Drug use and reported suicide ideation and attempt among Kosovar adolescents

Abstract

Suicide among adolescents continues to be a serious problem. Studies have found that substance use of tobacco, alcohol and illicit drugs is associated with suicide ideation and attempts. An article also analyzed gender differences in terms of suicide ideation and suicide attempts by considering substance use factors separately for males and females. The article is based on the data collected for the 2011 European School Survey Project on Alcohol and other Drugs (ESPAD), which was carried out in 42 secondary schools in Kosovo. A total of 4709 students born in 1995 and 1996 were surveyed according to ESPAD methodology. Logistic regression results indicate that cannabis use during the last 30 days was strongly associated with suicide attempts for both males and females. Frequency of alcohol consumption over the last 30 days was also associated with suicide ideation and attempts. The lifetime use of illegal drugs (amphetamines, ecstasy or hallucinogenic) was highly associated with suicide ideation for males but not for females. Findings show gender differences in suicide ideation; females reported higher rates of suicidal thoughts (9%) than males (6.3%). On the other hand, there were no gender differences for lifetime self-reported suicide attempt rates (3.4%). Findings from this article have a major relevance for youth suicide prevention strategies and action plans, emphasizing that not only the illegal drugs but also legal drugs such as, tranquilizers and alcohol are strongly associated with suicide ideation and attempts.     

Sexual abuse, alcohol and other drug use, and suicidal behaviors in homeless adolescents.

Previous research has shown that homeless youth have high rates of suicidal ideation, sexual abuse, and abuse of alcohol and other drugs. However, little is known about how these rates differ by gender and ethnicity. Our objective was to describe patterns of sexual abuse, alcohol and other drug use, and indicators of suicidal behaviors in homeless adolescents and to determine gender and ethnic differences in these factors. We used secondary data analysis of data from surveys completed by 96 homeless youth whose average age was 17.9 years. Over 60% of the sample reported a history of sexual abuse; the majority were under the age of 12 years when they first tried alcohol, marijuana, and cocaine; 56.3% had injected drugs, and 46.9% had tried inhalants. During the past 12 months, 35.1% had seriously considered suicide and 12.3% had actually attempted suicide at least once. Significantly more Hispanics than Whites had considered suicide (chi 2 = 4.31, p = .038). A disproportionate number of Hispanics (95% of the sample) reported a history of sexual abuse. Participants with a history of sexual abuse were significantly more likely than those who did not have a history of sexual abuse to have used alcohol and/or marijuana (chi 2 = 9.93, p < .01) and to have considered suicide in the past 12 months (F = 14.93, p < .001). We found that sexual abuse history is greater in this sample than in the general population and is particularly prevalent among Hispanic/Latino subjects. As in other studies, sexual abuse was more common among females than among males. High prevalence of sexual abuse, alcohol and other drug use, and suicidal behaviors in this sample of homeless youth underscores the need to develop and test community-based interventions to improve their health status.     

Stress-Related Symptoms and Suicidal Ideation: The Roles of Rumination and Depressive Symptoms Vary by Gender

There is a growing body of literature suggesting that reactions to stressful life events, such as intrusive thoughts, physiological hyperarousal, and cognitive/behavioral avoidance (i.e., stress-related symptoms) may increase risk for thinking about and attempting suicide. Cognitive vulnerability models have identified rumination (i.e., perseverating on a negative mood) as a maladaptive response that may increase risk for suicidal behavior, as it has also been linked to depression. The present study examined the direct and indirect effects of stress-related symptoms on suicidal ideation through rumination and depressive symptoms. Participants were 1375 young adults, primarily non-White (78 %) females (72 %), recruited from a public university in the Northeastern U.S., who completed measures of stress-related symptoms (as a response to a stressful event), rumination, depressive symptoms, and suicidal ideation. The relation between stress-related symptoms and suicidal ideation was accounted for by the brooding subtype of rumination and depressive symptoms among females. Depressive symptoms, but not rumination, better accounted for suicidal ideation among males. These findings suggest that the role of brooding and depressive symptoms in the relationship between stress-related symptoms and suicidal ideation may vary by gender.     

Prevalence and associated factors of suicidal ideation among school-going adolescents in Guyana: results from a cross sectional study

Background

Adolescent suicidal behaviour is a neglected public health issue especially in middle- and low-income countries. Informed policy decision-making on suicidal behaviour will need reliable information on the prevalence and correlates of suicidal ideation which is a determinant of suicidal behaviour.

Methods

We estimated the prevalence and associated factors of suicidal ideation among school-going adolescents using data from the Global School-Based Health Survey conducted in 2004 in Guyana.

Results

Of the 1197 respondents, 18.4% (14.9% males and 21.6% females)reported having seriously considered committing suicide in the last12 months. Males were less likely to seriously consider committingsuicide than females (OR = 0.45; 95% CI [0.30, 0.67]). Subjects whoreported having been bullied were more than twice as likely tocontemplate committing suicide as those who had not been bullied (OR = 2.46 [1.71, 3.54]). History of depression was positivelyassociated with suicidal ideation (OR = 2.67; 95% [1.87, 3.81] whilehaving close friends and understanding parents were negativelyassociated with suicide ideation (OR = 0.51; 95% CI [0.28, 0.94] and OR = 0.51; 95% CI [0.35, 0.76] respectively).

Conclusion

Suicidal ideation is a significant public health issue among in-school adolescents in Guyana that requires attention. The design, implementation and evaluation of suicidal behaviour interventions should incorporate our knowledge of these associated factors.

     

Sex differences and their relevance to primary prevention of adolescent suicide

Sex differences exist in suicide. Males kill themselves more often than females, although not in childhood. Females attempt suicide more frequently. Males also respond differently to prevention programs. Female students are consistently found to display higher levels of knowledge, attitudes, and behavior before the introduction of a suicide prevention curriculum, and they are more likely to benefit from the curriculum when it is provided. It is concluded that (a) in comparison to males, females appear more sensitive to suicide and its management, and (b) males may require suicide prevention programs that differ from the kind generally provided. It is concluded that prevention programs need to teach males to learn about and respond to a suicidal cry, not to deny it.     

Suicidal ideation among Viennese high school students

OBJECTIVE: Suicidality spans a spectrum ranging from suicidal thoughts to suicidal acts, and suicidal ideation is more prevalent in youth populations, suggesting important developmental issues. We assessed the prevalence of lifetime suicidal ideation and associated psychosocial factors among Viennese high school students. METHOD: An anonymous self-report survey assessing demographic characteristics and the major psychiatric risk factors of teenage suicide was completed by students at three Viennese high schools (n = 214; mean age 15.4 years). RESULTS: Eighty-one (37.9%) high school students reported having had suicidal thoughts at some point in their lives, girls significantly more often than boys (48.5% vs. 29.1%, P = 0.004). Furthermore, lifetime suicidal ideation in Viennese high school students was associated with living in broken-home families, cigarette smoking, substance problems (alcohol/drugs), self-reported depression, and high school type (the highest prevalence was in grammar school). After adjusting for confounders, we found that female gender, substance problems, school type and cigarette smoking were significantly associated with lifetime suicidal ideation in Viennese high school students. CONCLUSIONS: The psychosocial factors associated with adolescent suicidal ideation require attention in the contexts of suicide prevention and mental health promotion.     

Suicide ideation among later elementary school-aged youth

Suicide is extremely rare among persons under age 15 years old. Nationwide, it has been reported that 18% of students in grade 6 had thoughts of killing themselves. The Social Disintegration Model (SDM) summarizes intra-personal, interpersonal, peer network, physical and heath risk behaviour characteristics that may influence suicide ideation. As part of a larger study to test a family strengthening programme, 179 later elementary school children from two cities responded to 20 items about their participation in health risk behaviour. Sixteen youth indicated they had thought of killing themselves. Based on the SDM, these 16 youth were compared with the larger sample on measures of ways of coping; family communication, functioning and caring; school connectedness, pubertal development; and alcohol use and weapon carrying. Youth who responded positively to the 'thought of killing self' screening question, felt less connected to their school, used more internalizing behaviours and reported less cohesion, open communication, supervision and family caring than youth who answered no. Youth who thought of killing themselves may benefit from additional school support to feel more comfortable and connected at school. Community resources may help parents modify child-rearing behaviours. Building communication among parents and youth may prevent suicidal behaviour among young adolescents.     

Predictors of suicidal behavior in a sample of Turkish suicide attempters

In a Turkish sample, 100 suicide attempters, were compared with 60 healthy controls on measures of hopelessness, depression, and suicidal ideation. Suicide attempters were more depressive, more hopeless, and displayed greater suicidal ideation than healthy controls. Depression severity rather than hopelessness correlated with suicidal intent. Suicide lethality was independent of depression severity, hopelessness, and suicidal ideation and intent, suggesting that lethality is likely due to chance.     

PREDICTORS OF SUICIDAL BEHAVIOR IN A SAMPLE OF TURKISH SUICIDE ATTEMPTERS

In a Turkish sample, 100 suicide attempters, were compared with 60 healthy controls on measures of hopelessness, depression, and suicidal ideation. Suicide attempters were more depressive, more hopeless, and displayed greater suicidal ideation than healthy controls. Depression severity rather than hopelessness correlated with suicidal intent. Suicide lethality was independent of depression severity, hopelessness, and suicidal ideation and intent, suggesting that lethality is likely due to chance.     

A COMPARISON OF SUICIDAL THINKING AND REASONS FOR LIVING AMONG YOUNGER AND OLDER ADULTS

A cross-sectional design was used to examine age-related differences in suicidal thinking and reasons for living among younger (n = 82; M age = 21) and older (n = 82; M age = 68) adults. Volunteers anonymously completed the Beck Scale for Suicide Ideation and the Reasons for Living Inventory. Findings indicated that older adults do not manifest suicidal ideation differently than younger adults. However, there does appear to be some age-related differences in reasons for not committing suicide. Compared to the younger group, the older group reported moral objections and child-related concerns as stronger reasons for not committing suicide. An implication is that the identification of specific reasons that deter individuals from committing suicide may be clinically useful and provide some assistance in suicide prevention efforts.     

A COMPARISON OF SUICIDAL THINKING AND REASONS FOR LIVING AMONG YOUNGER AND OLDER ADULTS

A cross-sectional design was used to examine age-related differences in suicidal thinking and reasons for living among younger (n = 82; M age = 21) and older (n = 82; M age = 68) adults. Volunteers anonymously completed the Beck Scale for Suicide Ideation and the Reasons for Living Inventory. Findings indicated that older adults do not manifest suicidal ideation differently than younger adults. However, there does appear to be some age-related differences in reasons for not committing suicide. Compared to the younger group, the older group reported moral objections and child-related concerns as stronger reasons for not committing suicide. An implication is that the identification of specific reasons that deter individuals from committing suicide may be clinically useful and provide some assistance in suicide prevention efforts.     

Posttraumatic stress disorder, depression, and suicide in veterans

Suicidal behavior is a critical problem in war veterans. Combat veterans are not only more likely to have suicidal ideation, often associated with posttraumatic stress disorder (PTSD) and depression, but they are more likely to act on a suicidal plan. Especially since veterans may be less likely to seek help from a mental health professional, non-mental-health physicians are in a key position to screen for PTSD, depression, and suicidal ideation in these patients. The authors discuss the association of PTSD, depression, and suicide in veterans, keys to assessment of suicide risk, and interventions.     

Characteristics of Chinese suicide attempters: an emergency room study

Studying the characteristics of attempted suicide is helpful in knowing the background of some completed suicides and improving prevention or intervention strategies. This current study analyzed data of 74 suicide attempters and 92 accident injured patients admitted to 6 hospital emergency rooms in an area of Northeastern China and found both similarities and differences between Chinese and Western suicide attempters. The data show that more women than men attempted suicide. Perhaps because of the unavailability of firearms to Chinese civilians, pesticide was the most lethal means of suicidal behavior. The stressful life events that account for the majority of suicidal incidents were mostly familial or marital problems. Compared with accident victims, these Chinese suicide attempters were younger, poorer, more likely to believe in a religion/superstition,more likely to perceive gender inequality, and less likely to experience support from either family or community. The traditional culture downplaying the status of women coupled with a belief in the transmigration of life may play an important role in the suicide of Chinese young women.     

Cognitive Therapy for Suicide Prevention: A Randomized Pilot with Suicidal Youth Experiencing Homelessness

Homeless youth have extremely high rates of suicidal ideation and attempts, but limited research has evaluated the efficacy of suicide prevention interventions. Suicidal homeless youth (N?=?150) between the ages of 18 to 24 years were recruited from a local drop-in center. Of interest was (1) whether the proposed sample of eligible youth could be identified, (2) whether youth could be engaged and retained in the prevention intervention, and (3) whether the intervention was associated with reduced suicidal ideation, our primary outcome measure. In particular, youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP)?+?Treatment as Usual (TAU) (N?=?75) or TAU alone (N?=?75). Findings showed that the proposed sample of eligible youth could be identified and engaged in the study, and all youth showed a significant decline in suicidal ideation over time, with a faster decline among youth assigned to CTSP. These findings suggest that (1) at-risk suicidal youth can be identified and engaged outside of hospital emergency rooms, such as in drop-in centers, and (2) intervention added to TAU can strengthen reductions in suicidal ideation. Ultimately, attention towards reducing suicide risk among these youth has the potential to reduce premature mortality, hospitalization and loss of human capital.

     

Qualitative content analysis of suicidal ideation in Korean college students

The suicide rate for ages 15-24 increased recently in South Korea. The purpose of this study was to understand the suicidal ideation using the qualitative content analysis in South Korean college students. The data were collected with non-structured open questions in 134 college students and were analyzed with qualitative content analysis. The collected materials were classified 2 categories, 6 themes, and 21 theme clusters. Two categories are emerged: (1) facilitators of suicidal ideation, and (2) inhibitors of suicidal ideation. This study identified that the facilitators of suicidal ideation are physical, psychological and societal concerns, and suggested that the inhibitors of suicidal ideation are influenced by religious and cultural context. These results presented that Buddhism and Confucianism had influence on reasons to not attempting suicide behavior as the inhibitor of suicidal ideation. In conclusion, cultural context should be considered to develop strategies for the suicide prevention in South Korean college student.     

Thwarted Belongingness Mediates the Relationship Between Fear of Negative Evaluation and Suicidal Ideation

Fear of negative evaluation has been documented as a mechanism that explains variations in feelings of belongingness. According to the interpersonal theory of suicide (Joiner 2005), feelings of thwarted belongingness, that one does not belong, can significantly increase desire and risk for suicide. We proposed that differences in thwarted belongingness may explain variations in suicidal ideation and behavior as a function of levels of fear of negative evaluation. This hypothesis was tested by examining self-reported fears of negative evaluation, thwarted belongingness, and suicidal ideation in 107 young adults, many who were explicitly targeted for recruitment due to a history of suicidal ideation and behavior [13.1 % had thoughts about suicide without a previous attempt; 15.9 % reported at least one previous attempt (max = 5 attempts)]. Mediation analyses were conducted with suicidal ideation entered as the outcome variable. Results indicated that greater fears of negative evaluation were significantly and positively associated with levels of suicidal ideation. Differences in thwarted belongingness fully accounted for the relationship between fears of negative evaluation and suicidal ideation. We conclude with clinical implications and future directions.     

Ageism and sexism in suicide attitudes

This study was designed to measure attitudes toward suicide by sex and age. The SAVE-A scale was used to measure attitudes toward suicidal adolescents. A new inventory (the SAVE-L scale) was created to measure attitudes toward elderly suicidal people. The SAVE-L scale was found to possess good levels of internal consistency, to correlate in the expected direction with two concurrent validity measures and to break into the same three unitary factors found for the SAVE-A scale: sympathy, empathy, and agreement. Significant differences were found on each factor. Old suicidal females received the least sympathy from all age and sex subjects while young females received the most. With the exception of old female subjects, who empathized the most with old female target figures, the same pattern emerged on the factor of empathy. All subject groups showed higher agreement with suicide attempts for old females than for any other target group. The suggestion is made that devaluing of elderly females might be a result of their relatively large numbers compared to elderly males, an unconscious reaction to old females' inability to reproduce the species, or a reflection of a general devaluing of female lives, which may become more pronounced in old age. Discussion of the results also suggests that age and sex are important subject variables to researchers of suicide attitudes.