideation in late adolescents

The relationships among stress, self-esteem, and suicidal ideation in late adolescents were examined in a group of college students. Multiple regression analysis indicated that both stress and self-esteem were significantly related to suicidal ideation; low self-esteem and stressful life events significantly predicted suicidal ideation. The hypothesis that self-esteem would moderate the effects of life stressors on suicidal ideation was supported at the .06 level. A significant minority of the sample indicated having thoughts severe enough to be classified as clinical suicidal ideation. In general, participants who had experienced negative life events in the 6 to 12 months prior to participating in the study had lower self-esteem than those who had similar stresses within the prior six months. However, the opposite was true for clinical suicidal ideators; those who experienced negative life stressors recently had lower self-esteem than those who experienced negative life events six months to a year in the past.     

Toward an integrative model of suicide attempt: a cognitive psychological approach.

Applying a cognitive approach, the purpose of the present study was to expand previous research on stress-vulnerability models of depression and problem-solving deficits, as it relates to suicide attempt. Structural equation modelling, involving latent variables, was used to evaluate (a) whether low self-esteem, a low sense of self-efficacy, loneliness, and divorce constituted vulnerability factors for the development of depression; (b) whether hopelessness and suicidal ideation mediated the relationship between depression and suicide attempt; and (c) whether problem-solving deficits mediated the relationship between the vulnerability factors and suicide attempt, separate from depression/hopelessness. A total of 123 individuals, aged 18-75 years, participated in the study (72 suicide attempters and 51 psychiatric outpatients with no history of suicidal behavior). The results indicated a two path model of suicide attempt. The first path began with low self-esteem, loneliness, and separation or divorce, which advanced to depression, and was further mediated by hopelessness and suicidal ideation which led to suicide attempt. The second path developed from low self-esteem and a low sense of self-efficacy and advanced to suicide attempt, mediated by a negative appraisal of one's own problem-solving capacity, and poor interpersonal problem-solving skills. The importance of addressing both depression/hopelessness, and problem-solving deficits when working with suicide attempters is noted.     

Life events,predisposing cognitive strategies and well‐being

To investigate the extent to which the cognitive strategies people apply in various situations, and their subjective well‐being, predispose them to certain life events, 210 students filled in questionnaires measuring their strategy use, self‐esteem, and depression at the beginning of their studies. Self‐esteem and depression were also measured four and five years later. The participants also filled in a life‐event questionnaire yearly between the first and last measurements. Four groups were identified based on the patterns of positive and negative life events. Moreover, the cognitive strategies young adults reported at the beginning of their studies, and their well‐being, were found to predict group membership. Those who had experienced many positive and only few negative life events showed high well‐being and adaptive strategies, whereas those who had faced many negative but only few positive events reported low well‐being and self‐protective strategies. Groups that experienced many positive and many negative, or only few positive and few negative events, were in between these two extremes. Life event patterning was also found to influence later well‐being. Copyright © 1999 John Wiley & Sons, Ltd.     

Dispositional and explanatory style optimism as potential moderators of the relationship between hopelessness and suicidal ideation

To test the hypothesis that higher levels of optimism reduce the association between hopelessness and suicidal ideation, 284 college students completed self-report measures of optimism and Beck scales for hopelessness, suicidal ideation, and depression. A statistically significant interaction between hopelessness and one measure of optimism was obtained, consistent with the hypothesis that optimism moderates the relationship between hopelessness and suicidal ideation. Hopelessness is not inevitably associated with suicidal ideation. Optimism may be an important moderator of the association. The development of treatments to enhance optimism may complement standard treatments to reduce suicidality that target depression and hopelessness.     

Relationship Between Religious Coping and Suicidal Behaviors Among African American Adolescents

This study investigated whether hopelessness and depression were risk factors for suicidal thoughts and behaviors in African American adolescents and looked at whether religious participation and religious coping protected these students from suicidality. Participants were 212 African American high school students (133 females, 79 males). The results of multiple and logistic regression analyses found that hopelessness and depression were risk factors for suicidal ideation and attempts. Religious coping style was significantly related to suicidal behaviors: Self-directed coping was related to increased hopelessness, depression, and suicide attempts, and collaborative coping was related to increased reasons for living. Gender differences were found in symptoms of depression, religious coping style and religious participation. Results provide additional support for suicide interventions to target hopelessness and depressive symptoms and highlight the importance of examining the role of culturally salient variables, such as religious participation and religious coping style, when developing intervention programs for suicide.     

Concurrent validity of a stress-vulnerability model of suicidal ideation and behavior: a follow-up study

A follow-up study to test the concurrent validity of a stress-vulnerability model of suicidal ideation and behavior was conducted. A total of 202 college students (139 females, 63 males) completed self-report measures of life stress, loneliness, depression, dysfunctional cognitions, reasons for living, hopelessness, current suicide ideation, and predictions of future suicide probability. The results of a multiple-regression analysis indicated that 30% of the variation in suicide ideation scores could be accounted for by the linear combination of negative life stress, depression, loneliness, and few reasons for living. The linear combination of current suicide ideation, hopelessness, dysfunctional cognitions, and few reasons for living explained 56% of the variance in self-predicted future suicide probability. The results are interpreted as being supportive of the proposed model.