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TEENAGE SUICIDE.
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Incidence, age groups, suicide gestures, causes, theories.... More...
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Paper Abstract:
Incidence, age groups, suicide gestures, causes, theories.
Paper Introduction:
Teenage suicide Is one of the major problems mental health professionals must address. Over the last generation the incidence of adolescent suicide has increased at a rapid rate. Among teenagers and young adults, those 15 to 24, suicide is one of the three leading causes of death. In addition, the self-destructive behaviors of young people, including so-called "suicide gestures," constitute a substantial health issue closely related to adolescent suicide. For that reason, counselors and other professionals continue to seek theoretical explanations of teenage suicide that will assist in identifying and treating those most at risk. Unfortunately, beyond pointing to the turbulence of our society and to the decline of the family, research has been slow in establishing the causes of adolescent suicide. Most experts agree that the rising rate of suicide
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No one knows why some individuals react to life reverses bykilling themselves while others do not (Holden, 1988, p. Because the teen years are a time of growth, many, if not mostadolescents experience the considerable pain that oftenaccompanies change. Consequently,experts differ in whether they consider suicide the second or third leadingcause of death among young people. The highassociation between substance abuse and suicide probably has multiplecauses. The first,mentioned briefly above, is that many obvious suicide attempts probably gounreported. A large percentage of youngsters who attempt suicide becomeincreasingly isolated from social contact during the period preceding thesuicide attempt; they withdraw progressively from the friends, relativesand professionals who might be able to help them. In consequence, it isdifficult for researchers to go beyond generalizations about the adolescentpopulation to specific inferences that could fuel theory-based predictionsof individualsuicidal behavior (Holden, 1988, pp. It is widely recognized, in addition, that many automobile and otheraccidents are probably disguised suicide attempts. Corr & J. Teenage suicide continues to grow as a problem in American society.As many as a million young people attempt to kill themselves each year. Psychodynamic theory focuses onthe effects of early rejection, which can manifest during adolescence asresentment, guilt and ultimately, self-destructive behavior. According to the latest available statistics, the incidence ofsuicide among American young people is increasing markedly. 841; Neiger & Hopkins, 1988, pp.469-47 ). Adolescence, 23(Summer), 469-476. Actually, the identification of suicide attempts iscomplicated, and some sources indicate that the number of young suicideattempters may be as high as 1 million each year (Neiger & Hopkins, 1988,p. In the 197 's as well, the incidence of suicide amongyoung males went from 13.5 to 2 .2 per 1 , ("Youth," 1987, p. Unfortunately, beyond pointing to the turbulence of our society andto the decline of the family, research has been slow in establishing thecauses of adolescent suicide. Neiger, B.L., & Hopkins, R.W. In spiteof the seriousness of the problem, theoretical understanding of the factorsthat lead to suicide is still limited. A number of different theoretical perspectives have been brought tobear on the question of adolescent suicide. 839-84 ; Simons & Murphy, 1985, pp. The experts agreeunanimously that we know very little about the actual causes of adolescentsuicide. Counselors and other professionals can,however, prepare themselves for those moments of crisis by learning torecognize when suicide emerges as a possibility. By their nature, moreover, studies of suicideare retrospective; they describe behavior that has already occurred.Survivors of suicide attempts may be unreliable sources of data because oftheir feelings about what they have done. The purpose of such an insincere attempt is to call attentionto the individuals distress. Between 196 and 198 the suicide rate for individuals 15 to 24 increased from 5.2 to12.3 per 1 , , an increase of 136 percent (Wodarski & Harris, 1987, p.477). 472-475; Martin & Dixon, 1986, pp. Developmentaltheory emphasizes the stressful character of the adolescent years as theindividual attempts to find an acceptable role in society; a developmentalcrisis can trigger the kind of impulsive overreaction that culminates in asuicide attempt. Almosttwo-thirds of the males 15-24 who commit suicide use firearms, for example,but only about half the females do; more boys than girls hang themselves.It is generally believed that women choose less violent means, such aspoisoning, because they fear disfigurement should they live through theattempt. Over the last generation the incidence ofadolescent suicide has increased at a rapid rate. 266). Adolescent suicide: Myths,recognition, and evaluation. 423-434). (1987). Only some teenagers, however, actuallyengage in suicidal ideation. Among teenagers andyoung adults, those 15 to 24, suicide is one of the three leading causes ofdeath. Sex differences in the causes ofadolescent suicide ideation. It seems clear that many teenagersfeel overwhelmed. Simons, R., & Murphy, P. Nobody knows the number of such"passive suicides," which often involve drug and alcohol abuse. A youngster under highstress, who is losing weight, who appears to be depressed and to be usingdrugs or alcohol may, indeed, have a suicide attempt in his or her future.In the absence of reliable predictors of suicide, caution is advisable(Martin & Dixon, 1986, pp. During the last quartercentury, the suicide rate for females 15-24 has doubled and the rate formales has tripled (Neiger & Hopkins, 1988, p. The alarming rise in teenage suicide.McCall's, 16. (1985). In C. Young women who come into the emergency room with slitwrists are often described in the hospital report as merely having had"lacerations." Because estimates of the number of suicide attempts andactual suicides must take such under-reporting into account, thoseestimates vary greatly (Holden, 1988, p. Among young people the ratio of male to female suicides is about 4to 1, while among adults it is approximately 3 to 1 (Berman, 1986, pp. Last, through thelowering of inhibitions and the reduction of motor control, substance abusemay facilitate a passive or impulsive suicide attempt (Holden, 1988, p.839). Substance abuse is closely connected with the phenomenon of teenagesuicide. Although the reported suicide rate among black adolescents is muchlower than the reported rate for whites, over the last twenty years blackmales are the group with the greatest increase in suicide incidence; theincidence of suicide among black males went from 4.1 to 12.3 per 1 , .Clinical evidence supports the widespread belief that males and femalesdiffer in their use of suicide methods. Social Work, 32, 477-481. Some researchers believe that the increase in the societywideincidence of depression has led to an increase in suicide. 266). 472-473; O'Roark, 1982, p.16; Holden, 1988, pp. 84 -841; Neiger & Hopkins, 1988, pp.471-472). Journal of Youth and Adolescence,14(October), 423-434. Under most circumstances, the best a responsibleprofessional can do is to wait for the overt symptoms of crisis to ariseand intervene at that point. The distortions in suicide data discussed earlier handicap attemptsto develop theoretical perspectives that adequately describe (andultimately predict) suicide. Experts frequently point to a cluster of stressors, includingrelationship problems, family problems, school difficulties, and recentdeath of a loved one, as precipitators of suicide. 3333;Holden, 1988, pp. Youth suicide - United States. Shooting oneself is the most common method employed in completed(successful) suicides, but drug overdose is the most common method usedwhen the attempt fails. Alarge number of adolescents are sufficiently troubled to make a sincereattempt to kill themselves or to engage in behavior so dangerous that itcould easily lead to death. New York: Springer. Science, 233, 839-841. 469; Wodarski & Harris, 1987, p. It is also not known whether there is a genuinedifference between those who fail in their attempts at suicide and thosewho succeed. Although prospective studies of teenagers whohave not yet engaged in a recognized suicide attempt can yield useful data,there are difficulties with such studies as well. (1986). Especially if they come from a family who see the denialof feelings as normal, teenagers are inclined to enter a shell of silence,suppressing their feelings and all too often turning their frustrated rageon themselves. Holden, C. School Counselor, 33, 265271. 84 ; Neiger &Hopkins, 1988, pp. (1988, August 22). It seems likely that none of these theoretical perspectives contains "theanswer" to the problem of adolescent suicide (Neiger & Hopkins, 1988, p.471). For another, it is recognized thatmany successful suicides which were unsuccessful in previous attempts, wereoften identified at the time as "suicide gestures" (Martin & Dixon, 1986,p. Helping suicidal adolescents: Needs andresponses. During the 197 's alone, the incidence of suicide in the same agegroup increased 4 percent, from 8.8 per 1 , in 197 to 12.3 per1 , in 198 . Whether an attempt is successful or not, there is a tendencyto misdescribe it as an "accident" to protect the individual or the familyfrom embarrassment. Especially if suchattempts are successful, they are difficult to distinguish from ordinaryaccidents, and even if the person survives, he or she may be reluctant (orunable) to admit to suicidal intent. Research so far into the causes of adolescentsuicide has so far yielded a cluster of potential causal factors. 478-48 ). For that reason, counselorsand other professionals continue to seek theoretical explanations ofteenage suicide that will assist in identifying and treating those most atrisk. In addition, the self-destructive behaviors of young people,including so-called "suicide gestures," constitute a substantial healthissue closely related to adolescent suicide. 839-841). Although a number of factors have been identified asassociated with suicide, no one has yet identified a factor, a psychosocialdisorder or even a physical illness that predicts suicide in a largepercentage of cases (Neiger & Hopkins, 1988, pp. Second,substance abuse may be a direct cause of death; in many instances there isa fine line between an accidental overdose and suicide. It makes sense, therefore, that although femalesengage in suicidal ideation (thinking about suicide) more often and attemptsuicide more often, males are successful more often in the attempts they domake. 267-268; Simons &Murphy, 1985, pp. Otherresearchers disagree, pointing out that relatively few successfuladolescent suicides were actually clinically depressed or engaging inobvious antisocial behavior prior to killing themselves. 151-165). 469). There are gender- and race-related differences in suicide rates andin the characteristics of suicide attempts. Researchers have pointed to the many pressures on young people aspart of the teenage suicide problem. Adolescent suicide:Character traits of high-risk teenagers. 268-27 ). Paralleling the difficulties of interpretation presented by passivesuicide attempts are the difficulties of Interpreting suicide gestures. Boys prefer violent means. Obviously, the counselor who brought every depressedstudent in a high school into her office for a suicide screening would bedoing little else. O'Roark, M. (1987). References Berman, A.L. According to cognitive theory, the limited perspective ofthe adolescent can lead both to defective problem-solving and to amisunderstanding of the permanence of death. 477). Teenage suicide Is one of the major problems mental healthprofessionals must address. For one thing, the eventsleading up to the attempt may be similar, the breakup of a relationship,family discord, problems in school. 84 ; Martin & Dixon, 1986, pp. One study, for example, found that 7 percent of a group ofsuccessful suicide victims had been drug and alcohol abusers. Itis widely supposed that a large percentage of suicide attempts areinsincere. According tosome studies, a large percentage of young persons who attempt to commitsuicide have manifested other psychosocial problems, in addition todepression: drug abuse, anti-social behavior, severe inhibition,perfectionism. First of all, both substance abuse and suicide are related todepression and low self-esteem: A young person may try to ease his painwith drugs, and when that does not work, he kills himself. (1986). Many suicides, forexample, are associated with a recent arrest, perhaps triggering anunbearable sense of shame that leads the youngster to cut him or herselfoff from the world. Because suicide attempts,successful or not, are often identified in hospital records simply asserious injuries, the numbers are difficult to confirm. (1982, January). In the absence of a theoretical foundationfor understanding adolescent suicide, the counselors and otherprofessionals who are in a position to identify adolescents at risk forsuicide do not have reliable guidelines for evaluating youngsters aspossible suicides. 265-271; Wodarski &Harris, 1987, pp. At present,however, almost all of the available data are retrospective with all thelimitations that entails. JAMA, 257(June 26), 3333.----------------------- 1 Of the approximately 5 , young people who attempt suicideannually, 5, are "successful." Thus, approximately one suicide attemptin a hundred succeeds. Under those terms, suicide is the endpoint of a relativelylong, often unrecognized, process of emotional deterioration. Suicide gestures are presumed to contributesubstantially to the number of apparent suicide attempts by adolescents.The difference between suicide gestures and actual impulsive suicideattempts is, however, difficult to define. (1988). It is atleast possible that the young man who gets drunk and then drives his high-powered car into a tree consciously or unconsciously wants to die. Aside from race and gender, a number of factors complicate therelationship of suicide attempts to completed suicides. Most important, evenlarge samples may yield only modest amounts of data. McNeil (Eds.), Adolescence and death (pp. 155-157; Holden, 1988, p. One reason that suicide attempts are so difficult to classify is thatmotivation is notoriously difficult to identify. At the same time as there is so muchpressure to succeed, television promotes the notion that the solution tomost problems can be found quickly. Unfortunately, the sameevents occur in the lives of individuals who neither contemplate norattempt suicide. Sociological theory focuseson the widespread alienation and turbulence of society; the high rate ofsuicide among the young is seen as one symptom of a disintegrating society. Increases in substance abuse appear to be an important factor,but the cause-and-effect relation between substance abuse and suicide isnot clear. Thechances are great that the police and hospital reports of an accident willnot include speculation about suicide (Martin & Dixon, 1986, p. Martin, N.K., & Dixon, P. 423-434). Most experts agree that the rising rate ofsuicide among young people reflects, to a greater or lesser extent, ageneral failure of society to accommodate the difficulties of adolescence. Those who have successfullyattempted suicide, on the other hand, cannot testify at all. Adolescent suicide: A review ofinfluences and the means of prevention. Youth suicide: New research focuseson a growing social Problem. Wodarski, J., & Harris, P.
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