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Published in: Social Psychiatry and Psychiatric Epidemiology 4/2009

01-04-2009 | ORIGINAL PAPER

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

Authors: Wincy S. C. Chan, MEd, Chi Kin Law, PhD, Ka Y. Liu, PhD, Paul W. C. Wong, DPsyc (Clin), Yik Wa Law, MSW, Paul S. F. Yip, PhD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 4/2009

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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.
Literature
1.
go back to reference 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 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.
go back to reference 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 36:1747–1757PubMedCrossRef 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 36:1747–1757PubMedCrossRef
3.
go back to reference Census and Statistics Department (2005) Hong Kong annual digest of statistics. Government Logistics Department, Hong Kong SAR Census and Statistics Department (2005) Hong Kong annual digest of statistics. Government Logistics Department, Hong Kong SAR
4.
go back to reference 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 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.
go back to reference Cheung CK, Bagley C (1998) Validating an American scale in Hong Kong: the Center for Epidemiological Studies Depression Scale (CES-D). J Psychol 132:169–186PubMed Cheung CK, Bagley C (1998) Validating an American scale in Hong Kong: the Center for Epidemiological Studies Depression Scale (CES-D). J Psychol 132:169–186PubMed
6.
go back to reference Chou KL (2000) Assessing Chinese adolescents’ social support: the multidimensional scale of perceived social support. Pers Individ Dif 28:299–307CrossRef Chou KL (2000) Assessing Chinese adolescents’ social support: the multidimensional scale of perceived social support. Pers Individ Dif 28:299–307CrossRef
7.
go back to reference Cohen J (1969) Statistical power analysis for the behavioral sciences. Academic Press, New York Cohen J (1969) Statistical power analysis for the behavioral sciences. Academic Press, New York
8.
go back to reference De Man A, Wong IN, Leung PWL (2003) Perceived parental favouritism and suicidal ideation in Hong Kong adolescents. Soc Behav Pers 31:245–252CrossRef De Man A, Wong IN, Leung PWL (2003) Perceived parental favouritism and suicidal ideation in Hong Kong adolescents. Soc Behav Pers 31:245–252CrossRef
9.
go back to reference Durlak JA, Wells AM (1997) Primary prevention mental health programs for children and adolescents: a meta-analytic review. Am J Community Psychol 25:115–152PubMedCrossRef Durlak JA, Wells AM (1997) Primary prevention mental health programs for children and adolescents: a meta-analytic review. Am J Community Psychol 25:115–152PubMedCrossRef
10.
go back to reference Fu KW, Yip PSF (2007) Long-term impact of celebrity suicide on suicidal ideation: results from a population-based study. J Epidemiol Community Health 61:540–546PubMedCrossRef Fu KW, Yip PSF (2007) Long-term impact of celebrity suicide on suicidal ideation: results from a population-based study. J Epidemiol Community Health 61:540–546PubMedCrossRef
11.
go back to reference Gould M, Jamieson P, Romer D (2003) Media contagion and suicide among the young. Am Behav Sci 46:1269–1284CrossRef Gould M, Jamieson P, Romer D (2003) Media contagion and suicide among the young. Am Behav Sci 46:1269–1284CrossRef
12.
go back to reference 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 42:386–405PubMed 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 42:386–405PubMed
13.
go back to reference Gutierrez PM (2006) Integratively assessing risk and protective factors for adolescent suicide. Suicide Life Threat Behav 36:129–1357PubMedCrossRef Gutierrez PM (2006) Integratively assessing risk and protective factors for adolescent suicide. Suicide Life Threat Behav 36:129–1357PubMedCrossRef
14.
go back to reference Hawton K, Rodham K, Evans E, Weatherall R (2002) Deliberate self harm in adolescents: self report survey in schools in England. Br Med J 325:1207–1211CrossRef Hawton K, Rodham K, Evans E, Weatherall R (2002) Deliberate self harm in adolescents: self report survey in schools in England. Br Med J 325:1207–1211CrossRef
15.
16.
go back to reference Hesketh T, Ding QJ, Jenkins R (2002) Suicide ideation in Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 37:230–235PubMedCrossRef Hesketh T, Ding QJ, Jenkins R (2002) Suicide ideation in Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 37:230–235PubMedCrossRef
17.
go back to reference Horton NJ, Lipsitz SR (1999) Review of software to fit generalized estimating equation regression models. Am Stat 53:160–169CrossRef Horton NJ, Lipsitz SR (1999) Review of software to fit generalized estimating equation regression models. Am Stat 53:160–169CrossRef
18.
go back to reference 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 16:1–13CrossRef 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 16:1–13CrossRef
19.
go back to reference 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 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
20.
go back to reference Lai KW, McBride-Chang C (2001) Suicidal ideation, parenting style, and family climate among Hong Kong adolescents. Int J Psychol 36:81–87CrossRef Lai KW, McBride-Chang C (2001) Suicidal ideation, parenting style, and family climate among Hong Kong adolescents. Int J Psychol 36:81–87CrossRef
21.
go back to reference 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 58:487–498PubMedCrossRef 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 58:487–498PubMedCrossRef
22.
go back to reference 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 36:82–96PubMedCrossRef 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 36:82–96PubMedCrossRef
23.
go back to reference Legge J (1885) The sacred books of the East. Clarendon Press, Oxford Legge J (1885) The sacred books of the East. Clarendon Press, Oxford
24.
go back to reference 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 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
25.
go back to reference 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 36:1759–1767PubMedCrossRef 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 36:1759–1767PubMedCrossRef
26.
go back to reference Mann JJ (2002) A current perspective of suicide and attempted suicide. Ann Intern Med 136:302–311PubMed Mann JJ (2002) A current perspective of suicide and attempted suicide. Ann Intern Med 136:302–311PubMed
27.
go back to reference 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 294:2064–2074CrossRef 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 294:2064–2074CrossRef
28.
go back to reference Maris RW, Berman AL, Silverman MM (2000) Comprehensive textbook of suicidology. The Guilford Press, London and New York Maris RW, Berman AL, Silverman MM (2000) Comprehensive textbook of suicidology. The Guilford Press, London and New York
29.
go back to reference 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 27:71–79PubMedCrossRef 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 27:71–79PubMedCrossRef
30.
go back to reference 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 163:1226–1232PubMedCrossRef 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 163:1226–1232PubMedCrossRef
31.
go back to reference Shek DTL (1993) Measurement of pessimism in Chinese adolescents: the Chinese hopelessness scale. Soc Behav Pers 21:107–119CrossRef Shek DTL (1993) Measurement of pessimism in Chinese adolescents: the Chinese hopelessness scale. Soc Behav Pers 21:107–119CrossRef
32.
go back to reference 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 60:570–585PubMedCrossRef 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 60:570–585PubMedCrossRef
33.
go back to reference Speckens A, Hawton K (2005) Social problem solving in adolescents with suicidal behavior: a systematic review. Suicide Life Threat Behav 35:365–387PubMedCrossRef Speckens A, Hawton K (2005) Social problem solving in adolescents with suicidal behavior: a systematic review. Suicide Life Threat Behav 35:365–387PubMedCrossRef
34.
go back to reference 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 46:364–372PubMedCrossRef 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 46:364–372PubMedCrossRef
35.
go back to reference 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 29:227–240PubMed 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 29:227–240PubMed
36.
go back to reference Sun RCF, Hui EKP, Watkins D (2006) Towards a model of suicidal ideation for Hong Kong Chinese adolescents. J Adolesc 29:209–224PubMedCrossRef Sun RCF, Hui EKP, Watkins D (2006) Towards a model of suicidal ideation for Hong Kong Chinese adolescents. J Adolesc 29:209–224PubMedCrossRef
37.
go back to reference 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 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
38.
go back to reference Wagner BM, Cohen P (1994) Adolescent sibling differences in suicidal symptoms: the role of parent-child relationships. J Abnorm Child Psychol 22:321–337PubMedCrossRef Wagner BM, Cohen P (1994) Adolescent sibling differences in suicidal symptoms: the role of parent-child relationships. J Abnorm Child Psychol 22:321–337PubMedCrossRef
39.
go back to reference Watson CG, Vassar P, Plemel D, Herder J, Manifold V, Anderson D (1990) A factor analysis of Ellis’ irrational beliefs. J Clin Psychol 46:412–415PubMedCrossRef Watson CG, Vassar P, Plemel D, Herder J, Manifold V, Anderson D (1990) A factor analysis of Ellis’ irrational beliefs. J Clin Psychol 46:412–415PubMedCrossRef
40.
go back to reference Wei Y, Tang S (1996) A revision study on the COPE Scale. Acta Psychol Sin 28:380–387 Wei Y, Tang S (1996) A revision study on the COPE Scale. Acta Psychol Sin 28:380–387
41.
go back to reference Wong IN, De Man AF, Leung PW (2002) Perceived parental child rearing and suicidal ideation in Chinese adolescents. Soc Behav Pers 30:19–24CrossRef Wong IN, De Man AF, Leung PW (2002) Perceived parental child rearing and suicidal ideation in Chinese adolescents. Soc Behav Pers 30:19–24CrossRef
42.
go back to reference Wong JPS, Stewart SM, Ho SY, Rao U, Lam TH (2005) Exposure to suicide and suicidal behaviors among Hong Kong adolescents. Soc Sci Med 61:591–599PubMedCrossRef Wong JPS, Stewart SM, Ho SY, Rao U, Lam TH (2005) Exposure to suicide and suicidal behaviors among Hong Kong adolescents. Soc Sci Med 61:591–599PubMedCrossRef
43.
go back to reference Yip PSF, Liu KY, Hu J, Song XM (2005) Suicide rates in China during a decade of rapid social changes. Soc Psychiatry Psychiatr Epidemiol 40:792–798PubMedCrossRef Yip PSF, Liu KY, Hu J, Song XM (2005) Suicide rates in China during a decade of rapid social changes. Soc Psychiatry Psychiatr Epidemiol 40:792–798PubMedCrossRef
44.
go back to reference 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 34:284–297PubMedCrossRef 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 34:284–297PubMedCrossRef
Metadata
Title
Suicidality in Chinese adolescents in Hong Kong: the role of family and cultural influences
Authors
Wincy S. C. Chan, MEd
Chi Kin Law, PhD
Ka Y. Liu, PhD
Paul W. C. Wong, DPsyc (Clin)
Yik Wa Law, MSW
Paul S. F. Yip, PhD
Publication date
01-04-2009
Publisher
Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 4/2009
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-008-0434-x

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