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      Qualitative Approach to Attempted Suicide by Adolescents and Young Adults: The (Neglected) Role of Revenge

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          Abstract

          Background

          Suicide by adolescents and young adults is a major public health concern, and repetition of self-harm is an important risk factor for future suicide attempts.

          Objective

          Our purpose is to explore the perspective of adolescents directly involved in suicidal acts.

          Methods

          Qualitative study involving 16 purposively selected adolescents (sex ratio1∶1) from 3 different centers. Half had been involved in repeated suicidal acts, and the other half only one. Data were gathered through semistructured interviews and analyzed according to Interpretative Phenomenological Analysis.

          Results

          We found five main themes, organized in two superordinate themes. The first theme (individual dimensions of the suicide attempt) describes the issues and explanations that the adolescents saw as related to themselves; it includes the subthemes: (1) negative emotions toward the self and individual impasse, and (2) the need for some control over their lives. The second main theme (relational dimensions of attempted suicide) describes issues that adolescents mentioned that were related to others and includes three subthemes: (3) perceived impasse in interpersonal relationships, (4) communication, and (5) revenge.

          Conclusions

          Adolescents involved in suicidal behavior are stuck in both an individual and a relational impasse from which there is no exit and no apparent way to reach the other. Revenge can bridge this gap and thus transforms personal distress into a relational matter. This powerful emotion has been neglected by both clinicians and researchers.

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          Most cited references15

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          Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research.

          C Pope, N Mays (1995)
          Qualitative research methods have a long history in the social sciences and deserve to be an essential component in health and health services research. Qualitative and quantitative approaches to research tend to be portrayed as antithetical; the aim of this series of papers is to show the value of a range of qualitative techniques and how they can complement quantitative research.
          Article 0 comments Cited 299 times – based on 0 reviews     Review now
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            Epidemiology of youth suicide and suicidal behavior.

            J. Bridge, Sydney S. Cash (2009)
            Suicide is the third leading cause of death among young people in the U.S. and represents a significant public health problem worldwide. This review focuses on recent developments in our understanding of the epidemiology and risk factors for adolescent suicide and suicidal behavior. The suicide rate among children and adolescents in the U.S. has increased dramatically in recent years and has been accompanied by substantial changes in the leading methods of youth suicide, especially among young girls. Much work is currently underway to elucidate the relationships between psychopathology, substance use, child abuse, bullying, internet use, and youth suicidal behavior. Recent evidence also suggests sex-specific and moderating roles of sex in influencing risk for suicide and suicidal behavior. Empirical research into the causal mechanisms underlying youth suicide and suicidal behavior is needed to inform early identification and prevention efforts.
            Article 0 comments Cited 148 times – based on 0 reviews     Review now
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              Repetition of self-harm and suicide following self-harm in children and adolescents: findings from the Multicentre Study of Self-harm in England.

              Jennifer Ness, Sarah Steeg, Navneet Kapur … (2012)
              Self-harm (intentional self-poisoning and self-injury) in children and adolescents is often repeated and is associated with increased risk of future suicide. We have investigated factors associated with these outcomes. We used data collected in the Multicentre Study of Self-harm in England on all self-harm hospital presentations by individuals aged 10-18 years between 2000 and 2007, and national death information on these individuals to the end of 2010. Cox hazard proportional models were used to identify independent and multivariable predictors of repetition of self-harm and of suicide. Repetition of self-harm occurred in 27.3% of individuals (N = 3920) who presented between 2000 and 2005 and were followed up until 2007. Multivariate analysis showed that repetition was associated with age, self-cutting, and previous self-harm and psychiatric treatment. Of 51 deaths in individuals who presented between 2000 and 2007 and were followed up to 2010 (N = 5133) half (49.0%) were suicides. The method used was usually different to that used for self-harm. Multivariate analysis showed that suicide was associated with male gender [Hazard ratio (HR) = 2.4, 95% CI 1.2-4.8], self-cutting (HR = 2.1, 95% CI 1.1-3.7) and prior psychiatric treatment at initial presentation (HR = 4.2, 95% CI 1.7-10.5). It was also associated with self-cutting and history of psychiatric treatment at the last episode before death, and history of previous self harm. Self-cutting as a method of self-harm in children and adolescents conveys greater risk of suicide (and repetition) than self-poisoning although different methods are usually used for suicide. The findings underline the need for psychosocial assessment in all cases. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.
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                Author and article information

                Contributors
                Fiona Harris: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Electronic): 1932-6203
                Publication date Collection: 2014
                Publication date (Electronic): 6 May 2014
                Volume: 9
                Issue: 5
                Electronic Location Identifier: e96716
                Affiliations
                [1 ]INSERM 669 research unit, Paris-Sud University and Paris-Descartes University, Paris, France
                [2 ]Department Applied Psychology, University of Padua, Padua, Italy
                [3 ]Maison de Solenn, AP-HP Cochin Hospital, Paris, France
                [4 ]Centre de Soins Psychothérapeutiques de Transition pour Adolescents, Argenteuil Hospital Centre, Argenteuil, France
                University of Stirling, United Kingdom
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: MO MP. Performed the experiments: MO MP. Analyzed the data: MO MP ARL JL JS BF. Wrote the paper: MO MP ARL JL JS BF.

                Article
                Publisher ID: PONE-D-13-48744
                DOI: 10.1371/journal.pone.0096716
                PMC ID: 4011950
                PubMed ID: 24802777
                SO-VID: d2ea2d70-cc07-4fef-99a1-41f53b56dcfb
                Copyright statement: Copyright @ 2014
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 21 November 2013
                Date accepted : 9 April 2014
                Page count
                Pages: 8
                Funding
                The authors have no support or funding to report.
                Categories
                Subject: Research Article
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Clinical Psychology
                Subject: Psychological Defense Mechanisms
                Subject: Psychological Stress
                Subject: Medicine and Health Sciences
                Subject: Health Care
                Subject: Health Care Policy
                Subject: Child and Adolescent Health Policy
                Subject: Mental Health and Psychiatry
                Subject: Adolescent Psychiatry
                Subject: Suicide
                Subject: Research and Analysis Methods
                Subject: Research Design
                Subject: Clinical Research Design
                Subject: Qualitative Studies
                Subject: Social Sciences
                Subject: Sociology

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

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