Suicide is a complex behavior that is
usually caused by a combination of risk factors in the absence of protective
factors.
Researchers have identified a number of risk factors associated
with a higher risk for suicide and protective factors that may reduce
the likelihood of suicidal behavior. It is important to note, however,
that the importance of risk and protective factors can vary by age,
gender, and ethnicity.
Risk Factors
Risk factors for suicide completion include:
Previous suicide attempts - If a youth has attempted suicide
in the past, he or she is much more likely than other youths to attempt
suicide again in the future. If a male teen has attempted suicide in the
past, he is more than thirty times more likely to complete suicide,
while a female with a past attempt has about three times the risk.
Approximately a third of teenage suicide victims have made a previous
suicide attempt.
Mental disorders or co-occurring mental and alcohol or substance
abuse disorders - Research shows that over 90% of young people who
complete suicide have a diagnosable mental or substance abuse disorder
or both, and that the majority have depressive illness In a 10- to
15-year follow up study of 73 adolescents diagnosed with major
depression, 7 percent of the adolescents had completed suicide sometime
later. The depressed adolescents were five times more likely to have
attempted suicide as well, compared with a control group of age peers
without depression.20
Almost half of teenagers who complete suicide have had a previous
contact with a mental health professional. In addition, aggressive,
disruptive, and impulsive behavior is common in youth of both sexes who
complete suicide.21
Family history of suicide22
- A high proportion of suicides and attempters have had a close
family member (sibling, parent, aunt, uncle, or grandparent) who
attempted or completed suicide. Familial suicide can be a function of
imitation or genetics. Many of the mental illnesses which contribute to
suicide risk appear to have a genetic component.
Stressful life event or loss - Stressful life events often
precede a suicide and/or suicide attempt. Such stressful life events
include getting into trouble at school or with a law enforcement agency;
fighting or breaking up with a boyfriend or a girlfriend; and fighting
with friends. They are rarely a sufficient cause of suicide, but they
often act as precipitating factors in young people.23,
24
Easy access to lethal methods, especially guns - As mentioned
above, firearms are the most common method of suicide by youth. The most
common location for the occurrence of firearm suicides by youth is in
their homes, and there is a positive association between the
accessibility and availability of firearms in the home and the risk for
youth suicide. The risk conferred by guns in the home is proportional to
the accessibility (e.g., loaded and unsecured firearms) and the number
of guns in the home.25,
26
Exposure to the suicidal behavior of others, whether that of a
peer or in the media
27 - Suicide can be facilitated in vulnerable teens by exposure to
real or fictional accounts of suicide, including media coverage of
suicide, such as intensive reporting of the suicide of a celebrity, or
the fictional representation of a suicide in a popular movie or TV show.
In addition, there is evidence of suicide clusters, that is, local
epidemics of suicide that have a contagious influence. Suicide clusters
nearly always involve previously disturbed young people who knew about
each other's death but rarely knew the other victims personally.
Incarceration28
- Although there are insufficient national data regarding the incidence
of youth suicide in custody, information suggests a high prevalence of
suicidal behavior in juvenile correctional facilities. One study found
that suicide in juvenile detention and correctional facilities was more
than four times greater than youth suicide overall. According to another
recent study, more than 11,000 juveniles engage in more than 17,000
incidents of suicidal behavior in juvenile facilities each year.
Other identified risk factors include a family history of mental or
substance abuse disorders, a history of physical and/or sexual abuse,
low levels of communication with parents, the possession of certain
cultural and religious beliefs about suicide (for instance, the belief
that suicide is a noble resolution of a personal dilemma), and lack of
access or an unwillingness to seek mental health treat ment.29
The impact of some risk factors can be reduced by interventions (such
as providing effective treatments for depressive illness). Those risk
factors that cannot be changed (such as a previous suicide attempt) can
alert others to the heightened risk of suicide during periods of the
recurrence of a mental or substance abuse disorder, or following a
significant stressful life event.30
Protective factors
Protective factors can include an individual's genetic or
neurobiological makeup, attitudinal and behavioral characteristics, and
environmental attributes. Some identified protective factors are:
learned skills in problem solving, impulse control, conflict resolution,
and nonviolent handling of disputes; family and community support;
access to effective and appropriate mental health care and support for
help-seeking; restricted access to highly lethal methods of suicide; and
cultural and religious beliefs that discourage suicide and support
self-preservation instincts. Measures that enhance resilience or
protective factors are as essential as risk reduction in preventing
suicide. Positive resistance to suicide is not permanent, so programs
that support and maintain protection against suicide should be ongoing.
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References
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