High School Youth and Suicide Risk: Exploring Protection Afforded through Physical Activity and Sport Participation

Article excerpt

Suicide represents the third leading cause of death for youth 15 to 24 years, accounting for 12.9% of all deaths in this age range. (1) According to the Centers for Disease Control and Prevention (CDC), between 2003 and 2004, the suicide rate increased 18% for youth under age 20, and suicides constituted the only cause of death that increased among adolescents. (2) In 2004, youth 15 to 24 years represented 14.2% of the US population and comprised 13.3% of the suicides. Though females attempt suicide more often than males, young males aged 15 to 19 are 3.6 times more likely than females to complete suicide. (1) Further, for each completed suicide, an estimated 100 to 200 adolescents attempted to take their own lives. (1) Thus, Healthy People 2010 specifically targets reducing the rate of completed suicide (objective 18-1) and the rate of attempted suicide among adolescents (objective 18-2). (3) The National Institute of Mental Health urges researchers to focus on decreasing the adolescent suicide rate by studying risk and protective factors. (4)

Research indicates that physical activity affords the same psychological benefits to adolescents as to adults. Physical activity promotes positive emotional well-being (5) including improvements in depressed mood, (6-8) anxiety and stress, (8,9) and self-esteem. (5,6,10) Therefore, through its effect on psychological well-being, physical activity may protect against suicidality. Physical activity in the context of team sports may afford additional protection by facilitating social support and integration. (11) Conversely, youth involved in sport may benefit from psychosocial advantages that increase the likelihood of participation. (12)

Researchers have only recently examined the possible protective association between physical activity, sport participation, and suicide risk. However, the few studies completed yielded equivocal findings. The results become more complicated when examined by gender. For example, Brosnahan et a1 (13) found adolescents significantly less likely to plan suicide if they engaged in frequent, vigorous activity. Yet, they did not find a significant association between sport participation and suicidal behavior. Conversely, Brown and Blanton (14) found that, compared to inactive men, college students who reported low activity levels demonstrated reduced risk of suicidal behavior. However, neither moderately nor vigorously active men showed reduced suicide risk. Furthermore, moderately and vigorously active women actually showed increased levels of suicidal behavior, compared to inactive women. Notably, this study revealed that sport participation protected against suicidal behavior in both men and women. Compared to sport participants, male nonparticipants had 2.5 times the odds of reporting suicidal behavior, and female nonparticipants were 1.67 times more likely to report suicidal behavior.

Unger (15) found similarly complex relationships. Physical activity, especially when combined with team sports, related to lower rates of suicidal behavior for males. Yet, frequent, vigorous aerobic activity, especially without team sports, related to higher rates of suicidal behavior for females.

Though definitive reasons for these disparate results by gender remain unclear, researchers recognize that in young females, exercise behavior impacts mental health in complex ways. Thome and Espelage (16) found that exercise related to positive psychological health in college females, but only when exercise remained unassociated with an eating disorder. Hayes et a1 (17) highlighted body appearance as an important determinant of physical and global self-esteem, especially among females. Therefore, factors related to poor body image may contribute to low self-esteem, depression, and suicidal feelings that could influence the relationship between physical activity and suicidal behavior. (14,15)

Conversely, depressed or suicidal youth may choose not to engage in physical activity. …