Adolescent suicidal ideation and its relationship to other variables was tapped by a self-report questionnaire administered to 88 high school seniors. Eighteen percent responded positively to the statement "sometimes I feel suicidal." Those who reported suicidal ideation were found to differ from those who did not on a number of variables, including family relationships (quality of relationship with mother, intimacy with parents, and closeness to siblings), family history of depression (maternal depression), peer relations (quality of peer relationships, popularity, and number of friends), emotional well-being (happiness, anger, and depression), drug use (cigarettes, marijuana, and cocaine), and grade point average. Stepwise regression indicated that happiness explained 48% of the variance in suicidal ideation, and number of friends, anger, and marijuana use explained an additional 20%, for a total of 66% of the variance. While 34% of the variance remained unexplained, it is suggested that the questions used to measure these four variables be included in global screenings to identify adolescents at risk for suicidal ideation.
Suicidal ideation is typically investigated using multivariate models that include the following factors: family relationships, loneliness, anger, depression, and substance abuse (Jacobs, Brewer, & Klein, 1999). In a recent multivariate study of 120 adolescents, discriminant function analyses indicated that high levels of depression and anger expression predicted self-reported wish to die (Boergers, Spirito, & Donaldson, 1998). In a similar study of 374 high school students, social support and depression were significantly related to suicidal ideation levels one year later (Mazza & Reynolds, 1998). The research regarding family relationships has generally focused on social support. Peer relationships have often been overlooked except for the use of loneliness as a variable. In one study, suicidal thinking was found to be related to greater loneliness (Roberts, Roberts, & Chen, 1998). In that study, as in many studies, depression was the strongest factor to emerge in the regression analyses. In fact, in one st udy when the effect of depression was removed, the relationships between suicidal ideation and other correlates weakened or disappeared (De Man, 1999). In longitudinal studies, depression has been found to be the most frequent predictor of subsequent suicidal ideation and attempts, with suicidal ideation and attempts in turn being predictors of subsequent depression (see Fisher, 1999, for a review).
Family history of depression is also a significant risk factor (Brent, Moritz, Liotus, Schweers, Balach, Roth, & Perper, 1998). In particular, this has been noted for maternal depression (Garber, Little, Hilsman, & Weaver, 1998).
As noted, anger is often seen along with depression in adolescents who experience suicidal ideation (Boergers et al., 1998). In one recent study, adolescents who were depressed were at greater risk if they also manifested high levels of anger and aggression (Stein, Apter, Ratzoni, Har-Even, & Avidin, 1998). In another study, adolescent males were found to be at greater risk for suicidality if they were aggressive, and adolescent females were at greater risk if they were depressed (Prigerson & Slimack, 1999).
Gender differences have also been noted for the relationships between depression, substance use, and suicidality. In their model of adolescent suicide risk, Metha, Chen, Mulvenon, and Dode (1998) reported that males progressed from depression to substance use and then to suicide risk, while females progressed directly from depression to suicide risk. Similarly, in a longitudinal study across a 21-year period (1970-1990), detailed analyses of a random sample of 80 psychiatric patients showed that suicidal behavior increased significantly among male adolescents only, and substance misuse correlated with that increase over time (Fombonne, 1998). …