Abstract

There is limited insight into gender differences in suicide-related communication (SRC) in youths. SRC is defined as "the act of conveying one's own suicide ideation, intent or behaviours to another person". Increasing our understanding of SRC in youths will enable us to recognize and specify needs of female versus male youths. The current study explores SRC in a sample of Dutch suicide victims aged under 20 and examines gender differences. Interview data from a psychological autopsy study of 35 youths who died by suicide in the Netherlands in 2017 were analysed. Qualitative analyses were performed to examine explicit SRC throughout the youths' lives and implicit SRC during the last months prior to suicide. We employed the Constant Comparative Method to explore patterns in the debut, form, frequency, medium, content, type of recipient, and SRC in the last months prior to suicide death. We identified commonalities in the SRC of youths, including the content of suicide notes and an emphasis on suicide method and preparation in the last months. Girls, however, had an earlier debut of SRC, a higher frequency of explicit SRC, and more often directed SRC towards varied types of recipients compared to boys. Moreover, SRC of girls seemed focused on coping and achieving support from others more than SRC of boys. The SRC of boys in comparison to girls was often ambiguous or diluted by "humorous" connotations. Unique patterns in SRC of boys and girls posed corresponding challenges for next of kin to interpret communications and respond adequately to SRC. The early debut of girls' SRC highlights the importance of early screening and prevention efforts in girls, while the late debut and ambiguity in boys' SRC implores professionals and next of kin to encourage young males to be unequivocal about suicide ideation or intent.

Highlights

  • Suicide is a leading cause of death in young individuals in the Netherlands [1] and the third leading cause of death in young people aged 15–29 worldwide [2]

  • We identified commonalities in the suicide-related communication (SRC) of youths, including the content of suicide notes and an emphasis on suicide method and preparation in the last months

  • To the best of our knowledge, this is the first study to conduct a qualitative analysis of suiciderelated communication events of young people who died by suicide and to explore gender differences using psychological autopsy data

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Summary

Introduction

Suicide is a leading cause of death in young individuals in the Netherlands [1] and the third leading cause of death in young people aged 15–29 worldwide [2]. Suicidal behaviours (i.e. suicide ideation, deliberate self-harm, and suicide attempts) often debut between the ages of 12– 17 [3, 4]. The suicidal process is the timeframe in which an individual moves from first ideation towards the act of an attempted or completed suicide. The timeframe from ideation to lethal suicide shows large individual variation. Previous research showed that it can be as short as two months in young individuals (aged 15–29) and in 28% of youths spanned three months or less [3]. One third of adolescents with suicide ideation attempt suicide [5]. The suicidal process can go unnoticed until death by suicide occurs [6]

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