Suicidal Behavior of Adolescent Girls: Profile and Meaning
Joseph, Hanna Bar, Reznik, Ilya, Mester, Roberto, The Israel Journal of Psychiatry and Related Sciences
Abstract: In the last two decades the incidence of adolescent suicides has been very high (though it has been on the decrease in the U.S. A. over the last four years), giving rise to a multitude of empirical and theoretical studies. The extensive knowledge that has accumulated regarding adolescent suicidal behavior has led to a more differentiated attitude. Many studies try to clarify specific needs, motivations and the conceptualization of death and suicide in various adolescent subgroups (minorities, females, homosexuals), thereby enabling more specific and exact methods of evaluation, prevention and intervention. Adolescent girls' suicidal behavior is different in many aspects from boys' suicidal behavior: Girls mortality rate from suicide is a 3-5 times lower rate than boys, but their attempted suicide rate is four to hundreds time higher. Girls suicide mainly by drugs and their suicide is mainly in reaction to interpersonal difficulties. Their motivation is often a cry for help. The comorbidity of suicide and depression is much higher for adolescent girls than boys. These differences generate a different understanding and separate treatment strategies. Two theoretical approaches that may explain the profile which characterizes suicidal girls will be presented. One has a psychological developmental context, and the other a social cultural context. Implications for specific prevention measures include legal action on pack sizes of analgesics, compulsory registration of attempted suicide and more gender specific treatment and prevention programs.
This paper presents a multi-factorial analysis of the specific characteristics of suicide in adolescent girls, and looks for the reasons that would explain the low rates of fatal suicide and the very high rates of attempted suicide among them.
Suicide of Adolescent Girls
The suicide profile of adolescents from the point of view of gender is homogenous over time (several decades) and place (most Industrialized Western countries). While adolescent boys have a 3-5 times higher rate of mortality from suicide than adolescent girls, adolescent girls have a 3 times higher rate of suicide attempts. Most of these differences are not observed in the suicide rates of children or the elderly (the elderly have the highest fatal but not attempted male to female suicide ratio) (1-3). According to current surveys and studies, the ratio between suicidal attempts and fatal suicide varies between ten to one (non-fatal vs. fatal attempts) (4) and hundreds to one (5, 6).
Farbrow (7), in a summarizing article, presents suicide rates for a representative sample of the Industrial countries - United States of America, Japan, Canada, Australia, England and countries in Europe. The summary relates to the years 1960-1980. In most of these countries, a noticeable rise in the number of suicides was observed towards the '80, and in all these countries the ratio of fatal suicide in girls and boys of one to four was present.
In the ' 80s there was a certain decrease in suicide rates, but this tendency did not continue for long, and in the last two decades there has been another increase. In the US, a further decrease over the last four years has been detected. In a study carried out in Oregon in 1990-1992, the rate of adolescent suicide was found to have increased six-fold. The rate of suicide in this state had been higher than the all-American average, even prior to this study (8) and, as a result, a law had been passed obliging the hospitals to report to the authorities on adolescents who were referred to them after attempting suicide, and to refer these adolescents to counseling. In a scrupulous study following the legislation, the suicide rate of 15-17-year-old adolescent girls was 5.7:100,000 and the rate of boys 4 times that, 20.2: 100,000. This ratio of 1:4 corresponds with the ratio in all the Western countries. The gender ratio for younger adolescents aged 9-13 is 2:1. …