Suicide

The organization of this handbook and other texts on adolescent dysfunctional behaviors reflects the predominant state of the field, which is characterized by research and practice that is categorical or addresses specific dysfunctions. However, in one sense, such categorization is at variance with recent developments in the prevention and, to a lesser degree, treatment of adolescent dysfunctional behaviors. Current reviews of the prevention of youth problem behaviors conclude that they are mediated—increasing the likelihood or positively associated with common risk factors—and moderated—decreasing the likelihood or negatively associated with common protective factors (Biglan, Mrazek, Carnine & Flay, 2003). Moreover, as implied by the common chapter headings in this volume, adolescent dysfunctional behaviors are associated with risks and protections at every ecological level, including individual, peer, family, school, and community or society (Durlak, 1998). For example, substance abuse and other problem behaviors are associated with problem-solving and learning problems (individual); negative norms/modeling (peers); family pathology and punitive child-rearing (family); low expectations and poor relationships among students, faculty, and parents (school); and lack of resources (community). Suicide is no exception, as it has long been characterized as multiply determined (Goldsmith, Pellmar, Kleinman & Bunney, 2002; Gould, Greenberg, Velting & Shaffer, 2003; Rudd & Joiner, 1998). These findings have substantial implications for prevention programming and have led to the development of programs that have been variously described as comprehensive and multilevel (Silverman & Felner, 1995), ecological (Felner & Felner, 1989), and systemic (Kalafat, 2001; Sanddal, Sanddal, Berman & Silverman, 2003). They are described in subsequent sections of this chapter.