Suicide Adolescents With Suicidal Ideation

SUICIDE

Adolescents With Suicidal Ideation

Suicide assessment for adolescents

While suicidal ideation is troublesome when expressed by any client, it is particularly disturbing when expressed by an adolescent, given the specific risk factors inherent for this age group regarding brain development. "Impulsivity and risk-taking are common in adolescents because of immaturity in frontal lobe executive functioning. Additionally, the adolescent brain exhibits exceptional plasticity in response to new challenges, which may be helpful in learning, but it also results in more vulnerability to environmental stresses" (Varghese, P., & Gray, B.P. 2011: 186). Adolescents like the fifteen-year-old girl who attempted suicide twice after being bullied by her peers or the fourteen-year-old boy with 'anger issues' who tried to hang himself might not seem to be facing significant life events that justify such an extreme response, but given the functioning of the adolescent's brain and perception of risk, such a response becomes more comprehensible.

Of course, even non-adolescents may engage in impulsive behavior. Regarding unplanned suicides: "In a study of 100 patients who made a severe suicide attempt, 84% reported no specific plan, and 69% reported no specific plan and had only fleeting thoughts of suicide or no suicidal ideation at all prior to their attempt" (Schilling et al. 2009: 335). Not all potential suicides talk about their plans beforehand, which may mean that other risk factors must be taken into consideration, including such diverse components as a previous attempt of suicide; a history of drug and alcohol abuse; depression and other mental health issues; social isolation and even such concerns as frequent changes of residence and living in rural areas. For example, merely because an eleven-year-old girl who has been sexually abused and engages in self-harm does not 'say the word' suicide does not mean that she is not at significant risk, given her history.

Drug and alcohol abuse amongst adolescents is perhaps the most obvious factor which results in increased risk for suicidal attempts. "Drinking alcohol while down conveyed a threefold increase in the risk of self-reported suicide attempts among youths not reporting suicidal ideation, thus providing an alternative avenue for identification and early intervention" (Schilling et al. 2009: 338). An example of this can be found in that of a fifteen-year-old boy who reacted to his father's punishment of taking away the boy's cell phone by threatening to burn the house down and commit suicide. The boy had a record of being found in possession of marijuana. The reasons for the correlation between drug abuse and suicidal behavior remain unclear: it may be that the substance abuse exacerbates the inability of the adolescent to adequately assess risk; it may be that the adolescent is self-medicating with substance abuse; or that the substance abuse causes social isolation by disrupting healthy peer and parental connections.

The influence of social disconnectedness upon adolescent suicide is also manifested in one study which found that adolescents who moved frequently were significantly more at risk of attempted suicide (Qin, Mortensen, & Pedersen 2009). It should be noted that this risk factor was "attenuated, but still significant, after controlling for the child's own psychiatric morbidity and loss of a mother or father, as well as parental psychiatric history," indicating that some adolescents may be inherently more vulnerable to this type of environmental stressor (in other words, some adolescents may be more socially adept at coping with the inevitable social problems that occur with frequent moving) (Qin, Mortensen, & Pedersen 2009: 628). Risk of suicide has genetic and epigenetic components, but social difficulties as a risk factor cannot and should not be ignored. The association of frequent with moving suggests that positive peer relationships can act as a counterbalance to risk factors for suicide.