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Suicidality in Chinese adolescents in Hong Kong: the role of family and cultural influences

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Abstract

Background

Adolescent suicidal ideation has found to predict suicidal behaviors and psychopathology in adulthood. Previous studies focused solely on the medical and environmental risk factors, which were insufficient to give a holistic picture of adolescent suicidality.

Objectives

To assess the role of affective and cognitive attributes in the identification and prevention of adolescent suicidal ideation.

Method

A community sample of 511 participants (age 15–19 years) were asked to indicate their suicidality in the 12 months and in their lifetime. Generalized estimating equation regression models were used to examine the effect of psychosocial and socio-environmental correlates in relation to adolescent suicidal ideation.

Results

The data show that perceived responsibilities for family was the only protective factor, while a coping mechanism by behavioral disengagement, severity of depressive symptoms, a history of deliberate self-harm, chronic physical illness or pain, media reporting of suicide news, and low household income were the risk factors for adolescent suicidal ideation.

Conclusions

The results suggest that a multilayer effort for preventing adolescent suicide is needed by providing support for children in deprived families; enhancing life skills in the teens; strengthening family relationship; improving mental and health services; and promoting responsible media reporting on suicide.

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References

  1. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, DSM-IV-TR (4th edn., text revision), 4th edn, text revision. American Psychiatric Association, Washington, DC

  2. Borges G, Angst J, Nock MK, Ruscio AM, Walters EE, Kessler RC (2006) A risk index for 12-month suicide attempts in the national comorbidity survey replication (NCS-R). Psychol Med 36:1747–1757

    Article  PubMed  Google Scholar 

  3. Census and Statistics Department (2005) Hong Kong annual digest of statistics. Government Logistics Department, Hong Kong SAR

    Google Scholar 

  4. Centre for Suicide Research and Prevention (2005) Research findings into suicide and its prevention. Report for Centre for Suicide Research and Prevention, University of Hong Kong. (Available at 3B, 2 University Drive, University of Hong Kong, Pokfulam, HKSAR.), Hong Kong SAR

  5. Cheung CK, Bagley C (1998) Validating an American scale in Hong Kong: the Center for Epidemiological Studies Depression Scale (CES-D). J Psychol 132:169–186

    PubMed  CAS  Google Scholar 

  6. Chou KL (2000) Assessing Chinese adolescents’ social support: the multidimensional scale of perceived social support. Pers Individ Dif 28:299–307

    Article  Google Scholar 

  7. Cohen J (1969) Statistical power analysis for the behavioral sciences. Academic Press, New York

    Google Scholar 

  8. De Man A, Wong IN, Leung PWL (2003) Perceived parental favouritism and suicidal ideation in Hong Kong adolescents. Soc Behav Pers 31:245–252

    Article  Google Scholar 

  9. Durlak JA, Wells AM (1997) Primary prevention mental health programs for children and adolescents: a meta-analytic review. Am J Community Psychol 25:115–152

    Article  PubMed  CAS  Google Scholar 

  10. Fu KW, Yip PSF (2007) Long-term impact of celebrity suicide on suicidal ideation: results from a population-based study. J Epidemiol Community Health 61:540–546

    Article  PubMed  Google Scholar 

  11. Gould M, Jamieson P, Romer D (2003) Media contagion and suicide among the young. Am Behav Sci 46:1269–1284

    Article  Google Scholar 

  12. Gould MS, Greenberg T, Velting DM, Shaffer D (2003) Youth suicide risk and preventive interventions: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 42:386–405

    PubMed  Google Scholar 

  13. Gutierrez PM (2006) Integratively assessing risk and protective factors for adolescent suicide. Suicide Life Threat Behav 36:129–1357

    Article  PubMed  Google Scholar 

  14. Hawton K, Rodham K, Evans E, Weatherall R (2002) Deliberate self harm in adolescents: self report survey in schools in England. Br Med J 325:1207–1211

    Article  Google Scholar 

  15. Hays RD, DiMatteo MR (1987) A short-form measure of loneliness. J Pers Assess 51:69–81

    Article  PubMed  CAS  Google Scholar 

  16. Hesketh T, Ding QJ, Jenkins R (2002) Suicide ideation in Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 37:230–235

    Article  PubMed  CAS  Google Scholar 

  17. Horton NJ, Lipsitz SR (1999) Review of software to fit generalized estimating equation regression models. Am Stat 53:160–169

    Article  Google Scholar 

  18. Ivanoff A, Jang SJ, Smyth NJ, Linehan MM (1994) Fewer reasons for staying alive when you are thinking of killing yourself: the brief reasons for living inventory. J Psychopathol Behav Assess 16:1–13

    Article  Google Scholar 

  19. King CA (1997) Suicidal behavior in adolescence. In: Maris RW, Silverman MM, Canetto SS (eds) Review of suicidology. The Guilford Press, New York, pp 61–95

    Google Scholar 

  20. Lai KW, McBride-Chang C (2001) Suicidal ideation, parenting style, and family climate among Hong Kong adolescents. Int J Psychol 36:81–87

    Article  Google Scholar 

  21. Lam TH, Stewart SM, Yip PSF, Leung GM, Ho LM, Ho SY, Lee PWH (2004) Suicidality and cultural values among Hong Kong adolescents. Soc Sci Med 58:487–498

    Article  PubMed  CAS  Google Scholar 

  22. Lee MTY, Wong BP, Chow BWY, McBride-Chang C (2006) Predictors of suicide ideation and depression in Hong Kong adolescents: perceptions of academic and family climates. Suicide Life Threat Behav 36:82–96

    Article  PubMed  Google Scholar 

  23. Legge J (1885) The sacred books of the East. Clarendon Press, Oxford

    Google Scholar 

  24. Liu KY, Beautrais A, Caine E, Chan K, Chao A, Conwell Y, Law C, Lee D, Li P, Yip P (2007) Charcoal burning suicides in Hong Kong and urban Taiwan: an illustration of the impact of a novel suicide method on overall regional rates. Br Med J 61:248–253

    Google Scholar 

  25. Liu KY, Chen EYH, Chan CLW, Lee DTS, Law YW, Conwell Y, Yip PSF (2006) Socio-economic and psychological correlates of suicidality among Hong Kong working-age adults: results from a population-based survey. Psychol Med 36:1759–1767

    Article  PubMed  Google Scholar 

  26. Mann JJ (2002) A current perspective of suicide and attempted suicide. Ann Intern Med 136:302–311

    PubMed  Google Scholar 

  27. Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, Hegerl U, Lonnqvist J, Malone K, Marusic A, Mehlum L, Patton G, Phillips M, Rutz W, Rihmer Z, Schmidtke A, Shaffer D, Silverman M, Takahashi Y, Varnik A, Wasserman D, Yip P, Hendin H (2005) Suicide prevention strategies: a systematic review. J Am Med Assoc 294:2064–2074

    Article  CAS  Google Scholar 

  28. Maris RW, Berman AL, Silverman MM (2000) Comprehensive textbook of suicidology. The Guilford Press, London and New York

  29. Plutchik R, Van Praag HM, Picard S, Conte HR, Korn M (1989) Is there a relaxation between the seriousness of suicidal intent and lethality of the suicide attempt? Psychiatry Res 27:71–79

    Article  PubMed  CAS  Google Scholar 

  30. Reinherz HZ, Tanner JL, Berger SR, Beardslee WR, Fitzmaurice GM (2006) Adolescent suicidal ideation as predictive of psychopathology, suicidal behavior, and compromised functioning at age 30. Am J Psychiatry 163:1226–1232

    Article  PubMed  Google Scholar 

  31. Shek DTL (1993) Measurement of pessimism in Chinese adolescents: the Chinese hopelessness scale. Soc Behav Pers 21:107–119

    Article  Google Scholar 

  32. Snyder CR, Harris C, Anderson JR, Holleran SA, Irving LM, Sigmon ST, Yoshinobu L, Gibb J, Langelle C, Harney P (1991) The will and the ways: development and validation of an individual-differences measure of hope. J Pers Soc Psychol 60:570–585

    Article  PubMed  CAS  Google Scholar 

  33. Speckens A, Hawton K (2005) Social problem solving in adolescents with suicidal behavior: a systematic review. Suicide Life Threat Behav 35:365–387

    Article  PubMed  Google Scholar 

  34. Stewart SM, Kennard BD, Lee PWH, Mayes T, Hughes C, Emslie G (2005) Hopelessness and suicidal ideation among adolescents in two cultures. J Child Psychol Psychiatry 46:364–372

    Article  PubMed  Google Scholar 

  35. Stewart SM, Lam TH, Betson C, Chung SF (1999) Suicide ideation and its relationship to depressed mood in a community sample of adolescents in Hong Kong. Suicide Life Threat Behav 29:227–240

    PubMed  CAS  Google Scholar 

  36. Sun RCF, Hui EKP, Watkins D (2006) Towards a model of suicidal ideation for Hong Kong Chinese adolescents. J Adolesc 29:209–224

    Article  PubMed  Google Scholar 

  37. Taouk M, Lovibond P, Laube R (2001) Psychometric properties of a Chinese version of the 21-item depression anxiety stress scales (DASS21). Report for New South Wales Transcultural Mental Health Centre. Cumberland Hospital, Sydney

    Google Scholar 

  38. Wagner BM, Cohen P (1994) Adolescent sibling differences in suicidal symptoms: the role of parent-child relationships. J Abnorm Child Psychol 22:321–337

    Article  PubMed  CAS  Google Scholar 

  39. Watson CG, Vassar P, Plemel D, Herder J, Manifold V, Anderson D (1990) A factor analysis of Ellis’ irrational beliefs. J Clin Psychol 46:412–415

    Article  PubMed  CAS  Google Scholar 

  40. Wei Y, Tang S (1996) A revision study on the COPE Scale. Acta Psychol Sin 28:380–387

    Google Scholar 

  41. Wong IN, De Man AF, Leung PW (2002) Perceived parental child rearing and suicidal ideation in Chinese adolescents. Soc Behav Pers 30:19–24

    Article  Google Scholar 

  42. Wong JPS, Stewart SM, Ho SY, Rao U, Lam TH (2005) Exposure to suicide and suicidal behaviors among Hong Kong adolescents. Soc Sci Med 61:591–599

    Article  PubMed  Google Scholar 

  43. Yip PSF, Liu KY, Hu J, Song XM (2005) Suicide rates in China during a decade of rapid social changes. Soc Psychiatry Psychiatr Epidemiol 40:792–798

    Article  PubMed  Google Scholar 

  44. Yip PSF, Liu KY, Lam TH, Stewart SM, Chen E, Fan S (2004) Suicidality among high school students in Hong Kong, SAR. Suicide Life Threat Behav 34:284–297

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The current study was supported by the Chief Executive Community Projects and Hong Kong Jockey Club Charities Trust. The authors thank all of those who contributed to the administration of the survey, and most especially those who participated in the survey. The authors are grateful to the many useful comments from the two reviewers.

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Correspondence to Paul S. F. Yip PhD.

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Chan, W.S.C., Law, C.K., Liu, K.Y. et al. Suicidality in Chinese adolescents in Hong Kong: the role of family and cultural influences. Soc Psychiat Epidemiol 44, 278–284 (2009). https://doi.org/10.1007/s00127-008-0434-x

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  • DOI: https://doi.org/10.1007/s00127-008-0434-x

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