Adolescent suicide and attempted suicide is an unhealthy practice that involves mental illness which led the suicidal behavior to be an important public health problem globally and in Africa. Suicide prevalence rates in young people in South Africa and in all major ethnic groups are a significant cause for concern. The adolescent mental illness causes sleepless nights on the education system. Though much research has been done on this problem it still remains one of the leading causes of death amongst adolescent learners locally and globally. As a parent and an educator reading news articles, attending memorial services and funerals of adolescent learners who took their own lives, gave me enough reason for actions to be taken in order to find out what is causing adolescents to commit suicide. During this emotional experience as the researcher, I have discovered that the adolescent stage is a very fragile stage. I also discovered that when life stresses strike, coping as an adolescent becomes difficult. This study focuses on an in-depth study of the causative factors of suicide and attempted suicide amongst the adolescent learners of Tshwane North (D3) area. The topic was investigated by means of a literature study and an empirical investigation using a qualitative approach. Data was collected by means of focus group discussion and one to one interview using a tape recorder and taking notes. Participant's answers were analysed individually and compared with all others. Findings shows that adolescent suicide and attempted suicide is a mental disorder that need to be addressed by including physicians and psychologists, upon realizing the warning signs of suicide in order to minimalize the practice. It is also clear that adolescence is a fragile stage of growth and adolescents struggle to cope with life challenges such as peer pressure, parent separations, socialization, pregnancy, chronic illness and academic pressure. It is recommended that NGOs in collaboration with the Health and Education Departments need to take action by organizing workshops to address causative factors of suicide and how to find help when realizing a suicidal adolescent learner. The department of education needs to ensure that adolescent suicide and attempted suicide preventative strategies should be taught from primary school level and be added to life skills subject in all grades. Life Orientation educator's to be trained about adolescent suicide to be well equipped to teach learners on how to recognize warning signs in their peers and friends. / Inclusive Education / M. Ed. (Inclusive Education)

Adolescent suicide and attempted suicide is an unhealthy practice that involves mental illness which led the suicidal behavior to be an important public health problem globally and in Africa. Suicide prevalence rates in young people in South Africa and in all major ethnic groups are a significant cause for concern. The adolescent mental illness causes sleepless nights on the education system. Though much research has been done on this problem it still remains one of the leading causes of death amongst adolescent learners locally and globally. As a parent and an educator reading news articles, attending memorial services and funerals of adolescent learners who took their own lives, gave me enough reason for actions to be taken in order to find out what is causing adolescents to commit suicide. During this emotional experience as the researcher, I have discovered that the adolescent stage is a very fragile stage. I also discovered that when life stresses strike, coping as an adolescent becomes difficult. This study focuses on an in-depth study of the causative factors of suicide and attempted suicide amongst the adolescent learners of Tshwane North (D3) area. The topic was investigated by means of a literature study and an empirical investigation using a qualitative approach. Data was collected by means of focus group discussion and one to one interview using a tape recorder and taking notes. Participant's answers were analysed individually and compared with all others. Findings shows that adolescent suicide and attempted suicide is a mental disorder that need to be addressed by including physicians and psychologists, upon realizing the warning signs of suicide in order to minimalize the practice. It is also clear that adolescence is a fragile stage of growth and adolescents struggle to cope with life challenges such as peer pressure, parent separations, socialization, pregnancy, chronic illness and academic pressure. It is recommended that NGOs in collaboration with the Health and Education Departments need to take action by organizing workshops to address causative factors of suicide and how to find help when realizing a suicidal adolescent learner. The department of education needs to ensure that adolescent suicide and attempted suicide preventative strategies should be taught from primary school level and be added to life skills subject in all grades. Life Orientation educator's to be trained about adolescent suicide to be well equipped to teach learners on how to recognize warning signs in their peers and friends. / Inclusive Education / M. Ed. (Inclusive Education)

The purpose of this study is to provide descriptions of conversations with survivors of suicide, including their relationships with the persons who committed suicide, the relationships that followed these deaths, their experiences of suicide, and the way that they made sense of these deaths. The epistemological framework of this dissertation is ecosystemic and social constructionist. This study involved in-depth interviews with three suicide survivors, exploring personal and professional domains. Thematic analysis was the method used to generate patterns of meaning. The researcher recounted the research participants' stories and punctuated emergent themes and patterns according to what she deemed important. Each story was contextualised, and included reflections of the researcher. Themes both common and unique to each participant story were highlighted and discussed. The information yielded from this study could have value to survivors of suicide and psychotherapists whose clients commit suicide. / Psychology / M.A. (Clinical Psychology)

Substance abuse and suicidal behaviour are major challenges to public health. These phenomena are mainly studied by quantitative designs. This qualitative thesis aims at gaining a deeper understanding of substance abuse and suicidal behaviour, as experienced by young men in different types of treatment. By describing, exploring and interpreting lived experiences, in this thesis I try to give a more nuanced language of both substance abuse and suicidal behaviour, also in young migrating men. I also focus on the system of services related to the prevention and follow-up of life-threatening overdoses by describing and exploring how this phenomenon is experienced by individuals and professionals in Oslo. By researching the lived experiences of substance abuse and suicidal behaviour, combined with researching the phenomenon of life-threatening overdoses, a deeper insight is gained and this can be an important source to both prevention and health promotion for the group in question. The first three papers are based on descriptive, explorative and interpretative studies. How meaning is constructed is the core research question. In the fourth study I describe and explore life-threatening overdoses as a contemporary phenomenon in its context. The research questions are on a descriptive level. In the first three papers, the research object is the personal narratives from in-depth interviews, which are analysed using a phenomenological hermeneutic method. The case study is composed of data collected from different sources, and analysed by triangulation. The main finding in the first paper is that substance abuse and suicidal behaviour can be understood as goal-oriented, communicative and meaning-making activities about the individuals’ balance between death as an escape from pain and the hope of a life. In the second study, metaphorical expressions about a shifting sense of self is understood as balancing being an agent or a victim. In migrating young men these phenomena are interpreted as goal-oriented, communicative and meanig-making activities about existing in a maze that is perceived as closed. The findings of the case study show that different forms of life-threatening overdoses in Oslo are experienced in a state of existential and material stress. A wish of follow-up might not be expressed by the individual. Due to structural problems, such as lack of goals, professionals do not prevent such events in a planned way, nor do they cooperate between different levels. Professionals decide what is good quality in prevention and follow-up of life-threatening overdoses / Rusavhengighet og selvmordsadferd representerer store folkehelseproblemer. Disse fenomenene er hovedsakelig studert med kvantitative design. Målet med denne kvalitative avhandlingen er å få dypere kunnskap om rusavhengighet og selvmordsadferd slik fenomenene er opplevd av yngre menn i ulike typer behandling. Gjennom å beskrive, undersøke og tolke levde opplevelser forsøker avhandlingen å få fram en mer nyansert forståelse av, og språk om, både rusavhengighet og selvmordsadferd, også hos yngre menn med migrasjonserfaring. Avhandlingen fokuserer systemnivået gjennom å beskrive og undersøke hvordan livstruende overdoser oppleves og erfares som levde erfaringer og som yrkesutfordring i Oslo. Et omverdensperspektiv, kombinert med en dypere forståelse og et rikere språk kan være viktige bidrag til forebyggende og helsefremmende tiltak. Det første, andre og tredje arbeidet i avhandlingen er beskrivende, undersøkende og tolkende studier som fokuser yngre menns levde erfaringer med rusavhengighet og selvmordsadferd. Hvordan mening konstrueres er det sentrale forskningsspørsmålet. Det fjerde arbeidet, case studien, undersøker livstruende overdoser i en nå-tidig kontekst, og forskningsspørsmålene er beskrivende. I de første tre arbeidene er forskningsobjektet personlige narrativer samlet gjennom åpne dybdeintervjuer, og som er tolket ved bruk av en fenomenologisk hermeneutisk analyse. I case studien er data fra ulike kilder analysert ved hjelp av triangulering. Hovedfunnet i den første studien er at rusavhengighet og selvmordsadferd kan forstås som måltettede, kommunikative og meningsfulle handlinger om personens balanse mellom døden som befrielse fra smerte og håpet om et bedre liv. I den andre studien kommer metaforiske beskrivelser av en skiftende opplevelse av seg selv i prosessene knyttet til både rusavhengighet og selvmordsadferd tydelig fram. Dette kan forstås som å balansere en selvopplevelse mellom aktør og offer. I den tredje studien kan rusavhengighet og selvmordsadferd hos migrerte menn forstås som målrettede, kommunikative og meningsfulle handlinger om personens opplevelse av å eksistere i en stengt labyrint. Funnene i case studien tyder på at livstruende overdoser i Oslo erfares i eksistensielt stressfulle omstendigheter. Et personlig ønske om oppfølging gis ikke alltid eksplisitt. Strukturelle problemer medfører at profesjonelle arbeider med livstruende overdoser uten overordnete mål og uten samordnet planlegging. Profesjonelle bestemmer derfor selv hva som er god kvalitet når det gjelder forebygging og oppfølging av livstruende overdoser

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Made available in DSpace on 2016-07-27T14:20:17Z (GMT). No. of bitstreams: 1 ANA CRISTINA GOMES MARQUES DE FARIA.pdf: 632100 bytes, checksum: be1dd5c9ff65b961dc870b478b9250df (MD5) Previous issue date: 2014-02-28 / PARTE I: Recent studies show that there was significant growth in the number of suicides among teenagers. Firstly, literature review on the topic was held. Subsequently, we developed an empirical study in a town in Goias, popularly known by the occurrence of suicides . Participated in the empirical study of 371 adolescents aged between 12 and 18 years living and studying in the city. Data were collected in two schools, one public and one private. Its objective was to evaluate rates of suicidal ideation and suicide attempts in adolescents. According to the data it is observed that the total of 371 adolescents surveyed 321 (86.5 %) reported never having attempted suicide. However, 47 (12.7%) reported having attempted suicide in the past 12 months. Furthermore, while 301 (81.4 %) of teenagers have not submitted suicidal ideation, 67 or 18.2 % reported having thought about suicide. Furthermore, we sought to evaluate the relationship between suicidal ideation and suicide attempt with self-reported behavior problems. The instrument used was the Youth Self Report (YSR) developed by Achenbach (1991). This study showed that as much as suicidal ideation suicide attempts were associated with behavior problems analyzed as anxiety and depression, social isolation and depression, somatic problems, social problems, thought problems, attention problems, rule-breaking behavior, aggressive, internalizing and externalizing problems. The present study may be a subsidy to assist in the development of public policy and the health care more geared to this population and the region, in view of the reports of representative bodies from the municipality about the large number of attempts and suicides in the past years. PARTE II: This article aims to evaluate rates of suicidal ideation and suicide attempts in adolescents from an inner city of Goiás popularly known by the occurrence of suicides. Furthermore, we sought to evaluate the relationship between suicidal ideation and suicide attempt with self-reported behavior problems. The study included 371 adolescents from two schools, one private and one public. At the time of data collection, participants were attending to the corresponding Secondary School (sixth to ninth year) school years. Their ages ranged from 13 to 18 years old. Of these, 163 or 43.9% were boys and 208 or 56.1 % were girls. The data indicate that the total of 371 adolescents surveyed 321 (86.5 %) reported never having attempted suicide. However, 47 (12.7%) reported having attempted suicide in the past 12 months. Moreover, while 301 (81.4 %) of teenagers have not submitted suicidal ideation, 67 or 18.2% reported having thought about suicide. Teens who think suicide attempt do so in the next 6 months. A significant relationship between suicidal ideation and suicide attempt with behavior problems analyzed . / PARTE I: Estudos recentes demonstram que houve um crescimento significativo no número de suicídios entre Adolescentes. Em um primeiro momento, foi realizada revisão teórica sobre o tema. Posteriormente, foi desenvolvido um estudo empírico em uma cidade do interior de Goiás, popularmente conhecido pela ocorrência de suicídios. Participaram do estudo empírico 371 adolescentes com faixa etária entre 12 e 18 anos que residem e estudam no município. Os dados foram coletados em duas escolas, uma pública e outra particular. Seu objetivo foi avaliar os índices de ideação e tentativa de suicídio dos adolescentes. De acordo com os dados observa-se que do total dos 371 adolescentes pesquisados 321 (86,5%) relataram nunca haver tentado suicídio. Contudo, 47 (12,7%) relataram haver tentado suicídio nos últimos 12 meses. Além disso, embora 301 (81,4%) dos adolescentes não tenham apresentado ideação suicida, 67 ou 18,2% relataram haver pensado em suicidar. Além disso, buscou-se avaliar a relação entre ideação e tentativa de suicídio com o autorrelato de problemas de comportamento. O instrumento utilizado foi o Youth Self Report (YSR) desenvolvido por Achenbach (1991). Este estudo mostrou que, tanto a ideação suicida quanto tentativas de suicídio tiveram relação com os problemas de comportamento analisados como: ansiedade e depressão, isolamento social e depressão, problemas somáticos, problemas sociais, problemas de pensamento, problemas de atenção, quebrar regras, comportamento agressivo, problemas internalizantes e externalizantes. O presente estudo pode ser um subsídio para auxiliar no desenvolvimento de políticas públicas e de atenção a saúde mais voltadas a esta população e à região, tendo em vista os relatos de entidades representativas do município estudado acerca do grande número de tentativas e suicídios ocorridos nos últimos anos. PARTE II: Este artigo tem como objetivo avaliar os índices de ideação e tentativa de suicídio em adolescentes de uma cidade do interior de Goiás popularmente conhecida pela ocorrência de suicídios. Além disso, buscou avaliar a relação entre ideação e tentativa de suicídio com o autorrelato de problemas de comportamento. Participaram deste estudo 371 adolescentes provenientes de duas escolas, sendo uma pública e a outra particular. No momento da coleta de dados, os participantes cursavam os anos escolares correspondentes ao Ensino Fundamental II (sexto ao nono ano). As idades variaram de 13 a 18 anos de idade. Destes, 163 ou 43,9% eram meninos e 208 ou 56,1% eram meninas. Os dados indicam que do total dos 371 adolescentes pesquisados 321 (86,5%) relataram nunca haver tentado suicídio. Contudo, 47 (12,7%) relataram haver tentado suicídio nos últimos 12 meses. Além disso, embora 301 (81,4%) dos adolescentes não tenham apresentado ideação suicida, 67 ou 18,2% relataram haver pensado em suicidar. Adolescentes que pensam em suicídio tentam fazê-lo nos próximos 6 meses. Observouse relação significativa entre ideação e tentativa de suicídio com os problemas de comportamento analisados.

Este estudo teve como objetivo verificar as repercussões da violência por parceiro íntimo, ocorrida durante a atual gestação, na saúde mental de mulheres usuárias de um serviço de atendimento pré- natal. Trata-se de estudo observacional, com delineamento transversal, desenvolvido no Centro de Referência da Saúde da Mulher de Ribeirão Preto, São Paulo, Brasil, com 358 gestantes, em acompanhamento pré-natal no serviço, entre maio de 2012 e maio de 2013. A coleta dos dados aconteceu no dia da primeira consulta de pré-natal das gestantes no serviço, por meio de sete instrumentos: i. instrumento de caracterização sociodemográfica, econômica e comportamental; ii. instrumento de caracterização obstétrica; iii. Edinburgh Postnatal Depression Scale; iv. Post-Traumatic Stress Disorder Checklist - Civilian Version; v. Escala de Ideação Suicida de Beck; vi. Inventário de Ansiedade Traço-Estado; vii. Instrumento de identificação e caracterização da violência. Os dados foram analisados no software Statistical Package for Social Sciences, versão 21.0. Utilizamos as análises univariada, bivariada e multivariada dos dados, por meio da distribuição de frequências absolutas e relativas, medidas de tendência central e de variabilidade, os testes estatísticos Qui- quadrado e Teste t, razões de prevalência, razões de chances de prevalência, regressão logística múltipla e regressão linear múltipla. No momento da coleta dos dados, as participantes tinham, em média, 25 anos de idade e 9,5 anos de escolaridade formal. A maioria considerou-se não branca, era solteira, coabitava com o parceiro íntimo, possuía alguma religião, não exercia atividade remunerada e possuía renda familiar mensal média de 2,6 salários-mínimos, sendo o parceiro o principal provedor da família. A maioria não fumou, não consumiu bebidas alcoólicas e não fez uso de drogas ilícitas, durante a atual gestação. A amostra caracterizou-se por mulheres multigestas e nulíparas que, em sua maioria, possuíam filhos vivos e não haviam abortado. A prevalência da violência por parceiro íntimo, durante a atual gestação, foi de 17,6%. As prevalências dos indicativos das presenças de transtorno depressivo, do diagnóstico de transtorno de estresse pós-traumático e de ideação suicida foram de 28,2%, 17,0% e 7,8%, respectivamente. Os escores médios das gestantes nas escalas ansiedade-traço e ansiedade- estado foram de 39,1 e 42,5 pontos, respectivamente. Após se ajustar aos modelos de regressão logística múltipla, a violência por parceiro íntimo, durante a gestação, associou-se com o indicativo da presença de transtorno depressivo, com o indicativo do diagnóstico de transtorno de estresse pós- traumático e com o indicativo da presença de ideação suicida. Os modelos de regressão linear múltipla ajustados evidenciaram que as mulheres em situação de violência por parceiro íntimo, na atual gestação, apresentaram maiores escores dos sintomas de ansiedade-traço e estado do que aquelas que não sofreram esse tipo de violência. Portanto, reconhecer a violência como um fator de risco clinicamente relevante e identificável para a ocorrência de transtornos mentais, durante a gestação, pode ser um primeiro passo na prevenção destes problemas. Idealmente, as respostas devem incluir os setores da saúde, assistência social e justiça, no sentido de cumprir a obrigação do Estado para eliminar a violência contra a mulher / The objective of this study was to verify the repercussions of violence by the intimate partner during the present pregnancy on the mental health of women users of a prenatal care service. This is an observational study, performed with a cross-sectional design, at the Reference Center for Women\'s Health of Ribeirão Preto, São Paulo, Brazil, with 358 pregnant women following prenatal care at the referred service between May 2012 and May 2013. Data collection was performed on the day of the women\'s first prenatal appointment at the service, using seven instruments: i. instrument for sociodemographic, economic and behavioral characteristics; ii. instrument for obstetrical characteristics; iii. Edinburgh Postnatal Depression Scale; iv. Post-Traumatic Stress Disorder Checklist - Civilian Version; v. Beck Scale for Suicidal Ideation; vi. State-Trait Anxiety Inventory; vii. instrument for violence identification and characterization. The data were analyzed using Statistical Package for Social Sciences, version 21.0. Furthermore, univariate, bivariate and multivariate analyses of the data were performed, by absolute and relative frequency distribution, central and variability tendency measures, the Chi-square and T-Test statistical tests, prevalence ratio, prevalence odds ratio, multiple logistic regression and multiple linear regression. At the moment of data collection, the participants\' mean age was 25 years, and they had a mean of 9.5 years of formal education. Most women reported having the following characteristics: skin color different from white; single; living with the intimate partner; having some kind of religion; unemployed; mean monthly family income of 2.6 Brazilian minimum wages; partner was the breadwinner. Most reported not having smoked, consumed alcohol or any illicit drugs during the present pregnancy. Moreover, the sample was characterized by multiparous and nulliparous women, most of whom had living children and without a history of miscarriages. The prevalence rate for intimate partner violence during the present pregnancy was 17.6%. The prevalence rates of probable antenatal depression, probable antenatal post-traumatic stress disorder and probable antenatal suicidal ideation were 28.2%, 17.0% and 7.8%, respectively. The women\'s mean scores on the trait-anxiety and state-anxiety scales were 39.1 and 42.5, respectively. After adjustment using multiple logistic regression models, associations were found between intimate partner violence during the pregnancy and probable antenatal depression, probable antenatal post-traumatic stress disorder and probable antenatal suicidal ideation. The adjusted multiple linear regression models showed that women victims of intimate partner violence in the present pregnancy had higher scores for trait-anxiety and state-anxiety symptoms compared to those who did not endure this type of violence. Therefore, recognizing violence as a clinically relevant and identifiable risk factor for the occurrence of mental disorders during pregnancy may be a first step to prevent these problems. Ideally, the answers should include the health, social work and justice domains so as to meet the duty of the Brazilian State of eliminating the violence against women

Objectives. Evaluate differences in depressive symptoms, compare sociodemographic and health-related variables associated with depressive symptoms and report level of impact of depressive symptoms on daily activities. Methods. Cross-sectional study using a self-administered questionnaire and Patient Health Questionnaire-9 (PHQ-9) diagnostic survey on 1115 patients aged 60–93 years who attended a primary care clinic in Korea, Russia or USA. Results. At least mild depression (PHQ-9 score of ≥5) occurred in 28% of Koreans, 65% of Russian and 27% of US participants. Russians scored more depressed on all PHQ-9 items (P < 0.01) and more suicidal thoughts (P < 0.001), while Koreans had less feelings of worthlessness (P < 0.001). Depression predictors included poorer self-rated health [odds ratio (OR) 2.47, 95% confidence interval (CI) 1.84–3.33, P < 0.0001], chronic diseases (OR 1.34, CI 1.21–1.48, P < 0.0001), female gender (OR 1.56, CI 1.15–2.12, P = 0.0046) and religious attendance (OR 0.88, CI 0.79–0.97, P = 0.0099) for all subjects. Being employed was protective in Korea (OR 0.41, CI 0.21–0.77, P = 0.0061) and being married (OR 0.42, CI 0.27–0.66, P = 0.0002) and of older age (OR 0.95, CI 0.93–0.98, P = 0.0006) protective in US participants. Vascular disease was associated with depressive symptoms in Russia (OR 3.47, CI 1.23–9.80, P = 0.0187). In regression analyses stratified by country for a given level of depressive symptoms, the Russian sample had less impact on daily activities (Russia R2 = 0.107 versus Korea R2 = 0.211 and US R2 = 0.419) P = 0.029. Conclusions. Depressive symptoms were more common in Russia than in Korea and USA but had less impact on daily functioning. Cultural or environmental factors may account for this finding.

Both substance abuse and suicidal behavior are global public health concerns. Much of the progress made in addressing problematic substance use and suicidal ideation and behavior stems from the notion of alleviating pathological factors. Positive psychological characteristics, such as forgiveness, have received much less attention from empirical investigators. We review the extant literature pertaining to the value and role of forgiveness as an effective resource for clinicians when treating individuals struggling with substance abuse and suicidal behavior. We discuss relevant theory and research (i.e., definitions, processes, and linkages) regarding similarities in models of forgiveness, substance abuse, and suicidal behavior and conclude with an overview of various means of using the process of forgiveness as a positive psychotherapy; whether through stand-alone forgiveness interventions, infusion with Twelve-Step Facilitation Therapy, or application through acceptance-based treatment modalities. In sum, forgiveness may be an important factor in the facilitation of change in the difficult often existangst-derived struggles (i.e., emotionally and philosophically driven psychological distress) inherent to substance abuse and suicidal behavior.

Plus de la moitié des adolescents suicidaires dont une large proportion présente un trouble de personnalité limite (TPL) abandonnent leur traitement. Les conséquences de leur défection sont préoccupantes considérant la récurrence de leurs conduites suicidaires et le fait que cette pathologie augmente le risque d’une évolution défavorable à l’âge adulte. À partir d’une méthode de théorisation ancrée constructiviste, cette étude visait à comprendre les processus associés à l’instabilité du mode de consultation des adolescents avec TPL. Elle a permis de spécifier les vulnérabilités à l’abandon des adolescents avec TPL et celles de leurs parents et mis au jour que l’atténuation des problèmes d’accessibilité, la préparation au traitement, l’adaptation des soins aux particularités du TPL et finalement la prise en compte de la disposition à traiter des soignants constituent des réponses déterminantes pour leur engagement. Les processus de désengagement ont également été spécifiés. Des perceptions négatives à l’égard du traitement, du soignant ou du fait d’être en traitement génèrent une activation émotionnelle. Celle-ci induit ensuite des attitudes contre-productives qui évoluent vers des comportements francs de désengagement. Dans ce contexte, des réponses du dispositif de soins telles une régulation insuffisante de l’engagement, des impairs thérapeutiques et des demandes paradoxales précipitent l’abandon de traitement. Finalement, les processus impliqués dans l’abandon de traitement ont été formalisés dans le Modèle de l’engagement et de l’abandon de traitement des adolescents avec TPL. Celui-ci illustre que des processus distincts caractériseraient les abandons précoces et les abandons tardifs des adolescents avec TPL. L’abandon précoce résulterait de l’échec du dispositif de soins à profiter de l’impulsion de la demande d’aide pour engager l’adolescent et le parent lors de ce premier moment critique de sa trajectoire de soins. En contrepartie, les abandons tardifs traduiraient les défaillances du dispositif de soins à adopter des mesures correctives pour les maintenir en traitement lors d’un deuxième moment critique marqué par leur désengagement. Les taux d’abandon de traitement de ces jeunes pourraient être diminués par un dispositif de soins qui reconnaît les périls inhérents au traitement de cette clientèle, se montre proactif pour résoudre les problèmes de désengagement, intègre des mécanismes de soutien aux soignants et favorise une pratique réflexive. / More than half of suicidal adolescents, a large proportion of which manifest borderline personality disorder (BPD), drop out from treatment. The consequences of their premature termination are cause for concern, given the recurrence of their suicidal attempts and that they present elevated risk for major mental disorders during adulthood. The current study sought to gain a broader appreciation of processes involved in treatment dropout among adolescents with BPD through a constructivist grounded theory. Various dropout vulnerabilities specific to adolescents with BPD and their parents, including psychological characteristics, help-seeking context and perception of mental illness and mental healthcare were identified. Care-setting response including management of accessibility problems, adaptation of services to needs of adolescents with BPD, preparation for treatment, and consideration for the health professional's disposition to treat were also found to be determinant to their engagement to treatment. The processes of disengagement from treatment have also been specified. Negative perceptions regarding treatment, clinicians, and receiving treatment have been shown to generate emotional activation. The aforementioned lead to counter-productive attitudes that evolve into outright disengagement behaviours. In this context, responses from the care-setting, such as an insufficient regulation of the engagement, therapeutic faux pas and paradoxical demands, precipitate premature treatment termination. Finally, the processes involved in the abandonment of treatment were formalized in the Model of engagement and treatment dropout for Adolescent with BPD. This illustrates that distinct processes characterise the premature and late dropouts of adolescents with BPD. The early terminations result from the failure of the care-setting to take advantage of the impetus at help seeking to engage the adolescent and the parent at that first critical moment in the care trajectory. On the other hand, the late dropouts translate failures of the care-setting to adopt corrective measures to maintain the patient in treatment at a second critical moment indicated by their disengagement. The termination rate of those adolescent treatments could be diminished by a system of care-setting that recognizes the inherent difficulties related to the treatment of those specific patients, is proactive to solve problems of disengagement, integrates support systems for clinicians and promotes a reflexive practice.