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Ge Y, Zhang M. Interpersonal relationships and suicidal ideation among Chinese youths: A network analysis. J Affect Disord 2024; 354:267-274. [PMID: 38494135 DOI: 10.1016/j.jad.2024.03.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 02/27/2024] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Suicidal ideation is a noteworthy health problem that requires further study in the field of interpersonal relationships. The main scope of relationships include family, teachers, peers, and the Internet. However, few studies have considered the effects of interpersonal interactions. Based on the Interpersonal Theory of Suicide, this study explores the relation between different interpersonal relationships and suicidal ideation. METHODS A network analysis approach was used to test the relationships. Cross-sectional data (N = 1694; 52.1 % boys; Mage = 11.86 years, SD = 1.59) were collected from primary and secondary students in October-November 2022. Participants completed a survey including demographic part and questionnaires: Positive and Negative Suicide Ideation Inventory (PANSI), Interpersonal Needs Questionnaire (INQ), Family Adaptability and Cohesion Evaluation Scale (FACES II), Inventory of Parent and Peer Attachment (IPPA), Student-Teacher Relationship Scale (STRS) and Facebook Intensity Scale (FIS). RESULTS All variables showed a significant correlation in this inferred network. Family, teacher-student, and peer relationships are protective against suicidal ideation. The closeness of the teacher-student relationship showed the highest strength centrality. However, online interpersonal relationship is a risk factor for suicide. Thwarted belongingness and perceived burdensomeness are proximal factors of suicidal ideation that influenced all interpersonal relationships. LIMITATIONS The network analysis as a data-driven and exploratory method may be limited to provide exact cause and effect relationship. CONCLUSIONS This study shows that teacher-student connections may be more important than other relationships of young people. Improper peer and online interpersonal relationship could be risky for suicide. Further studies are needed to examine the role of these relationships elaborately.
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Affiliation(s)
- Yuanjie Ge
- College of Education, Huaibei Normal University, Huaibei, China
| | - Min Zhang
- College of Education, Huaibei Normal University, Huaibei, China.
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Jeong T. Family economic status and vulnerability to suicidal ideation among adolescents: A re-examination of recent findings. CHILD ABUSE & NEGLECT 2023; 146:106519. [PMID: 37922616 DOI: 10.1016/j.chiabu.2023.106519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/10/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND According to the "differential vulnerability hypothesis," individuals in adverse socioeconomic circumstances as less mentally resilient to stressful events. However, several recent papers radically challenged this hypothesis based on the accumulated literature on stress inoculation and presented cases in which lower-SES adolescents appear to be less vulnerable to suicidal ideation in the face of interpersonal aggression. OBJECTIVE We re-examine the link between psychological vulnerability to acute stressors and SES using yearly longitudinal public survey data from South Korea. PARTICIPANTS AND SETTING This is a secondary data analysis of a multi-year public health panel dataset on South Korean adolescents. METHODS Logistic regression is used to examine the association between suicidal ideation and a range of predictor variables, with a particular focus on the interaction between bullying victimhood and log family income. These variables and the sample were chosen for consistency with recent revisionist research. RESULTS We reaffirm the well-established finding that bullying victimhood strongly and consistently increases the odds of suicidal ideation (OR = 1.859, p < 0.01). However, we find no evidence in favor of the traditional "differential vulnerability hypothesis" or the recently proposed counterhypothesis. A subsample analysis from the latest wave (W4-W5) did produce results that are consistent with recent revisionist findings, but we suggest this is likely a false positive. CONCLUSIONS There appears to be no systematic association between SES and vulnerability to suicidal ideation in the face of peer aggression among South Korean adolescents. The claim that lower-SES adolescents may be more resilient to stressful events stands on limited empirical support.
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Liew SH, Razak MAA, Kassim MSA, Ahmad NA, Tan L. Suicide attempt among Malaysian school-going adolescents: relationship with bullying. BMC Public Health 2023; 23:2165. [PMID: 37932717 PMCID: PMC10626749 DOI: 10.1186/s12889-023-17019-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND According to World Health Organization (WHO), the fourth leading cause of death among adolescents aged 15 -19 years is suicide. The National Health and Morbidity Survey (NHMS) 2017 reported that suicidal attempts among school adolescents increased from 6.8%-6.9% as compared to NHMS 2012. Suicide attempts can cause significant negative impacts on health, social and economic status. Bullying is one of the factors for adolescent suicide attempts, and its relationship to suicidality in adolescents has been shown in numerous research. OBJECTIVES This study examined the relationship between suicide attempts and bullying among school adolescents in Malaysia. METHODS Data from the Malaysia NHMS 2017, a nationwide study that adopted a two-stage cluster sampling design, were analysed. The survey used a self-administered questionnaire in bilingual language adapted from GSHS developed by WHO. Participants were secondary school students aged 13 -17 in all states. Descriptive and multiple logistic regression analyses were performed using IBM SPSS version 28. RESULTS A total of 27,497 school adolescents participated in the study. Results showed that 6.9% of school adolescents had attempted suicide. There was 16.2% of adolescents being bullied. Multiple logistic regression revealed that students who were bullied were more likely to have suicide attempts (aOR 4.827, 95% CI: 4.143, 5.624) P < 0.001. DISCUSSION/CONCLUSION This study revealed that bullying is associated with suicide attempts among school adolescents in Malaysia. The respective authority should consider and plan effective measures to curb bullying among school adolescents.
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Affiliation(s)
- Siaw Hun Liew
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia.
| | - Mohamad Aznuddin Abd Razak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Mohd Shaiful Azlan Kassim
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - LeeAnn Tan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
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Cho S. Long-Term Relationships Between Negative Life Events and Suicidal Ideation Specifying Agnew's General Theory of Crime and Delinquency: A 7-Year Longitudinal Mediation Analysis. VIOLENCE AND VICTIMS 2023; 38:459-484. [PMID: 37380340 DOI: 10.1891/vv-2021-0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
The purpose of this study was to examine the longitudinal mediationa(l pathways on the link between various straining experiences and suicidal ideation and to test whether its relationship was mediated by the role of negative emotions, constraints, and motivations. Data for this study were collected as part of the Korean Welfare Panel Study, which was a longitudinal study conducted among 7,027 Korean households, surveyed annually from 2006 to 2012. The results indicated that bullying victimization had important effects on negative emotions, although bullying victimization was not significant for later suicidal ideation. Peer delinquency was significantly correlated with negative emotions and positively predicted later suicidal ideation. Also, the significant impact of bullying victimization was transmitted to suicidal ideation through negative emotions. It implies that individuals' negative life events predicted strain or stressors generating negative emotions that, in turn, led to a high risk of suicidal ideation as a possible coping skill.
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Affiliation(s)
- Sujung Cho
- Department of Criminology and Criminal Justice, Southern Illinois University Carbondale, Carbondale, Illinois, USA
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Jiang MM, Chen JN, Huang XC, Zhang YL, Zhang JB, Zhang JW. The Effect of Teacher Discrimination Behavior on Adolescent Suicidal Ideation: A Cross-Sectional Survey. Psychol Res Behav Manag 2023; 16:2667-2680. [PMID: 37485285 PMCID: PMC10361406 DOI: 10.2147/prbm.s420978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Suicidal ideation and suicidal behavior, as the most severe psychological and behavioral problems among adolescents, bring not only significant damage to individual social functioning but also cause enormous economic and social pressure, which will ultimately be detrimental to social development and social stability. This paper aimed to explore the potential relationship between teacher discrimination behavior, peer bullying victimization, anxiety disorders, and adolescent suicidal ideation based on the Vulnerability-Stress Model. Methods From September to November 2022, our research team surveyed 21,017 junior high school students from 12 secondary schools in ten cities in China. Mplus 8.3 software was used to analyze the pathways of teacher discrimination behavior on adolescent suicidal ideation. Results The results showed that teacher preference had a significant negative effect on suicidal ideation, and teacher prejudice significantly positively affected suicidal ideation. Mediation test results indicated that there were significant independent mediating effects of peer bullying victimization and anxiety disorders between teacher discrimination behavior and adolescents' suicidal ideation, as well as significant chain mediating effects. Conclusion Secondary school teachers should improve their self-quality and pay more attention to adolescents' suicidal ideation. Teachers are expected to put love into their education, respect and trust each student, and attend to their emotional needs unbiasedly. Educators should develop targeted prevention and intervention measures according to the actual situation of school bullying and also strengthen adolescents' life-value education to improve the psychological quality of adolescents and create a healthy campus atmosphere.
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Affiliation(s)
- Mao-Min Jiang
- School of Public Affairs, Xiamen University, Xiamen, People’s Republic of China
| | - Ji-Neng Chen
- Graduate School, St.Paul University Philippines, Tuguegarao, Philippines
| | - Xin-Cheng Huang
- School of Economics and Management, Beijing Institute of Graphic Communication, Beijing, People’s Republic of China
| | - Yi-Lin Zhang
- School of Humanities, Yangzhou University, Yangzhou, People’s Republic of China
| | - Jia-Bo Zhang
- School of Literature and Media, Lingnan Normal University, Zhanjiang, People’s Republic of China
| | - Jia-Wen Zhang
- School of Education, Silliman University, Dumaguete, 6200, Philippines
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Zheng M, Guo X, Chen Z, Deng J, Hu M. Association between interpersonal relations and anxiety, depression symptoms, and suicidal ideation among middle school students. Front Public Health 2023; 11:1053341. [PMID: 36866094 PMCID: PMC9971595 DOI: 10.3389/fpubh.2023.1053341] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
Objective This study aimed to explore the relationship between different types of interpersonal relationships and anxiety symptoms, depressive symptoms, and suicidal ideation and discusses the impact of different grades among middle school students. Methods The Patient Health Questionnaire Depression Scale, the Chinese version of the Generalized Anxiety Scale, suicidal ideation questions, and interpersonal relations items were used to measure the depression symptoms, anxiety symptoms, suicidal ideation, and interpersonal relations of the participants. The variables of anxiety symptoms, depressive symptoms, suicidal ideation, and interpersonal relations were screened using the Chi-square test and principal component analysis. AMOS17.0 constructs the path of the association between interpersonal relations and depressive symptoms, anxiety symptoms, and suicidal ideation. Results The mother-child relationship had direct impacts of -0.06, -0.07, and -0.06 on anxiety symptoms, depressive symptoms, and suicidal ideation. On anxiety symptoms, depressive symptoms, and suicidal ideation, the direct impacts of the father-child relationship were -0.09, -0.03, and -0.08. Moreover, the direct effects of peer relationships on depressive symptoms were -0.04, whereas the direct impact of teacher-student relationships on anxiety and depressive symptoms were -0.10 and -0.09. Further pathway analysis based on grade level showed that in the junior high school model, the direct effect of the mother-child relationship on anxiety and depressive symptoms was -0.18 and -0.16. The direct impact of the father-child relationship on depressive symptoms and suicidal ideation was -0.08 and 0.09. The direct effect of peer relationships on depressive symptoms was -0.08, and the direct impact of the teacher-student relationship on anxiety symptoms was -0.06. In the high school model, the direct effect of the mother-child relationship on suicidal ideation was -0.07, while the direct impact of the father-child relationship on anxiety, depression, and suicidal ideation was -0.10, -0.07, and -0.12, respectively. In addition, the direct effects of peer relationships on anxiety and depression were -0.06 and -0.05, and the direct impact of teacher-student relationships on anxiety and depression was -0.10 and -0.11. Conclusion The father-child relationship affects suicidal ideation and depression the most, followed by the mother-child relationship, the teacher-student interaction, and the peer relationship. The teacher-student relationship influences anxiety symptoms the most, followed by the father-child and mother-child relationships. The association between interpersonal interactions and anxiety, depressive symptoms, and suicidal ideation varied significantly across grade levels.
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Affiliation(s)
- Meixin Zheng
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiaoyan Guo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhiyan Chen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Mi Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Grzejszczak J, Strzelecki D, Gabryelska A, Kotlicka-Antczak M. Affiliation to a Social Group as a Preventive Factor in Suicidal Behaviors in Children and Adolescents during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020333. [PMID: 36832461 PMCID: PMC9955561 DOI: 10.3390/children10020333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
Suicide is one of the most common causes of death in the population of children and adolescents. Available data show the continuous growth of this phenomenon and the ineffectiveness of prevention programs. Additionally, the COVID-19 pandemic significantly affected young people's mental health, including an increased risk of suicidal behaviors due to limited direct contact with the school and peer groups in favor of the home environment. Therefore, the aim of this narrative review was to consider the risk factors and protective factors for suicidal behavior in the under-18 population, with a particular focus on the importance of belonging to a social group and building identification with it as a phenomenon protecting against suicidal behavior. Additionally, in this review, we evaluate how the COVID-19 pandemic affected these relationships. The PubMed database was used in the search with the following keywords: suicide, suicide behaviors, child and adolescent suicide behaviors, group affiliation, family affiliation, ethnicity, religious affiliation, and the COVID-19 pandemic, with articles published between 2002 and 2022 analyzed. Research conducted to date indicates that both sustained and stable family and peer relationships, as well as a sense of identification and belonging, noticeably reduce the risk of suicidal behavior. Ethnic or cultural affiliation seems to have been particularly important during the isolation in the home environment caused by the COVID-19 pandemic. Additionally, it has been shown that while in lockdown, contact through social media with individuals' identification groups was associated with a reduced chance of emotional crises. Furthermore, regardless of cultural background, attachment to a particular group correlates with enhanced psychiatric state of children and adolescents. Thus, available data highlight the need for building and maintaining affiliations with suitable groups as a protective factor against suicidal behaviors.
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Affiliation(s)
- Jagoda Grzejszczak
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 92-216 Lodz, Poland
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
- Correspondence:
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Chen SS, Lam TP, Lam KF, Lo TL, Chao DVK, Mak KY, Lam EWW, Tang WS, Chan HY, Yip PSF. The Use of Close Friends on Instagram, Help-Seeking Willingness, and Suicidality Among Hong Kong Youth: Exploratory Sequential Mixed Methods Study. J Med Internet Res 2022; 24:e37695. [PMID: 36223182 PMCID: PMC9607886 DOI: 10.2196/37695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/20/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Social networking sites (SNSs) have gained popularity in recent years for help seeking and self-distress expression among adolescents. Although online suicidal expression is believed to have major benefits, various concerns have also been raised, particularly around privacy issues. Understanding youths’ help-seeking behavior on SNSs is critical for effective suicide prevention; however, most research neglects the impacts of the private SNS context. Objective This study aims to examine youths’ private SNS use via the new Instagram feature, Close Friends, and its association with both online and offline help-seeking willingness as well as youths’ suicidality. Methods This study employed an exploratory sequential mixed methods approach with a combination of explorative qualitative interviews and a systematic quantitative survey, targeting youth aged 15-19 years in Hong Kong. The motivations for utilizing Close Friends and concerns regarding online expression were addressed in the focus group and individual interviews (n=40). A cross-sectional survey (n=1676) was conducted subsequently with eligible secondary school students to examine the prevalence of Close Friends usage, their online and offline help-seeking willingness, and suicide-related experiences. Results A total of 3 primary motives for using Close Friends were identified during interviews, including (1) interaction and help seeking, (2) release of negative emotions, and (3) ventilation and self-expression. Most participants also highlighted the privacy concerns associated with public online communication and the importance of contacting close friends for emotional support. Survey results showed that use of Close Friends was quite prevalent among adolescents (1163/1646, 70.66%), with around 46% (754/1646, 45.81%) of respondents being frequent users. Differences by gender and school academic banding were also revealed. Regarding help-seeking intentions, youths were generally positive about seeking help from peers and friends offline (1010/1266, 79.78%) yet negative about seeking assistance from online friends or professionals with whom they had not yet developed a real-world connection (173/1266, 13.67%). Most notably, frequencies of Close Friends usage were differentially associated with online and offline help-seeking willingness and youths’ suicidality. Compared with nonusers, those who had ever used the feature were more likely to seek offline support (adjusted odds ratios [AORs] 1.82-2.36), whereas heavy use of Close Friends was associated with increased odds of online help-seeking willingness (AOR 1.76, 95% CI 1.06-2.93) and a higher risk of suicidality (AOR 1.53, 95% CI 1.01-2.31). Conclusions The popularity of Close Friends reflects the increasing need for private online expression among youth. This study demonstrates the importance of Close Friends for self-expression and private conversation and inadequacy of peer support for suicidal adolescents. Further research is needed to identify the causal relationship between Close Friends usage and help-seeking willingness to guide the advancement of suicide prevention strategies. Researchers and social media platforms may cooperate to co-design a risk monitoring system tailored to the private SNS context, assisting professionals in identifying youth at risk of suicide.
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Affiliation(s)
- Sikky Shiqi Chen
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Kwok Fai Lam
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Tak Lam Lo
- Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - David Vai Kiong Chao
- Department of Family Medicine and Primary Health Care, Hospital Authority Kowloon East Cluster, Hong Kong, China
| | - Ki Yan Mak
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Edmund Wing Wo Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Wai Sin Tang
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Hoi Yan Chan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Yamazaki J, Kizuki M, Fujiwara T. Association between Frequency of Conversations and Suicidal Ideation among Medical Students during COVID-19 Pandemic in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116385. [PMID: 35681969 PMCID: PMC9180649 DOI: 10.3390/ijerph19116385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/20/2022] [Accepted: 05/22/2022] [Indexed: 11/16/2022]
Abstract
To mitigate the spread of COVID-19, universities in Japan shifted from face-to-face to online classes, which might have reduced social interaction and increased psychiatric problems among students. A self-report questionnaire was administered to fourth-year medical students in Tokyo in May 2021, during the fourth wave of the COVID-19 outbreak, to examine the association between the frequency of conversations and suicidal thoughts. The questionnaire assessed the frequency of conversations and, using part of the Mini International Neuropsychiatric Interview, suicidal ideation. Of the 113 students, 98 (86.7%) responded, of whom 20 (20.4%) had suicidal ideation. Poisson regression analysis revealed that those with less than 1 conversation per week and no conversations at all had a significantly higher risk of suicidal ideation than those with 3 conversations per week or more, after adjusting for personality, family relationship, income level, living alone, number of friends, gender, and age. These results indicate that less frequent conversations increased the risk of suicidal ideation among medical students. Mental health support for students needs to be strengthened if universities suspend face-to-face classes during a pandemic.
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Affiliation(s)
- Juri Yamazaki
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan;
| | - Masashi Kizuki
- Department of Tokyo Metropolitan Health Policy Advisement, Tokyo Medical and Dental University, Tokyo 113-8519, Japan;
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan;
- Correspondence:
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Mental Health, Bullying, and Victimization among Chinese Adolescents. CHILDREN 2022; 9:children9020240. [PMID: 35204959 PMCID: PMC8869807 DOI: 10.3390/children9020240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to examine if adolescents who experience anxiety or depression have higher levels of reported bullying victimization or perpetration than those who do not. Based on the existing research, we hypothesized that those who experienced moderate or severe depression and anxiety would have higher rates of bullying victimization and perpetration when compared to those who experienced mild or no depression. This study used an observational design, and data were collected from a convenience sample of adolescents in a large regional high school in an Eastern province of China. The final sample included 1481 adolescents aged 14–19 years who provided complete data for each of the study variables. Demographic data were collected through a four-item demographic survey, bullying perpetration and victimization data were collected using subscales from the Illinois Bully Scale, and anxiety and depression were measured using the Chinese version of the General Anxiety Disorder-7 scale and the Patient Health Questionnaire, respectively. Descriptive analyses, correlational analyses, and multivariate analysis of covariance were used to analyze the data. About 7.1% and 15.2% of participants reported moderate-to-severe depression or moderate-to-severe anxiety, respectively. Pairwise comparisons indicated that adolescents with no or mild depression had significantly lower bullying perpetration than those with moderate-to-severe depression, but those with no or mild anxiety had significantly higher perpetration than those with moderate-to-severe anxiety. There was no statistically significant difference in victimization among different anxiety or depression levels alone (all p-values ≥ 0.05). This is among the first studies to examine reported levels of bullying perpetration and victimization among adolescents experiencing anxiety and depression. The findings help to identify adolescents who experience moderate-to-severe levels of depression as an at-risk group for bullying perpetration, who should therefore be a focus of bullying intervention work.
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Musetti A, Grazia V, Manari T, Terrone G, Corsano P. Linking childhood emotional neglect to adolescents' parent-related loneliness: Self-other differentiation and emotional detachment from parents as mediators. CHILD ABUSE & NEGLECT 2021; 122:105338. [PMID: 34560397 DOI: 10.1016/j.chiabu.2021.105338] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 08/26/2021] [Accepted: 09/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The detrimental role of childhood emotional neglect (CEN) on long-term affective and social development has received increasing attention in the literature. Individuals who were emotionally neglected during their childhood are more prone to feeling isolated and excluded by their parent during adolescence. However, little is known about the mediating processes underlying this association. OBJECTIVE This study investigated whether self-other differentiation (SOD) and emotional detachment from parents mediate the link between CEN and parent-related loneliness. METHOD AND PARTICIPANTS A sample of 535 high school students aged 13-18 years (63.6% female; Mage = 16.21; SD = 1.40) completed questionnaires regarding demographics, CEN, SOD, emotional detachment, and parent-related loneliness. RESULTS After controlling for demographic covariates, structural equation modeling (SEM) showed that (a) CEN was positively associated with parent-related loneliness (β = 0.64, p < .001), (b) SOD did not mediate the relationship between CEN and parent-related loneliness (β = -0.01, p = .142), (c) emotional detachment partially mediated the relationship between CEN and parent-related loneliness (β = 0.16, p < .001), and (d) SOD and emotional detachment partially and sequentially mediated the link between CEN and parent-related loneliness, albeit with a small effect size (β = 0.02, p = .027). CONCLUSIONS The findings underscore the significance of the link between CEN and parent-related loneliness in adolescence. Moreover, our results suggest that some adolescents with a history of CEN have difficulties in establishing clear boundaries between "self" and "other" and tend to engage in emotionally detached relationships with their parents, which may lead them to feel more parent-related loneliness. Clinical implications and directions for future research are discussed.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy.
| | - Valentina Grazia
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
| | - Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, Via Cracovia 50, 00133 Rome, Italy
| | - Paola Corsano
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
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Lee J, Chun J, Kim J, Lee J, Lee S. A Social-Ecological Approach to Understanding the Relationship between Cyberbullying Victimization and Suicidal Ideation in South Korean Adolescents: The Moderating Effect of School Connectedness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010623. [PMID: 34682368 PMCID: PMC8535638 DOI: 10.3390/ijerph182010623] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022]
Abstract
Background: Cyberbullying victimization and suicidal ideation are both ongoing deleterious social problems in South Korea. Using the social-ecological approach, this study examined the association between cyberbullying victimization and suicidal ideation as well as the buffering role of school connectedness in this relationship. Methods: A nationally representative sample of 7333 adolescents from the 2016 Korean Children and Youth Right Study participated in the study. Data were analyzed using descriptive statistics, Wald chi-square test, bivariate correlations, and multivariate logistic regression analyses. Results: Nearly 17.7% of adolescents were cyberbullied, and 28.4% had suicidal ideation in the past 12 months. Cyberbullying victims were at an increased risk of suicidal ideation. The results also found that parental abuse, family dysfunction, and perceived peer relationship stress were positively associated with suicidal ideation, while parental support for autonomy was negatively associated with suicidal ideation. Further, school connectedness moderated on the relationship between cyberbullying victimization and adolescent suicidal ideation. Conclusions: These findings suggest that various stakeholders should consider interventions and preventive programs that address school connectedness when working with adolescents who are victims of cyberbullying and exhibit suicidal behavior.
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Affiliation(s)
- Jungup Lee
- Department of Social Work, National University of Singapore, Singapore 117570, Singapore
- Correspondence:
| | - JongSerl Chun
- Department of Social Welfare, Ewha Womans University, Seoul 03760, Korea; (J.C.); (J.K.); (J.L.); (S.L.)
| | - Jinyung Kim
- Department of Social Welfare, Ewha Womans University, Seoul 03760, Korea; (J.C.); (J.K.); (J.L.); (S.L.)
| | - Jieun Lee
- Department of Social Welfare, Ewha Womans University, Seoul 03760, Korea; (J.C.); (J.K.); (J.L.); (S.L.)
| | - Serim Lee
- Department of Social Welfare, Ewha Womans University, Seoul 03760, Korea; (J.C.); (J.K.); (J.L.); (S.L.)
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13
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Chen X, Jiang L, Liu Y, Ran H, Yang R, Xu X, Lu J, Xiao Y. Childhood maltreatment and suicidal ideation in Chinese children and adolescents: the mediation of resilience. PeerJ 2021; 9:e11758. [PMID: 34277155 PMCID: PMC8269734 DOI: 10.7717/peerj.11758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/21/2021] [Indexed: 11/20/2022] Open
Abstract
Background Childhood maltreatment could increase the risk of suicidal ideation (SI) in adolescents. However, the mediation of resilience in this association remains unclear. Methods A population-based cross-sectional study has been done among 3,146 Chinese adolescents. We collected relevant information from the study participants by using self-administered questionnaire. Chinese version of the Childhood Trauma Questionnaire (CTQ), the Resilience Scale for Chinese Adolescents (RSCA), and the Beck Scale for Suicide Ideation (BSSI) were used to measure childhood maltreatment, resilience, and SI, respectively. Univariate and multivariate binary Logistic regression models were employed to estimate crude and adjusted associations between childhood maltreatment, resilience, and SI. Path analysis has subsequently been performed to measure the mediation of resilience in this association. Results Multivariate Logistic regression models revealed that compared to non-abused counterparts, adolescents who had ever experienced any type of childhood maltreatment was 1.74 times likely to report SI. Among the specific types of childhood maltreatment, emotional abuse showed the strongest association with SI (adjusted OR = 3.01, 95% CI [2.37–3.82]). Path model suggested that over one-third (39.8%) of the total association between childhood maltreatment and SI was mediated via resilience. Emotion regulation and interpersonal assistance were the most prominent mediators among all dimensions of resilience. Conclusions Resilience played as a significant mediator in the association between childhood maltreatment and SI. Resilience-oriented intervention measures could be considered for suicidal risk prevention among abused Chinese adolescents.
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Affiliation(s)
- Xue Chen
- School of Public Health, Kunming Medical University, Kunming, China.,The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Linling Jiang
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Yi Liu
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Hailiang Ran
- School of Public Health, Kunming Medical University, Kunming, China
| | - Runxu Yang
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Jin Lu
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Yuanyuan Xiao
- School of Public Health, Kunming Medical University, Kunming, China
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14
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Adewuya AO, Oladipo EO. Prevalence and associated factors for suicidal behaviours (ideation, planning, and attempt) among high school adolescents in Lagos, Nigeria. Eur Child Adolesc Psychiatry 2020; 29:1503-1512. [PMID: 31858265 DOI: 10.1007/s00787-019-01462-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 12/13/2019] [Indexed: 12/28/2022]
Abstract
To plan effective school-based adolescent suicide prevention strategies, there is need for valid epidemiology data. The aim of this study was to estimate the current (1 month) prevalence and associated factors of suicidal behaviours (ideation, planning, and attempt) amongst secondary school adolescents in Lagos, Nigeria. A total of 9441 adolescents (4684 males and 4757 females) with mean age 15.61 years (SD 1.49) recruited from 47 public senior secondary schools self-completed questionnaire consisting of sociodemographic, family, school, physical health, and mental health-related variables. Suicidal behaviours (ideation, planning, and attempt) in the past 1 month were also assessed. The weighted 1-month prevalence for suicidal ideation was 6.1% (95% CI 5.5-6.7), suicidal planning was 4.4% (95% CI 3.8-4.9), and suicidal attempt was 2.8% (95% CI 2.4-3.2). The factors significantly associated with suicidal behaviours included being female, not staying with the mother, maternal drinking, witnessing domestic violence, past and present academic difficulties, having no close friend in school and having problems relating with peers and teachers. Also, presence of chronic physical illnesses, depression, anxiety, behavioural disorders, and psychotic-like experiences were associated with adolescent suicidal behaviour. We have shown that a substantial percentage of adolescent have suicidal behaviours, and that there were demographic, family, school, physical health, and psychological health-related factors. We believe that our findings will be important when planning suicide prevention services that could be incorporated into the school mental health services.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. .,Centre for Mental Health Research and Initiative (CEMHRI), Ikeja, Lagos, Nigeria.
| | - Eniola O Oladipo
- Centre for Mental Health Research and Initiative (CEMHRI), Ikeja, Lagos, Nigeria
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15
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Chen R, Liu J, Cao X, Duan S, Wen S, Zhang S, Xu J, Lin L, Xue Z, Lu J. The relationship between mobile phone use and suicide-related behaviors among adolescents: The mediating role of depression and interpersonal problems. J Affect Disord 2020; 269:101-107. [PMID: 32250862 DOI: 10.1016/j.jad.2020.01.128] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 11/17/2019] [Accepted: 01/20/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study examined (a) the relationship that interpersonal problems and depression share with the intensity of mobile phone use and (b) their effects on suicide-related behaviors (SRBs) and self-harming behaviors among adolescents. METHODS In this cross-sectional study, adolescents were recruited from 11 middle and high schools in Shenzhen, China. They completed self-reported measures that assessed mobile phone use, their history of SRBs (i.e., suicidal ideation, suicidal planning, and attempted suicide) and self-harming behaviors, depression, and interpersonal problems. RESULTS Interpersonal problems and depression mediated the relationship between high-intensity mobile phone use and the risk for SRBs and self-harming behaviors among Chinese adolescents. CONCLUSIONS The findings delineate the pathways through which interpersonal problems and depression increase the risk for SRBs and self-harming behaviors among adolescents who report high-intensity mobile phone use. Future studies should develop interventions that alleviate interpersonal problems and depressive symptoms to reduce the risk for SRBs and self-harming behaviors among adolescents who report high-intensity mobile phone use.
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Affiliation(s)
- Runsen Chen
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Jianbo Liu
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Xiaolan Cao
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Suqian Duan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Siyang Wen
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Simei Zhang
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Jianchang Xu
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Ling Lin
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Zhenpeng Xue
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Jianping Lu
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China.
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16
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Bullock A, Xiao B, Xu G, Liu J, Coplan R, Chen X. Unsociability, peer relations, and psychological maladjustment among children: A moderated‐mediated model. SOCIAL DEVELOPMENT 2020. [DOI: 10.1111/sode.12444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Amanda Bullock
- School of Psychology and Cognitive Science East China Normal University Shanghai China
| | - Bowen Xiao
- Department of Psychology Carleton University Ottawa Ontario Canada
| | - Gangmin Xu
- School of Psychology and Cognitive Science East China Normal University Shanghai China
| | - Junsheng Liu
- School of Psychology and Cognitive Science East China Normal University Shanghai China
| | - Robert Coplan
- Department of Psychology Carleton University Ottawa Ontario Canada
| | - Xinyin Chen
- Graduate School of Education University of Pennsylvania Philadelphia PA USA
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17
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Lu L, Xu L, Luan X, Sun L, Li J, Qin W, Zhang J, Jing X, Wang Y, Xia Y, Li Y, Jiao A. Gender difference in suicidal ideation and related factors among rural elderly: a cross-sectional study in Shandong, China. Ann Gen Psychiatry 2020; 19:2. [PMID: 31956335 PMCID: PMC6958769 DOI: 10.1186/s12991-019-0256-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/31/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Suicide is a global public health problem which has significant negative influence on individuals, families and the society. The aim of this study is to investigate the prevalence of suicidal ideation and related factors among elderly people in rural China, and further examine the gender differences of suicidal ideation. METHODS Data were collected from the 2017 Survey of the Shandong Elderly Family Health Service, which was conducted by Shandong University. A total of 5514 elderly aged 60 and above from rural Shandong were included in this study. Binary logistic regression model was performed to examine the gender difference towards suicidal ideation, and to identify the influencing factors of suicidal ideation by gender among elderly. RESULTS 7.7% rural elderly reported suicidal ideation in the past 12 months in Shandong, China. The prevalence of suicidal ideation among females was significantly higher than that among males (P < 0.001). Education level, debts, stress of daily life, loneliness and psychological distress were significantly related to suicidal ideation in both males and females. Besides, negative life events and life satisfaction were found to be significantly associated with suicidal ideation in females but not in males. CONCLUSIONS There was a significant gender difference towards suicidal ideation among rural elderly in Shandong, China. So, gender difference should be considered when medical practitioners and public health workers seek to prevent and manage suicidal ideation among rural elderly, which will be important to develop strategies for coping with risk factors for suicidal ideation among males and females. In other words, more attention should be paid to females who had encountered negative life event or with lower life satisfaction.
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Affiliation(s)
- Lu Lu
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Lingzhong Xu
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Xiaorong Luan
- 4Department of Nursing Management of Qilu Hospital, Shandong University, Jinan, 250012 China
| | - Long Sun
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China
| | - Jiajia Li
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Wenzhe Qin
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Jiao Zhang
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Xiang Jing
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Yali Wang
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Yu Xia
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - Yaozu Li
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
| | - An'an Jiao
- 1School of Public Health, Shandong University, Jinan, 250012 China.,2NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012 China.,3Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012 China
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18
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Dema T, Tripathy JP, Thinley S, Rani M, Dhendup T, Laxmeshwar C, Tenzin K, Gurung MS, Tshering T, Subba DK, Penjore T, Lhazeen K. Suicidal ideation and attempt among school going adolescents in Bhutan - a secondary analysis of a global school-based student health survey in Bhutan 2016. BMC Public Health 2019; 19:1605. [PMID: 31791280 PMCID: PMC6889681 DOI: 10.1186/s12889-019-7791-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 10/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide is one of the leading causes of death and Disability Adjusted Life Years (DALYs) worldwide. The economic, emotional and human cost of suicidal behaviour to individuals, families, communities and society makes it a serious public health issue. We aim to determine the prevalence and factors associated with self-reported suicidal behaviour (suicidal ideation and attempt) among school going adolescents (13-17 years). METHODS This is a secondary analysis of a nationally representative data for Bhutan namely Global School Based Student Health Survey in 2016 which reports on various dimensions of adolescent health including suicidal behaviour. The survey employed a multistage sampling method to recruit participants aged 13-17 years (n = 5809) from 50 schools (25 each in rural and urban area). The survey used an anonymous self-administered pre-tested 84-item questionnaire. Weighted analysis was done. Adjusted prevalence ratios (aPRs) and adjusted Odds Ratios (aORs) have been presented with 95% confidence intervals (95% CI). RESULTS A total of 667 (11.6%) adolescents reported considering a suicide attempt whereas 656 (11.3%) reported attempting suicide in the past 12 months. Among those reporting suicidal ideation, 388 (58.6%) reported attempting a suicide and 274 (41.4%) had ideation alone, whereas, 247 (38.9%) reported attempting a suicide without previous ideation. Female sex, food insecurity, physical attack, sexual violence, bullying, feeling of loneliness, low parental engagement, reported worry about lack of sleep, urge to use drugs/alcohol, smokeless tobacco use, drug abuse and parental smoking were the factors associated with suicidal attempt. All these factors except smokeless tobacco use and parental smoking were associated with suicidal ideation. Having helpful/close friends was found to be protective against suicide ideation. CONCLUSION Suicidal behaviour among school going adolescents in Bhutan is high and alarming, especially among girls. Bullying, sexual violence, feeling of loneliness and drug abuse were some of the key risk factors identified. It is important to identify these risk factors early and effectively tackle them in order to prevent suicides. It requires a multi-faceted intervention with the support of the children, community, teachers and parents.
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Affiliation(s)
- Tashi Dema
- HMIS Evaluation and Research Section, Policy and Planning Division, Ministry of Health, Thimphu, Bhutan.
| | - Jaya Prasad Tripathy
- International Union Against Tuberculosis and Lung Disease, Paris, France.,Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Sangay Thinley
- School Health Programme, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Manju Rani
- Regional Office for South East Asia, World Health Organization, New Delhi, India
| | - Tshering Dhendup
- Policy and Planning Division, Ministry of Health, Thimphu, Bhutan
| | | | - Karma Tenzin
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Mongal Singh Gurung
- HMIS Evaluation and Research Section, Policy and Planning Division, Ministry of Health, Thimphu, Bhutan
| | - Tashi Tshering
- School Health Programme, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Dil Kumar Subba
- Mental Health Programme, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Tashi Penjore
- Policy and Planning Division, Ministry of Health, Thimphu, Bhutan
| | - Karma Lhazeen
- Department of Public Health, Ministry of Health, Thimphu, Bhutan
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19
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Abdul Aziz FA, Abd Razak MA, Ahmad NA, Awaluddin SM, Lodz NA, Sooryanarayana R, Shahein NA, Mohamad Kasim N, Abd Wahab N, Jamaluddin R. Factors Associated With Suicidal Attempt Among School-Going Adolescents in Malaysia. Asia Pac J Public Health 2019; 31:73S-79S. [PMID: 31353928 DOI: 10.1177/1010539519862161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Various factors contribute to suicidal attempt. This study aims to determine the relationship between suicidal attempt and its associated factors among school-going adolescents in Malaysia. Data from the National Health and Morbidity 2017 survey were analyzed. This survey was implemented as a nationwide school-based survey targeting adolescents 13 to 17 years old. Descriptive and multiple logistic regression analysis was done using SPSS version 20. A total of 27 399 adolescents participated in this survey. The prevalence of suicidal attempt was 6.9% (95% confidence interval = 6.2-7.7). Multivariate analysis found that the odds of suicidal attempt among adolescent with depression is 4.3 (adjusted odds ratio = 4.3; 95% confidence interval = 3.9-4.8). Other significant factors are young adolescent, non-Malay ethnicities especially Indian, adolescent with parents living apart, and those without peer support and parental connectedness. A holistic approach for the planning of preventative strategies and public health policies should be made according to these risk factors.
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Affiliation(s)
- Fazly Azry Abdul Aziz
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Mohamad Aznuddin Abd Razak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - S Maria Awaluddin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Noor Aliza Lodz
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Rajini Sooryanarayana
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Nik Adilah Shahein
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Noraida Mohamad Kasim
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Nor'ain Abd Wahab
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Rasidah Jamaluddin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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20
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Guo L, Xu Y, Huang G, Gao X, Deng X, Luo M, Xi C, Zhang WH, Lu C. Association between body weight status and suicidal ideation among Chinese adolescents: the moderating role of the child's sex. Soc Psychiatry Psychiatr Epidemiol 2019; 54:823-833. [PMID: 30712066 DOI: 10.1007/s00127-019-01661-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Suicidality (ranging from suicidal ideation to suicidal attempts and completed suicide) is a major and preventable public health concern, and body weight is considered a modifiable factor which might be helpful to the early risk assessment of suicidal ideation. This study aimed to comprehensively evaluate the association of body weight status with suicidal ideation across sex among Chinese adolescents. METHODS Data were drawn from the 2015 National School-based Chinese Adolescents Health Survey, and 54,640 students' questionnaires were completed and qualified for the survey. Body mass index z scores were calculated and categorized into four levels: underweight (less than the 5th percentile for sex and age), normal weight (between the 5th and 85th percentile), overweight (between the 85th and 95th percentile), and obese (above the 95th percentile). RESULTS Of the total sample, 47.3% (25,852) were boys. The weighted prevalence of suicidal ideation among Chinese adolescents is 15.7% (14.6% in boys and 17.3% in girls). After adjusting for demographics, smoking, drinking, and depressive symptoms, our final multivariate logistic regression models demonstrated that only boys identified as underweight (Adjusted odds ratio [AOR] = 1.23, 95% CI = 1.06-1.44) or obese (AOR = 1.19, 95% CI = 1.02-1.38) were at a higher risk of suicidal ideation. Additionally, the association between weight status and suicidal ideation among boys might be moderated by academic pressure, smoking, and depressive symptoms. CONCLUSIONS There was a significant J-shaped association between relative body weight and suicidal ideation in boys. The child's sex should be taken into consideration when developing interventions against unhealthy weight and suicidal ideation.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yan Xu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Center for ADR Monitoring of Guangdong, Guangzhou, 510080, People's Republic of China
| | - Guoliang Huang
- Center for ADR Monitoring of Guangdong, Guangzhou, 510080, People's Republic of China
| | - Xue Gao
- Center for ADR Monitoring of Guangdong, Guangzhou, 510080, People's Republic of China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Min Luo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Chuhao Xi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Wei-Hong Zhang
- Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China. .,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
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21
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Stewart JG, Valeri L, Esposito EC, Auerbach RP. Peer Victimization and Suicidal Thoughts and Behaviors in Depressed Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 46:581-596. [PMID: 28444481 DOI: 10.1007/s10802-017-0304-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Suicide is a leading cause of death among youth worldwide, and depressed adolescents are at a significantly elevated risk to report suicidal ideation, planning, and attempts. Peer victimization is a robust predictor of adolescent suicidal thoughts and behaviors (STBs), but little research has focused on why bullying leads to suicidal thoughts and behaviors. To address this empirical gap, we recruited 340 (246 female) depressed adolescents ages 13-19 (M = 15.59, SD = 1.41) within 48 h of admission for acute psychiatric treatment. At the initial assessment, participants were administered clinical interviews characterizing psychopathology, nonsuicidal self-injury, and STBs (ideation, plans, and attempts). Further, they completed questionnaires assessing 3 forms of victimization (overt, relational, and reputational), recent risky behavior engagement, and psychiatric symptom severity. Controlling for internalizing symptoms and age, overt and reputational bullying were associated with more frequent past month suicide attempts, but not suicide ideation. Past month risky behavior engagement, but not NSSI, mediated the relation between victimization and attempts. However, sex differences revealed that this effect only held for males whereas bullying was directly associated with suicide attempts among females. In contrast, overt and relational bullying were non-linearly associated with suicide plans, and these relations were not mediated by risky behaviors or NSSI. Results highlight the complex network of factors that lead victimized adolescents to engage in STBs and may inform targeted suicide prevention and intervention programs.
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Affiliation(s)
- Jeremy G Stewart
- Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA.
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Mailstop 331, de Marneffe building, room 239, 115 Mill Street, Belmont, MA, 02478-9106, USA.
| | - Linda Valeri
- Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA
- Psychiatric Biostatistics Laboratory, McLean Hospital, Mailstop 331, 115 Mill Street, Belmont, MA, 02478-9106, USA
| | - Erika C Esposito
- Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Mailstop 331, de Marneffe building, room 239, 115 Mill Street, Belmont, MA, 02478-9106, USA
| | - Randy P Auerbach
- Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Mailstop 331, de Marneffe building, room 239, 115 Mill Street, Belmont, MA, 02478-9106, USA
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Primananda M, Keliat BA. Risk and Protective Factors of Suicidal Ideation in Adolescents. Compr Child Adolesc Nurs 2019; 42:179-188. [DOI: 10.1080/24694193.2019.1578439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Meulu Primananda
- Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia
| | - Budi Anna Keliat
- Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia
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Factors associated with suicidal ideation and suicidal attempts among adolescent students in Nepal: Findings from Global School-based Students Health Survey. PLoS One 2019; 14:e0210383. [PMID: 31002715 PMCID: PMC6474648 DOI: 10.1371/journal.pone.0210383] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/27/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Suicide has been recognized as a major public health problem with high burden in low and middle income countries. Suicide has long lasting psychological trauma on friends and relatives in addition to loss of economic productivity. Although the need of high quality evidence is essential for designing suicide prevention program, Nepal lacks reliable evidence from nationally representative data. This study aimed to estimate the prevalence of suicidal ideation and attempt among adolescent students and identify the factors associated with them. MATERIALS AND METHODS Total of 6,531 students of grade 7 to 11 from 74 schools representing all three ecological belts and five development regions participated in this cross sectional study. To select the representative sample from study population, two stage cluster sampling method was used. Standardized self-administered questionnaire were completed by participants. Multivariable logistic regression was done to identify the factors associated with suicidal ideation and attempt. RESULTS Nearly 13.59% of the participants had considered suicide while 10.33% had attempted it. Food insecurity (OR = 2.32, CI = 1.62-3.32), anxiety (OR = 2.54, CI = 1.49-4.30), loneliness (OR = 2.51, CI = 1.44-4.36) and gender (OR = 1.39, CI = 1.03-1.89) were identified as risk factors of suicidal ideation. Anxiety (OR = 3.02, CI = 1.18-7.74), loneliness (OR = 2.19, CI = 1.28-3.73) truancy (OR = 1.99, CI = 1.40-2.82), cigarette use (OR = 3.13, CI = 1.36-7.23) and gender (OR = 1.60, CI = 1.07-2.39) were identified as risk factors of suicidal attempt. Having 3 or more close friends was found to have protective effect (OR = 0.35, CI = 0.16-0.75) against suicidal attempt. CONCLUSION Study reveals relatively high prevalence of suicidal ideation and suicidal attempt among school-going adolescents in Nepal. Appropriate coping strategies for factors like anxiety, loneliness seem could be useful for preventing both suicidal ideation and attempt.
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Calati R, Ferrari C, Brittner M, Oasi O, Olié E, Carvalho AF, Courtet P. Suicidal thoughts and behaviors and social isolation: A narrative review of the literature. J Affect Disord 2019; 245:653-667. [PMID: 30445391 DOI: 10.1016/j.jad.2018.11.022] [Citation(s) in RCA: 288] [Impact Index Per Article: 57.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/27/2018] [Accepted: 11/03/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Social isolation is one of the main risk factors associated with suicidal outcomes. The aim of this narrative review was to provide an overview on the link between social isolation and suicidal thoughts and behaviors. METHODS We used the PubMed database to identify relevant articles published until April 13, 2018. We focused on: (a) systematic reviews, meta-analyses, and narrative reviews; (b) original observational studies with large samples (N ≥ 500); and (c) qualitative studies. We included all relevant suicidal outcomes: suicidal ideation (SI), suicidal planning, non-suicidal self-injury, deliberate self-harm, suicide attempt (SA), and suicide. RESULTS The main social constructs associated with suicidal outcomes were marital status (being single, separated, divorced, or widowed) and living alone, social isolation, loneliness, alienation, and belongingness. We included 40 original observational studies, the majority of them performed on adolescents and/or young adults (k = 23, 57.5%). Both the objective condition (e.g., living alone) and the subjective feeling of being alone (i.e., loneliness) were strongly associated with suicidal outcomes, in particular with SA and SI. However, loneliness, which was investigated in most studies (k = 24, 60%), had a major impact on both SI and SA. These associations were transculturally consistent. LIMITATIONS Confounding factors can limit the weight of the results obtained in observational studies. CONCLUSIONS Data from the observational studies suggest that both objective social isolation and the subjective feeling of loneliness should be incorporated in the risk assessment of suicide. Interventional studies targeting social isolation for suicide prevention are needed.
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Affiliation(s)
- Raffaella Calati
- INSERM, Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France; Department of Psychiatry, Mount Sinai Beth Israel, New York, USA.
| | - Chiara Ferrari
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Marie Brittner
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Osmano Oasi
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Emilie Olié
- INSERM, Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
| | - André F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Philippe Courtet
- INSERM, Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
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Lin M, Wolke D, Schneider S, Margraf J. Bullying History and Mental Health In University Students: The Mediator Roles of Social Support, Personal Resilience, and Self-Efficacy. Front Psychiatry 2019; 10:960. [PMID: 31993000 PMCID: PMC6971115 DOI: 10.3389/fpsyt.2019.00960] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 12/04/2019] [Indexed: 01/22/2023] Open
Abstract
Bullying victimization by peers is highly prevalent in childhood and adolescence. There is convincing evidence that victimization is associated with adverse mental health consequences. In contrast, it has been found that perpetrators suffer no adverse mental health consequences. These findings originate from Western countries such as Germany but have rarely been investigated in collectivistic societies such as China. Furthermore, it has been rarely studied whether positive intrapersonal characteristics (e.g., personal resilience and self-efficacy) and interpersonal positive resources (e.g., social support) may mediate the impact of bullying on mental health. The current study used a path analytic model to examine, firstly, whether previous bullying experiences (both victimization and perpetration) are associated with current positive and negative mental health in university students and, secondly, whether these influences are mediated by social support, resilience, and self-efficacy. The model was tested in 5,912 Chinese and 1,935 German university students. It was found that in both countries, higher victimization frequency was associated with lower levels of social support, personal resilience, and self-efficacy, which in turn predicted poorer mental health. Moreover, and only in China, perpetration was negatively associated with social support and personal resilience but not self-efficacy. In contrast, in the German sample, perpetration experience was found to enhance one's self-efficacy, and the later was associated with better mental health. The results support a mediation model in which social support, personal resilience, and self-efficacy partially mediate the influence of victimization on mental health in both countries. For the relationship between perpetration and mental health, self-efficacy was the only full mediator in Germany, whereas in China, both social support and personal resilience were partial mediators. In conclusion, peer victimization has adverse effects on mental health in both Germany and China. Only in China, however, is perpetration also associated with adverse mental health outcomes. In contrast, getting ahead by bullying in an individualistic society such as Germany is associated with increased self-efficacy and mental health. The differences found between an individualistic country and a collectivistic country have important implications for understanding and planning interventions to reduce bullying.
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Affiliation(s)
- Muyu Lin
- Department of Clinical Psychology and Psychotherapy, Mental Health Research & Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Dieter Wolke
- Department of Psychology and Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Silvia Schneider
- Department of Clinical Child and Adolescent Psychology of the Faculty of Psychology, Mental Health Research & Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Margraf
- Department of Clinical Psychology and Psychotherapy, Mental Health Research & Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
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Liu X, Huang Y, Liu Y. Prevalence, distribution, and associated factors of suicide attempts in young adolescents: School-based data from 40 low-income and middle-income countries. PLoS One 2018; 13:e0207823. [PMID: 30566431 PMCID: PMC6300318 DOI: 10.1371/journal.pone.0207823] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/05/2018] [Indexed: 02/05/2023] Open
Abstract
Suicide attempts are the most important known predictor of death by suicide. The aim of this study is to examine the prevalence, distribution, and associated factors of suicide attempts among young adolescents in 40 low-income and middle-income countries. We used data from the Global School-Based Student Health Survey (2009–2013) and a nationally representative study in China (2010), which are school-based surveys of students primarily aged 12–18 years that assess health behaviors using an anonymous, standardized, self-reported questionnaire. We calculated the prevalence of suicide attempts in young adolescents from 40 low-income and middle-income countries using the surveys. Multilevel logistic models were used to estimate the associations between suicide attempts and potential risk factors, adjusting for gender, age, school and survey year. Results show that the mean 12-month prevalence of suicide attempts was 17.2%, ranging from 6.7% in Malaysia to 61.2% in Samoa. The overall prevalence of suicide attempts was higher for girls than for boys (18.2% vs 16.2%, P<0.05). Among the suicide attempts, the proportion of suicide attempts with a plan was higher for girls than for boys (62.7% vs 53.2%, P<0.05). Both the prevalence of suicide attempts and the proportion of suicide attempts with a plan increased with age. Factors associated with suicide attempts included poor socioeconomic status, history of bullying, loneliness and anxiety, tobacco and alcohol use, and weak family and social relationships. In conclusion, suicide attempts are frequent among young adolescents in low-income and middle-income countries. Girls and older adolescents tend to make suicide attempts with a plan. The data demonstrate the need to strengthen suicide intervention and prevention programs for young adolescents in low-income and middle-income countries.
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Affiliation(s)
- Xiang Liu
- Department of Health and Social Behavior, School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yuanyuan Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
- * E-mail:
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Huang Y, Li P, Lai Z, Jia X, Xiao D, Wang T, Guo L, Lu C. Role of sleep quality in mediating the relationship between sexual minority status and suicidal behavior among Chinese adolescents. Psychol Res Behav Manag 2018; 11:607-615. [PMID: 30573996 PMCID: PMC6292244 DOI: 10.2147/prbm.s186586] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Studies suggest that sexual minority adolescents experience higher rates of sleep disturbance than their heterosexual peers, and disturbed sleep is a well-known risk factor for suicidality. This study aimed to explore whether sleep quality had mediating effects on the relationship between sexual minority status and suicidal behavior in Chinese adolescents. Methods We analyzed data collected from 7th to 12th graders from seven randomly selected provinces of People’s Republic of China in the 2015 School-Based Chinese Adolescents Health Survey. The 123,459 students who completed questionnaires regarding sexual attraction, the Pittsburgh Sleep Quality Index, past-year suicidal ideation, and past-year suicide attempts were included in our study (response rate: 95.9%). Results After adjustment for covariates, sexual minority status was associated with suicidal ideation (adjusted odds ratio =1.82, 95% CI=1.69–1.95) and suicide attempts (adjusted odds ratio =2.16, 95% CI=1.82–2.56). Sleep quality partially mediated the effects of sexual minority status on suicidal ideation (standardized β estimate=0.009, 95% CI=0.007–0.012) and suicide attempts (standardized β estimate=0.004, 95% CI=0.003–0.005). Conclusion Poor sleep quality partially explained the increased risk of suicidality for Chinese sexual minority adolescents. To prevent subsequent suicidality, suicide interventions targeting sexual minorities should be made, with a focus on their disparities in sleep disturbance and sleep health promotion.
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Affiliation(s)
- Yeen Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
| | - Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
| | - Zhisheng Lai
- Department of HIV/AIDS Prevention and Control, Yuexiu District Center for Disease Control and Prevention, Guangzhou, Guangdong, People's Republic of China
| | - Xiaofei Jia
- Department of HIV/AIDS Prevention and Control, Tianhe District Center for Disease Control and Prevention, Guangzhou, Guangdong, People's Republic of China
| | - Di Xiao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
| | - Tian Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
| | - Lan Guo
- Department of HIV/AIDS Prevention and Control, Yuexiu District Center for Disease Control and Prevention, Guangzhou, Guangdong, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China, .,Guangdong Provincial Key Laboratory of Food, Guangdong Engineering Technology Research Center of Nutrition Translation, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
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Gallagher ML, Miller AB. Suicidal Thoughts and Behavior in Children and Adolescents: An Ecological Model of Resilience. ADOLESCENT RESEARCH REVIEW 2018; 3:123-154. [PMID: 29904718 PMCID: PMC5995470 DOI: 10.1007/s40894-017-0066-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Cacioppo JT, Cacioppo S. Loneliness in the Modern Age: An Evolutionary Theory of Loneliness (ETL). ADVANCES IN EXPERIMENTAL SOCIAL PSYCHOLOGY 2018. [DOI: 10.1016/bs.aesp.2018.03.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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30
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Gender differences and stage-specific influence of parent-adolescent conflicts on adolescent suicidal ideation. Psychiatry Res 2017; 255:424-431. [PMID: 28668758 DOI: 10.1016/j.psychres.2017.06.077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 05/13/2017] [Accepted: 06/24/2017] [Indexed: 01/19/2023]
Abstract
This study examined familial and peer related factors as predictors of suicidal ideation in school students. Total 2896 participants were included from Taiwan Youth Project released data, a longitudinal survey of adolescent suicidal ideation at ages 15, 18, and 20. Logistic regression analysis risk factors associated with adolescent suicidal ideation reveled differences during the developmental stages. After adjusted for psychological symptoms, effect of quarrels with parents on suicidal ideation lasts in early and middle stages; in the late adolescent stage, only cigarette or alcohol use remained significant. Girls who reported quarrels with parents had the highest level of suicidal ideation before age 18. Stage- and gender-specific differences may provide appropriate intervention strategies for parents and teachers preventing adolescent suicidal ideation.
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Li D, Zhang R, Liu S, Liu J, Zhang T. The Characteristics of Chinese Adolescents With Suicidal Ideation: A Mixed-Methods Approach. JOURNAL OF ADOLESCENT RESEARCH 2017. [DOI: 10.1177/0743558417723603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We conducted a mixed-methods study to explore the characteristics of Chinese adolescents with suicidal ideation, using both quantitative and qualitative data and analysis. Participants were N = 244 adolescents, who completed self-report assessments of suicidal ideation, as well as indices of psychological functioning and well-being. A subset of n = 6 high and n = 6 low suicidal ideation adolescents participated in the follow-up interviews. Among the quantitative results, as compared with adolescents with low suicidal ideation, adolescents with high suicidal ideation reported significantly higher scores for stressful life events, coping-avoidant strategies, loneliness, and depression, as well as significantly lower scores for coping-approach strategies. Among the qualitative results, adolescents with high suicidal ideation demonstrated the following characteristics: (a) most troubled by academic pressures and relations, (b) negative self-evaluations, (c) maladaptive understanding of life and death, (d) individual-oriented attributions, and (e) negative coping strategies and self-fulfilling prophesy. These findings contribute to the early identification of adolescents who are at higher risk for suicide, further expand the stress and coping model with the distress-to-meaninglessness framework, and suggest that improving positive self-evaluation may be a focus of prevention and intervention.
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Affiliation(s)
- Dan Li
- Shanghai Normal University, Shanghai, China
| | - Rongwei Zhang
- Shanghai Normal University, Shanghai, China
- Fujian Polytechnic of Information Technology, Fuzhou, China
| | | | | | - Ting Zhang
- Zhejiang Industry & Trade Vocational College, Wenzhou, China
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Aherne C, Coughlan B, Surgenor P. Therapists’ perspectives on suicide: A conceptual model of connectedness. Psychother Res 2017; 28:803-819. [DOI: 10.1080/10503307.2017.1359428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Cian Aherne
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Barry Coughlan
- Department of Psychology, University of Limerick, Limerick, Ireland
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Sharma B, Lee TH, Nam EW. Loneliness, Insomnia and Suicidal Behavior among School-Going Adolescents in Western Pacific Island Countries: Role of Violence and Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070791. [PMID: 28714893 PMCID: PMC5551229 DOI: 10.3390/ijerph14070791] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 07/08/2017] [Accepted: 07/12/2017] [Indexed: 11/25/2022]
Abstract
This study aimed to examine whether being bullied, fighting, and injury, regarded in terms of frequency and nature, were significantly associated with psychological distress and suicidal behavior, independent of substance abuse and parental support in adolescents. Secondary analysis of data from the Global School-based Student Health Survey from Kiribati, the Solomon Islands, and Vanuatu was conducted. Binomial logistic regression analysis was used to examine the association of being bullied, fighting and injury with psychological health outcomes (loneliness, insomnia, suicidal ideation and suicide attempt) at a 5% level of significance. A total of 4122 students were included; 45.5% were male, and 52.0% were 14 years of age or younger. Of the total, 9.3% felt lonely and 9.5% had insomnia most of the time over the last 12 months; 27.6% had suicidal ideation, and 30.9% reported at least one suicide attempt in the last 12 months. Multivariable logistic regression analysis showed that being bullied, fighting and injury were significantly associated with psychological health outcomes; adjusted odds ratios (AORs) of loneliness, insomnia, suicidal ideation and suicide attempt increased with increased exposure to bullying, fighting, and injury compared to non-exposed group. Among the types of bullying victimization, the highest AORs of insomnia and suicide attempt were among students who were left out of activities, compared to the non-bullied. Among the causes of injury, adolescents injured due to a physical attack were the most likely to report the highest AORs of loneliness, insomnia and suicidal ideation compared to those not injured. Preventing violence and injury among adolescents might contribute to better mental health and reduction of suicidal behavior.
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Affiliation(s)
- Bimala Sharma
- Yonsei Global Health Center, Yonsei University, Wonju, Gangwon-do 26493, Korea.
- Department of Health Administration, Graduate School, Yonsei University, Wonju, Gangwon-do 26493, Korea.
| | - Tae Ho Lee
- Yonsei Global Health Center, Yonsei University, Wonju, Gangwon-do 26493, Korea.
- Department of Health Administration, Graduate School, Yonsei University, Wonju, Gangwon-do 26493, Korea.
| | - Eun Woo Nam
- Yonsei Global Health Center, Yonsei University, Wonju, Gangwon-do 26493, Korea.
- Department of Health Administration, Graduate School, Yonsei University, Wonju, Gangwon-do 26493, Korea.
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Davaasambuu S, Batbaatar S, Witte S, Hamid P, Oquendo MA, Kleinman M, Olivares M, Gould M. Suicidal Plans and Attempts Among Adolescents in Mongolia. CRISIS 2017; 38:330-343. [PMID: 28228061 DOI: 10.1027/0227-5910/a000447] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although 75% of suicides occur in low- and middle-income countries, few studies have examined suicidal behaviors among young people in these countries. AIMS This study aimed to examine what individual characteristics were associated with suicidal plans and attempts among Mongolian youth and whether suicidal risks and behaviors varied by urban and rural locations. METHOD Logistic regression analyses were utilized to investigate suicidal plans and attempts among 5,393 adolescents using the Global Student Health Survey - 2013. RESULTS Adolescents who lived in urban areas were at higher risk for suicidal plans and behaviors than those who lived in rural areas; however, the patterns of suicidal risks were similar. Specifically, individual characteristics, such as being female, feeling lonely and worried, smoking cigarettes, drinking alcohol, and having fights at school, were associated with suicidal plans and behaviors regardless of the residential places. LIMITATIONS A number of important variables have not been included in the questionnaire such as depression, family and parental support, household income, family constructs etc. CONCLUSION Given the comparable patterns of risk between urban and rural adolescents and the relatively high rates of suicidal plans and attempts, similar mental health services and interventions are necessitated for both urban and rural areas.
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Affiliation(s)
- Sarantsetseg Davaasambuu
- 1 Global Mental Health Fellowship Program, Department of Psychiatry Epidemiology, Columbia University, New York, NY, USA
| | - Suvd Batbaatar
- 2 Public Health Institute, Ministry of Health, Ulaanbaatar, Mongolia
| | - Susan Witte
- 3 School of Social Work, Columbia University, New York, NY, USA
| | - Phillip Hamid
- 1 Global Mental Health Fellowship Program, Department of Psychiatry Epidemiology, Columbia University, New York, NY, USA
| | - Maria A Oquendo
- 1 Global Mental Health Fellowship Program, Department of Psychiatry Epidemiology, Columbia University, New York, NY, USA.,4 Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA.,5 Departments of Psychiatry, Columbia University, New York, NY, USA
| | - Marjorie Kleinman
- 6 Epidemiology of Psychiatry, Columbia University, New York, NY, USA
| | - Michael Olivares
- 6 Epidemiology of Psychiatry, Columbia University, New York, NY, USA
| | - Madelyn Gould
- 6 Epidemiology of Psychiatry, Columbia University, New York, NY, USA
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Effort-reward Imbalance at Work, Parental Support, and Suicidal Ideation in Adolescents: A Cross-sectional Study from Chinese Dual-earner Families. Saf Health Work 2016; 8:77-83. [PMID: 28344844 PMCID: PMC5355538 DOI: 10.1016/j.shaw.2016.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 07/27/2016] [Accepted: 09/08/2016] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In contemporary China, most parents are dual-earner couples and there is only one child in the family. We aimed to examine the associations of parents' work stress with suicidal ideation among the corresponding adolescent. We further hypothesized that low parental support experienced by adolescents may mediate the associations. METHODS Cross-sectional data from school students and their working parents were used, with 907 families from Kunming City, China. Stress at work was measured by the effort-reward imbalance questionnaire. Perceived parental support was assessed by an item on parental empathy and their willingness to communicate with the adolescent. Suicidal ideation was considered positive if students reported thoughts about suicide every month or more frequently during the previous 6 months. Logistic regression was used to examine the associations. RESULTS We observed that parents' work stress was positively associated with low parental support, which was in turn associated with adolescent suicidal ideation. The odds ratio for parents' work stress and adolescent suicidal ideation was 2.91 (95% confidence interval: 1.53-5.53), and this association was markedly attenuated to 2.24 (95% confidence interval: 1.15-4.36) after additional adjustment for parental support. Notably, mothers' work stress levels exerted stronger effects on children's suicidal ideation than those of fathers. CONCLUSION Parents' work stress (particularly mother's work stress) was strongly associated with adolescent's suicidal ideation, and the association was partially mediated by low parental support. These results need to be replicated and extended in prospective investigations within and beyond China, in order to explore potential causal pathways as a basis of preventive action.
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Ni H, Li C, Wang C. Students’ perceptions of resilience promoting factors in Chinese and American middle schools. SCHOOL PSYCHOLOGY INTERNATIONAL 2016. [DOI: 10.1177/0143034316664391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The current study first examined the applicability of the ClassMaps Survey (CMS)—a measurement of resilience in classroom/school settings developed in the US with Chinese middle school students and then compared the group differences on student perceptions of the resilience factors in the CMS across the two cultures. The findings suggest that the CMS and all its seven subscales have good to acceptable scalar measurement equivalence. The current study supports the use of the CMS and its seven subscales with Chinese middle school students as a measurement of resilience in classroom context. Furthermore, the study found that Chinese students scored significantly higher on academic self-determination, behavior self-control, teacher-student relationship, home-school relationship, and peer conflict but significantly lower on academic self-efficacy than American students. There was no significant difference in peer friendships between the two groups. Implications for resilience promotion in school settings were discussed in cultural context.
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Affiliation(s)
- Hong Ni
- California State University-Fresno, USA
| | | | - Cixin Wang
- University of Maryland, College Park, USA
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Hong L, Guo L, Wu H, Li P, Xu Y, Gao X, Deng J, Huang G, Huang J, Lu C. Bullying, Depression, and Suicidal Ideation Among Adolescents in the Fujian Province of China: A Cross-sectional Study. Medicine (Baltimore) 2016; 95:e2530. [PMID: 26844460 PMCID: PMC4748877 DOI: 10.1097/md.0000000000002530] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The relationship of bullying with suicidal ideation among adolescents is controversial. Although depression has been related to bullying and suicidal ideation, little is known about the combined impacts of depression and bullying on suicidal ideation.A sample of 20,509 high school students from Fujian Province were selected randomly by multistage stratified sampling. All participants completed an adolescent health status questionnaire. Three categories of bullying were assessed: perpetration, victimization, and both (victimization and perpetration). The associations of these 3 categories of bullying with depression and their interaction with suicidal ideation were examined in logistic models.After adjustment for potential confounders, all 3 categories of bullying (perpetration, victimization, and both) were related to increased risk of suicidal ideation with odds ratios (ORs) of 1.66 (95% confidence interval [CI] 1.20-2.30), 2.74 (95% CI 2.29-3.29), and 2.83 (95% CI 2.27-3.52), respectively. There was an interaction between depression and bullying (P = 0.001). Subgroup analyses showed a stronger association between perpetration and suicidal ideation in students with depression (odds ratio [OR] 2.97; 95% CI 1.44-6.09) than in those without depression (OR 1.65; 95% CI 1.19-2.28). The association between victimization and suicidal ideation was weaker in students with depression (OR 1.49; 95% CI 1.07-2.07) than in those without (OR 2.69; 95% CI 2.24-3.23). The association of both victimization and perpetration with suicidal ideation was weaker in students with depression (OR 2.22, 95% CI 1.43-3.47) than those without (OR 2.78; 95% CI 2.23-3.47).We observed an independent association of bullying with increased risk of suicidal ideation among adolescent students, and this association was affected by depression. Prospective studies should be conducted to confirm these findings.
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Affiliation(s)
- Lingyao Hong
- From the Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University (LH, LG, HW, PL, CL); Center for ADR monitoring of Guangdong (YX, XG, JD, GH, JH); and Epidemiology Research Unit, Clinical trials Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (LH)
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Joiner TE, Hom MA, Hagan CR, Silva C. Suicide as a derangement of the self-sacrificial aspect of eusociality. Psychol Rev 2015; 123:235-54. [PMID: 26524155 DOI: 10.1037/rev0000020] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Building upon the idea that humans may be a eusocial species (i.e., rely on multigenerational and cooperative care of young, utilize division of labor for successful survival), we conjecture that suicide among humans represents a derangement of the self-sacrificial aspect of eusociality. In this article, we outline the characteristics of eusociality, particularly the self-sacrificial behavior seen among other eusocial species (e.g., insects, shrimp, mole rats). We then discuss parallels between eusocial self-sacrificial behavior in nonhumans and suicide in humans, particularly with regard to overarousal states, withdrawal phenomena, and perceptions of burdensomeness. In so doing, we make the argument that death by suicide among humans is an exemplar of psychopathology and is due to a derangement of the self-sacrificial behavioral suite found among eusocial species. Implications and future directions for research are also presented.
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De-la-Iglesia M, Olivar JS. Risk Factors for Depression in Children and Adolescents with High Functioning Autism Spectrum Disorders. ScientificWorldJournal 2015; 2015:127853. [PMID: 26413564 PMCID: PMC4562099 DOI: 10.1155/2015/127853] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 04/14/2015] [Accepted: 05/24/2015] [Indexed: 12/28/2022] Open
Abstract
The objective of our study was to examine, discuss, and provide proposals on diagnostic comorbidity of depression in children and adolescents with high functioning autism spectrum disorder (HFASD) in the following aspects. (1) Prevalence. It was concluded that there are an elevated depression rate and the need for longitudinal studies to determine prevalence and incidence based on functioning level, autistic symptoms, gender, age, type of depression, prognosis, duration, and treatment. (2) Explicative Hypotheses and Vulnerability. The factors that present the greatest specific risk are higher cognitive functioning, self-awareness of deficit, capacity for introspection, stressful life events, adolescence, quality of social relationships, and alexithymia. (3) Risk of Suicide. The need for control and detection of suicidal tendencies and bullying is emphasised. (4) Depressive Symptoms. Indicators for early detection are proposed and their overlap with HFASD is analysed, examining the assessment techniques used and arguing that specific adapted tests are needed.
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Affiliation(s)
- Myriam De-la-Iglesia
- Departamento de Psicología, Facultad de Educación, Universidad de Valladolid, Campus María Zambrano, Plaza Alto de los Leones 1, 40005 Segovia, Spain
- Laboratoire LPPS, EA 4057, 92100 Paris, France
| | - José-Sixto Olivar
- Laboratoire LPPS, EA 4057, 92100 Paris, France
- Departamento de Psicología, Facultad de Educación y Trabajo Social, Universidad de Valladolid, Campus Miguel Delibes, Paseo de Belén 1, 47011 Valladolid, Spain
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Hu J, Dong Y, Chen X, Liu Y, Ma D, Liu X, Zheng R, Mao X, Chen T, He W. Prevalence of suicide attempts among Chinese adolescents: A meta-analysis of cross-sectional studies. Compr Psychiatry 2015; 61:78-89. [PMID: 26005111 DOI: 10.1016/j.comppsych.2015.05.001] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 04/10/2015] [Accepted: 05/04/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE According to World Health Organization, for every committed suicide there were 20 suicide attempts at least. In the last decade, despite the increasing awareness on suicide attempts among adolescents in China, there has been no comprehensive system reporting vital statistics. Consequently, the prevalence of suicide attempts reported in some studies ranged variedly. Therefore, the purpose of this study was to provide the first meta-analysis of cross-sectional studies of suicide attempts to fill this gap. METHODS Two reviewers independently screened potentially relevant cross-sectional studies of suicide attempts through PubMed-Medline, Embase, Wanfang Data, Chongqing VIP and Chinese National Knowledge Infrastructure databases using the core terms 'suicid*'/'suicide attempt*'/'attempted suicide' and 'adolescen*'/'youth'/'child*'/'student*' and 'China'/'Chinese' in the article titles, abstracts and keywords. Chi-square based Q test and I(2) statistic assessed the heterogeneity. Forest plot was used to display results graphically. Potential publication bias was assessed by the funnel plot, Begg's and Egger's test. RESULTS In total, 43 studies with 200,124 participants met the eligibility criteria. The pooled prevalence of suicide attempts among Chinese adolescents was 2.94% (95% CI: 2.53%-3.41%). Substantial heterogeneity in prevalence estimates was revealed. Subgroup analyses showed that the prevalence for males was 2.50% (95% CI: 2.08%-3.01%), and for females was 3.17% (95% CI: 2.56%-3.91%). CONCLUSIONS In sum, abstracting across the literatures, the prevalence of suicide attempts among Chinese adolescents was moderate compared with other countries around the world. Necessary measures should be set out prevent them in the future.
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Affiliation(s)
- Jiande Hu
- Nanhui Mental Health Center, Pudong New Area, Shanghai, 201300, China
| | - Yonghai Dong
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China.
| | - Xiaodan Chen
- Jiangxi Provincial Cancer Hospital, 519 Beijing East Road, Nanchang 330029, Jiangxi, China
| | - Yun Liu
- Cadre Wards of Neurology Medicine, Jiangxi Provincial People's Hospital, Nanchang, 330006, China
| | - Dongyang Ma
- Nanhui Mental Health Center, Pudong New Area, Shanghai, 201300, China
| | - Xiaoyun Liu
- Cadre Wards of Neurology Medicine, Jiangxi Provincial People's Hospital, Nanchang, 330006, China
| | - Ruizhi Zheng
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Xiangqun Mao
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China
| | - Ting Chen
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China
| | - Wei He
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China
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Jia CX, Li SB, Han M, Bo QG. Health-Related Factors and Suicidal Ideation in High School Students in Rural China. OMEGA-JOURNAL OF DEATH AND DYING 2015. [DOI: 10.1177/0030222815576126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study aimed to understand the reporting rate of suicidal ideation and its health-related factors in 1,378 high school students in rural China. These students were recruited from two high schools in Lijin County, Shandong Province, China by using a stratified random cluster sampling method. Overall, 13.5% of the sample reported having suicidal ideation in the past year, and there was no significant difference between boys and girls in reporting rate of suicidal ideation. Nightmares, physical activity, and sleep duration as well as family environment, paternal education, and mental heath status were significantly associated with suicidal ideation. More efforts for these factors should be considered in suicide prevention for high school students in rural China.
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Affiliation(s)
- Cun-Xian Jia
- Shandong University School of Public Health, China
- Shandong University Center for Suicide Prevention Research, China
| | - Shi-Bao Li
- Shandong University School of Public Health, China
| | - Mei Han
- Qingdao Municipal Women and Children’s Hospital, Shandong, China
| | - Qi-Gui Bo
- Centers of Disease Control and Prevention of Lijin County, Shandong, China
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Holt MK, Vivolo-Kantor AM, Polanin JR, Holland KM, DeGue S, Matjasko JL, Wolfe M, Reid G. Bullying and suicidal ideation and behaviors: a meta-analysis. Pediatrics 2015; 135:e496-509. [PMID: 25560447 PMCID: PMC4702491 DOI: 10.1542/peds.2014-1864] [Citation(s) in RCA: 281] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Over the last decade there has been increased attention to the association between bullying involvement (as a victim, perpetrator, or bully-victim) and suicidal ideation/behaviors. We conducted a meta-analysis to estimate the association between bullying involvement and suicidal ideation and behaviors. METHODS We searched multiple online databases and reviewed reference sections of articles derived from searches to identify cross-sectional studies published through July 2013. Using search terms associated with bullying, suicide, and youth, 47 studies (38.3% from the United States, 61.7% in non-US samples) met inclusion criteria. Seven observers independently coded studies and met in pairs to reach consensus. RESULTS Six different meta-analyses were conducted by using 3 predictors (bullying victimization, bullying perpetration, and bully/victim status) and 2 outcomes (suicidal ideation and suicidal behaviors). A total of 280 effect sizes were extracted and multilevel, random effects meta-analyses were performed. Results indicated that each of the predictors were associated with risk for suicidal ideation and behavior (range, 2.12 [95% confidence interval (CI), 1.67-2.69] to 4.02 [95% CI, 2.39-6.76]). Significant heterogeneity remained across each analysis. The bullying perpetration and suicidal behavior effect sizes were moderated by the study's country of origin; the bully/victim status and suicidal ideation results were moderated by bullying assessment method. CONCLUSIONS Findings demonstrated that involvement in bullying in any capacity is associated with suicidal ideation and behavior. Future research should address mental health implications of bullying involvement to prevent suicidal ideation/behavior.
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Affiliation(s)
- Melissa K. Holt
- School of Education, Boston University, Boston, Massachusetts
| | - Alana M. Vivolo-Kantor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joshua R. Polanin
- Peabody Research Institute, Vanderbilt University, Nashville, Tennessee
| | - Kristin M. Holland
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah DeGue
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L. Matjasko
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Misty Wolfe
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gerald Reid
- School of Education, Boston University, Boston, Massachusetts
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Park S, Kim JW, Kim BN, Bae JH, Shin MS, Yoo HJ, Cho SC. Clinical characteristics and precipitating factors of adolescent suicide attempters admitted for psychiatric inpatient care in South Korea. Psychiatry Investig 2015; 12:29-36. [PMID: 25670943 PMCID: PMC4310918 DOI: 10.4306/pi.2015.12.1.29] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 12/14/2013] [Accepted: 12/23/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We aimed to examine the rates, correlates, methods, and precipitating factors of suicide attempts among adolescent patients admitted for psychiatric inpatient care from 1999 to 2010 in a university hospital in Korea. METHODS The subjects consisted of 728 patients who were admitted for psychiatric inpatient care in a university hospital over a 12-year period and who were aged 10-19 years at the time of admission. We retrospectively investigated the information on suicidal behaviors and other clinical information by reviewing the subjects' electronic medical records. Whether these patients had completed their suicide on 31 December 2010 was determined by a link to the database of the National Statistical Office. RESULTS Among 728 subjects, 21.7% had suicidal ideation at admission, and 10.7% admitted for suicidal attempts. Female gender, divorced/widowed parents, and the presence of mood disorders were associated with a significantly increased likelihood of suicide attempts. Most common method of suicide attempts was cutting, and most common reason for suicide attempts was relationship problems within the primary support group. A diagnosis of schizophrenia was associated with increased risk of death by suicide after discharge. CONCLUSION These results highlight the role of specific psychosocial factor (e.g., relational problems) and psychiatric disorders (e.g., mood disorders) in the suicide attempts of Korean adolescents, and the need for effective prevention strategies for adolescents at risk for suicide.
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Affiliation(s)
- Subin Park
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong-Hoon Bae
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Republic of Korea
| | - Min-Sup Shin
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee-Jeong Yoo
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Soo-Churl Cho
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
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Yen CF, Liu TL, Yang P, Hu HF. Risk and Protective Factors of Suicidal Ideation and Attempt among Adolescents with Different Types of School Bullying Involvement. Arch Suicide Res 2015; 19:435-52. [PMID: 26566860 DOI: 10.1080/13811118.2015.1004490] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Suicide has been found to be prevalent among adolescents involved in bullying; however, there has been a lack of research examining whether the risk and protective factors of suicidal ideation and attempt are different among adolescents with different types of bullying involvement. The aims of this study were to examine the risk and protective factors of suicidal ideation and attempt among adolescents with different experiences of bullying involvement, victimization, and perpetration. A total of 4,533 adolescents participated in this study. Different groups of bullying involvement, victimization, and perpetration were determined through use of the Chinese version of the School Bullying Experience Questionnaire. The associations of suicidal ideation and attempt with possible risk factors (domestic violence, overweight, depression, anxiety, and alcohol abuse) and protective factors (family support and self-esteem) were examined using logistic regression analysis. Pure victims, pure perpetrators, and victim-perpetrators were more likely to report suicidal ideation and attempt than the neutral group. The risk and protective factors of suicidal ideation and attempt were different across adolescents with different experiences of bullying involvement, victimization, and perpetrators. The risk of suicide should be monitored among adolescents who are involved in any type of bullying. The risk and protective factors of suicide identified in this study should be taken into consideration in prevention and intervention programs for suicide in adolescents involved in bullying.
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46
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Potard C, Kubiszewski V, Fontaine R, Pochon R, Rusch E, Courtois R. Peer violence, mental health and suicidal ideation in a sample of French adolescent. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2014. [DOI: 10.1080/14623730.2014.963403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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47
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Shireen F, Janapana H, Rehmatullah S, Temuri H, Azim F. Trauma experience of youngsters and Teens: A key issue in suicidal behavior among victims of bullying? Pak J Med Sci 2014; 30:206-10. [PMID: 24639862 PMCID: PMC3955573 DOI: 10.12669/pjms.301.4072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 11/05/2013] [Accepted: 11/16/2013] [Indexed: 02/02/2023] Open
Abstract
UNLABELLED This study examines the association between suicide and bullying among teenagers and adolescents in school besides exploring strategies to prevent acts of bullying. "Bullying" is a risk factor that is linked to suicidal ideation and attempts among school-age children and teenagers. Since youth suicide is an urgent and serious problem, we conducted a systematic review of 28 previous studies conducted in children and adolescents which examined the connection between bullying experiences and suicide. DATA COLLECTION A literature search was carried out using 4 databases, without date description including: PubMed, PsychInfo, Medline and Google Scholar. The search terms contained: bullying, suicide and bullying, suicide in teens, school bullying, and peer victimization. An initial search generated about 97 articles; however, only 28 articles were appropriate for inclusion in the current review. Inclusion criteria was (1) Cross-sectional studies published from 1997-2013. (2) Study based on school bullying and suicidal risk in adolescents and teens 18 years or less (3) Studies had enough information to calculate effect sizes that did include a control group. (4) Studies based on gender discrimination. Papers that focused on specific populations, that did not include quantitative data, that did not use a control group of non-bullied subjects and studies based on cyber bullying, studies with longitudinal design were excluded. The risk of suicide attempts was higher in girls, who were involved in bullying, either as the victim or perpetrator, than in boys. Depression, feelings of hopelessness and loneliness can develop in the child after being bullied for long periods of time; these feelings are indirectly related to suicidal ideation and attempts. Involvement in bullying increases the likelihood of suicidal ideation and attempts in children and teenagers.
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Affiliation(s)
- Farhat Shireen
- FarhatShireen, M.D.M.P.H, MentalHealthResearcher, BrookdaleHospitalandMedicalCenter Brooklyn,NewYork,USA
| | - Himani Janapana
- Himani Janapana, MD, Director of Clinical Education, Brookdale Hospital and Medical Center Brooklyn, NewYork, USA
| | - Sanila Rehmatullah
- Sanila Rehmatullah, MD, Residency Program Director, Department of Psychiatry. Brookdale Hospital and Medical Center Brooklyn, NewYork, USA
| | | | - Fatima Azim
- FatimaAzim,MD, Consultant Psychiatrist, VA Veterans North Texas Health Care System, Dallas Texas,USA
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Choi JH, Yu M, Kim KE. Suicidal ideation in adolescents: A structural equation modeling approach. Nurs Health Sci 2014; 17:119-125. [PMID: 24943997 DOI: 10.1111/nhs.12142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 02/15/2014] [Accepted: 03/06/2014] [Indexed: 11/29/2022]
Abstract
The purpose of this study is to test a model linking adolescents' experience of violence and peer support to their happiness and suicidal ideation. The participants were high school students in Seoul, and in Kyungi, and Chungnam Provinces in Korea. The Conflict Tactics Scale, School Violence Scale, Oxford Happiness Inventory, and Suicidal Ideation Questionnaire were administered to just over 1000 adolescents. The model was tested using a path analysis technique within structural equation modeling. The model fit indices suggest that the revised model is a better fit for the data than the original hypothesized model. The experience of violence had a significant negative direct effect and peer support had a significant positive direct effect on their happiness. Happiness had a significant negative effect and the experience of violence had a significant positive effect on suicidal ideation. These findings demonstrate the fundamental importance of reducing exposure of violence to adolescents, and that increasing peer support and their happiness may be the key to adolescent suicidal ideation prevention.
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Affiliation(s)
- Jung-Hyun Choi
- Department of Nursing, Namseoul University, Cheonan, Republic of Korea
| | - Mi Yu
- Department of Nursing, Namseoul University, Cheonan, Republic of Korea
| | - Kyoung-Eun Kim
- Department of Child Welfare, Namseoul University, Cheonan, Republic of Korea
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Jang JM, Park JI, Oh KY, Lee KH, Kim MS, Yoon MS, Ko SH, Cho HC, Chung YC. Predictors of suicidal ideation in a community sample: roles of anger, self-esteem, and depression. Psychiatry Res 2014; 216:74-81. [PMID: 24507544 DOI: 10.1016/j.psychres.2013.12.054] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 09/18/2013] [Accepted: 12/29/2013] [Indexed: 10/25/2022]
Abstract
The objective of this cross-sectional study was to investigate the relationships of anger, self-esteem, and depression with suicidal ideation. A survey was conducted in a wide range of community areas across Jeollabuk-do Province, Korea. A total of 2964 subjects (mean age=44.4yr) participated in this study. Hierarchical regression was used to investigate predictors of suicidal ideation in terms of their sociodemographic characteristics, depression, self-esteem, and anger. Hierarchical regression analyses revealed that anger and self-esteem were significantly associated with suicidal ideation regardless of age and after controlling for depression. Moderation analysis showed that the impact of anger on suicidal ideation was significantly greater among females than males in adolescents, but not in other age groups. Additionally, there were some differences in sociodemographic predictors of suicidal ideation among age groups. Predictors included gender and family harmony in adolescents, marital status and family harmony in middle-aged individuals, and economic status and family harmony in elderly individuals. Our results revealed that anger and self-esteem play important roles in suicidal ideation beyond the effect of depression. Development and implementation of preventive strategies, including management of anger and self-esteem, could possibly reduce suicidal ideation and subsequent suicide attempts.
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Affiliation(s)
- Jin-Mahn Jang
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea
| | - Jong-Il Park
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea
| | - Keun-Young Oh
- Maeumsarang Hospital, In-san Medical Foundation, Wanju
| | - Keon-Hak Lee
- Maeumsarang Hospital, In-san Medical Foundation, Wanju
| | - Myung Sig Kim
- Department of Psychology, Jeonju University, Jeonju, Korea
| | - Myeong-Sook Yoon
- Department of Social Welfare, Chonbuk National University, Jeonju, Korea
| | - Sung-Hee Ko
- Department of Nursing, Chonbuk National University Medical School, Jeonju, Korea
| | - Hye-Chung Cho
- Department of Elderly Welfare, Shingyeong University, Hwaseong, Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
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50
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Shang L, Li J, Li Y, Wang T, Siegrist J. Stressful psychosocial school environment and suicidal ideation in Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 2014; 49:205-10. [PMID: 23811953 DOI: 10.1007/s00127-013-0728-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Suicide is one of the leading causes of death during adolescence worldwide. This study, using a sample of Chinese adolescents, examines associations of a stressful psychosocial school environment with suicidal ideation, which were rarely investigated so far. METHODS A total of 1,004 Chinese students (468 boys and 536 girls) from Grade 7-12 were recruited into our questionnaire survey. Psychosocial school environment was measured by the effort-reward imbalance questionnaire adapted to the school setting, and suicidal ideation was assessed by a standardized question. Multivariate logistic regression was applied, adjusting odds ratios for age, gender, grade, smoking, alcohol drinking, physical activity, family wealth, and self-rated health. RESULTS In school settings, 10.86% students reported suicidal ideation during the last 6 months, which was found to be significantly related to both effort and reward. Remarkably, effort-reward imbalance was associated with elevated risk of suicidal ideation (odds ratio = 1.77, 95% confidence interval = 1.34-2.35). CONCLUSIONS This study finds significant associations between a stressful psychosocial school environment in terms of effort-reward imbalance and suicidal ideation in Chinese adolescents. Preventive actions aiming at reducing this imbalance may define a promising approach towards a healthy psychosocial school environment.
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Affiliation(s)
- Li Shang
- School of Public Health, Kunming Medical University, Kunming, China
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