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Published in: Social Psychiatry and Psychiatric Epidemiology 10/2017

01-10-2017 | Original Paper

Relative social standing and suicide ideation among Kenyan males: the interpersonal theory of suicide in context

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 10/2017

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Abstract

Purpose

The purpose of this study is to investigate the association between subjective social status and suicide ideation in a sample of young Kenyan men (age 18–34 years). Situating insights from the interpersonal theory of suicide within social determinants of health framework, we consider whether lower subjective social status predicts lower collective self-esteem (CSE), hopelessness, less meaning in life and more loneliness, and whether these characteristics mediate associations between subjective social status and suicide ideation.

Method

A community-based, semi-rural sample (n = 532) of young men, aged 18–34 years, was collected using a standardized questionnaire. The survey questionnaire included the following validated scale items: the short form of the Social and Emotional Loneliness Scale for Adults, CSE, Herth Hope Index, the Meaning in Life Questionnaire, and the Modified Scale for Suicide Ideation. Regression and mediation analyses were used to test hypotheses.

Results

Nearly 12% of respondents reported suicide ideation. Suicide ideation was significantly more common among survey respondents who reported lower subjective social standing. In the first of two mediation models, we found that lower CSE and more loneliness mediate the association between lower subjective social status and suicide ideation. In the second model, we found that respondents with lower CSE and more loneliness expressed lower hope and meaning in life, which also mediated pathways to suicide ideation.

Conclusions

Findings show a novel synthesis of social determinants literature with the interpersonal theory of suicide. Suicide ideation, along with other mental and social outcomes, may figure more prominently than previously appreciated in the benefits of socio-economic equality. Those who do not participate equally in socio-economic development may be at greater risk of engaging in suicide ideation and behaviors. Suicide prevention research and programmatic responses should adopt a health equity perspective to ensure that prevention is targeted where people are more likely to engage in suicide ideation.
Literature
5.
go back to reference Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A et al (2008) Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry 192(2):98–105CrossRefPubMedPubMedCentral Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A et al (2008) Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry 192(2):98–105CrossRefPubMedPubMedCentral
6.
go back to reference McKinnon B, Gariépy G, Sentenac M, Elgar FJ (2016) Adolescent suicidal behaviours in 32 low-and middle-income countries. Bull World Health Organ 94(5):340–350GCrossRefPubMedPubMedCentral McKinnon B, Gariépy G, Sentenac M, Elgar FJ (2016) Adolescent suicidal behaviours in 32 low-and middle-income countries. Bull World Health Organ 94(5):340–350GCrossRefPubMedPubMedCentral
7.
go back to reference Mars B, Burrows S, Hjelmeland H, Gunnell D (2014) Suicidal behaviour across the African continent: a review of the literature. BMC Public Health 14:606CrossRefPubMedPubMedCentral Mars B, Burrows S, Hjelmeland H, Gunnell D (2014) Suicidal behaviour across the African continent: a review of the literature. BMC Public Health 14:606CrossRefPubMedPubMedCentral
8.
9.
go back to reference Henry KL, Lovegrove PJ, Steger MF, Chen PY, Cigularov KP, Tomazic RG (2014) The potential role of meaning in life in the relationship between bullying victimization and suicidal ideation. J Youth Adolesc 43(2):221–232CrossRefPubMed Henry KL, Lovegrove PJ, Steger MF, Chen PY, Cigularov KP, Tomazic RG (2014) The potential role of meaning in life in the relationship between bullying victimization and suicidal ideation. J Youth Adolesc 43(2):221–232CrossRefPubMed
10.
go back to reference Singh-Manoux A, Adler NE, Marmot MG (2003) Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 56(6):1321–1333CrossRefPubMed Singh-Manoux A, Adler NE, Marmot MG (2003) Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 56(6):1321–1333CrossRefPubMed
11.
go back to reference Michelson N, Riis JL, Johnson SB (2016) Subjective social status and psychological distress in mothers of young children. Mater Child Health J 20(10):2019–2029CrossRef Michelson N, Riis JL, Johnson SB (2016) Subjective social status and psychological distress in mothers of young children. Mater Child Health J 20(10):2019–2029CrossRef
12.
go back to reference Operario D, Adler NE, Williams DR (2004) Subjective social status: reliability and predictive utility for global health. Psychol Health 19(2):237–246CrossRef Operario D, Adler NE, Williams DR (2004) Subjective social status: reliability and predictive utility for global health. Psychol Health 19(2):237–246CrossRef
13.
go back to reference Adler NE, Epel ES, Castellazzo G, Ickovics JR (2000) Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy, White women. Health Psychol 19(6):586CrossRefPubMed Adler NE, Epel ES, Castellazzo G, Ickovics JR (2000) Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy, White women. Health Psychol 19(6):586CrossRefPubMed
14.
go back to reference Christensen H, Batterham PJ, Soubelet A, Mackinnon AJ (2013) A test of the Interpersonal Theory of Suicide in a large community-based cohort. J Affect Disord 144(3):225–234CrossRefPubMed Christensen H, Batterham PJ, Soubelet A, Mackinnon AJ (2013) A test of the Interpersonal Theory of Suicide in a large community-based cohort. J Affect Disord 144(3):225–234CrossRefPubMed
15.
go back to reference Baumeister RF, Leary MR (1995) The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull 117(3):497CrossRefPubMed Baumeister RF, Leary MR (1995) The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull 117(3):497CrossRefPubMed
17.
go back to reference Turner B (2003) Social capital, inequality and health: the Durkheimian revival. Soc Theory Health 1(1):4–20CrossRef Turner B (2003) Social capital, inequality and health: the Durkheimian revival. Soc Theory Health 1(1):4–20CrossRef
18.
go back to reference Durkheim E (1951) Suicide: a study in sociology (JA Spaulding & G. Simpson, trans.). Free Press, Glencoe (Original work published 1897) Durkheim E (1951) Suicide: a study in sociology (JA Spaulding & G. Simpson, trans.). Free Press, Glencoe (Original work published 1897)
19.
go back to reference Kelly BD, Davoren M, Mhaoláin ÁN, Breen EG, Casey P (2009) Social capital and suicide in 11 European countries: an ecological analysis. Soc Psychiatry Psychiatr Epidemiol 44(11):971–977CrossRefPubMed Kelly BD, Davoren M, Mhaoláin ÁN, Breen EG, Casey P (2009) Social capital and suicide in 11 European countries: an ecological analysis. Soc Psychiatry Psychiatr Epidemiol 44(11):971–977CrossRefPubMed
21.
go back to reference Sani F, Bowe M, Herrera M (2008) Perceived collective continuity and social well-being: exploring the connections. Eur J Soc Psychol 38(2):365–374CrossRef Sani F, Bowe M, Herrera M (2008) Perceived collective continuity and social well-being: exploring the connections. Eur J Soc Psychol 38(2):365–374CrossRef
22.
go back to reference Au AC, Lau S, Lee MT (2009) Suicide ideation and depression: the moderation effects of family cohesion and social self-concept. Adolescence 44(176):851PubMed Au AC, Lau S, Lee MT (2009) Suicide ideation and depression: the moderation effects of family cohesion and social self-concept. Adolescence 44(176):851PubMed
23.
go back to reference Kraus MW, Piff PK, Mendoza-Denton R, Rheinschmidt ML, Keltner D (2012) Social class, solipsism, and contextualism: how the rich are different from the poor. Psychol Rev 119(3):546CrossRefPubMed Kraus MW, Piff PK, Mendoza-Denton R, Rheinschmidt ML, Keltner D (2012) Social class, solipsism, and contextualism: how the rich are different from the poor. Psychol Rev 119(3):546CrossRefPubMed
24.
go back to reference Klonsky ED, May AM (2014) Differentiating suicide attempters from suicide ideators: a critical frontier for suicidology research. Suicide Life-Threat Behav 44(1):1–5CrossRefPubMed Klonsky ED, May AM (2014) Differentiating suicide attempters from suicide ideators: a critical frontier for suicidology research. Suicide Life-Threat Behav 44(1):1–5CrossRefPubMed
25.
go back to reference Kessler RC, Borges G, Walters EE (1999) Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry 56(7):617–626CrossRefPubMed Kessler RC, Borges G, Walters EE (1999) Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry 56(7):617–626CrossRefPubMed
26.
go back to reference Thompson SK (2006) Targeted random walk designs. Surv Methodol 32(1):11 Thompson SK (2006) Targeted random walk designs. Surv Methodol 32(1):11
27.
go back to reference Pettit JW, Garza MJ, Grover KE, Schatte DJ, Morgan ST, Harper A, Saunders AE (2009) Factor structure and psychometric properties of the Modified Scale for Suicidal Ideation among suicidal youth. Depress Anxiety 26(8):769–774CrossRefPubMed Pettit JW, Garza MJ, Grover KE, Schatte DJ, Morgan ST, Harper A, Saunders AE (2009) Factor structure and psychometric properties of the Modified Scale for Suicidal Ideation among suicidal youth. Depress Anxiety 26(8):769–774CrossRefPubMed
28.
go back to reference Yang B, Clum GA (1994) Life stress, social support, and problem‐solving skills predictive of depressive symptoms, hopelessness, and suicide ideation in an Asian student population: a test of a model. Suicide Life Threat Behav 24(2):127–139PubMed Yang B, Clum GA (1994) Life stress, social support, and problem‐solving skills predictive of depressive symptoms, hopelessness, and suicide ideation in an Asian student population: a test of a model. Suicide Life Threat Behav 24(2):127–139PubMed
29.
go back to reference Miller IW, Norman WH, Bishop SB, Dow MG (1986) The modified scale for suicidal ideation: reliability and validity. J Consult Clin Psychol 54(5):724CrossRefPubMed Miller IW, Norman WH, Bishop SB, Dow MG (1986) The modified scale for suicidal ideation: reliability and validity. J Consult Clin Psychol 54(5):724CrossRefPubMed
30.
go back to reference Luhtanen R, Crocker J (1992) A collective self-esteem scale: self-evaluation of one's social identity. Pers Soc Psychol Bull 18(3):302–318CrossRef Luhtanen R, Crocker J (1992) A collective self-esteem scale: self-evaluation of one's social identity. Pers Soc Psychol Bull 18(3):302–318CrossRef
31.
go back to reference Sato T, Cameron JE (1999) The relationship between collective self-esteem and self-construal in Japan and Canada. J Soc Psychol 139(4):426–435CrossRefPubMed Sato T, Cameron JE (1999) The relationship between collective self-esteem and self-construal in Japan and Canada. J Soc Psychol 139(4):426–435CrossRefPubMed
32.
go back to reference Kinoti KE, Jason LA, Harper GW (2011) Determinants of alcohol, khat, and bhang use in rural Kenya. Afr J Drug Alcohol Stud 10(2):107–118PubMedPubMedCentral Kinoti KE, Jason LA, Harper GW (2011) Determinants of alcohol, khat, and bhang use in rural Kenya. Afr J Drug Alcohol Stud 10(2):107–118PubMedPubMedCentral
33.
go back to reference Ditommaso E, Brannen C, Best LA (2004) Measurement and validity characteristics of the short version of the social and emotional loneliness scale for adults. Educ Psychol Meas 64(1):99–119CrossRef Ditommaso E, Brannen C, Best LA (2004) Measurement and validity characteristics of the short version of the social and emotional loneliness scale for adults. Educ Psychol Meas 64(1):99–119CrossRef
34.
go back to reference Adamczyk K (2013) Development and validation of the Polish-language version of the Multidimensional Scale of Perceived Social Support (MSPSS). Revue internationale de psychologie sociale 26(4):25–48 Adamczyk K (2013) Development and validation of the Polish-language version of the Multidimensional Scale of Perceived Social Support (MSPSS). Revue internationale de psychologie sociale 26(4):25–48
35.
go back to reference Çeçen AR (2007) The Turkish short version of the social and emotional loneliness scale for adults (SELSA-S): initial development and validation. Soc Behav Personal Int J 35(6):717–734CrossRef Çeçen AR (2007) The Turkish short version of the social and emotional loneliness scale for adults (SELSA-S): initial development and validation. Soc Behav Personal Int J 35(6):717–734CrossRef
36.
go back to reference Herth K (1992) Abbreviated instrument to measure hope: development and psychometric evaluation. J Adv Nurs 17(10):1251–1259CrossRefPubMed Herth K (1992) Abbreviated instrument to measure hope: development and psychometric evaluation. J Adv Nurs 17(10):1251–1259CrossRefPubMed
37.
go back to reference Arnau RC, Martinez P, de Guzmán IN, Herth K, Konishi CY (2010) A Spanish-language version of the Herth Hope Scale: development and psychometric evaluation in a Peruvian sample. Educ Psychol Measurement 70:808–824CrossRef Arnau RC, Martinez P, de Guzmán IN, Herth K, Konishi CY (2010) A Spanish-language version of the Herth Hope Scale: development and psychometric evaluation in a Peruvian sample. Educ Psychol Measurement 70:808–824CrossRef
38.
go back to reference Chan KS, Li HCW, Chan SWC, Lopez V (2012) Herth hope index: psychometric testing of the Chinese version. J Adv Nurs 68(9):2079–2085CrossRefPubMed Chan KS, Li HCW, Chan SWC, Lopez V (2012) Herth hope index: psychometric testing of the Chinese version. J Adv Nurs 68(9):2079–2085CrossRefPubMed
39.
go back to reference Lin CC, Lai YL, Ward SE (2003) Effect of cancer pain on performance status, mood states, and level of hope among Taiwanese cancer patients. J Pain Symptom Manage 25(1):29–37CrossRefPubMed Lin CC, Lai YL, Ward SE (2003) Effect of cancer pain on performance status, mood states, and level of hope among Taiwanese cancer patients. J Pain Symptom Manage 25(1):29–37CrossRefPubMed
40.
go back to reference Steger MF, Frazier P, Oishi S, Kaler M (2006) The meaning in life questionnaire: assessing the presence of and search for meaning in life. J Couns Psychol 53(1):80CrossRef Steger MF, Frazier P, Oishi S, Kaler M (2006) The meaning in life questionnaire: assessing the presence of and search for meaning in life. J Couns Psychol 53(1):80CrossRef
41.
go back to reference Boyraz G, Lightsey Jr OR, Can A (2013) The Turkish version of the Meaning in Life Questionnaire: assessing the measurement invariance across Turkish and American adult samples. J Pers Assess 95(4):423–431CrossRefPubMed Boyraz G, Lightsey Jr OR, Can A (2013) The Turkish version of the Meaning in Life Questionnaire: assessing the measurement invariance across Turkish and American adult samples. J Pers Assess 95(4):423–431CrossRefPubMed
42.
go back to reference Chan WCH (2014) Factor structure of the Chinese version of the Meaning in Life Questionnaire among Hong Kong Chinese caregivers. Health Soc Work 39(3):135–143CrossRefPubMed Chan WCH (2014) Factor structure of the Chinese version of the Meaning in Life Questionnaire among Hong Kong Chinese caregivers. Health Soc Work 39(3):135–143CrossRefPubMed
43.
go back to reference Goodman ML, Johnson TM, Guillot-Wright S, Porter KA, Keiser PH, Gitari S (2017) How do Kenyan orphan girls experience less meaningful lives and how much does it matter for ‘health’? Qual Life Res 26(6):1551–1559CrossRefPubMed Goodman ML, Johnson TM, Guillot-Wright S, Porter KA, Keiser PH, Gitari S (2017) How do Kenyan orphan girls experience less meaningful lives and how much does it matter for ‘health’? Qual Life Res 26(6):1551–1559CrossRefPubMed
44.
go back to reference Ezeamama AE, Guwatudde D, Wang M, Bagenda D, Brown K, Kyeyune R et al (2016) High perceived social standing is associated with better health in HIV-infected Ugandan adults on highly active antiretroviral therapy. J Behav Med 39(3):453–464CrossRefPubMed Ezeamama AE, Guwatudde D, Wang M, Bagenda D, Brown K, Kyeyune R et al (2016) High perceived social standing is associated with better health in HIV-infected Ugandan adults on highly active antiretroviral therapy. J Behav Med 39(3):453–464CrossRefPubMed
45.
go back to reference Kondo N, Kawachi I, Subramanian SV, Takeda Y, Yamagata Z (2008) Do social comparisons explain the association between income inequality and health?: relative deprivation and perceived health among male and female Japanese individuals. Soc Sci Med 67(6):982–987CrossRefPubMedPubMedCentral Kondo N, Kawachi I, Subramanian SV, Takeda Y, Yamagata Z (2008) Do social comparisons explain the association between income inequality and health?: relative deprivation and perceived health among male and female Japanese individuals. Soc Sci Med 67(6):982–987CrossRefPubMedPubMedCentral
46.
go back to reference Macleod J, Smith GD, Metcalfe C, Hart C (2005) Is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men. Soc Sci Med 61(9):1916–1929CrossRefPubMed Macleod J, Smith GD, Metcalfe C, Hart C (2005) Is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men. Soc Sci Med 61(9):1916–1929CrossRefPubMed
47.
go back to reference Morris SS, Carletto C, Hoddinott J, Christiaensen LJ (2000) Validity of rapid estimates of household wealth and income for health surveys in rural Africa. J Epidemiol Commun Health 54(5):381–387CrossRef Morris SS, Carletto C, Hoddinott J, Christiaensen LJ (2000) Validity of rapid estimates of household wealth and income for health surveys in rural Africa. J Epidemiol Commun Health 54(5):381–387CrossRef
49.
go back to reference Deane F, Wilson C, Ciarroch J (2001) Suicidal ideation and help-negation: not just hopelessness or Prior help. J Clin Psychol 57(7):901–914CrossRefPubMed Deane F, Wilson C, Ciarroch J (2001) Suicidal ideation and help-negation: not just hopelessness or Prior help. J Clin Psychol 57(7):901–914CrossRefPubMed
50.
go back to reference Goldsmith S, Pellmar T, Kleinman A, Bunney W (2002) Reducing suicide: a national imperative. The National Academic Press, Washington DC Goldsmith S, Pellmar T, Kleinman A, Bunney W (2002) Reducing suicide: a national imperative. The National Academic Press, Washington DC
51.
go back to reference Marangu E, Sands N, Rolley J, Ndetei D, Mansouri F (2014) Mental healthcare in Kenya: exploring optimal conditions for capacity building. Afr J Prim Health Care Fam Med 6(1):1–5CrossRef Marangu E, Sands N, Rolley J, Ndetei D, Mansouri F (2014) Mental healthcare in Kenya: exploring optimal conditions for capacity building. Afr J Prim Health Care Fam Med 6(1):1–5CrossRef
52.
go back to reference Jenkins R, Kiima D, Njenga F, Okonji M, Kingora J, Kathuku D, Lock S (2010) Integration of mental health into primary care in Kenya. World Psychiatry 9(2):118–120CrossRefPubMedPubMedCentral Jenkins R, Kiima D, Njenga F, Okonji M, Kingora J, Kathuku D, Lock S (2010) Integration of mental health into primary care in Kenya. World Psychiatry 9(2):118–120CrossRefPubMedPubMedCentral
53.
go back to reference Morris J, Belfer M, Daniels A, Flisher A, Villé L, Lora A, Saxena S (2011) Treated prevalence of and mental health services received by children and adolescents in 42 low-and-middle-income countries. J Child Psychol Psychiatry 52(12):1239–1246CrossRefPubMed Morris J, Belfer M, Daniels A, Flisher A, Villé L, Lora A, Saxena S (2011) Treated prevalence of and mental health services received by children and adolescents in 42 low-and-middle-income countries. J Child Psychol Psychiatry 52(12):1239–1246CrossRefPubMed
54.
go back to reference Chibanda D, Weiss HA, Verhey R, Simms V, Munjoma R, Rusakaniko S, Chingono A, Munetsi E, Bere T, Manda E, Abas M, Araya R (2016) Effect of a primary care-based psychological Intervention on symptoms of common Mental disorders in Zimbabwe: a randomized clinical trial. JAMA 316(24):2618–2626CrossRefPubMed Chibanda D, Weiss HA, Verhey R, Simms V, Munjoma R, Rusakaniko S, Chingono A, Munetsi E, Bere T, Manda E, Abas M, Araya R (2016) Effect of a primary care-based psychological Intervention on symptoms of common Mental disorders in Zimbabwe: a randomized clinical trial. JAMA 316(24):2618–2626CrossRefPubMed
Metadata
Title
Relative social standing and suicide ideation among Kenyan males: the interpersonal theory of suicide in context
Publication date
01-10-2017
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 10/2017
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-017-1427-4

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