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Industry: Email Alert RSS FeedGender differences in the suicide-related behaviors of adolescents and young adults
Sex Roles: A Journal of Research, Dec, 1998 by Jennifer Langhinrichsen-Rohling, Peter Lewinsohn, Paul Rohde, John Seeley, Candice M. Monson, Kathryn A. Meyer, Richard Langford
Controversy exists about how to define and measure suicidality in adolescents and young adults. Some researchers and clinicians have preferred to assess only overt suicidal behavior that is engaged in with intentionality. Other researchers have posited that there is a conceptual link among overt suicidal behaviors, less lethal suicidal behaviors such as self-mutilation and self-denigration, and life-threatening behaviors that may be unintentionally suicidal such as risk-taking, illness-enhancing or injury-producing behaviors (e.g., Lewinsohn et al., 1995; Shneidman, Farberow, & Litman, 1970). Consistent with this line of reasoning, a variety of diverse problem behaviors, many of which are self-destructive, (e.g., cigarette smoking, alcohol use, risk taking) have been shown to be intercorrelated beginning in early adolescence in both males and females (Hawkins, Catalano, & Miller, 1992; Jessor & Jessor, 1975). Furthermore, as predicted theoretically, overtly suicidal behavior has been directly associated with a broad range of other potentially self-destructive and life-threatening behaviors. For example, individuals who have engaged in a suicide attempt have been found to be at greater risk of engaging in early sexual activity and substance use than individuals without a suicide behavior history (Ensminger, 1987). Data collected on 8th and 10th graders found that both alcohol use and risky behaviors were significant predictors of suicide ideation and attempts (Windle, Miller-Tutzauer, & Domenico, 1992). Furthermore, Shaffer and colleagues have determined that a variety of psychiatric disorders are related to suicide (Shaffer, Garland, Gould, Fisher & Trautman, 1988). For example, a study of adolescents in New York City who had committed suicide revealed that nearly 1/2 of the victims had been identified as needing treatment or had sought mental health services (Shaffer & Gould, 1987). Gender differences in the expression of and associations among various suicide-related behaviors have been a relatively neglected topic, however.
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Consistent with the notion that diverse factors (e.g., depression, poor self-esteem, drug and alcohol abuse) are related to suicide, Lewinsohn and colleagues (1995) recently delineated a broad conceptualization of suicidality. Specifically, they posited a continuum of suicide-related behaviors. One end of their continuum consisted of life-enhancing behaviors; traditionally defined, overtly suicidal behaviors comprised the opposite pole. This group of researchers theorized that efforts to prevent fatal suicides will be enhanced if an individual's propensity to engage in life-enhancing behaviors is increased while her or his engagement in a variety of potentially life-threatening and suicide-related behaviors is decreased.
To test their theoretical construct, Lewinsohn et al. (1995) created a self-report measure, the Life Attitudes Schedule (LAS), that assesses engagement in a broad range of risky, life-threatening and potentially suicide-related behaviors. The instrument also assesses the degree to which the individual is engaging in life-promoting or life-enhancing behaviors. The LAS consists of four content category subscales which measure overtly suicidal and death-related (DR), illness and health-related (HR), risk and injury-related (IR), and self-related (SR) behaviors. Equal numbers of items were included on each subscale. Each subscale score is a combination of the number of negative items endorsed as well as the number of positive items that were not endorsed. To further delineate the construct of suicide proneness, items were selected that loaded highly on their respective subscales while showing only moderate correlations with measures of depressive symptomology, hopelessness, and social desirability. Initial data indicate that, as predicted, LAS total scores and all four LAS subscale scores are significantly associated with the occurrence of current suicide ideation and past suicide attempts in adolescents and young adults (Lewinsohn et al., 1995).
To date, no gender-specific results have been presented using the LAS as a measure of suicide-related behaviors. However, gender differences in overtly suicidal behaviors have been consistently demonstrated in the literature (e.g., Allgood-Merten, Lewinsohn, & Hops, 1990; McIntosh & Jewell, 1986; National Center for Health Statistics, 1994). For example, adolescent males engage in fatal suicidal behavior much more frequently than adolescent females. In 1992, among those aged 15 to 24, the rate of completed suicides was 21.9 per 100,000 for males and 3.7 per 100,000 for females (National Center for Health Statistics, 1994). Although young females do not complete suicide as often as young males, they frequently report more suicidal thoughts (Andrews & Lewinsohn, 1992; Simons & Murphy, 1985) and more suicide attempts (e.g., Andrews & Lewinsohn, 1992). Because gender differences in the expression of overt suicidal behavior have been documented, the current research was conducted to determine if there are also gender differences in the expression of the broad range of suicide-related behaviors that are assessed on the LAS.
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