Suicidal ideation among Tunisian adolescents and the association with adverse life experiences

Abstract Background Youth suicidality is a significant public health problem. Understanding the factors leading to suicide is essential to implement effective preventive efforts. In this context, this study was conducted to assess the link between suicidal ideation and adverse life experiences among Tunisian school aged youth. Methods A cross-sectional survey was conducted among a sample of 2020 secondary school adolescents in 2016. An anonymous self-administered questionnaire was used to collect data. The adverse life events measured were: domestic violence, parental divorce, physical aggression, sexual abuse and a familial antecedent of suicide. Results Overall, 17.0% (95% CI [15.3%-18.6%]) reported having suicide ideation during the past 12 months with no gender difference (16.3% among girls and 17.3% among boys, p = 0.62). Among the participants, 26.7% experienced at least one adverse life experience. Those who reported domestic violence (Odds Ratio = 8.93; 95% CI = 6.84–11.66), parental divorce (Odds Ratio = 3.02; 95% CI = 1.57–5.79), physical aggression (Odds Ratio = 6.97; 95% CI =5.14–9.46), sexual abuse (Odds Ratio = 8.69; 95% CI =3.94–19.15), familial antecedent of suicide (Odds Ratio = 8.17; 95% CI = 5.75–11.60) were associated with increased odds of suicide ideation. Conclusions The prevalence of suicidal ideation observed in the survey area was relatively high and associated with all the measured life adverse events. These factors should be included in a suicide screening tool to be integrated in a suicide prevention program. Key messages Suicidal ideation among adolescents was associated with all the measured life adverse events. Identifying adolescents at higher risk of suicide and help them to cope with their adverse experiences could be effective to prevent taking action to attempt suicide.

Download Full-text

Intimate Partner Sexual Coercion Mediates the Childhood Sexual Abuse–Suicidal Ideation Link Among African American Women

Journal of Black Psychology ◽

10.1177/0095798416644885 ◽

2016 ◽

Vol 43 (3) ◽

pp. 305-324 ◽

Cited By ~ 7

Author(s):

Dorian A. Lamis ◽

Courtenay E. Cavanaugh ◽

Maria H. Anastasiades ◽

Amanda Garcia-Williams ◽

Claudine Anderson ◽

...

Keyword(s):

Sexual Abuse ◽

African American ◽

Suicidal Ideation ◽

Childhood Sexual Abuse ◽

African American Women ◽

Sexual Coercion ◽

Suicide Ideation ◽

Well Being ◽

Intimate Partner ◽

American Women

Suicide is a leading cause of morbidity and mortality among women. Childhood sexual abuse (CSA) and intimate partner violence are significant risk factors for suicidal ideation among women. The purpose of this study was to examine the interrelationships among these three constructs and test if intimate partner sexual coercion may explain the CSA–suicidal ideation link. African American women ( N = 141) completed an assessment of childhood trauma, intimate partner sexual coercion, and suicide ideation. A significant positive correlation was found between CSA and sexual coercion, between CSA and suicidal ideation, and between sexual coercion and suicidal ideation. Also, intimate partner sexual coercion was found to mediate the relationship between CSA and suicidal ideation when controlling for covariates such as spiritual well-being, self-esteem, and barriers to services. The association between CSA and suicidal ideation may be explained by sexual revictimization in the context of an intimate relationship among African American women. Clinically, practitioners should engage in regular screening for suicide ideation among African American women who have experienced CSA and intimate partner sexual coercion.

Download Full-text

Childhood adversity and midlife suicidal ideation

Psychological Medicine ◽

10.1017/s0033291716002336 ◽

2016 ◽

Vol 47 (2) ◽

pp. 327-340 ◽

Cited By ~ 11

Author(s):

S. A. Stansfeld ◽

C. Clark ◽

M. Smuk ◽

C. Power ◽

T. Davidson ◽

...

Keyword(s):

Sexual Abuse ◽

Suicidal Ideation ◽

Life Events ◽

Parental Divorce ◽

Adult Life ◽

Childhood Adversity ◽

Externalizing Disorders ◽

Birth Cohort Study ◽

Interpersonal Difficulties ◽

Internalizing And Externalizing

BackgroundChildhood adversity predicts adolescent suicidal ideation but there are few studies examining whether the risk of childhood adversity extends to suicidal ideation in midlife. We hypothesized that childhood adversity predicts midlife suicidal ideation and this is partially mediated by adolescent internalizing disorders, externalizing disorders and adult exposure to life events and interpersonal difficulties.MethodAt 45 years, 9377 women and men from the UK 1958 British Birth Cohort Study participated in a clinical survey. Childhood adversity was prospectively assessed at the ages of 7, 11 and 16 years. Suicidal ideation at midlife was assessed by the depressive ideas subscale of the Revised Clinical Interview Schedule. Internalizing and externalizing disorders were measured by the Rutter scales at 16 years. Life events, periods of unemployment, partnership separations and alcohol dependence were measured through adulthood.ResultsIllness in the household, paternal absence, institutional care, parental divorce and retrospective reports of parental physical and sexual abuse predicted suicidal ideation at 45 years. Three or more childhood adversities were associated with suicidal ideation at 45 years [odds ratio (OR) 4.31, 95% confidence interval (CI) 2.67–6.94]. Psychological distress at 16 years partially mediated the associations of physical abuse (OR 3.41, 95% CI 2.29–5.75), sexual abuse (OR 4.99, 95% CI 2.90–11.16) with suicidal ideation. Adult life events partially mediated the association of parental divorce (OR 6.34, 95% CI −7.16 to 36.75) and physical (OR 9.59, 95% CI 4.97–27.88) and sexual abuse (OR 6.59, 95% CI 2.40–38.36) with suicidal ideation at 45 years.ConclusionsAdversity in childhood predicts suicidal ideation in midlife, partially mediated by adolescent internalizing and externalizing disorders, adult life events and interpersonal difficulties. Understanding the pathways from adversity to suicidal ideation can inform suicide prevention and the targeting of preventive interventions.

Download Full-text

Exploring Suicidal Ideation Using an Innovative Mobile App-Strength Within Me: The Usability and Acceptability of Setting up a Trial Involving Mobile Technology and Mental Health Service Users (Preprint)

10.2196/preprints.18407 ◽

2020 ◽

Author(s):

Ashley Jane Bruen ◽

Abbie Wall ◽

Alina Haines-Delmont ◽

Elizabeth Perkins

Keyword(s):

Mental Health ◽

Suicidal Ideation ◽

Real Time ◽

Suicide Risk ◽

Suicide Ideation ◽

Public Health Problem ◽

Mobile App ◽

Inpatient Setting ◽

Service Users ◽

Risk Of Death

BACKGROUND Suicide is a growing global public health problem that has resulted in an increase in the demand for psychological services to address mental health issues. It is expected that 1 in 6 people on a waiting list for mental health services will attempt suicide. Although suicidal ideation has been shown to be linked to a higher risk of death by suicide, not everybody openly discloses their suicidal thoughts or plans to friends and family or seeks professional help before suicide. Therefore, new methods are needed to track suicide risk in real time together with a better understanding of the ways in which people communicate or express their suicidality. Considering the dynamic nature and challenges in understanding suicide ideation and suicide risk, mobile apps could be better suited to prevent suicide as they have the ability to collect real-time data. OBJECTIVE This study aims to report the practicalities and acceptability of setting up and trialing digital technologies within an inpatient mental health setting in the United Kingdom and highlight their implications for future studies. METHODS Service users were recruited from 6 inpatient wards in the north west of England. Service users who were eligible to participate and provided consent were given an iPhone and Fitbit for 7 days and were asked to interact with a novel phone app, Strength Within Me (SWiM). Interaction with the app involved journaling (recording daily activities, how this made them feel, and rating their mood) and the option to create safety plans for emotions causing difficulties (identifying strategies that helped with these emotions). Participants also had the option to allow the study to access their personal Facebook account to monitor their social media use and activity. In addition, clinical data (ie, assessments conducted by trained researchers targeting suicidality, depression, and sleep) were also collected. RESULTS Overall, 43.0% (80/186 response rate) of eligible participants were recruited for the study. Of the total sample, 67 participants engaged in journaling, with the average number of entries per user being 8.2 (SD 8.7). Overall, only 24 participants created safety plans and the most common <i>difficult emotion</i> to be selected was feeling sad (n=21). This study reports on the engagement with the SWiM app, the technical difficulties the research team faced, the importance of building key relationships, and the implications of using Facebook as a source to detect suicidality. CONCLUSIONS To develop interventions that can be delivered in a timely manner, prediction of suicidality must be given priority. This paper has raised important issues and highlighted lessons learned from implementing a novel mobile app to detect the risk of suicidality for service users in an inpatient setting.

Download Full-text

Adolescent’s substance use and suicidal thoughts in Tunisia

European Journal of Public Health ◽

10.1093/eurpub/ckz187.197 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M El Ghardallou ◽

J Sahli ◽

M Mellouli ◽

M Limam ◽

C Zedini ◽

...

Keyword(s):

Substance Use ◽

Suicidal Ideation ◽

Odds Ratio ◽

Suicide Ideation ◽

Cross Sectional Study ◽

Cannabis Use ◽

Suicidal Thoughts ◽

Cross Sectional ◽

Health Related ◽

The Relationship

Abstract Background Experimentation with substance use is common during adolescence. Substance use may result in many health-related problems and contribute to adolescent suicidal behavior. We conducted this study to examine the relationship between substance use and suicidal ideation. Methods This is a cross sectional study conducted among a representative sample of 2020 adolescents enrolled in Tunisian secondary schools using a self-administered questionnaire. Results The prevalence of tobacco, alcohol and cannabis use was respectively 3.7% (95% CI [2.87%-4.52%]), 4.4% (95% CI [3.5%-5.29%]) and 0.8% (95% CI [0.40%-1.18%]) Overall, 17.0% (95% CI [15.3%-18.6%]) reported having suicide ideation during the past 12 months. Tobacco (Odds Ratio = 2.61; 95% CI = 1.59–4.29), alcohol (Odds Ratio = 2.77; 95% CI = 1.76–4.36), and cannabis use (Odds Ratio = 4.98; 95% CI = 1.85–13.96) were significantly associated with suicidal thoughts among adolescents (p < 10-3). Conclusions This cross study has shown a significant association between substance use and suicidal ideation. This relationship can be bidirectional and suicidal ideation and substance use may affect each other. Key messages In his study, the prevalence of substance use was relatively low and was associated with suicidal ideations. The reciprocal link between the two problems and their co-occurrence should be taken into account when planning preventive substance use and suicide programs.

Download Full-text

The Experience of Disgust in Women Exposed to Domestic Violence in Turkey

Journal of Interpersonal Violence ◽

10.1177/08862605211013953 ◽

2021 ◽

pp. 088626052110139

Author(s):

Seray Akça ◽

Faruk Gençöz

Keyword(s):

Domestic Violence ◽

Sexual Abuse ◽

Interpretative Phenomenological Analysis ◽

Qualitative Methodology ◽

Life Experiences ◽

Traumatic Event ◽

Phenomenological Analysis ◽

Traumatic Experience ◽

Limited Information ◽

Structured Interviews

In trauma, fear as a basic emotion that evokes avoidance after exposure to a traumatic event is important for posttraumatic process. Another emotion causing avoidance is disgust. Despite the fact that disgust also plays an important role in trauma, there is limited information about how it is experienced during and after exposure to the traumatic event. In this study, the aim was to understand how women experience disgust during and after domestic violence, as a prolonged and repeated traumatic experience, and how they try to cope with disgust evoking situations in this process. For this aim, qualitative methodology was used. With purposive sampling, six women exposed to domestic violence including physical, verbal and sexual abuse were interviewed. With each woman, approximately seven semi-structured interviews were completed. Forty-one interviews were audio recorded and transcribed. Data was analyzed by Interpretative Phenomenological Analysis. At the end of the analysis, three superordinate themes, namely, experience of perpetrator-directed disgust with gustatory expressions of moral disgust and association of disgust in domestic abuse to daily life experiences; experience of self-disgust with two themes of internalization of assault without awareness and contamination by sexual abuse; coping with disgust in domestic violence with four subthemes, namely, avoidance from perpetrator, reidentification of the perpetrator with substitutive identity, alienation from self, reidentification of self with new relationships were constructed. Results showed that disgust is experienced in a repressed way as a result of the aversive nature of traumatic experience. The results were evaluated in psychological, social and cultural contexts. Their implications for understanding disgust in domestic violence were discussed.

Download Full-text

Association between Health Risk Behavior and Suicidal Ideation, Continuous Sadness and Depression among Malaysian Youth

Global Journal of Health Science ◽

10.5539/gjhs.v10n1p11 ◽

2017 ◽

Vol 10 (1) ◽

pp. 11

Author(s):

Nor Asiah Muhamad ◽

Norazilah Mohd Roslan ◽

Aziman Mahdi ◽

Norbaidurah Ithnain ◽

Normi Mustapha ◽

...

Keyword(s):

Public Health ◽

Sexual Abuse ◽

Suicidal Ideation ◽

Health Risk ◽

Risk Behavior ◽

Public Health Problem ◽

The United States ◽

Health Risk Behavior ◽

Global Public Health ◽

Public Health Importance

BACKGROUND: Suicide is a global public health importance and a second leading cause of death in adolescents. It is more common among adolescents and is considered as a serious public health problem worldwide. This study aims to determine the association between health risk behavior with suicidal ideation, continuous sadness and depression among Malaysian youth.METHODS: A cross-sectional study was carried out among 4088 youth aged 13–17 years old from 50 selected schools. A stratified random sampling was used to select respondents from different classes. The students were randomly selected using the same software throughout the country. Verbal consent was obtained from the student and parents prior to data collection. A standardized self-administered questionnaire adapted from the United States’ Youth Behaviour Risk Surveillance Survey (YBRSS) were used.RESULTS: The rates of Continuous Sadness (CS), Depression (DP) and Suicidal Ideation (SI) were 34.3%, 13.2% and 7.9% respectively. The multivariable-adjusted odds ratio showed that sexual abuse was associated with SI 8.04 (95% CI: 4.66, 13.84), CS 5.72 (95% CI: 3.21, 9.82) and DP 4.68% (95% CI: 2.80, 7.83); alcohol use was associated with SI 1.62 (95% CI: 1.06, 2.47) and DP 1.67 (95% CI: 1.20, 2.33). Female was associated with all suicidal behaviours: SI 2.48 (95% CI: 1.90, 3.24), CS 2.07 (95% CI: 1.80, 2.37) and DP 1.41 (95% CI: 2.17, 1.71). Smoking and drug was not associated with CS, DP and SI.CONCLUSIONS: Given the well-founded concern of increasing risk of suicidal behaviour among youth, preventive efforts should adopt a more comprehensive approach in dealing with sexual abuse and alcohol abuse, especially in female.

Download Full-text

Exploring Suicidal Ideation Using an Innovative Mobile App-Strength Within Me: The Usability and Acceptability of Setting up a Trial Involving Mobile Technology and Mental Health Service Users

JMIR Mental Health ◽

10.2196/18407 ◽

2020 ◽

Vol 7 (9) ◽

pp. e18407

Author(s):

Ashley Jane Bruen ◽

Abbie Wall ◽

Alina Haines-Delmont ◽

Elizabeth Perkins

Keyword(s):

Mental Health ◽

Suicidal Ideation ◽

Real Time ◽

Suicide Risk ◽

Suicide Ideation ◽

Public Health Problem ◽

Mobile App ◽

Inpatient Setting ◽

Service Users ◽

Risk Of Death

Background Suicide is a growing global public health problem that has resulted in an increase in the demand for psychological services to address mental health issues. It is expected that 1 in 6 people on a waiting list for mental health services will attempt suicide. Although suicidal ideation has been shown to be linked to a higher risk of death by suicide, not everybody openly discloses their suicidal thoughts or plans to friends and family or seeks professional help before suicide. Therefore, new methods are needed to track suicide risk in real time together with a better understanding of the ways in which people communicate or express their suicidality. Considering the dynamic nature and challenges in understanding suicide ideation and suicide risk, mobile apps could be better suited to prevent suicide as they have the ability to collect real-time data. Objective This study aims to report the practicalities and acceptability of setting up and trialing digital technologies within an inpatient mental health setting in the United Kingdom and highlight their implications for future studies. Methods Service users were recruited from 6 inpatient wards in the north west of England. Service users who were eligible to participate and provided consent were given an iPhone and Fitbit for 7 days and were asked to interact with a novel phone app, Strength Within Me (SWiM). Interaction with the app involved journaling (recording daily activities, how this made them feel, and rating their mood) and the option to create safety plans for emotions causing difficulties (identifying strategies that helped with these emotions). Participants also had the option to allow the study to access their personal Facebook account to monitor their social media use and activity. In addition, clinical data (ie, assessments conducted by trained researchers targeting suicidality, depression, and sleep) were also collected. Results Overall, 43.0% (80/186 response rate) of eligible participants were recruited for the study. Of the total sample, 67 participants engaged in journaling, with the average number of entries per user being 8.2 (SD 8.7). Overall, only 24 participants created safety plans and the most common difficult emotion to be selected was feeling sad (n=21). This study reports on the engagement with the SWiM app, the technical difficulties the research team faced, the importance of building key relationships, and the implications of using Facebook as a source to detect suicidality. Conclusions To develop interventions that can be delivered in a timely manner, prediction of suicidality must be given priority. This paper has raised important issues and highlighted lessons learned from implementing a novel mobile app to detect the risk of suicidality for service users in an inpatient setting.

Download Full-text

Suicidality amongst young adults in South-south Nigeria

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20212998 ◽

2021 ◽

Vol 8 (8) ◽

pp. 3737

Author(s):

Obielumanii I. Oguche ◽

Ulunma I. Mariere ◽

Adedotun D. Adesina ◽

Hilda C. Afakwu-Adimoha ◽

Rukevwe Akakabota ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Young Adults ◽

Suicidal Ideation ◽

Attempted Suicide ◽

Suicide Ideation ◽

Positive Family History ◽

Critical Time ◽

Public Health Problem ◽

Suicidal Plans

Background: Suicidality is a broad term that encompasses suicidal ideation, suicide plans and suicide attempts. Suicide cuts across all age groups however the young adulthood phase is a critical time for the onset of suicidal behaviours. Often suicide is underreported because of the shame, as such it is a neglected public health problem in our environment. This study seeks to describe the pattern of suicidality and reported health seeking behaviour amongst young people in Bayelsa State.Methods: A descriptive cross-sectional study conducted in the national youth service corps orientation camp, Bayelsa amongst 387 corps members. With the aid of an electronic, self-administered questionnaire adapted from the WHO STEPwise manual on non-communicable diseases; information on socio demographic features, suicide ideation, plan and attempt were obtained. Data was analysed using IBM SPSS version 25.0.Results: The mean age was 25.37 (SD±2.38) years. Most participants were males (58.9%) and single (95.3%). Prevalence of suicidal ideation, plans and attempts was 7.5%, 4.4% and 3.1% respectively. Above one third (35.4%) of those who made suicidal plans in the past 12 months, actually attempted suicide, 4.4% and 2.6% of the respondents had a positive family history of suicide attempt and suicide death respectively.Conclusions: Young adults are a critical population for suicidality. Public health awareness on mental health promotion and uptake of mental health service should be encouraged. Decriminalisation of attempted suicide in Nigeria and better surveillance will enable more effective suicide prevention strategies.

Download Full-text

Attachment Organization in Suicide Prevention Research

Crisis ◽

10.1027/0227-5910/a000231 ◽

2014 ◽

Vol 35 (1) ◽

pp. 60-66 ◽

Cited By ~ 10

Author(s):

Amanda Venta ◽

Carla Sharp

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Interpersonal Relationships ◽

Suicide Ideation ◽

Suicide Attempts ◽

Critical Role ◽

Self Report ◽

Future Research ◽

Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

Download Full-text

Substance Abuse and Drug-Related Death, Suicidal Ideation, and Suicide: A Review

Crisis ◽

10.1027//0227-5910.20.1.28 ◽

1999 ◽

Vol 20 (1) ◽

pp. 28-35 ◽

Cited By ~ 29

Author(s):

Annie Mino ◽

Arnaud Bousquet ◽

Barbara Broers

Keyword(s):

Public Health ◽

Risk Factors ◽

Substance Abuse ◽

Suicidal Ideation ◽

Family Support ◽

Drug Users ◽

Suicide Attempts ◽

Public Health Problem ◽

Major Public Health Problem ◽

Hiv Epidemic

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.

Download Full-text