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Adolescent Research Review

, Volume 3, Issue 2, pp 155–172 | Cite as

Why Suicide?

Reasons for Suicide Attempts as Self-Reported by Youth: A Systematic Evaluation of Qualitative Studies
  • Alexandra Nicolopoulos
  • Katherine Boydell
  • Fiona Shand
  • Helen Christensen
Qualitative Review

Abstract

Suicide is a complex phenomenon, and no two suicides are ever the same. While current theoretical models of suicide are heavily informed by first-rate epidemiological and clinical knowledge, little research has qualitatively investigated the motivation for a suicide attempt, from the personal perspective of the person who makes the attempt. These perspectives are particularly absent for youth, whose cognitive interpretation and reasoning skills are less likely to be adequately established than those of adults, and who may need to be approached differently to adults to ensure their reported reasons are genuinely reflected in the published literature. This study sought to identify and examine past qualitative research which has investigated motivating factors for suicide attempts among youth aged 12–25. MEDLINE, EMBASE, and PsycINFO databases were searched and a systematic narrative review of qualitative studies was undertaken. Independent raters assessed comprehensiveness of reporting of included studies. Thematic networks analysis was used to analyze the data. From 17 studies involving 613 participants, basic and organizing themes were identified and grouped into four major themes: intrapersonal, sociocultural, interpersonal and historical factors, as those directly attributed to suicide attempts. Comprehensiveness of reporting among studies was assessed, and particular subdomains identified as inadequately reported, i.e., relationships with participants, theoretical frameworks, and design and implementation of studies. We conclude that more robust and comprehensive theoretical frameworks could enhance the knowledge base of the complex and multiple factors that motivate youth to take their own lives. These findings revealed that comprehensive qualitative inquiry is essential in effectively identifying central themes which may otherwise be minimized or missed in clinical and epidemiological studies.

Keywords

Suicide attempt Adolescents Qualitative Self-report Youth 

Notes

Acknowledgements

The NHMRC Centre of Research Excellence in Suicide Prevention (CRESP) and The Anika Foundation both sponsor Ms Nicolopoulos as a PhD candidate. We therefore acknowledge their full support of the research reported in this article.

Authors’ Contribution

AN conceived of the study and its design and coordination, directed the design and interpretation of data, and drafted the manuscript. KB participated in the interpretation of data and measurement outcomes, and helped to draft the manuscript. FS participated in the design and coordination of the study, as well as assisting in the design and interpretation of data. HC oversaw the design of the manuscript in its entirety. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors report no conflicts of interest.

References

  1. Arria, A. M., O’Grady, K. E., Caldeira, K. M., Vincent, K. B., Wilcox, H. C., & Wish, E. D. (2009). Suicide ideation among college students: A multivariate analysis. Archives of Suicide Research, 13(3), 230–246.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Attride-Stirling, J. (2001). Thematic networks: an analytic tool for qualitative research. Qualitative Research, 1(3), 385–405.CrossRefGoogle Scholar
  3. Baker, N., Willinsky, C., & Boydell, K. M. (2015).Just say know: Creatively engaging young people to explore the link between cannabis use and psychosis in order to promote informed decision-making about substance use. World Cultural Psychiatry Research Review, 201–220.Google Scholar
  4. Ball, J. S., Links, P. S., Strike, C., & Boydell, K. M. (2005). “It’s overwhelming… Everything seems to be too much:” A theory of crisis for individuals with severe persistent mental illness. Psychiatric Rehabilitation Journal, 29(1), 10.CrossRefPubMedGoogle Scholar
  5. Baumeister, R. F. (1990). Suicide as escape from self. Psychological Review, 97(1), 90.CrossRefPubMedGoogle Scholar
  6. Beautrais, A. L., Joyce, P. R., & Mulder, R. T. (1997). Precipitating factors and life events in serious suicide attempts among youths aged 13 through 24 years. Journal of the American Academy of Child and Adolescent Psychiatry, 36(11), 1543–1551.PubMedGoogle Scholar
  7. Beekrum, R., Valjee, S. R., & Collings, S. J. (2011). An emic perspective on the dynamics of non-fatal suicidal behaviour in a sample of South African Indian women. South African Journal of Psychology, 41(1), 63–73.CrossRefGoogle Scholar
  8. Bertolote, J. M., & Fleischmann, A. (2015). A global perspective in the epidemiology of suicide. Suicidologi, 7(2).Google Scholar
  9. Biddle, L., Cooper, J., Owen-Smith, A., Klineberg, E., Bennewith, O., Hawton, K., Gunnell, D. et al (2013). Qualitative interviewing with vulnerable populations: Individuals’ experiences of participating in suicide and self-harm based research. Journal of Affective Disorders, 145(3), 356–362.CrossRefPubMedGoogle Scholar
  10. Bostik, K. E., & Everall, R. D. (2006). In my mind I was alone: Suicidal adolescents’ perceptions of attachment relationships. International Journal for the Advancement of Counselling, 28(3), 269–287.CrossRefGoogle Scholar
  11. Boydell, K. M., Volpe, T., & Pignatiello, A. (2010). THEME ARTICLES: A qualitative study of young people’s perspectives on. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19(1), 5.PubMedPubMedCentralGoogle Scholar
  12. Conner, K. R., Hesselbrock, V. M., Schuckit, M. A., Hirsch, J. K., Knox, K. L., Meldrum, S., Preuss, U., et al (2006). Precontemplated and impulsive suicide attempts among individuals with alcohol dependence. Journal of Studies on Alcohol, 67(1), 95–101.CrossRefPubMedGoogle Scholar
  13. DakshinaMurthy, R., & Selvam, S. P. (2012). Suicide among adolescents. Journal of Biological Chemistry, 2(3).Google Scholar
  14. de Oliveira, L. A. A., Ferreira, L. F. P., da Silva, R. B., de Souza, S. I. R., das Neves Peixoto, F. S., de Sousa Cartaxo, J., Neto, M. L. R. et al (2015). Global suicide: A problem of health systems. International Archives of Medicine, 8.Google Scholar
  15. Dickson-Swift, V. (2005). Undertaking sensitive health research: The experiences of researchers. Bendigo: La Trobe University (Unpublished manuscript).Google Scholar
  16. Dieserud, G., Gerhardsen, R. M., Van den Weghe, H., & Corbett, K. (2010). Adolescent suicide attempts in Baerum, Norway, 1984–2006: Trends, triggers, and underlying reasons. Crisis, 31(5), 255–264.CrossRefPubMedGoogle Scholar
  17. Doumen, S., Smits, I., Luyckx, K., Duriez, B., Vanhalst, J., Verschueren, K., & Goossens, L. (2012). Identity and perceived peer relationship quality in emerging adulthood: The mediating role of attachment-related emotions. Journal of Adolescence, 35(6), 1417–1425.CrossRefPubMedGoogle Scholar
  18. Evans, D. L. (2005). Treating and preventing adolescent mental health disorders: What we know and what we don’t know. New York: Oxford University Press.CrossRefGoogle Scholar
  19. Everall, R. D. (2000). The meaning of suicide attempts by young adults. Canadian Journal of Counselling, 34(2), 111–125.Google Scholar
  20. Everall, R. D., Bostik, K. E., & Paulson, B. L. (2005). I’m sick of being me: Developmental themes in a suicidal adolescent. Adolescence, 40(160), 693.PubMedGoogle Scholar
  21. Everall, R. D., Bostik, K. E., & Paulson, B. L. (2006). Being in the safety zone emotional experiences of suicidal adolescents and emerging adults. Journal of Adolescent Research, 21(4), 370–392. doi:  10.1177/0743558406289753.CrossRefGoogle Scholar
  22. Gilchrist, H., & Sullivan, G. (2006). The role of gender and sexual relations for young people in identity construction and youth suicide. Culture, Health and Sexuality, 8(3), 195–209.CrossRefPubMedGoogle Scholar
  23. Herrera, A., Dahlblom, K., Dahlgren, L., & Kullgren, G. (2006). Pathways to suicidal behaviour among adolescent girls in Nicaragua. Social Science and Medicine (1982), 62(4), 805–814. doi: 10.1016/j.socscimed.2005.06.055.CrossRefGoogle Scholar
  24. Irving, M. J., Tong, A., Jan, S., Cass, A., Rose, J., Chadban, S., Allen, R. D., Craig, J. C., Wong, G., & Howard, K. (2012). “Factors that influence the decision to be an organ donor: a systematic review of the qualitative literature. Nephrology Dialysis Transplantation, 27(6), 2526–2533.CrossRefGoogle Scholar
  25. Johnson, J. G., Cohen, P., Gould, M. S., Kasen, S., Brown, J., & Brook, J. S. (2002). Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Archives of General Psychiatry, 59(8), 741–749.CrossRefPubMedGoogle Scholar
  26. Joiner, T., Conwell, Y., Fitzpatrick, K., Witte, T., Schmidt, N., & Berlim, M. (2005). Four studies on how past and current suicidality relate even when “everything but the kitchen sink” is covaried. Journal of Abnormal Psychology, 114, 291–303.CrossRefPubMedGoogle Scholar
  27. Keyvanara, M., & Haghshenas, A. (2011). Sociocultural contexts of attempting suicide among Iranian youth: A qualitative study. Eastern Mediterranean Health Journal, 17(6), 529–535.CrossRefPubMedGoogle Scholar
  28. Kidd, S. A., & Kral, M. J. (2002). Suicide and prostitution among street youth: A qualitative analysis. Adolescence, 37(146), 411–430.PubMedGoogle Scholar
  29. Kienhorst, I. C., De Wilde, E. J., Diekstra, R. F., & Wolters, W. H. (1995). Adolescents’ image of their suicide attempt. Journal of the American Academy of Child and Adolescent Psychiatry, 34(5), 623–628.CrossRefPubMedGoogle Scholar
  30. Klineberg, E., Kelly, M. J., Stansfeld, S. A., & Bhui, K. S. (2013). How do adolescents talk about self-harm: a qualitative study of disclosure in an ethnically diverse urban population in England. BMC Public Health, 13, 572.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Kuper, A., Reeves, S., & Levinson, W. (2008). An introduction to reading and appraising qualitative research. BMJ 337, 404–409.Google Scholar
  32. Lachal, J., Orri, M., Sibeoni, J., Moro, M. R., & Revah-Levy, A. (2015). Metasynthesis of youth suicidal behaviours: Perspectives of youth, parents, and health care professionals. PLoS One, 10(5).Google Scholar
  33. Luker, J., Murray, C., Lynch, E., Bernhardsson, S., Shannon, M., & Bernhardt, J. (2017). Carers’ experiences, needs and preferences during inpatient stroke rehabilitation: a systematic review of qualitative studies. Archives of Physical Medicine and Rehabilitation.Google Scholar
  34. Obando Medina, C., Dahlblom, K., Dahlgren, L., Herrera, A., & Kullgren, G. (2011). I keep my problems to myself: Pathways to suicide attempts in Nicaraguan young men. Suicidology Online, 2, 17–28.Google Scholar
  35. O’Connor, R. C. (2011). Towards an integrated motivational–volitional model of suicidal behaviour. In R. C. O’Connor, S. Platt & J. Gordon (Eds.), International Handbook of Suicide Prevention: Research, policy and practice. Chichester: Wiley, pp 181–198.CrossRefGoogle Scholar
  36. O’Connor, R. C., & Nock, M. K. (2014). The psychology of suicidal behaviour. The Lancet Psychiatry, 1(1), 73–85.CrossRefPubMedGoogle Scholar
  37. Orri, M., Paduanello, M., Lachal, J., Falissard, B., Sibeoni, J., & Revah-Levy, A. (2013). Qualitative approach to attempted suicide by adolescents and young adults: The (neglected) role of revenge. PLoS One, 9(5), e96716. doi: 10.1371/journal.pone.0096716.CrossRefGoogle Scholar
  38. Orri, M., Paduanello, M., Lachal, J., Falissard, B., Sibeoni, J., & Revah-Levy, A. (2014). Qualitative approach to attempted suicide by adolescents and young adults: the (neglected) role of revenge. PLoS One, 9(5), e96716. doi: 10.1371/journal.pone.0096716.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Pompili, M., Serafini, G., Innamorati, M., Biondi, M., Siracusano, A., Di Giannantonio, M.,. .. Girardi, P. (2012). Substance abuse and suicide risk among adolescents. European Archives of Psychiatry and Clinical Neuroscience, 262(6), 469–485.CrossRefGoogle Scholar
  40. Pope, C., Ziebland, S., & Mays, N. (2000). Analysing qualitative data. BMJ, 320(7227), 114–116. doi: 10.1136/bmj.320.7227.114.CrossRefPubMedPubMedCentralGoogle Scholar
  41. River, J. (2015). Theories of suicide: past, present and future. British Journal of Guidance and Counselling, 43(2), 245–247.CrossRefGoogle Scholar
  42. Rudd, M. D., Berman, A. L., Joiner, T. E., Nock, M. K., Silverman, M. M., Mandrusiak, M., Witte, T., et al (2006). Warning signs for suicide: Theory, research, and clinical applications. Suicide and Life-Threatening Behavior, 36(3), 255–262.CrossRefPubMedGoogle Scholar
  43. Saini, M., & Shlonsky, A. (2012). Systematic synthesis of qualitative research. Oxford: Oxford University Press.CrossRefGoogle Scholar
  44. Santos, J. C. (2015). Suicide: Can we prevent the most mysterious act of the human being? Revista Portuguesa de Enfermagem de Saúde Mental (SPE2), pp. 07–08.Google Scholar
  45. Schwartz, S., & Corcoran, C. (2010). Biological theories of psychiatric disorders: A sociological approach. A handbook for the study of mental health, pp. 64–88.Google Scholar
  46. Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Stewart, L. A., et al (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015. BMJ (online).Google Scholar
  47. Shilubane, H. N., Ruiter, R. A., Bos, A. E., van den Borne, B., James, S., & Reddy, P. S. (2012). Psychosocial determinants of suicide attempts among black South African adolescents: A qualitative analysis. Journal of Youth Studies, 15(2), 177–189.CrossRefGoogle Scholar
  48. Shneidman, E. S. (1993). Suicide as Psychache. Journal of Nervous and Mental Disease, 181(3), 145–147. doi: 10.1097/00005053-199303000-00001. doi.CrossRefPubMedGoogle Scholar
  49. Simon, T. R., Swann, A. C., Powell, K. E., Potter, L. B., Kresnow, M. j., & O’Carroll, P. W. (2002). Characteristics of impulsive suicide attempts and attempters. Suicide and Life-Threatening Behavior, 32(s1), 49–59.Google Scholar
  50. Stewart, S. M., et al. (2015). “The validity of the interpersonal theory of suicide in adolescence: A review. Journal of Clinical Child and Adolescent Psychology: 1–13.Google Scholar
  51. Stewart, S. M., Eaddy, M., Horton, S. E., Hughes, J., & Kennard, B. (2016). The validity of the interpersonal theory of suicide in adolescence: A review. Journal of Clinical Child & Adolescent Psychology, 46(3), 437–449.CrossRefGoogle Scholar
  52. Thoits, P. A. (1999). Sociological approaches to mental illness. A handbook for the study of mental health, pp. 121–138.Google Scholar
  53. Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8(45), 1–10.Google Scholar
  54. Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. doi: 10.1093/intqhc/mzm042.CrossRefPubMedGoogle Scholar
  55. Tramontana, M. G. (2013). The adolescent brain: learning, reasoning, and decision making. LWW.Google Scholar
  56. Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. Jr. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575–600.CrossRefPubMedPubMedCentralGoogle Scholar
  57. Wasserman, D., Thanh, T. T. H., Goldstein, P. T. D., Nordenskiöld, M. A., & Wasserman, C. (2008). Suicidal process, suicidal communication and psychosocial situation of young suicide attempters in a rural Vietnamese community. World Psychiatry, 7(1), 47–53.CrossRefPubMedPubMedCentralGoogle Scholar
  58. World Health Organization. (2014). Preventing suicide: A global imperative.Google Scholar
  59. Yang, S. (2012). A life history of a Korean adolescent girl who attempted suicide. Death Studies, 36(3), 253–269.CrossRefPubMedGoogle Scholar
  60. Zayas, L., Gulbas, L. E., Fedoravicius, N., & Cabassa, L. J. (2010). Patterns of distress, precipitating events, and reflections on suicide attempts by young Latinas. Social Science and Medicine (1982), 70(11), 1773–1779. doi: 10.1016/j.socscimed.2010.02.013.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Black Dog Institute. University of New South Wales: School of PsychiatrySydneyAustralia

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