Psychosocial factors as predictors of suicidal ideation amongst adolescents in the Free State Province: a cross-cultural study

[摘要] English:The recently published National Youth Risk Behaviour Surveys highlighted an alarming increase in adolescent suicidal behaviour in South Africa. The death of a young person has a profound psychological and social effect on both the family and broader community. Moreover, the high incidence of adolescent suicides and suicide-related hospitalisations places a heavy burden on the service delivery of the South African health sector. Understanding the social-cultural context in which suicidal behaviour occurs is essential for public health efforts to reduce this behaviour amongst adolescents. The aim of this study was to investigate the role of underlying psychosocial factors in adolescent suicidal behaviour, as well as to explore ethnic differences in the stressors and resources as reported by a sample of black, white and coloured adolescents in the Free State province. Both quantitative and qualitative methods were used to collect and analyse data. Quantitatively, a cross-sectional, correlational, and criterion-group design was used, while thematic content analysis was used for the analysis of the qualitative data. A stratified, multi-ethnic sample of 1033 Grade 11 and 12 learners was included from eighteen schools in the Free State province. The Suicidal Ideation Questionnaire for Adolescents, the Social Stressors and Resources Inventory - Youth Form, the COPE Questionnaire, the South African Acculturation Scale, and a biographical questionnaire were used to gather information from the participants. Various statistical analyses were conducted such as a multivariance of analysis to compare the ethnic groups with regard to significant differences in suicidal ideation, stressors, resources, acculturation and coping strategies. A product- term analysis was also performed to investigate the role of coping strategies in the relationship between stressors and suicidal ideation, while hierarchical regression analyses were conducted to determine the unique contributions of stressors, resources, acculturation- and coping strategies to suicidal ideation. The qualitative data was gathered through the use of two open-ended statements that required participants to identify stressors and resources in their lives. Thematic content analysis was used to analyse these responses. The results from the quantitative study indicated that the level of suicidal ideation reported by the current sample was substantially higher than for a comparative American sample. Ethnic and gender differences were also found between groups, with coloured females reporting the highest levels of suicidal ideation. Parent-child relationship, peer relationships and financial constraints appear to be common stressors among coloured adolescents, while black adolescents reported financial constraints and romantic relationships as major sources of stress. For white adolescents, their parent-child relationship seemed to act as a major stressor. Coping strategies did not mediate the relationship between perceived life stressors and suicidal ideation amongst any of the three ethnic groups, on either the 1% or 5% level of statistical significance. Coping strategies, did, however, act as moderators in this relationship. Furthermore, coping strategies did not explain a statistically significant proportion of the variance in the suicidal ideation of either black or coloured adolescents in the current sample. The findings, however, suggested that active coping and alcohol and drug disengagement contributed significantly to the variance in suicidal ideation amongst the white adolescents. None of the acculturation scales contributed significantly to the variance in suicidal ideation for any of the three ethnic groups. The main findings of the qualitative data suggested ethnic differences in the reported experiences of stressors and resources. In terms of stressors, participants from all three ethnic groups identified negative self-perception, poor behaviour regulation and financial difficulties as major sources of stress in their lives. Black and coloured participants identified alcohol abuse in their communities and financial problems as major stressors and white participants identified the high levels of crime. Black adolescents identified a positive self-esteem as most important resource, while white participants identified the relationship with their families, as well as material resources as main resources. Coloured adolescents, on the other hand, showed stronger identification with religion as prominent resource. It is recommended that future research focuses on the inclusion of additional variables such as socio-economic status, as well as the use of longitudinal studies to explore the dynamics of adolescent suicidal behaviour. The implementation of programmes aimed at enhancing effective coping strategies and social skills of adolescents are also recommended.

[发布机构] University of the Free State