Academic journal article Journal of School Health

Discriminating Suicide Ideation among High-Risk Youth

Academic journal article Journal of School Health

Discriminating Suicide Ideation among High-Risk Youth

Article excerpt

Among the types of violence evident in society, youth suicide is perhaps the most disconcerting, least understood. Adolescent suicide rates rose dramatically the past several decades and suicide now ranks as the second leading cause of death among adolescents.[1] A youth's suicide is a social as well as personal tragedy; its effects reverberate throughout the youth's social network, affecting not only family and friends, but peers and the broader social community. School communities, in particular, must struggle with the sorrow and emotional trauma caused by the death and impact of these events on other vulnerable youth.

Schools are the hub of an adolescent's life. Charged with educational goals, schools also provide structures and processes that shape the adolescent's personal and social development. It is thus congruent that suicide prevention should fall within the purview of the educational institution. From the perspective of health promotion, schools are in a unique position to identify suicide vulnerable youth. This conviction fostered the development of numerous school-based prevention programs. Generally, these programs were designed for full school populations to increase awareness of suicidal signs and symptoms and to provide strategies for help-seeking. Only a few programs, however, have been systematically evaluated.[2-4] Students' responses to these "first wave" prevention studies were typically positive, but their efficacy for altering suicide-related knowledge and beliefs was questioned. Additionally, concerns arose because of a few potentially negative effects.[2,4]

Gleaned from these early studies is the knowledge that prevention efforts should focus on youth who are at elevated risk for suicide.[3,5] Youth showing marked difficulties in school and potential school dropouts constitute a known high-risk group; these youth frequently manifest multiple risk factors including suicide ideation and behaviors.[6-10] Drug involvement, also common among high-risk youth, has been linked with both depression and suicidal ideation and behaviors among adolescents.[9-15] Thus, a need exists for further research regarding suicide vulnerability within this high-risk group.

Suicide ideation, it has been argued, falls along a suicidality continuum ranging from thoughts of suicide to suicidal behaviors (plans, methods) to suicide attempts, and, in some cases, to suicide.[3,16] In as much as a trajectory exists, then knowledge of factors that contribute to a youth's movement along such a trajectory is indispensable for prevention efforts.

Recognition of suicide ideation is an important aspect of screening and a target for preventive interventions. Suicide ideation, however, is common among adolescents; estimates are that about 20% to 60% of high school youth occasionally have thoughts about suicide.[3,17] Less common, however, is preoccupation with suicide ideation, manifested by intense and frequent thoughts. High suicide ideation is a readily measured dimension that may differentiate youth at elevated risk of suicide.[3,10,11] An important research priority is, thus, to identify factors that differentiate youth expressing high levels of suicide ideation among high-risk youth.

Some psychosocial correlates common to suicide ideation and suicidal behaviors include depression, low self-esteem, impulsivity and anger control problems, and feelings of severe anxiety or stress.[3,10,13] Youth with poor problem-solving and inadequate coping skills are thought to be more vulnerable to suicidal behaviors, particularly when exposed to multiple stressors.[8,11,18] Precipitating stressful life events and circumstances have been linked with suicidal behaviors, particularly stressors related to interpersonal relationships, family, and school performance problems.[3,19-22] Common among the stressors reported by suicidal youth is family strain, characterized by interpersonal conflicts, parental alcohol abuse, and demanding or discrepant parental expectations; moreover, youth who have run away appear vulnerable to suicidal behaviors. …

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