Gender roles, suicidal ideation, and self-harming in young adults

Exploring gender differences in risk factors for self-harm in adolescents using data from the Millennium Cohort Study

BACKGROUND

Self-harm is common in young people and girls have consistently higher rates of self-harm than boys. Differences in exposure and reactions to risk and protective factors, adverse events and problematic interpersonal relationships, and levels of wellbeing could contribute to the gender difference. This study aims to explore gender differences in risk factors associated with self-harm, to provide the foundation for developing more gender-sensitive approaches to self-harm management.

METHODS

Data were analysed from 11,196 young people recruited to the Millennium Cohort Study, surveyed around age 14. We examined gender differences in the prevalence of key psychological and social risk factors for self-harm, including family and peer relationships, emotional wellbeing, and bullying and victimisation. We utilised modified Poisson regression to estimate gender-specific risks.

RESULTS

At age 14 self-harm prevalence was 15.4 % with a ratio of 2.6 females to 1 male. Differential exposure to recorded psychosocial risk factors explained a third of the gender difference in risk of self-harm. Intense social media use and not confiding in family members were associated with a greater likelihood of self-harm in girls than boys. Bullying others and same-sex attraction were more strongly associated with self-harm in boys than girls.

LIMITATIONS

Self-harm data were obtained by self-report therefore subject to misclassification. The cross-sectional design does not enable us to establish causation.

CONCLUSIONS

Unhappiness and dissatisfaction are common in adolescence. Our findings suggest the need for further research into young people's experiences to explore why rates differ and inform the development of gender-specific approaches to self-harm management.

Deliberate self-harm among adolescents: A structural equation modelling analysis

Deliberate self-harm is an intentional behaviour involving direct destruction of body tissues that causes non-fatal physical trauma to the extent that bleeding or bruising occurs without conscious suicidal intent. Adolescents' self-harm is an important issue in mental health work due to its high prevalence in Thailand. This study aims to test a causal model of deliberate self-harm and identify how sex, family relationship, school connectedness, stress, resilience, and self-control influenced deliberate self-harm behaviour in Thai adolescents. A model-testing, cross-sectional study was conducted to test a causal model of deliberate self-harm in Thai adolescents. Multi-stage random sampling was used to recruit 360 adolescents. Adolescents completed six self-report instruments: the family relationship questionnaire, student-school connectedness scale, resilience factors scale for Thai adolescents, self-control questionnaire, Perceived Stress Scale-10 (Thai version), and Deliberate Self-Harm Inventory. Internal consistencies ranged from 0.81 to 0.89. Data were analysed by using descriptive statistics and structural equation modelling. The findings found sex, resilience, stress, and school connectedness had direct effects on deliberate self-harm (β = -0.139, β = -0.266, β = 0.163, and β = -0.671, respectively). Resilience and stress also mediated the links between sex (female), family relationship, school connectedness, and deliberate self-harm. The variables accounted for 65.2% of the variance in the prediction of deliberate self-harm behaviour in Thai adolescents. These findings suggest the causal model of deliberate self-harm fit the empirical data. Interventions to reduce stress and strengthen school connectedness, family relationship, and resilience among Thai adolescents should be implemented, particularly for boys, to prevent deliberate self-harm.

Why Brazilian women suffer more from depression and suicidal ideation: a mediation analysis of the role of violence

OBJECTIVE

We aimed to investigate the mediating effect of violence by a family member or acquaintance on biological sex, depression and suicidal ideation.

METHODS

We used data from the 2013 Brazilian National Health Survey, a cross-sectional nationwide survey. Major depressive episode and suicidal ideation were evaluated with the Patient Health Questionnaire. Violence victimization and other sociodemographic variables were self-reported. We used logistic regression to estimate the OR, 95%CI and G-computation to calculate the natural direct and indirect effects.

RESULTS

A total of 60,202 individuals were evaluated. Women had higher prevalences of major depressive episode (OR = 2.36; 95%CI 2.03-2.74), suicidal ideation (OR = 2.02; 95%CI 1.73-2.36) and violence victimization (OR = 1.73; 95%CI 1.45-2.06). The mediation analysis showed that 10.6% of the association between sex and major depressive episode and 8.0% of the association between sex and suicidal ideation is explained by violence.

CONCLUSIONS

Women in Brazil have an increased risk of major depressive episode and suicidal ideation, and this association is mediated, in part, by the fact that they suffer more violence from family members or acquaintances.

Suicide attempts and non-suicidal self-harm among university students: prevalence study

BACKGROUND

Suicide attempts and non-suicidal self-harm (NSSH) are major public health concerns that affect millions of young people worldwide. Consequently, there is a strong need for up-to-date epidemiological data in this population.AimsTo provide prevalence and trend estimates of suicidal thoughts and behaviours and NSSH thoughts and behaviour in university students.

METHOD

Data are from a 2018 national health survey for higher education in Norway. A total of 50 054 full-time students (69.1% women) aged 18-35 years participated (response rate 31%). Suicidal ideation, suicide attempts and NSSH were assessed with three items drawn from the Adult Psychiatric Morbidity Survey, and thoughts of NSSH were assessed with one item from the Child and Adolescent Self-Harm in Europe study.

RESULTS

Lifetime suicidal thoughts were reported by 21.0%, and 7.2% reported having such thoughts within the past year. In total, 4.2% reported a suicide attempt, of whom 0.4% reported attempting suicide within the past year. The prevalence of lifetime NSSH behaviour and thoughts was 19.6% and 22.6%, respectively. All four suicidal behaviour and NSSH variables were more common among students who were single, living alone and with a low annual income, as well as among immigrants. There was an increase in suicidal thoughts from 2010 (7.7%) to 2018 (11.4%), which was evident in both men and women.

CONCLUSIONS

The observed high and increasing prevalence of suicidal thoughts and NSSH among college and university students is alarming, underscoring the need for further research, preferably registry-linked studies, to confirm whether the reported prevalence is representative of the student population as a whole.Declaration of interestNone.

The role of social support in suicidal ideation: a comparison of employed vs. unemployed people

Background: With the financial crisis, the number of unemployed has grown up, and so has suicidal ideation in these individuals. Although extensive research has been done about the factors associated with it, studies about protective factors are also necessary.Aims: To examine the relationship between unemployment and suicidal ideation, and the protective effect of social support.Methods: Participants were 149 people in full-time employment (age M = 41.63, SD = 10.37), 55 unemployed (M = 42.25, SD = 10.23 years), and 32.72 months average unemployment time (SD = 26.13). Instruments were a sociodemographic questionnaire, the Suicide Ideation Questionnaire (SIQ) and the Social Support Appraisal (SSA). Results: Suicidal ideation was significantly higher in the unemployed group, and positively associated with duration of unemployment. Social support, both from family and friends, was found to be a protective factor in suicidal ideation, particularly in long-term unemployment.Limitations: Cross-sectional study, convenience sample.Conclusions: Suicidal ideation is markedly present in unemployed individuals, particularly those unemployed for a year or more, and social support from family and friends may act as a significant protective factor.

Beyond medicalization: Self-injuring acts revisited

For too long, medical/psychiatric and psychological studies, with focus on emotional sensitivity, personality traits, and correlation with psychopathology, have dominated research on self-injuring acts. The phenomenon thus has been defined as a predominantly medical issue. However, a large body of community prevalence studies show self-injuring acts to be a common phenomenon in society, and most of those who self-injure are unknown in psychiatric or other clinical settings. This article describes and analyzes the medicalization of self-injuring acts and argues a need to move research on self-injuring acts out of the medical paradigm. There is a need to explicitly explore the impact of social, cultural, structural, and gendered factors surrounding and influencing self-injuring acts. A non-medical approach, beyond the limits of the medical perspective, would feed research forward and create a more nuanced view on this widespread social phenomenon.

Gender-specific factors of suicide ideation among adolescents in the Republic of Korea: a nationally representative population-based study

The purposes of this study are to explore the differences in the rates of suicide ideation (SI) between male and female youths, and to investigate gender-specific factors strongly associated with SI. This study analyzed nationally representative secondary data, the Fourth Korea National Health and Nutrition Examination Survey collected over a 3 year period (2007-2009) (N=2358; youths aged 12-18 years). Significant differences in characteristics between adolescents with and without SI were analyzed using either t-test or chi-square test. After adjusting for demographics (i.e., age, monthly household income, and family intactness), gender-specific factors associated with SI were examined using multivariate logistic regression. Current research reveals that (a) the prevalence of SI is higher among female adolescents than among their male counterparts, (b) depression and stress are strong factors in both males and females, and (c) psychological counseling and experimentation with smoking and drinking are strong factors among females only. Different factors influencing SI between males and females should be considered when identifying youths at risk for SI and providing targeted interventions.

Self-harm and conventional gender roles in women

A total of thirty-two women admitted to a general hospital for medical treatment after self-harming completed measures of conventional positive and negative masculinity and femininity. Comparisons were made with two control groups with no self-harm history; 33 women receiving psychiatric outpatient treatment and a nonclinical sample of 206 women. Multinomial logistic regression analyses showed that those with lower scores on Instrumentality and Unmitigated Agency (positive and negative masculinity) and higher scores on Insecurity (negative femininity) had greater odds of self-harming. Relationships were weaker after accounting for generalized self-efficacy. Results are discussed in relation to previous findings and suggestions for prevention are made.