Adolescents who are at risk for suicide may respond to one or several situational or personal stressors. These have been outlined by McEvoy and McEvoy (1994) and are listed below.
Situational Conditions
- Death of a family member or close friend
- Anniversary dates of painful life events, such as the death of a parent or other loved one
- Tough transition times (e.g., parents' divorce, breakup with a dating partner, severe dread of the "real world" following graduation, loss of a valued peer relationship, transferring to a new school)
- Being socially isolated (lack of close personal relationships)
- Involvement in blended family relationships in which there is frequent and serious conflict with stepparent or siblings
- Chronic and intensifying conflicts with parents, employers, teachers, or peers
- Prolonged presence in a pathological family (e.g., parental substance abuse, incest, family violence)
- The onset of severe illness or disability in self or a family member with little hope of improvement
- For the disabled or seriously ill, the worsening of the disability or pain (or fear of progressive deterioration), especially when coupled with the discouragement of the medical personnel or the withdrawal of treatment or support services
- The experience (or anticipated experience) of significant failure or embarrassment (e.g., flunking, being bullied in front of others)
- The loss of a job or other valued role
- Incarceration or other significant trouble with the law
- Serious alcohol or other drug abuse (This may be a symptom of depression as well as a condition producing depression.)
- Confirmation of an unwanted pregnancy, especially before parents or peers find out
- Being forced to assume significant responsibilities while lacking the emotional resources and skills to do so
- Intense and relentless emphasis by others (e.g., parents) on one's achievement coupled with the fear of disapproval for failure to achieve
- Conflicts over one's emerging sexual identity or preferences
- Suicides by peers or famous people
Personal Conditions
- Marked changes in behavior, which may include changes in sleeping habits, the onset of eating disorders (including dramatic weight gain or loss), extreme promiscuity, dramatic emotional outbursts, uncharacteristic acts of rebellion, or dramatic decline in school performance
- Voluntary isolation from friends and withdrawal from normally sociable activities
- Significant increase in the use of alcohol or other drugs
- Neglect of personal appearance
- Senseless risk taking or clear lack of concern for personal welfare
- An exaggeration of health complaints or the emergence of psychosomatic illnesses
- A pronounced difficulty in being able to concentrate on tasks (often coupled with dramatic mood changes)
- Preoccupation with death, with morbid thoughts, or with themes of destruction
- Expressions of pervasive and enduring sadness, or expressions of inappropriate affect (bursts of laughter or crying that do not fit with the social context)
- Serious distortions in perceptions of reality
- Inability to make even the most minor decisions
- Very low self-esteem
- Preoccupation with escape fantasies
- Intense anger or desire for revenge against real or imagined enemies
- Behavior that is characterized by trying to put one's life in order (e.g., giving away possessions and settling accounts)
- Constant seeking of attention through inappropriate behaviors
- Suicide threats or attempts to commit suicide
Source: McEvoy, M. L., McEvoy, A. W (1994). Prevellting youth suicide: A handbook for educators and human service professionals. Holmes Beach, FL: Learning Publications, pp. 34, 36.
Two final triggering conditions are suicide contagion ("copycat" suicide) and entering into a suicide pact. Suicide contagion, or copycat suicide, is a phenomenon that appears to be unique to young people and occurs when adolescents are exposed to the suicidal behavior of others, either actual or fictional. Others then attempt to copy the suicide of the deceased person. The completed suicide of the other person (e.g., a well-known celebrity, someone in the media, or someone at a school) serves as a model. In the absence of protective factors, others who know of the suicide might be at risk. Sometimes these copycat suicides spread through a school system or a community, and their existence highlights the need for quick and thorough postvention activities after a completed suicide to minimize the risk of suicide contagion. In some instances, it appears that the susceptibility and impulsiveness of some adolescents toward suicidal behavior increase when the adolescents are exposed to the suicide of others. It is for this reason that many mental health professionals have asked that the media downplay the suicides of famous people, in particular limiting the glamorizing of such events. The suicide death of grunge music star Kurt Cobain in April of 1994 at age 27 represents how relentless media coverage (including a cover story in Newsweek magazine when his diaries were released, more than eight years after his death) and Internet sites (a search for Cobain's name yields over 165,000 hits) can perpetuate and glamorize suicide. More than ten years after his death, Internet message boards dedicated to Cobain still receive hundreds of messages per day, many of them related to the suicidal thoughts and behaviors of the participants.
Suicide pacts among adolescents (between boyfriend and girlfriend or in peer friendship groups) are a dangerous and poorly understood phenomenon. Although relatively rare, they are often highly lethal endeavors with apparently high completion rates. Although suicide pacts exist in the adolescent world, they are typically more common among middle-aged or older spouses. The pacts often are instigated by a depressed person with a history of attempts. The other person or people are more passive-dependent. The main motivation in adolescent suicide pacts appears to be the threat of loss suffered by the passive-dependent member(s) due to the upcoming suicide of the dominant member (Santy, 1982). Family conflict and loss appear to be even more prevalent in suicide pact members than in suicidal adolescents as a whole. Adolescents who engage in suicide pacts are also, as a group, more likely to be socially isolated from others and dependent almost exclusively on other members of the pact for all their interactions and support (Granboulan, Zivi, & Basquin, 1997). Hemphill and Thornley (1969) called this an "encapsulated unit" and suggested that the suicides may occur because the unit feels threatened by an external force (e.g., one of the families is moving away, one of the members is being sent to a juvenile detention facility). As a rule, the actual attempts are decided on rather impulsively, although the pact might have been in force for quite some time.
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Excerpt from Suicide: An Essential Guide for Helping Professionals and Educators, by D.H. Granello, P.F. Granello, 2007 edition, p. 48-50 .
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