Risk Factors for Suicidal Behavior: Psychosocial Risk Models with Turkish Adolescents
Terzi-Unsal, Sevim, Kapci, Emine Gul, Social Behavior and Personality: an international journal
This study aimed to test three different suicide models for adolescents residing in a Turkish City, Batman. A total of 605 adolescents from five different high schools participated in this study (M=411, F=190, sex of 4 participants not recorded). A Psychosocial Variables Form (developed for this study), the Offer Self-Image Questionnaire (Offer, Ostrov, Howard, & Dolan, 1989, adapted by Sahin 1993), the Adolescence Life Events Questionnaire (Kapci & Terzi-Unsal, 2001), the Piers-Harris Self-Worth Scale for Children (Harris & Piers, 1969, adapted by Catakli & Oner, 1996), the Suicide Behaviors Questionnaire (Linehan & Nielsen, 1981, adapted by Bayam, Dilbaz, Bitlis, Holat, & Tuzer, 1995), the Beck Hopelessness Scale (Beck, Weissman, Lester, & Trexler, 1974, adapted by Durak, 1994), the Suicide Ideation Questionnaire (Dilbaz, Holat, Bayam, Tuzer, & Bitlis, 1995), the Brief Symptom Inventory (Derogatis, 1992, adapted by Sabin & Durak, 1994) and the Multidimensional Scale for Perceived Social Support (Zimmet, Dahlen, Zimmet, & Farley, 1998, adapted by Eker & Arkar, 1995) were utilized. The data were analyzed by using Structural Equation Modeling. The findings suggest that adolescent life events, psychosocial variables, social support and self-image are secondary risk factors for adolescent suicides, predicting self-worth, psychological health and hopelessness. These variables, in turn, predicted suicide ideation identified as a primary risk factor - that predicted suicide behaviors. The results are discussed in the context of primary-secondary risk factors for adolescent suicides.
Keywords: adolescence, suicide, risk factors, self-esteem, life events.
Suicide, which can be defined as a behavior committed to end one's own life, has become one of the leading causes of adolescent deaths in many countries in recent decades. For example, studies conducted in the USA reveal that adolescent suicide has increased threefold since the 1960s and it threatens adolescents as the second most frequent cause of death after traffic accidents (Queralt, 1998). A similar increase can be seen in European countries and a higher increase is observed in the rate of suicide in Northern Europe (Wichstrom, 2000).
In Turkey, as deaths are not classified according to their causes, there is no information about the place of adolescent suicides in the list of general deaths in adolescents. In the statistics compiled by the State Statistics Institute of Turkey (SSI, 2002), suicides are categorized according to age groups along with the reasons for these deaths - such as parental disputes, failure in education and others. It is possible to monitor the annual increases in the suicide rate which were 1.92 in a 100,000, in 1988 and increased to 2.42 in 1990 and to 3.30 in 1997 with the highest rate of suicide observed in the 15-24 age groups (SSI). Batman is one of the provinces of Turkey located in the South Eastern Region1 and it attracts attention because of increases in the rates of suicides and attempted suicides. According to a study, the rate of attempted and completed suicides were found to be 20.18% and 6.51% respectively in 2000 (Oto, Altindag, Bagli, Ozen, & Erkan, 2001). This rate is three times higher than the average of Turkey. In another study covering the years between 1995-2000, this increase is also evident and it is stated that there is a dramatic increase in the number of completed and attempted suicides especially in the age group of 15-34 in Batman (Family Research Institute of Turkey, 2000).
Parallel to the high rates of attempted and completed adolescent suicides, increased efforts to identify the risk factors for adolescent suicides have been observed. While some of these studies aim to identify risk factors, other studies examine these risk factors within the framework of an adolescent suicide risk model (Stoelb & Chiriboga, 1998; McGee, Williams, & Nada-Raja, 2000). …