Suicidal Behavior as Communication in a Cultural Context

Hjelmeland, Heidi; Knizek, Birthe Loa; Kinyanda, Eugene; Musisi, Seggane; Nordvik, Hilmar; Svarva, Kyrre

doi:10.1027/0227-5910.29.3.137

Cited by 21 publications

(12 citation statements)

References 25 publications

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“…In these societies, collective norms, community characteristics and other-centred social roles and interactions, rather than individual specific characteristics and experiences, constitute the frame of reference in the construction and presentation of the self and meaningmaking in daily life [50,53]. Based on this communal world view, the accounts of some of the adolescents in this study portray self-harm in adolescents as relational acts that can be interpreted as a protest against harsh punishment, abuse and powerlessness, assertion of innocence, cry for help, and an appeal [54][55][56].…”

Section: Discussionmentioning

confidence: 99%

Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts

Quarshie¹,

Waterman²,

House³

2020

BMC Psychiatry

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Background: Recent prevalence studies suggest that self-harm among adolescents in sub-Saharan Africa is as common as it is in high income countries. However, very few qualitative studies exploring first-person accounts of adolescent self-harm are available from sub-Saharan Africa. We sought to explore the experiences and first-person perspectives of Ghanaian adolescents reporting self-harm-for deeper reflections on the interpretive repertoires available in their cultural context for making sense of self-harm in adolescents. Methods: Guided by a semi-structured interview protocol, we interviewed one-to-one 36 adolescents (24 in-school adolescents and 12 street-connected adolescents) on their experiences of self-harm. We applied experiential thematic analysis to the data. Results: Adolescents' description of the background to their self-harm identified powerlessness in the family context and unwanted adultification in the family as key factors leading up to self-harm among both in-school and streetconnected adolescents. Adolescents' explanatory accounts identified the contradictory role of adultification as a protective factor against self-harm among street-connected adolescents. Self-harm among in-school adolescents was identified as a means of "enactment of tabooed emotions and contestations", as a "selfish act and social injury", as "religious transgression", while it was also seen as improving social relations. Conclusions: The first-person accounts of adolescents in this study implicate familial relational problems and interpersonal difficulties as proximally leading to self-harm in adolescents. Self-harm in adolescents is interpreted as an understandable response, and as a strong communicative signal in response to powerlessness and family relationship difficulties. These findings need to be taken into consideration in the planning of services in Ghana and are likely to be generalisable to many other countries in sub-Saharan Africa.

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Section: Discussionmentioning

confidence: 99%

Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts

Quarshie¹,

Waterman²,

House³

2020

BMC Psychiatry

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“…Interpretation can be done from many different theoretical perspectives. We are, for instance, working from a perspective where suicidal behavior is interpreted as communicative acts within the framework of communication theory (Hjelmeland et al, 2008; Hjelmeland, Knizek, & Nordvik, 2002; Knizek & Hjelmeland, 2007).…”

Section: Moving the Suicidological Field Forwardmentioning

confidence: 99%

Why We Need Qualitative Research in Suicidology

Hjelmeland¹,

Knizek²

2010

Suicide and Life-Threatening Behavior

Self Cite

299

196

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Using the differentiation between explanations and understanding from philosophy of science as the point of departure, a critical look at the current mainstream suicidological research was launched. An almost exclusive use of quantitative methodology focusing on explanations is demonstrated. This bias in scope and methodology has to a large extent taken the suicidological field into a dead-end of repetitious research. It is argued that an increased focus on understanding and thus extended use of qualitative methodology is essential in bringing the suicidological field forward.

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“…Studies conducted in Nigeria [8], South Africa [9], Zambia [10], and Uganda [5,11] indicate that suicidal behavior is relatively common, but also varies across countries [12]. For example, among school students, self-reported suicidal ideation ranges between 19.6% in Uganda, 23.1% in Botswana, 27.9% in Kenya, and 31.9% in Zambia [12].…”

Section: Introductionmentioning

confidence: 99%

Correlates of Suicide Ideation and Attempt among Youth Living in the Slums of Kampala

Swahn

Palmier

Kasirye³

et al. 2012

IJERPH

100

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While suicidal behavior is recognized as a growing public health problem world-wide, little is known about the prevalence and risk factors for suicidal behaviors among street and slum youth in Africa, and in Uganda, specifically. The number of youth who live on the streets and in the slums of Kampala appears to be growing rapidly, but their mental health needs have not been documented, which has hampered resource allocation and service implementation. This study of youth, ages 14–24, was conducted in May and June of 2011, to assess the prevalence and correlates of suicidal behavior. Participants (N = 457) were recruited for a 30-minute interviewer-administered survey through eight drop-in centers operated by the Uganda Youth Development Link for youth in need of services. Bivariate and multivariate logistic regression analyses were computed to determine associations between psychosocial correlates and suicide ideation and suicide attempt. Reporting both parents deceased Adj.OR = 2.36; 95% CI: 1.23–4.52), parental neglect due to alcohol use (Adj.OR = 2.09; 95% CI: 1.16–3.77), trading sex for food, shelter or money (Adj.OR = 1.95; 95% CI: 1.09–3.51), sadnesss (Adj.OR = 2.42; 95% CI: 1.20–4.89), loneliness (Adj.OR = 2.67; 95% CI: 1.12–6.40) and expectations of dying prior to age 30 (Adj.OR = 2.54; 95% CI: 1.53–4.23) were significantly associated with suicide ideation in multivariate analyses. Parental neglect due to alcohol use (Adj.OR = 2.04; 95% CI: 1.11–3.76), sadness (Adj.OR = 2.42; 95% CI: 1.30–7.87), and expectations of dying prior to age 30 (Adj.OR = 2.18; 95% CI: 1.25–3.79) were significantly associated with suicide attempt in multivariate analyses. Given the dire circumstances of this vulnerable population, increased services and primary prevention efforts to address the risk factors for suicidal behavior are urgently needed.

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Suicidal Behavior as Communication in a Cultural Context

Cited by 21 publications

References 25 publications

Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts

Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts

Why We Need Qualitative Research in Suicidology

Correlates of Suicide Ideation and Attempt among Youth Living in the Slums of Kampala

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