This research was conducted in the hope of making some contribution to the emerging field of developmental psychopathology through an examination of the relations between progressive movement toward social-cognitive maturity and socioemotional adjustment in adolescence. The two developmental matters of particular concern were the contrastive ways in which suicidal and nonsuicidal adolescents undertake to secure a sense of their own personal continuity across time, and a sense of conviction in the face of growing skeptical doubts. Alternative accounts of suicidal behaviour generally fail to offer any explanatory framework with which to account for the sudden and dramatic increase in suicidal behaviour during the adolescent years. It is argued in this thesis that the self-destructive tendencies of suicidal youth may be better understood as behavioural manifestations of difficulties in dealing with the developmental matters of personal continuity and nascent skeptical doubt More specifically, the arguments presented in this thesis lead to the hypotheses that suicidal adolescents are less able than their nonsuicidal age-mates to 1) adequately warrant their own and others' persistent identity across time, and 2) make use of more mature strategies for dealing with issues of uncertainty and doubt. To test these predictions, 29 psychiatrically hospitalized suicidal adolescents, who were subsequently categorized in to either a high suicide risk group (n=13) or a low suicide risk group (n =16), and an age- and sex-matched group of 29 high school students were individually administered: (1) The Continuity Measure, comprised of 2 stories and a semi-structured interview procedure which inquires into how subjects warrant their own and others' personal continuity in the face of dramatic personal change; (2) The Nascent Skeptical Doubt Interview, also comprised of 2 stories and an associated semi-structured interview procedure aimed at determining subjects' characteristic strategies for dealing with uncertainty; and (3) The Nascent Skeptical Doubt Questionnaire, which permits the placement of respondents along an objectivist-relativist dimension. The results of this study indicate that, in comparison to their nonhospitalized age-mates, the psychiatrically hospitalized suicidal adolescents did evidence difficulties both in their abilities to understand how they and others could be said to remain continuous or self-same persons throughout time, and in their ability to cope with questions of uncertainty and doubt. In addition, adolescents at high risk for suicide were distinguished from other psychiatrically hospitalized individuals at low risk to suicide, and from their high school age-mates by: 1) their unique inability to find any workable means of justifying persistent identity across change; and 2) by their more extreme endorsement of absolutistic views in the face of uncertainty. These findings are seen to lend support to the general theoretical attempt of this thesis to interpret certain socioemotional difficulties experienced by adolescents as arising from a developmental asynchrony between progressive movement toward the more abstract, relativized, and self-reflective modes of thought associated with cognitive maturity, and the task of securing more mature strategies for dealing with the reconceptualizations of the problems of continuity and doubt which these cognitive advances necessitate. In addition, a number of theoretical, diagnostic, and treatment implications which are seen to follow from the results of this study are discussed. / Arts, Faculty of / Psychology, Department of / Graduate

published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Social Work / Master / Master of Social Sciences

A review of the literature strongly suggests that poor family dynamics play a critical role in an adolescent's choice of suicide. This thesis examines the literature and research findings on adolescent suicide and family functioning. It will bring together recent findings to help professionals access the information on adolescent suicide as it relates to the family. The psychosocial and cognitive theories of development are explored to provide a framework for understanding adolescents and the reasons for the choices and problem solving they make in their quest for identity. Since social workers are increasingly implicated in the prevention of youth suicide, the thesis applies the argument to prevention from a social work perspective.

Afrikaans: In hierdie navorsingstuk en proefskrif word die probleem van adolessente selfmoord en selfmoordgedrag binne ‘n sosiaal-konstruksionistiese paradigma met die klem op ‘n pastoraal narratiewe terapeutiese benadering ondersoek. Met hierdie doelstelling voor oë word die verhale van adolessente met selfmoordgedrag aangehoor en in gesprek gebring met literêre verhale oor adolessente, selfmoord en selfmoordgedrag. Hierdie studie soek terselfdertyd na 'n gepaste terapeutiese werkswyse deur middel waarvan daar met hierdie tieners in interaktiewe verhoudings getree kan word. In die terapeutiese proses wat uit hierdie wedersydse samewerking ontwikkel, kan daar aan hulle betekenisvolle berading verleen word. In die sensitiewe interaksie tussen die vertel van en luister na noodverhale word dit progressief duidelik dat adolessente selfmoord en selfmoordgedrag spruit uit ‘n integrasie van oorkoepelende komplekse omstandighede en verhale wat in negatiewe wisselwerking ten opsigte van mekaar staan. Die noodwendige gevolg hiervan is ‘n gevoel van sinloosheid en gevangenheid in die lewe wat uitloop op selfmoord en selfmoordgedrag. • Die algemene tendens is om adolessente te tipeer as "blote tieners". Hierdie kategorisering het tot gevolg dat alle adolessente as gesamentlike groep hanteer word. Met in agneming van die verskillende adolessente se verhale, blyk dit duidelik dat die individu in sy uniekheid en eksentrisiteit totaal binne hierdie tiperingsraamwerk verdwyn. Die narratiewe benadering tot en beskouing van adolessente selfmoord en selfmoordgedrag skep ‘n onbevooroordeelde platvorm waarop elke unieke lewensverhaal van die individu aangehoor kan word. • Normaalweg vra ouers vrae oor die rede of motief waardeur die adolessent tot ‘n selfmoordpoging gedryf is. Hulle aanvaar summier dat slegs een gebeurtenis die oorsaak of probleem kan vaspen. Hierdie studie toon aan dat dit ‘n kumulatiewe opeenhoping van oorsake is wat uiteindelik tot so ‘n desperate poging of daad aanleiding gee. Die narratiewe benadering skep die ruimte vir die aanhoor van die individueel unieke verhaal binne die vervlegte verhale. • Die invloed van die groter samelewingsdiskoers ("grand narrative") is ook ‘n aspek wat in die studie uitgelig word as ‘n besonders bydraende faktor tot adolessente selfmoord en selfmoordgedrag. Die pastoraal narratiewe beskouing van adolessente selfmoord en selfmoordgedrag het nie al die antwoorde nie, maar stel ten slotte die vraag na die begrip selfmoord aan die orde. Is dit "self” en is dit "moord"? English: In this research study and thesis the problem of adolescent suicide and suicidal behavior is examined within a social - constructionist paradigm with the emphasis on a pastoral narrative therapeutic approach. With this purpose in mind, the stories of adolescents with suicidal behavior are listened to and brought into conversation with literary tales of adolescents' suicide and suicidal behavior. At the same time the study seeks for an appropriate therapeutic approach by means of which interactive relationships can be established with these teenagers. In the therapeutic process that results from this mutual collaboration, meaningful counseling can be provided. During the sensitive interaction between the telling of and listening to stories of distress, it progressively becomes clear that adolescent suicide and suicidal behavior is a result of the integration of complex circumstances and stories that have a negative reciprocal impact on each other. • The general tendency is to label adolescents as "mere teenagers". This categorisation results in all adolescents being treated as a collective group. In consideration of the different adolescents' stories, it becomes clear that the individual uniqueness and eccentricity totally disappears within this typifying framework. The narrative approach to and contemplation of adolescent suicide and suicide behavior creates an unprejudiced platform from which each unique life-story can be listened to. • Generally parents ask questions about the reason or motive that drove an adolescent to suicide. They summarily assume that only one incident can identify the cause or problem. This study shows that it is a cumulative conglomeration of causes that eventually leads to such a desperate attempt or action. The narrative approach provides a wide scope for listening to each unique story within the interwoven stories. • The influence of the greater social discourse (grand narrative) is also an aspect that is highlighted in the study as a particular contributive factor to adolescent suicide and suicidal behavior. The pastoral narrative approach to adolescent suicide and suicidal behavior does not have all the answers, but concludes with the question: Is it "self' (sui) and is it "murder" (cidium)? / Thesis (PhD (Practical Theology: Pastoral Family Therapy))--University of Pretoria, 2006. / Practical Theology / unrestricted

The present study aimed to investigate the role of self-oriented and socially prescribed perfectionism in conjunction with stressful life experiences in suicidal ideation, potential, and prior attempts among depressed adolescents. Self-oriented perfectionism involves striving to meet one's own unrealistically high standards and evaluating one's performance stringently. Socially prescribed perfectionism involves the perception that significant others have very high expectations for oneself, which the perfectionist strives to meet. This study examined correlations between these perfectionism dimensions and suicidal ideation, potential or risk, and prior attempts in addition to investigating whether either perfectionism dimension accounted for additional variance in suicide outcomes beyond the established risk factors depression and hopelessness. Also examined was a moderational model whereby dimensions of perfectionism were hypothesized to interact with stress to predict suicide outcomes. A sample of 55 adolescents (41 females, 14 males) who met the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV; APA, 1994) criteria for Major Depression (65.5%), Dysthymia (16.4%), or Depressive Disorder NOS (18.2%) completed self-report measures of perfectionism, daily hassles, depression, hopelessness, suicidal ideation, suicide potential, and prior suicidal attempts. Additionally, adolescents and one of their parents completed a diagnostic interview and a stress interview measuring major stressful experiences. Results revealed that self-oriented perfectionism was not correlated with any aspect of suicide; however, socially prescribed perfectionism was associated with suicide potential. Hierarchical regression analyses indicated that self-oriented perfectionism did not account for unique variance in suicide outcomes, whereas, socially prescribed perfectionism predicted additional variance in suicide potential once depression and hopelessness were controlled. Regarding the moderational model, both self-oriented and socially prescribed perfectionism were found to interact with aspects of stress to predict suicidality. More specifically, self-oriented perfectionism interacted with daily hassles to predict suicide potential/risk. Socially prescribed perfectionism interacted with subjective and objective ratings of major stressful experiences and with daily hassles to predict suicide potential/risk. Neither perfectionism dimension interacted with stress to predict suicidal ideation or prior suicide attempts. Taken together, these findings suggest that among depressed adolescents, socially prescribed perfectionism is correlated with suicide risk and predicts unique variance in this suicide outcome beyond other established risk factors. Additionally, both selforiented and socially prescribed perfectionism act as vulnerability factors that are predictive of suicide potential when adolescents experience elevated levels of stress. As these relationships were apparent even after controlling for the contributions of depression and hopelessness to suicide, the results of this study highlight the importance of considering perfectionistic tendencies when evaluating suicide risk among youth. / Arts, Faculty of / Psychology, Department of / Graduate

Suicidality is an important problem among adolescents. This study compares Durkheim's and Tarde's perspectives on suicide. While the Durkheimian perspective alleges that integration, regulation, and anomie play the major role on adolescent suicidality, Tarde's theory considers imitation as the most important factor affecting suicidality. Durkheim suggests that individuals with higher integration and regulation are less likely to commit suicide. Individuals with less integration and regulation, on the other hand, are more likely to experience anomie and higher suicidality. Tarde claims that individuals with suicidal peers are more likely to commit suicide. In particular, the effects of school integration, family integration, peer integration, religious integration, neighborhood integration, family regulation, anomie, and suicide imitation on adolescent suicidality in Turkey are examined using binary logistics regression in the current attempt. The results indicate that school integration, family integration, and religious integration have significant negative effects on adolescents' suicidality whereas suicide imitation has a positive effect. The results of the study are expected to help to prevention programs purposed at reducing suicidality among adolescents.

No description available.

Suicidal thoughts and behaviors are important public health concerns and suicide is the second leading cause of death among adolescents in the United States (CDC, 2019). The months following hospital discharge mark an increased period of risk for recurrence of suicidal thoughts and behaviors. During this elevated risk period, the first month following discharge is a particularly high-risk period for suicide death (Meehan et al., 2006). Despite this known high-risk period, the processes that place an individual at increased risk during this time are not well understood. Emotion intensity and lability are known risk factors for suicidal ideation and are demographically salient risk factors among adolescents. Historic methodologies for assessing emotion intensity and lability rely on long-term retrospective self-report questionnaires and interviews which fail to capture the variability of these risk factors that are known to fluctuate on a daily to hourly basis. The present study implemented ecological momentary assessment (EMA; a methodology for repeatedly assessing variables in real-time), to study both positive and negative emotion intensity and lability among adolescents during the first month following discharge from psychiatric hospitalization. The current study sought to compare the power of traditional baseline assessments of emotions to that of EMA in the prediction of intensity and recurrence of suicidal ideation at 1- and 4-months post-hospitalization. Forty-five adolescents (12-18 years; M= 15.85; SD= 1.58) psychiatrically hospitalized due to a suicide related chief complaint were recruited from an inpatient unit in a larger treatment development study. Adolescents completed interviews and self-reports to assess demographic variables, baseline emotion characteristics, and history of suicidal thoughts and behavior. Following discharge, participants completed one month of daily EMA surveys, in which adolescents were asked to rate the extent to which they felt positive and negative emotions in the moment. Adolescents then completed a follow-up survey at 1-month and 4-months post-discharge to assess recurrence and intensity of suicidal ideation. We found that positive and negative emotions at baseline did not significantly predict suicidal ideation recurrence or intensity at either of the study follow-ups. High intensity of negative emotions as assessed via EMA was significantly associated with more intense suicidal ideation severity at both 1- and 4- months post-discharge, even after controlling for baseline suicidal ideation intensity and depressive symptoms. Assessing emotions on a daily basis provided stronger prediction models of suicidal ideation intensity in the months following hospital discharge compared to traditional methods of assessment. Limitations and future directions are discussed.

This research utilized data concerning adolescents at imminent risk for harm confined to the Edmonton and Lethbridge secure treatment centres in Alberta. Once screened for inclusion criteria in a single stage, non-random convenience sampling protocol, 210 files were included in the study. From these files, the adolescents' psychopathological diagnoses, Suicide Probability Scale (SPS) scores as well as other demographic data (including age, gender, ethnicity and previous suicide attempts) were recorded. This research was designed to delineate the characteristics of adolescents admitted to secure treatment, examine the overall suicide risk in this sample, investigate the relationship between study variables via crosstabulation and chi-square analysis, and to determine which independent variable/s best predicted suicide risk via ANOVA and multiple lineear regression analysis. Analysis results indicated that the sample was predominantly comprised of female adolescents, Caucasian ethnicity and was aged between 13 and 15 years. The majority of adolescents with suicide history information available in their file had previously attempted suicide. Youth demonstrated an average of 2.7 psychopathological diagnoses, the most frequent of which were conduct disorder, substance abuse, depression, adjustment disorder and parent child relational disorder. The majority of youth were in the moderate suicide risk category from SPS scores. Multiple linear regression analysis determined that the diagnoses of adjustment disorder and depression were found to be predictive of increased suicide risk scores, as was gender (females had higher risk scores), age (younger adolescents had higher risk scores) and previous suicide attempts. Those in the "other" ethnicity category demonstrated lower suicide risk scores. / xi, 193 leaves ; 29 cm.