Suicide Risk And Protective Factors Essay ⋆ Criminal Justice Essay Examples ⋆ EssayEmpire

Risk and protective factors related to suicide can be grouped in several ways, one of which is to separate them into individual, interpersonal, and environmental factors. Such distinctions are somewhat artificial, as individual characteristics can be fully understood only as they exist and are expressed in a person’s social and physical environment. However, categorizing risk and protective factors this way is useful in identifying potential solutions to the complex causes of suicidal behavior.

The body of research examining suicide risk and protective factors is so large that it is impossible to list all that has been learned, let alone describe how the influence of each characteristic varies for different groups by age, sex, race-ethnicity, and geography. For example, a debilitating physical illness influences suicidal behavior somewhat differently for males than females and for adolescents compared to elderly individuals. Similarly, some risk and protective factors influence fatal and nonfatal suicidal behavior differently, with small differences in the magnitude of their effects. However, the associations identified here are robust for describing overall suicidal behavior.

Although most of the risk factors below are discussed individually, recent research indicates that the number of cumulative risk factors may be a better predictor of suicide risk than the risk factors themselves. This has been shown most convincingly for environmental exposures experienced in childhood, but likely applies to individual risk factors as well.

Mental And Physical Illnesses

Mental illnesses, particularly when two or more coexist, are the most potent risk factors yet identified for suicidal behavior. Depression is the most frequently diagnosed mental illness in both fatal and nonfatal suicide attempts; diagnoses related to alcohol abuse are also common. Duration, relapse/recurrence after treatment, and severity all contribute to suicide risk. A suicide attempt, particularly one of high intent or lethality, is a risk factor for a later completed suicide, with the risk most pronounced in the 6 months following the attempt.

Other factors related to mental illness that influence suicidal behavior include the availability and accessibility of treatment, and patients’ willingness and ability to accept a mental illness diagnosis and adhere to their treatment protocols. From 2001–2003, 59% of persons in the United States with mental illness were not receiving any type of treatment. Of those receiving treatment, 67% were undertreated. Many patients do not take their medications as prescribed or fail to appear for therapy sessions.

Certain types of physical illness are also correlated with suicidal behavior, independent of their influence on mental health. Predominant among these are illnesses and injuries that result in chronic, severe pain or disability. Examples include AIDS, renal disease, coronary artery disease, some types of cancer, back injuries, and traumatic brain injuries.

Values, Temperament, And Other Personal Attributes

Individual values can influence whether or not a person considers suicide. For example, some religions forbid suicide and warn of serious consequences for those who kill themselves. Participation in religious activities has been shown to be protective with respect to suicide, perhaps in part because these activities provide individuals with a community and a support system. Also, cultural (including religious) teachings can influence a person’s perspective on the value of human life. Other values that have been shown to be protective factors in suicide are self-esteem (self value), feeling as though life has a purpose, and feeling useful and valued at home, at work, and in the community.

Research has identified several personal attributes that influence suicidal behavior. Locus of control, interpersonal dependency, problem-solving ability, intellect, and resilience are each associated with suicidal behavior, particularly among youth. People who believe that they are in control of their own lives, and that the things that happen to them occur because of decisions they themselves make, are less likely to attempt suicide than those who feel as though their lives are controlled by forces external to them. Individual attitudes, such as hope and optimism about the future, are also protective. Many of these characteristics can be enhanced with therapy and skills training. Impulsivity and aggressiveness are risk factors for suicide; the magnitude of the risk appears to be higher for youth and young adults than for older individuals.

Behavioral Risk Factors

Use of alcohol and other substances is a well-known risk factor for suicidal behavior. Some substance use is abusive and is serious enough to be diagnosed as a mental illness. However, use of alcohol and other substances can occur outside the realm of mental illness, yet these behaviors remain risk factors for suicidal behavior. Studies have shown that even nicotine consumption, especially heavy cigarette smoking, is associated with suicide death. The mechanisms by which alcohol and other substances contribute to suicidal behavior are not fully understood, but reduced inhibitions and impaired judgment are likely contributors. Numerous studies have examined the role of alcohol in completed suicides, and estimates of the percentage of these deaths that are alcohol-related range from 28% to 79%. Alcohol use prior to suicide is higher for males than females, for young adults than the elderly, and for some racial/ethnic subgroups and geographic locations.

The role of behavioral risk factors has been more thoroughly studied among adolescents than among adults. Multiple years of data are available from the National Longitudinal Study of Adolescent Health, initiated in 1994, and the Youth Risk Behavior Survey Surveillance System, initiated in 1991. Data from these studies have consistently shown that, among teens, risk factors for suicide include early onset of sexual activity, substance use, educational failure, same-sex attraction, and being a victim or perpetrator of violence.

Other behavioral risk factors, such as exaggerated risk taking, may be difficult to discern from suicidal behavior. Examples include games such as Russian roulette, the hanging game, drug overdoses, and dangerous climbing activities. Finally, access to highly lethal means has been shown to be a risk factor in suicide fatalities, particularly among young people. For example, individuals who can easily acquire a firearm are more likely to use a firearm in a suicide attempt than persons for whom firearms are less available, and such attempts are nearly always fatal.

Bibliography:

Brezo, J., Paris, J., & Turecki, G. (2006). Personality traits as correlates of suicidal ideation, suicide attempts, and suicide completions: A systematic review. Acta Psychiatrica Scandinavia, 113, 180–206.
Goldsmith, S. K., Pellmar, T. C., & Kleinman, W. E. (Eds.). (2002). Reducing suicide: A national imperative. Committee on Pathophysiology and Prevention of Adolescent and Adult Suicide and Board on Neuroscience and Behavioral Health. Institute of Medicine. Washington, DC: National Academies Press.
Wang, P. S., Lane, M., Olfson, M., Pincus, H., Wells, K., & Kessler, R. (2005). Twelve-month use of mental health services in the United States: Results from the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 629–640.

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