Sex differences in peer responsiveness to suicide ideation

The potential role of attitudes towards suicide between mental health status and suicidal ideation among Chinese children and adolescents

BACKGROUND

The objective of this study was to investigate the contributions of mental health status and attitudes towards suicide on suicidal ideation in a sample of 6568 Chinese children and adolescents in China. Attitudes towards suicide were investigated as a possible moderator and mediator of the influence of mental health status on suicidal ideation.

METHODS

Descriptive statistical analyses, Pearson correlation analyses and hierarchical regression analyses were adopted as methods of data analyses.

RESULTS

Approximately 35.38% of children and adolescents in our study reported having suicidal ideation. Mental health status and attitudes towards suicide both had an independent effect on the severity of suicidal ideation. Results indicated that mental health status was positively associated with suicidal ideation, while attitudes towards suicide were negatively associated with suicidal ideation. Moderation analysis showed that the impact of mental health status on suicidal ideation was significantly greater among children and adolescents who reported favourable attitudes towards suicide. Attitudes towards suicide partially mediated the link between mental health status and the severity of suicidal ideation. Specifically, students who experienced poorer mental health status might be more likely to report significantly more favourable attitudes towards suicide, which in turn promote greater suicidal ideation.

CONCLUSIONS

These results have implications for the prevention of youth suicide, suggesting that mental health status and attitudes towards suicide could be important targets for prevention and intervention for children and adolescents at risk of suicidal ideation.

Attitudes Toward Suicide: Past, Present and Future

This article maintains that it is important to understand how any given society views the act of suicide. It traces the forces that have shaped attitudes toward suicide in the Western world, documenting the change from viewing suicide as a sin to viewing it as a mental health problem. It also discusses recent methods of assessing attitudes toward suicide, including both normed and non-normed approaches. Finally, it calls for new types of research in the area of attitudes toward suicide that will permit finer-grained analyses of this most complex human behavior.

Suicidal Behavior among African American College Students: A Preliminary Study

This preliminary study examined suicidality in 233 African American college students who attended a historically Black college. Suicidality involves both suicidal ideation and suicidal behaviors. Suicidal ideation includes the thoughts andfeelings that are often associated with suicidal behavior (e.g., developing a suicide plan, preoccupation with thoughts of death, etc.). Suicidal behavior involves the deliberate attempt to take one's life. The results indicate that the suicidality among African American college students is similar to the suicidality manifested in White American college students with the exception of two critical areas: African American college students report less suicidal ideation than the literature reports on White American college students, andfewerAfrican American than White college students use alcohol or illicit drugs while making a suicide attempt. This study also found preliminary evidence that suggests that the measures typically used to measure suicide and its correlates in White American samples (e.g., Beck Depression Inventory and the Scale for Suicidal Ideation) appear to reliably measure these phenomena in an African American sample as well. Issues pertaining to the role of the supportive Black institution in ameliorating the stress associated with suicidal behavior and methodological concerns regarding the measurement of depression, suicidal ideation, and suicidal attempts in African American college students are discussed.

Views on suicide among middle-aged and elderly populations in Japan: their association with demographic variables and feeling shame in seeking help

AIMS

The purpose of this study was to investigate the relationship between inappropriate views on suicide, such as it being a personal choice, inevitable, unpreventable, and permissible, with demographic variables and the feeling of shame in seeking help among the general population.

METHODS

A self-administered questionnaire on mental health and suicide was distributed to all residents aged 40-74 in four areas in Oita Prefecture, Japan, and 4487 responded. The association of seven inappropriate views on suicide with demographic variables was examined by multiple logistic analyses. The association between feeling shame in seeking help with demographic variables and the above views on suicide was similarly analyzed.

RESULTS

Inappropriate views on suicide were associated with gender (i.e. men). Some of these views also correlated with age, never having been married, and living in rural areas or areas with high suicide mortality rates. Multivariate analysis revealed that feeling shame in seeking help when distressed was associated with being aged 70-74, living in rural areas or areas with high suicide mortality rates, the view on suicide as a matter of self-choice, and a pessimistic view toward life.

CONCLUSION

These findings suggest that inappropriate views on suicide adversely affect coping strategies and mental health. Suicide prevention programs aimed at improving mental health literacy in a community should take into consideration the characteristics of elderly male residents.

THERAPEUTIC AND NONTHERAPEUTIC REACTIONS IN A GROUP OF NURSES AND DOCTORS IN TURKEY TO PATIENTS WHO HAVE ATTEMPTED SUICIDE

In this study a questionnaire was used to investigate the predictors of therapeutic versus nontherapeutic reactions to patients hospitalized for attempting suicide in a group of doctors (n = 158) and in a group of nurses (n = 206) working in the health care system of a small city in the Western part of Turkey. Doctors said that they would react therapeutically towards patients hospitalized for attempting suicide to a greater extent than did nurses, while nurses said that they would engage in nontherapeutic reactions to a greater extent than doctors did. Believing that suicidal problems should be communicated, feeling sympathy for a suicidal patient and not feeling anxiety/fear for a suicidal patient were found to be the independent predictors of therapeutic reactions, while feeling anger about a suicidal patient emerged as an independent predictor of nontherapeutic reactions in both doctors and nurses. The attitudes of nurses towards suicide were more traditional than the attitudes of doctors. Nurses believed to a greater extent than doctors that suicidal people would be punished after death and that suicide in one's family was to be hidden. Doctors, on the other hand, believed to a greater extent than nurses that suicide attempts resulted from illness/biological reasons. Men were found to be more prejudiced about suicide and suicidal individuals than were women.

Development of visuospatial short-term memory in the second half of the 1st year

Eighty 5.5- to 12.5-month-old infants participated in 4 delayed-response procedures challenging shortterm visuospatial memory (STVM), 2 that varied the time between presentation and search and 2 that varied the number of locations. Within each type of challenge, 1 task required a gaze response and 1 required a reach response. There was little improvement in STVM performance from 5.5 to 8 months and linear improvement in the percentage correct from 8 to 12 months, with overall STVM performance accounting for 66% of the variance in age. Improvement in searching multiple locations lagged behind improvement in spanning longer delays. Memory scores did not vary for the visual and manual tasks. Perseveration was greatest for reach responses, increased with challenge, and decreased with age. ((c) 2004 APA, all rights reserved)

Young adults' support strategies when peers disclose suicidal intent

In response to the growing suicide rate among adolescents and young adults, researchers have noted the importance of peer responses to suicidal disclosures in this population. The most adaptive response is to inform a responsible adult about the suicidal peer, but existing data indicate that most adolescents and young adults choose to talk to the peer on their own. The present study examined whether young adults' own history of suicidal ideation, gender, social history with suicide, and ambiguity of the disclosure would predict their response to a hypothetical suicidal peer. The data revealed significant effects of ambiguity and participants' suicidal ideation on the confidants' response strategy. The confidants' experience with others' attempted or completed suicides increased their likelihood of saving they would tell an authority, whereas their own history of ideation or attempts reduced the likelihood of that response. These effects were most pronounced when the hypothetical peer's suicidal intent was not completely clear, which may often be the case in disclosures by suicidal adolescents. Youth and young adults should be encouraged to inform adults about suicidal peers, particularly those who have been suicidal themselves previously, and who may resist that strategy. It is postulated that these particular peers may be more easily convinced to respond in this manner if they could be involved in the intervention with their suicidal peer.

Young adults' reactions to gay and lesbian peers who became suicidal following "coming out" to their parents

Rates of nonfatal suicidal behavior among gay and lesbian youth surpass those recorded among their heterosexual peers. A frequently cited precipitant of gay and lesbian nonfatal suicidal behavior is the turmoil associated with coming out to one's family. This study investigated young adults' attitudes toward peers who engaged in suicidal behavior after coming out and being rejected by their parents, and compared them with attitudes toward persons who had become suicidal in response to other stressors (a physical illness, a relationship loss, or an academic failure). Our goal was to explore whether young persons hold beliefs that may encourage lesbian and gay suicidal behavior. We found that gays and lesbians who engaged in suicidal behavior following coming out were not viewed in particularly forgiving or empathic ways, as was the case for persons who became suicidal following an incurable illness. All suicidal persons were perceived as relatively feminine. At the same time, suicidal males were rated as more masculine if they engaged in suicidal behavior because of an academic failure or a physical illness, while suicidal females were viewed as more masculine only if their suicidal behavior followed an academic failure. Finally, we found that both respondent sex and respondent gender-identity influenced evaluations of suicidal persons. Building on these findings, future research should explore attitudes toward the permissibility of a suicidal decision by lesbian and gay persons.

Comparative study of suicide potential among Pakistani and American psychiatric patients

This study compared suicide potential and suicide attempts in 50 Pakistani and 50 American psychiatric patients all of whom reported a positive history of suicide attempts during the past 1-5 years. It further explored the role of nationality, gender, diagnosis, and marital status in respondents' potential for suicide and suicide attempts. The American sample reported a higher degree of suicide potential on the Firestone Assessment of Self-Destructive Thoughts (FAST), more suicide attempts, and a larger number of suicide precipitants (family conflicts, work pressure, wish for death, loneliness, financial problems, and mental disorders/drug withdrawal) than did the Pakistani sample. For suicide attempts, effects of 3-way interaction for gender, marital status and nationality were found significant. However, these effects were non-significant for respondent's potential for suicide. In addition, the FAST was found to have a significantly high correlation with suicide attempts. Thus, it may be inferred that the FAST can be used as a valuable screening instrument for the identification of patients at risk for suicide in diverse cultural settings. However, more prospective validity studies are needed to enhance our cross-cultural understanding of suicide; identification of psychiatric patients at risk for suicide by the FAST; and for effective treatment and prevention programs for Eastern and Western societies.

Risk of Suicide Ideation Associated with Problem-Solving Ability and Attitudes Toward Suicidal Behavior in University Students

Summary: The present paper investigates the risk of lifetime suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in a sample of 328 university students (41% male, 59% female). The response rate was 77% based on the total number of students registered for the relevant courses. A series of questions assessed lifetime suicide ideation, while problem solving and attitudes toward suicide were measured using the Self-Rating Problem Solving scale and four subscales of the Suicide Opinion Questionnaire, respectively ( McLeavey, 1986 ; Domino et al., 1989 ). Almost one-third of the students surveyed had lifetime suicide ideation. Both genders were similar in terms of their suicide ideation history, problem solving, and attitudes toward suicidal behavior with the exception that male students were more in agreement with the attitude that nonfatal suicidal behavior lacks real intent. Compared with 2% of nonideators and ideators, one in four planners reported that they would more than likely attempt suicide at some point in their life. Greater agreement with the attitude that suicidal behavior is normal was associated with significantly increased risk of being an ideator, as was poor problem solving and less agreement with the attitude that suicidal behavior is associated with mental illness.

Infants use handrails as tools in a locomotor task

In 2 experiments the authors demonstrated that adaptive locomotion can involve means-ends problem solving. Sixteen-month-old toddlers crossed bridges of varying widths in the presence or absence of a handrail. Babies attempted wider bridges more often than narrow ones, and attempts on narrow bridges depended on handrail presence. Toddlers had longer latencies, examined the bridge and handrail more closely, and modified their gait when bridges were narrow and/or the handrail was unavailable. Infants who explored the bridge and handrail before stepping onto the bridge and devised alternative bridge-crossing strategies were more likely to cross successfully. Results challenge traditional conceptualizations of tools: Babies used the handrail as a means for augmenting balance and for carrying out an otherwise impossible goal-directed task.

College students' perceptions of suicide: the role of empathy on attitudes, evaluation, and responsiveness

A total of 334 college-age students (18719 years) participated in a study investigating the role of empathy in perceptions of and responsiveness toward a hypothetical friend exhibiting symptoms associated with suicide risk. High-empathy participants viewed both affective and behavioral characteristics associated with suicide risk as more serious, and they were more likely to provide direct assistance and talk with the troubled peer. Gender of participant and type of symptom displayed also emerged as important factors in participants' evaluations. These findings underscore the importance of considering social-cognitive factors that may influence perceptions of at-risk behaviors. The implications of these findings for the development of primary prevention intervention efforts are discussed.

The role of gender and suicide precipitant in attitudes toward nonfatal suicide behavior

This study examined factors affecting young adults' attitudes about nonfatal suicidal behavior. It evaluated how respondent sex, respondent gender identity, the precipitant of the suicidal act (i.e., a relationship loss, an achievement failure, or a physical illness), and gender of the suicidal person influence reactions to a suicidal decision. In this study of nonfatal suicidal behavior, like in studies of suicide, attitudes were least negative when the suicidal act was in response to a physical illness. Men were more likely to agree with and accept the suicidal decision than women. Androgynous persons, on the other hand, tended to view the decision to kill oneself as foolish, independent of precipitant. They also reported less agreement, acceptance, and sympathy for such decision. The implications of these findings for the prevention of suicidal behaviors are considered. Because gender seems to play a role in the acceptability of suicidal behavior, prevention programs ought to explicitly examine gender issues in attitudes toward suicidal behavior.

Content analysis of previously suicidal college students' experiences

To ascertain actual helpful and unhelpful remarks received from others, 40 previously suicidal students answered open-ended questions about their experiences and completed the Suicidal Behaviors Questionnaire (SBQ). Respondents were still moderately suicidal on the SBQ, even though their most recent suicidal episode was an average of 3 years earlier. Respondents reported that family, friends, and personal resources were most helpful in keeping them alive. Those who told someone about their suicidal ideas or plans reported helpful remarks ("The situation is not worth dying for") that appeared to be empathic and thoughtful. Those who told no one about their suicidal ideas or plans, speculated helpful remarks that also appeared to be empathic and thoughtful. In contrast, unhelpful remarks (e.g., "You are stupid") appeared to be simplistic and thoughtless. Implications are that those who are suicidal should be careful in choosing person(s) in whom they confide, and training modules that give examples of actual helpful remarks might be useful for students.

Arguments for and against teaching suicide prevention in schools

OBJECTIVE

To present arguments for and against the provision of curriculumbased suicide prevention programs in schools.

METHOD

The authors developed their arguments independently, based on the available literature on school-based programs, prior to debating the topic at a national conference on suicide prevention.

RESULTS

The rationale for school-based programs is that the school has the responsibility: to resolve problems that interfere with education; to teach health education; and to acknowledge a duty of care to parents and to the community as well as to youth. Primary prevention programs in schools are not aimed at so-called 'at-risk' students, but potential 'helpers', based on the knowledge that peers are a primary support for troubled adolescents. One measure of the efficacy of school-based prevention programs must be the extent to which there is an increase in the tendency for adolescents to turn to adults for help. There is ample evidence that increasing the tendency for adolescents to approach adults for help is achievable. The argument against such programs is that evidence from evaluation research suggests that they are ineffective, inefficient, not universally acceptable, and of questionable safety.

CONCLUSIONS

Those persuaded by the positive argument will wish to see these programs adopted in all Australian secondary schools. Those persuaded by the negative argument will recommend that suicide prevention resources be allocated to activities other than school-based suicide education programs.

Adolescents' attitudes toward suicide, and a suicidal peer: a comparison between Swedish and Turkish high school students

The present paper first presents the attitudes toward suicide and a suicidal classmate among 98 female and 69 male (N = 167) Swedish high school students. Secondly, the Swedish sample was compared with 167 (89 female and 78 male) Turkish high school students from a previous study. Among Swedish students, more males than females said that people have the right to commit suicide and suicide can be a solution to some problems. More females than males expressed a belief in life after death. Swedish adolescents were found to be holding more liberal attitudes toward suicide than Turkish adolescents. However, Turkish adolescents showed greater acceptance for a suicidal peer than Swedish adolescents. The results are discussed in terms of socio-cultural factors and related literature. The need for educational programs to provide basic knowledge about suicide and, effective ways of dealing with and helping suicidal peers is implicated.

Gender Differences in Attributions about Suicide and Alcohol Use

This research examined attributions that female and male college students made about an individual who committed suicide. The gender of the victim and whether alcohol use was involved were systematically varied. Results indicated that female and male respondents see the issues involved in suicide differently. Female respondents appear to place more emphasis on contextual clues such as alcohol use and gender of the actor. In addition, both female and male respondents tended to associate alcohol use and suicide for male actors but not for female actors. These results are discussed in terms of stereotypes that may be held for females and males vis-a-vis emotional expression and alcohol use. The use of population base rates in attributions about suicide and alcohol use is also considered. Directions for future research are also presented.

HOW YOUNG MEN AND WOMEN ASSESS PARENTS OF A CHILD SUICIDE VICTIM

Research in the area of attitudes toward child suicide may aid professionals in helping grieving friends and families and help pinpoint areas where more education maybe needed. This study examined the differences between young men and women in their blaming of parents for a child's suicide. A total of 124 people read one of three scenarios and answered the Youth Suicide Scale (YSS). Results revealed men to be more blaming of parents of a child suicide than were women. There was no main effect for the age of the victim in the scenarios when using the total YSS score, but when using only question four, replicating past use of the YSS, subjects blamed the parents of the 10 year old more than the other two age groups.

Child sexual abuse and gender differences: attitudes and prevalence

A great deal of attention has been focused on child sexual abuse in recent years. The present study reports attitudes and beliefs of 824 male and female college students concerning sexual abuse, and the participants' own experience with such abuse. Results indicate that women have much stronger pro-social beliefs, attitudes, and emotional reactions to sexual abuse and to abusers and victims than men do. In addition, 6% of men and 13% of women participants reported that they had been sexually abused as children or adolescents, while equal proportions of males and females reported that they were sexually approached by a potential perpetrator. These results are discussed in terms of socialization experiences of males and females in our society, and the literature regarding helping behaviors and compassion for others perceived as helpless and in need of aid. In particular, females may be abused more often than males, even though both sexes are approached in equal frequency, because females have been socialized to be more compliant and responsive to the needs of others, while males are perpetrators more often than females because males have been socialized to be more aggressive, powerful, and dominant.

Opinions about and reactions to suicide, and the social acceptance of a suicidal classmate among Turkish high school students

The present study investigated the opinions about suicide and reactions to a suicidal peer among 89 female and 78 male Turkish high school students. Females more than males believed that suicide should be discussed among friends. More males than females perceived suicidal persons to be mentally ill and to be punished in the other world. Females showed greater acceptance for a suicidal classmate than males. An attitude for openly discussing suicide was associated with higher acceptance of a suicidal classmate. Perceiving suicidal individuals to be mentally ill was associated with lower acceptance of a suicidal peer.