Psychosocial Stressors and Patterns of Coping in Adolescent Suicide Attempters

By Mathew, Anju; Nanoo, Subha | Indian Journal of Psychological Medicine, January-March 2013 | Go to article overview

Psychosocial Stressors and Patterns of Coping in Adolescent Suicide Attempters


Mathew, Anju, Nanoo, Subha, Indian Journal of Psychological Medicine


Byline: Anju. Mathew, Subha. Nanoo

Context: Different risk factors associated with adolescent suicide attempts have been identified including those of socio-demographic and clinical variables. Relatively, little research has been done in the area of their stressors and coping patterns. Aims: To study the recent psychosocial stressors and patterns of coping associated with adolescent suicide attempts. Settings and Design: Tertiary care hospital, case-control study. Materials and Methods: One hundred consecutive cases of adolescent attempted suicide admitted to the hospital and an equal number of controls, matched individually for age and sex, from the relatives and friends of other patients in the ward, were studied. Assessment included details regarding socio-demographic data, psychiatric and physical morbidity, their recent stressors, and patterns of coping. Stressors were assessed using Presumptive Stressful Life Event Scale and coping strategies by Ways of Coping Questionnaire (revised). Statistical Analysis: Chi-square test and multivariate logistic regression analysis. Results: The number of stressful life events and mean stress scores in the preceding 1 month and certain coping strategies such as confronting, distancing, and escape-avoidance were found to be significant risk factors associated with adolescent suicide attempts. Strategies such as self-control, seeking social support, accepting responsibilities, problem solving, and positive appraisal act as protective factors. Conclusions: Recent stressors and strategies such as confronting, distancing, and escape-avoidance are significant risk factors associated with adolescent suicide attempts, whereas certain coping strategies act as protective factors. Teaching adolescents these protective coping patterns may be a promising strategy for prevention of adolescent suicide attempts.

Introduction

According to the World Health Organization, almost 1 million people die from suicide every year. Attempted suicides are about 20 times more. Rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of countries. [sup][1] Suicide ranks as the second cause of death worldwide among 15-19 year olds, with at least one lakh adolescents dying by suicide every year. [sup][2]

The National Crime Records Bureau (India), reports that in 2011, more than one lakh (135,585) persons committed suicide. Around 2.24% of the victims were children up to 14 years, whereas 35.4% suicide victims were youths in the age group of 15-29 years showing that the suicidal behavior increases markedly during adolescence. [sup][3]

Adolescents who attempt suicide, in clinical samples, are a heterogeneous group. [sup][4] Different risk factors associated with adolescent suicide attempts have been identified including those of socio-demographic and clinical variables. [sup][5],[6],[7],[8],[9],[10] Relatively little research has been done in the area of their stressors and coping patterns. [sup][11],[12] and hence this attempt to examine these factors is in more detail.

This study, in particular, aims at identifying the psychosocial risk factors and patterns of coping associated with adolescent attempted suicides so that necessary steps can be implemented to cut down the rates and prevent the family and the society from such a heavy loss.

Materials and Methods

The study was conducted in a tertiary care hospital after clearance from the Human Ethical Committee of the Institution. It was designed to be a hospital-based case-control study. One hundred consecutive cases admitted to Medicine and Surgery wards of the hospital were recruited for the study. One hundred age- and sex-matched controls were also recruited for the purpose of the study.

Inclusion criteria

*A case of adolescent suicide attempt was defined as "an adolescent (13-19 years of age) who had made deliberate act of self-harm consciously aimed at self-destruction with non-fatal outcome. …

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