Predictors of Suicidal Ideation among High School Students by Gender in South Korea

Article excerpt

Youth suicide is the second leading cause of death for adolescents in South Korea. (1) Suicidal behavior in adolescents is becoming an increasingly important public health concern. (2) Systematic screening to identify adolescents at risk is an important component of prevention efforts. (3)

Research has revealed numerous warning signs and risk factors for suicidal ideation and behavior. (4-10) Rohde et al, (8) for example, included risk factors from 6 categories presumed to contribute to suicide-prone action, thoughts, and feelings for adolescents: demographic factors, suicide/ depression, problem behavior factors, personality factors, parent/family factors, and peer factors. Beautrais (9) noted that risk factors related to youth suicidal behavior could be categorized into several domains including social and educational disadvantage, childhood and family adversity, psychopathology, individual and personal vulnerabilities, exposure to stressful life events and circumstances, and social, cultural, and contextual factors. Preventive approaches described in previous research have focused on risk factors in relation to suicidal ideation and behavior.

Sanchez created an assessment checklist addressing 5 domains related to suicidal ideation and behavior: historical risk factors, personal risk factors, psychosocial-environmental risk factors, clinical risk factors, and protective factors. (10) This checklist is based on a risk-protective factor model. (11) A risk-protective approach may inform suicide risk recognition and suicide prevention direction in a supportive setting, such as the school.

Important risk factors and protective factors in relation to suicidal ideation and behavior such as depression, self-esteem, alcohol abuse, and disruptive behavior are known to be gender skewed. (5,12) In suicidal ideation and behavior for adolescents, gender seems to be an important factor. Therefore, by explaining the differences between risk factors and protective factors by gender, a greater understanding of suicidal ideation for adolescents in general will be possible.

This study included risk factors from 5 domains and protective factors from 1 domain in relation to suicidal ideation for adolescents: demographic variables, historical variables, personal variables, behavioral variables, psychosocial-environmental variables, and protective variables. Demographic variables consisted of school type and grade. Historical variables include unchangeable conditions in one's life that is statistically associated with a high risk of suicide, (11) such as childhood physical abuse, childhood sexual abuse, history of suicidal attempt, history of depression treatment, and history of family depression. Personal variables refer to characteristic traits of individuals that are related to higher suicidality, (11) such as depression and hostility. Behavioral variables include problem behaviors for adolescents, such as smoking, drinking, using drugs, Wang-tta or victim of bullying behavior, sexual orientation, and sexual behavior. Psychosocial-environmental variables are life events and environmental difficulties that have a negative impact on an individual's well-being, (11) such as parental divorce, parental alcohol abuse, and economic status. Protective variables are aspects of a person's life that lower the risk of suicide, (11) such as academic performance, communication with family, communication with friends, and self-esteem. For this study, the focus was on investigating risk factors and protective factors in relation to suicidal ideation for adolescents by gender.

The aim of this study was to examine the main effect of risk factors and protective factors by gender and identify the most important predictors of suicidal ideation by gender. Furthermore, this study examines gender issues in adolescents' suicidal ideation in consideration of the implications for suicide screening and prevention.

METHOD

Subjects

Subjects consisted of 1312 adolescents who were students in the 10th (N = 440), 11th (N = 436), and 12th (N = 436) grade in 3 academic high schools (N = 660) and 3 vocational high schools (N = 652) in South Korea. …