Gender differences in suicide-related communication of young suicide victims

Balt, Elias; Mérelle, Saskia; Bergen, Diana van; Gilissen, Renske; Post, Pommeline van der; Looijmans, Milou; Creemers, Daan H. M.; Rasing, Sanne P. A.; Mulder, Wico; Domburgh, Lieke van; Popma, Arne

doi:10.1371/journal.pone.0252028

Cited by 12 publications

(16 citation statements)

References 41 publications

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“…A higher acceptance rate was found on Instagram among adolescents for distress expression, owing to its advanced privacy settings [ 58 ]. The gender differences identified were in line with what was found in the majority of previous studies [ 59 , 60 ]. Interestingly, students from Band 1 schools used Close Friends more often, which contradicted the findings of most prior studies, where social media usage had little or a negative association with academic performance [ 61 , 62 ].…”

Section: Discussionsupporting

confidence: 91%

The Use of Close Friends on Instagram, Help-Seeking Willingness, and Suicidality Among Hong Kong Youth: Exploratory Sequential Mixed Methods Study

Chen¹,

Lam²,

Lam³

et al. 2022

J Med Internet Res

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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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Section: Discussionsupporting

confidence: 91%

The Use of Close Friends on Instagram, Help-Seeking Willingness, and Suicidality Among Hong Kong Youth: Exploratory Sequential Mixed Methods Study

Chen¹,

Lam²,

Lam³

et al. 2022

J Med Internet Res

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“…A systematic review and meta-analysis of randomized controlled trials (RCTs) found self-guided digital interventions are effective for directly targeting individuals’ suicidal ideation (immediately after post-intervention) ( Torok et al, 2020 ). An emerging indication of a late debut and ambiguous presentation of suicide-related communication in boys led to the suggestion for future research to explore online suicide-related communication and the potential for suicide prevention on digital platforms ( Balt et al, 2021 ). To our knowledge, there is no literature specifically focusing on gender differences in the efficacy of digital assistance in suicide prevention.…”

Section: Introductionmentioning

confidence: 99%

The Potential Impact of Adjunct Digital Tools and Technology to Help Distressed and Suicidal Men: An Integrative Review

Balcombe

Leo

2022

Front. Psychol.

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Suicidal men feel the need to be self-reliant and that they cannot find another way out of relationship or socioeconomic issues. Suicide prevention is of crucial importance worldwide. The much higher rate of suicide in men engenders action. The prelude is a subjective experience that can be very isolating and severely distressing. Men may not realize a change in their thinking and behaviors, which makes it more difficult to seek and get help, thereby interrupting a “downward spiral”. Stoicism often prevents men from admitting to their personal struggle. The lack of “quality” connections and “non-tailored” therapies has led to a high number of men “walking out” on traditional clinical approaches. But there are complicated relationships in motivations and formative behaviors of suicide with regards to emotional state, psychiatric disorders, interpersonal life events and suicidal behavior method selection. Middle-aged and older men have alternated as the most at-risk of suicide. There is no one solution that applies to all men, but digital tools may be of assistance (e.g., video conferences, social networks, telephone calls, and emails). Digital interventions require higher levels of effectiveness for distress and suicidality but self-guided approaches may be the most suitable for men especially where linked with an integrated online suicide prevention platform (e.g., quick response with online chats, phone calls, and emails). Furthermore, technology-enabled models of care offer promise to advance appropriate linking to mental health services through better and faster understanding of the specific needs of individuals (e.g., socio-cultural) and the type and level of suicidality experienced. Long-term evidence for suicidality and its evaluation may benefit from progressing human computer-interaction and providing impetus for an eminent integrated digital platform.

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“…Those young men communicate at a later stage and less clearly than young women who died by suicide. Compared to girls, SRC by boys was more ambiguous or diluted by "humorous" connotations [32].…”

Section: Introductionmentioning

confidence: 88%

“…It was difficult for recipients to assess the intent, meaning and relevance of the statements [30,31]. Balt et al [32] address gender differences in SRC. Again, these data relate to a psychological autopsy study and interviews with relatives of young men and women who have died by suicide.…”

Section: Introductionmentioning

confidence: 99%

Gender-Specific Aspects of Suicide-Related Communication in a High Risk Sample of Psychiatric Inpatients

Spahn¹,

Kranz²,

Teismann³

et al. 2022

JOMH

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Background: In addition to help-seeking behavior in a professional context, suicide-related communication (SRC) with that discloses suicidal thoughts and plans to relatives and significant others play a major role in suicide prevention. While studies revealed gender differences in help-seeking behavior in case of suicidal thoughts and intent in a professional context, the empirical evidence on SRC and gender is limited. The present study aims to examine gender-specific aspects of prevalence, recipients, pathways, and content of SRC in a high-risk sample of psychiatric inpatients. Results may provide information for the development of gender-specific suicide prevention measures. Methods: This study considered data on SRC among individuals who had been admitted to a psychiatric ward due to suicide attempt or to an increased suicide risk and have previously attempted suicide. In this high-risk sample of 219 psychiatric inpatients (56.2% female: n = 123), SRC was assessed using the Suicide Attempt Self Injury Interview (SASII) and was analyzed with a mixed-method design. Results: There are no significant differences (Chi 2 (4, n = 219) = 3.189, p = 0.074) in the frequencies of SCR between men and women. 34.4% (n = 33) of men and 46.3% (n = 57) of women reported SRC. Differences were found regarding the recipients. No differences in oral/written and explicit/implicit communication are evident. The most frequently addressed themes in SRC in men are exhaustion, resignation, and listlessness. For women, the suicide method is the most common topic, followed by the topics mentioned among men. Conclusions: A high proportion of participants reported having engaged in SRC. In contrast, the themes addressed are very ambiguous and not clearly suicide-related, especially among men. This can lead to difficulties in the interpretation of the statements by the recipients. Women seem to communicate more often with recipients who may provide assistance. These aspects ought to be considered for developing gender specific suicide prevention measures.

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Gender differences in suicide-related communication of young suicide victims

Cited by 12 publications

References 41 publications

The Use of Close Friends on Instagram, Help-Seeking Willingness, and Suicidality Among Hong Kong Youth: Exploratory Sequential Mixed Methods Study

The Use of Close Friends on Instagram, Help-Seeking Willingness, and Suicidality Among Hong Kong Youth: Exploratory Sequential Mixed Methods Study

The Potential Impact of Adjunct Digital Tools and Technology to Help Distressed and Suicidal Men: An Integrative Review

Gender-Specific Aspects of Suicide-Related Communication in a High Risk Sample of Psychiatric Inpatients

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