Suicidal ideation in adolescence: Depression, substance use, and other risk factors

Abstract

The interrelationships of depression and suicide with adolescent drug use, delinquency, eating disorders, and the risk factors for these different problems were investigated among 597 9th and 11th graders in an urban high school. There is a strong association of drug use with suicidal ideation among girls, and a stronger relationship with attempts among girls and boys. Suicidal youths are ill-adjusted and display a lack of attachment and commitment to family and school. Causal models indicate that poor interpersonal interactions with parents, absence of peer interactions, and life events lead to depression, which in turn leads to suicidal ideation. Depressive symptoms are the strongest predictors of suicidal ideation. Among females, depression predicts drug involvement, and in turn, drug use increases suicidal ideation. Drug use is only one class of problem behaviors that constitutes a risk factor for suicidal behavior in adolescence. Delinquency and eating disorders also have direct effects on suicidal ideation beyond those of depressive affect. As for drug involvement, these problem behaviors are more predictive of suicidal behavior among girls than boys. Similarity and specificity of the predictors for problem behaviors within and between the sexes are discussed. Although young women use drugs to handle feelings of depression, drug use appears ineffective in the long run in relieving these depressive feelings. Understanding the dynamics of suicidal ideation in adolescence has important public health implications, since ideation is a strong predictor of attempts, especially among females.

Suicidality, depression, and alcohol use among adolescents: A review of empirical findings

“…Maladaptive coping mechanisms include drug use (e.g. alcohol) as a means of temporarily dealing with social and emotional problems (22) that typically characterize adolescence. Such coping strategies may be ineffective and provide only an immediate respite from stressful situations, and may even exacerbate the problems that the adolescent is currently experiencing.…”

Suicidal Ideation among Canadian Youth: A Multivariate Analysis

“…For example, in one study of youth in Hong Kong, Wong and colleagues (2005) found that suicidal ideation increases for adolescents exposed to suicide attempts, but not necessarily completions. Prior research has also documented the influence deviant friends often have on the negative behaviour of children and youth (Liu, 2004;Kandel, Raveis, & Davies, 1991;Simons & Murphy, 1985). Finally, studies on youth suicide have identified substance use as a significant correlate of suicidal ideation (Kandel, Raveis & Davies, 1991;Metha et al, 1998;Prinstein et al, 2000;Reynolds and Mazza, 1994).…”

“…Put another way, suicidal youths are more likely to exhibit weak attachments (DiFilippo & Overholser, 2000;Kandel, Raveis, & Davies, 1991;Perkins & Hartless, 2002). In particular, lack of parental attachment has been empirically shown to impact suicidal ideation (Adams et al, 1994) and completion (Brent et al, 1994).…”

“…In terms of socio-demographic predictors, girls consistently rate higher than boys in suicidal ideation (Kandel, Raveis, & Davies, 1991;Reinherz et al, 1995), but not completion (Bingham, 1994;Canadian Institute on Child Health, 2000). There is also evidence that suicidal ideation among young people increases with age (Beautrais, 2002).…”

Suicide among Italian adolescents: 1970–2002

“…Several large general population studies report suicide attempt rates ranging from 7 to 16% among adolescents [1,15,18,24,28,31]. These studies show clear gender differences, with approximately 4-10% of boys versus 10-20% of girls reporting a history of suicide attempt.…”