Rozprawy doktorskie na temat „Teenagers – Suicidal behavior – Fiction”

Skating the Edge is a contemporary Young Adult novel, set partly in an adolescent psychiatric hospital in the narrated present time, and partly in the school and home of the protagonist Caitlin Michaels, in the narrated past. The novel deals with Caitlin's attempts to understand the suicide of one of the residents of the hospital, Anna, and also to understand the events that led to her own hospitalisation, which include her complicated relationship with her talented older brother, Nick. As the narrative unfolds, it is evident that Anna's suicide has been prompted by serial sexual abuse at the hands of her father and the inappropriate relationship between Anna and a male psychiatric nurse.

This research utilized data concerning adolescents at imminent risk for harm confined to the Edmonton and Lethbridge secure treatment centres in Alberta. Once screened for inclusion criteria in a single stage, non-random convenience sampling protocol, 210 files were included in the study. From these files, the adolescents' psychopathological diagnoses, Suicide Probability Scale (SPS) scores as well as other demographic data (including age, gender, ethnicity and previous suicide attempts) were recorded. This research was designed to delineate the characteristics of adolescents admitted to secure treatment, examine the overall suicide risk in this sample, investigate the relationship between study variables via crosstabulation and chi-square analysis, and to determine which independent variable/s best predicted suicide risk via ANOVA and multiple lineear regression analysis. Analysis results indicated that the sample was predominantly comprised of female adolescents, Caucasian ethnicity and was aged between 13 and 15 years. The majority of adolescents with suicide history information available in their file had previously attempted suicide. Youth demonstrated an average of 2.7 psychopathological diagnoses, the most frequent of which were conduct disorder, substance abuse, depression, adjustment disorder and parent child relational disorder. The majority of youth were in the moderate suicide risk category from SPS scores. Multiple linear regression analysis determined that the diagnoses of adjustment disorder and depression were found to be predictive of increased suicide risk scores, as was gender (females had higher risk scores), age (younger adolescents had higher risk scores) and previous suicide attempts. Those in the "other" ethnicity category demonstrated lower suicide risk scores.
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This research was conducted in the hope of making some contribution to the emerging field of developmental psychopathology through an examination of the relations between progressive movement toward social-cognitive maturity and socioemotional adjustment in adolescence. The two developmental matters of particular concern were the contrastive ways in which suicidal and nonsuicidal adolescents undertake to secure a sense of their own personal continuity across time, and a sense of conviction in the face of growing skeptical doubts. Alternative accounts of suicidal behaviour generally fail to offer any explanatory framework with which to account for the sudden and dramatic increase in suicidal behaviour during the adolescent years. It is argued in this thesis that the self-destructive tendencies of suicidal youth may be better understood as behavioural manifestations of difficulties in dealing with the developmental matters of personal continuity and nascent skeptical doubt More specifically, the arguments presented in this thesis lead to the hypotheses that suicidal adolescents are less able than their nonsuicidal age-mates to 1) adequately warrant their own and others' persistent identity across time, and 2) make use of more mature strategies for dealing with issues of uncertainty and doubt. To test these predictions, 29 psychiatrically hospitalized suicidal adolescents, who were subsequently categorized in to either a high suicide risk group (n=13) or a low suicide risk group (n =16), and an age- and sex-matched group of 29 high school students were individually administered: (1) The Continuity Measure, comprised of 2 stories and a semi-structured interview procedure which inquires into how subjects warrant their own and others' personal continuity in the face of dramatic personal change; (2) The Nascent Skeptical Doubt Interview, also comprised of 2 stories and an associated semi-structured interview procedure aimed at determining subjects' characteristic strategies for dealing with uncertainty; and (3) The Nascent Skeptical Doubt Questionnaire, which permits the placement of respondents along an objectivist-relativist dimension. The results of this study indicate that, in comparison to their nonhospitalized age-mates, the psychiatrically hospitalized suicidal adolescents did evidence difficulties both in their abilities to understand how they and others could be said to remain continuous or self-same persons throughout time, and in their ability to cope with questions of uncertainty and doubt. In addition, adolescents at high risk for suicide were distinguished from other psychiatrically hospitalized individuals at low risk to suicide, and from their high school age-mates by: 1) their unique inability to find any workable means of justifying persistent identity across change; and 2) by their more extreme endorsement of absolutistic views in the face of uncertainty. These findings are seen to lend support to the general theoretical attempt of this thesis to interpret certain socioemotional difficulties experienced by adolescents as arising from a developmental asynchrony between progressive movement toward the more abstract, relativized, and self-reflective modes of thought associated with cognitive maturity, and the task of securing more mature strategies for dealing with the reconceptualizations of the problems of continuity and doubt which these cognitive advances necessitate. In addition, a number of theoretical, diagnostic, and treatment implications which are seen to follow from the results of this study are discussed.
Arts, Faculty of
Psychology, Department of
Graduate

There has been an epidemic rate of increase in youth suicide since 1960. Professionals, teachers, counselors and parents want to identify youth at risk of suicide and intervene prior to an attempt or a suicide. The premise of this study is that youth who display similar risk factors as past attempters and completers may be at risk of attempting themselves and can be identified by these risk factors. This is a quantitative and descriptive study of youth suicide attempters and completers in the state of Oregon in 1989 and 1990 in an effort to further identify risk factors of youth suicide attempters and completers. The researcher petitioned the Oregon Center for Health Statistics and obtained databases of 1150 youth attempters and 40 suicide completers. The attempter database was compiled from a legislatively mandated informational form filled out in public and private hospital emergency rooms for anyone under 18 sustaining injuries due to a suicide attempt. The second database is compiled from death certificates for youth under 18, specifying suicide as the cause of death. Data, both in the number of cases, and in the depth of the material is sparse on suicide completers. The first question employed both databases to examine the demographic similarities and differences between youth suicide attempters and completers in Oregon in 1989 and 1990. The second and third research questions are answered using the attempter data base. The second question is an in depth examination of 18 social, psychological and behavioral factors taken from the attempter database, resulting in a description of the youth who have previously attempted in Oregon in 1989 and 1990. The third research question again studies the same 18 social psychological and behavioral factors of the attempter population, dividing it into subgroups of sex, race, and age. Through crosstabulation and the chi-square tests of statistical significance, each group was specifically described. A fourth research question called for a qualitative focus group of professional suicidologists who confirmed the findings by comparing them to their own practical experience.

A review of the literature strongly suggests that poor family dynamics play a critical role in an adolescent's choice of suicide. This thesis examines the literature and research findings on adolescent suicide and family functioning. It will bring together recent findings to help professionals access the information on adolescent suicide as it relates to the family. The psychosocial and cognitive theories of development are explored to provide a framework for understanding adolescents and the reasons for the choices and problem solving they make in their quest for identity. Since social workers are increasingly implicated in the prevention of youth suicide, the thesis applies the argument to prevention from a social work perspective.

This study examined the relationship between psychological birth order and substance abuse and suicide in adolescents. It was hypothesized that adolescents operating from a perceived inferior position as measured by the Psychological Birth Order Instrument would be more likely to abuse substances and/or engage in self-destructive behavior. Ninety-five adolescents from Southern Arizona volunteered to participate in this study. The forty-eight treatment subjects were current in-patients at a psychiatric hospital. The control group consisted of forty-seven high school students. The results indicated that there was a difference in perceptions between adolescents in treatment versus those not in treatment for substance abuse and/or suicide. There was a significant relationship at the.005 level and it was concluded that adolescents operating from a perceived inferior position are more likely to abuse substances and/or attempt suicide.

This research developed two best-fitting structural equation models of risk factors for adolescent depression and suicidality: a core model, which included parenting factors, gender, depression, and suicidality, and an extended model, which also encompassed personality traits (Introversion and Impulsivity) and mood factors (Anxiety and Anger). Further, this research investigated the consistency of model fit across time (Le., 1 month & 12 months) and samples, and explored the effectiveness of the ReachOut! Internet site as a psychoeducational prevention strategy for adolescent depression and suicidality. Gender, age, and location differences were also explored. Participants were 185 Year-9 students and 93 Year-10 students aged 14 - 16 years, from seven secondary schools in regional and rural Victoria. Students were given a survey which included the Parental Bonding Instrument (Parker, Tupling, & Brown, 1979), the Millon Adolescent Personality Inventory (Millon, Green, & Meagher, 1982), the Profile of Mood States Inventory (McNair & Lorr, 1964), items on suicidal behaviour including some questions from the Revised Adolescent Suicide Questionnaire (Pearce & Martin, 1994), and questions on loss and general demographics. Results supported an indirect model of risk factors, with family factors directly influencing personality factors, which in turn influenced mood factors, including depression, which then influenced suicidality. At the theoretical level, results supported Attachment Theory (Bowlby, 1969), demonstrating that perceived parenting styles that are warm and not overly controlling are more conducive to an adolescent's emotional well-being than are parenting styles that are cold and controlling. Further, results supported Millon's theory of personality (1981), demonstrating that parenting style influences a child's personality. Short-term intervention effects from the internet site were a decrease in Introversion for the full sample, and decreased Inhibition and Suicidality for a high-risk subgroup. Long-term age effects were decreased Inhibition and increased Anxiety for the fall sample. There was also a probable intervention effect for Depression for the high-risk subgroup. No location differences for the risk factors were found between regional and rural areas.

Suicidality is an important problem among adolescents. This study compares Durkheim's and Tarde's perspectives on suicide. While the Durkheimian perspective alleges that integration, regulation, and anomie play the major role on adolescent suicidality, Tarde's theory considers imitation as the most important factor affecting suicidality. Durkheim suggests that individuals with higher integration and regulation are less likely to commit suicide. Individuals with less integration and regulation, on the other hand, are more likely to experience anomie and higher suicidality. Tarde claims that individuals with suicidal peers are more likely to commit suicide. In particular, the effects of school integration, family integration, peer integration, religious integration, neighborhood integration, family regulation, anomie, and suicide imitation on adolescent suicidality in Turkey are examined using binary logistics regression in the current attempt. The results indicate that school integration, family integration, and religious integration have significant negative effects on adolescents' suicidality whereas suicide imitation has a positive effect. The results of the study are expected to help to prevention programs purposed at reducing suicidality among adolescents.

The present study attempted to identify demographic and psychological variables predictive of adolescent suicidal ideations and attempts. Data from 90 adolescents, who completed an intake form at a university community mental health clinic or were student volunteers, were utilized. Two judges tabulated information regarding age, gender, number of siblings, ethnicity, parental marital status, drug use, depression, suicidal ideation, and previous suicidal attempts. A multiple regression analysis was performed to identify which variables had predictive significance. Depression was the best predictor of both suicidal ideations and attempts. Ethnicity was also predictive; white adolescents were found to be at higher risk for suicide than individuals from other ethnic groups. It is suggested that additional studies be done exploring other predictors of suicide among adolescents.

Thesis (M.P.H.)--Georgia State University, 2008.
Title from file title page. Monica H. Swahn, committee chair; Frances McCarty, committee member. Description based on contents viewed June 19., 2009. Includes bibliographical references (p. 67-69).

In South Africa, suicidal behaviour in the younger generations has become rapidly part of a major public health problem. It is a well-known fact that adolescence is a critical period of progression in a teenager’s development which makes them more susceptible and vulnerable to suicide. Statistics have shown that there has been an increase in suicide among adolescents within the last decade (Schlebusch, 2005). The main aim of this research study is to explore the perceptions of adolescents regarding the factors that contribute to adolescent suicide. This study reviews literature concerning various risks factors for adolescent suicidality. It also described major social and psychological theories of suicide and the extent to which these studies support the importance to adolescent suicide. In the literature review theories of Bronfenbrenner’s Ecological Systems Theory, Durkheim’s sociological theory of suicide, Freud’s psychological perspective and Baumeister’s Escape Theory were discussed. A qualitative research design will be used by using visual participatory methodology techniques namely photo voice and reflective writing. A sample of 12 grade 11 learners, male and female, was purposely selected to participate in the research study. The focus of the study is to investigate the risk factors underlying adolescent suicidal behaviour in schools in the Northern Areas of Port Elizabeth, as well as to explore the stressors experienced by adolescents that could contribute to them having a higher suicide risk. Another focus point will be to look at prevention strategies as an antipode for suicidal behaviour. The main findings that emerged from the data analysis include contributing factors namely: socio-economic factors, personal factors, psychological factors and educational and school-related factors. The main prevention strategy themes emerged from findings derived from the data and include: parental involvement, religion, professional help and support groups and confiding in someone that you trust.

This study seeks to attain understanding of attempted suicide in young women from non-English speaking backgrounds, constructing meaning(s) of attempted suicide and eliciting information about sociocultural influences and guided by philosophical hermeneutics and narrative inquiry using life story methods. Thematic analysis was used to explicate from the text 30 sub-themes, five themes (being in a gap between cultures and creating space for themselves, being traumatised and diminished by abuse, surviving dangerous relationships, suffering psychic pain, expressing the self by attempting suicide), and a meta-theme (paradoxically asserting the indefinite self). Interpretation was predicated on the belief that life stories are statements about self-identity, and represent coming into being through the interaction of coherence (the ability to establish connections between events, unifying themes, frames of reference and goal states), continuity (a longitudinal and sequential perspective on life) and connectedness (intrapersonal, interpersonal and transpersonal relationships). The paradox is that being unable to overcome the uncertainties of incoherence, discontinuity and problematic connectedness, participants were predisposed to act against self as a means of asserting agency. This understanding of attempted suicide represents a hermeneutic narrative reconceptualisation of the phenomenon, which places it outside discourses that sanction the language of psychopathology and provides a basis for developing alternative nursing theory and informing education and practice

Approximately 2-11% of adolescents report chronic insomnia. The study used an archival data set from ADDHealth that assessed adolescent health and health-related behaviors. Adolescents (N = 4102) provided data at baseline (Time 1) and at 1-year follow-up (Time 2). Participants were excluded if no ethnicity, gender, or insomnia data were given at Time 1 or 2. Females were more likely to report insomnia than males at Times 1 and 2. In addition, adolescents with remitted insomnia were significantly younger than adolescents without insomnia at Times 1 and 2. Analyses found a prevalence of 9.6%, a remittance of 6.2%, an incidence of 4.4%, and a chronicity of 2.9%. At Time 1 and 2, AWI were significantly more likely to have depression, suicidal behaviors, and behavioral problems in school than AWOI. At Time 2, incidence and chronic insomnia increased the risk of depression, suicidal behaviors and behavioral problems in school. Risk and protective factors analyses indicated psychological counseling was associated with both remitted and chronic insomnia and depression was associated with incidence insomnia.

The purpose of this project was to explore perceptions of effective components in adolescent suicide prevention programs among San Bernardino school counselors. The stress model and the mental health model are the two models implemented in suicide prevention programs.

This study seeks to attain understanding of attempted suicide in young women from non-English speaking backgrounds, constructing meaning(s) of attempted suicide and eliciting information about sociocultural influences and guided by philosophical hermeneutics and narrative inquiry using life story methods. Thematic analysis was used to explicate from the text 30 sub-themes, five themes (being in a gap between cultures and creating space for themselves, being traumatised and diminished by abuse, surviving dangerous relationships, suffering psychic pain, expressing the self by attempting suicide), and a meta-theme (paradoxically asserting the indefinite self). Interpretation was predicated on the belief that life stories are statements about self-identity, and represent coming into being through the interaction of coherence (the ability to establish connections between events, unifying themes, frames of reference and goal states), continuity (a longitudinal and sequential perspective on life) and connectedness (intrapersonal, interpersonal and transpersonal relationships). The paradox is that being unable to overcome the uncertainties of incoherence, discontinuity and problematic connectedness, participants were predisposed to act against self as a means of asserting agency. This understanding of attempted suicide represents a hermeneutic narrative reconceptualisation of the phenomenon, which places it outside discourses that sanction the language of psychopathology and provides a basis for developing alternative nursing theory and informing education and practice
Doctor of Philosophy (PhD)

This creative personal essay examines the long-term effects of surviving a friend's adolescent suicide. The piece begins with the story of the narrator's suicide loss, and subsequently follows her on a quest to understand her grief. She explores cultural perceptions of suicide in America, such as the dialogue around suicide, suicide prevention objectives, the suicide survivor experience, suicide tourism, and media responses to suicide--all reflecting her relationship to the subject. In the end, the narrator returns to the place where her quest began, carrying the wisdom she has gleaned from her inquiries.

Cette recherche s’intéresse à la façon singulière dont l’adolescent ou le jeune adulte suicidant se représente ses liens familiaux et extra-familiaux. Elle explore la façon dont ces jeunes s’inscrivent dans leur histoire familiale, se repèrent dans leur généalogie, mais aussi la façon dont ils construisent, dans le monde qui les entoure, leur réseau d’appartenance. Comprenant l’accès aux transmissions familiales et la possibilité de tisser un réseau de lien extra-familiaux, comme un élément capital de la construction identitaire, ce travail envisage l’hypothèse selon laquelle l’acte suicidaire de l’adolescent traduirait une revendication de l’unicité et de l’authenticité de son existence. L’intention de se faire exister serait plus prégnante que l’intention de se donner la mort. De telles conduites, à valeur ordalique, témoigneraient d’un affrontement avec le monde, dont l’enjeu serait de vivre plus. Elles amèneraient l’adolescent à s’imposer, inconsciemment, de frôler la mort pour se transformer, renaître, revivre après le traumatisme, pour enfin exister. A l’aide d’entretiens cliniques et d’outils d’évaluation systémique comprenant la réalisation de génogrammes libres et imaginaires, seize études de cas ont été réalisées. Ces données ont permis d’effectuer une analyse qualitative individuelle et groupale et, plus particulièrement une exploration familiale tri-générationnelle. Sans confirmer la valeur ordalique de la conduite suicidaire, nos résultas suggèrent que les jeunes rencontrés tentent de se faire exister en cherchant une enveloppe généalogique mais aussi affiliative, contenante au sein de laquelle ils se sentent inscrits et reconnus. Le sentiment d'appartenance qui permet la différenciation et qui donne sens à l’existence fait défaut chez tous. Ces résultats ouvrent une piste de réflexion sur la signification du geste suicidaire à l’adolescence: il s’agit d’une quête de sens, mais aussi de reconnaissance, qui passe par l’épreuve personnelle et le fait d’y survivre.

Doctorat en Sciences Psychologiques et de l'éducation
info:eu-repo/semantics/nonPublished

This study examined psychological, social, and cultural factors that can affect suicide risk among Mong/Hmong youth between the ages of 18 and 25. Emerging evidence suggests that Mong/Hmong youth are at an increased risk for suicide (Huang, Lee, & Arganza, 2004; Jesilow & Xiong, 2007). Additionally, initial findings and theories have suggested potential associations between Mong/Hmong youth suicide risk and intergenerational family conflict, ethnic identity, acculturation, depression, and spirituality. The seriousness of suicide risk among Mong/Hmong youth in this country has been overlooked for decades; therefore, the purpose of this study was to examine these associations with the hope that the findings would be beneficial in future efforts to reduce suicide risk among Mong/Hmong youth. This research was a cross-sectional exploratory study that used a purposive sampling method in addition to snowball sampling. The sample consisted of 165 Mong/Hmong youth between the ages of 18 and 25 from three California academic institutions. Results indicated that of 165 respondents, 59% (n=98) have had passing thoughts of suicide. There was a correlation between ethnic identity, intergenerational family conflict, depression, and spiritual beliefs. Furthermore, ethnic identity and intergenerational family conflict were significant predictors of depression. Lastly, depression and having a belief in Mong/Hmong traditional spiritual and healing practices were predictors of suicide risk among the sampled population. Two open-ended protective factor questions were explored to encourage participants to reflect on their resilience to suicide by sharing how they responded to thoughts of ending their life and what helped them to overcome those thoughts. Five themes were identified as protective factors: (1) having the cognitive ability to understand how death affects loved ones; (2) optimism and having a positive orientation toward the future; (3) connectedness with family, friends, and community; (4) having a sense of self-worth; and (5) a social life. Implications for social work practice and policy include the development, expansion and delivery of culturally appropriate mental health treatment services for young adults. This entails the incorporation of traditional Mong/Hmong mental health healing practices into western mental health treatment, ongoing clinical research to better understand the mental health needs of the Mong/Hmong young adult population, and educating and empowering the Mong/Hmong community to access the mental health system, thereby reducing the stigma associated with mental health and increasing access to treatment.

La conducta suicida en adolescentes atendidos por instituciones gestionadas por el Estado (e.g., protección infantil, justicia juvenil) ha sido foco de escaso interés en el ámbito empírico. No obstante, la mayoría de los estudios que se han llevado a cabo ha enfatizado la condición de vulnerabilidad en la que se encuentran estos jóvenes. Gran parte de estos chicos y chicas presentan una alta prevalencia de conducta suicida y han sufrido numerosas experiencias de victimización antes y durante su vinculación con estas instituciones, constituyendo así un problema psicosocial grave y de interés en las políticas sociales. Esta tesis se presenta como un compendio de dos trabajos empíricos originales de investigación científica que abordan la relación entre la acumulación de experiencias victimizantes o polivictimización, la resiliencia y la conducta suicida en adolescentes del sistema de protección y de justicia juvenil en España. Ambos trabajos han sido publicados en revistas indexadas en el Journal Citation Reports (JCR), detallándose más abajo las correspondientes referencias: - Artículo 1: Suárez-Soto, E., Guilera, G., & Pereda, N. (2018). Victimization and suicidality among adolescents in child and youth-serving systems in Spain. Children and Youth Services Review, 91, 383-389. doi.org/10.1016/j.childyouth.2018.06.037 - Artículo 2: Suárez-Soto, E., Pereda, N., & Guilera, G. (2019). Poly-victimization, resilience, and suicidality among adolescents in child and youth-serving systems. Children and Youth Services Review, 106, 104500. doi.org/10.1016/j.childyouth.2019.104500 Secundariamente, se incluye como lectura complementaria (ver apéndices, Anexo I) a la comprensión de la victimización en este colectivo, un tercer trabajo publicado, que exploró las características sociodemográficas, perfil victimológico y sintomatología externalizante de los jóvenes con doble expediente en el sistema de protección y justicia juvenil, y aquellos jóvenes con expediente único en justicia juvenil. - Artículo complementario: Suárez-Soto, E., Pereda, N., Guilera, G., & Catalan, N. (2018). ¿Víctimas o delincuentes?: Jóvenes implicados en los sistemas de protección y justicia juvenil en Cataluña: Un estudio exploratorio. Revista de Victimología, 8, 103-130. doi:10.12827/RVJV.8.04 La muestra objeto de estudio estuvo conformada por 227 adolescentes de entre 12 y 17 años (M = 15,26; DT = 1,54) (145 hombres y 82 mujeres). De éstos, 126 adolescentes fueron reclutados en 18 instalaciones residenciales diferentes, administradas por la Direcció General d’Atenció a la Infància i l’Adolescència (DGAIA). A su vez, 101 adolescentes fueron reclutados en tres centros de detención (77,2%) y cinco centros de régimen abierto (22,8%), administrados por la Direcció General d’Execucció Penal a la Comunitat i de Justícia Juvenil (DGEPCJJ). En general, los resultados destacan la significativa carga de violencia interpersonal a la que los adolescentes de estos colectivos se ven expuestos y muestran que rara vez los jóvenes experimentan un único episodio de victimización de forma aislada, sino más bien viven diferentes experiencias de victimización. También se destaca que la conducta suicida es común entre los jóvenes atendidos en la administración pública; siendo la ideación suicida particularmente frecuente. La condición de polivíctima o ser víctima de abuso sexual aumenta la probabilidad de presentar conducta suicida en comparación con otros tipos de victimización. Además, el género femenino y la participación en el sistema de protección infantil están relacionados con la presencia de conducta suicida (ideación suicida/conducta autolesiva). Otro de los resultados que destaca es que los jóvenes con conducta suicida presentan una menor capacidad de resiliencia en diferentes dominios (es decir, individual, familia, pares, escuela, comunidad) que los jóvenes sin este comportamiento. En segundo lugar, los factores de resiliencia asociados con el dominio individual (por ejemplo, insight emocional) serían los más relevantes en la prevención de conducta suicida en estos jóvenes. Estos hallazgos resaltan la importancia de los recursos propios, como un objetivo de intervención clave en adolescentes con conducta suicida y polivictimización. Los resultados sugieren que trabajar sobre la visión que los adolescentes tienen de sus propios recursos, específicamente sobre su capacidad de regular sus emociones de manera positiva, puede ayudarles a desarrollar su resiliencia frente a la adversidad. Esta investigación pretende ser un aporte científico de utilidad para clínicos y otros profesionales del ámbito de la salud y de las ciencias sociales, que promueve la implementación de medidas para prevenir el suicidio observando los factores significativamente relacionados con el comportamiento suicida que reducen el riesgo (es decir, los recursos personales) o lo aumentan (por ejemplo, la polivictimización).
Suicidal behavior in adolescents in the care of state managerial institutions (e.g., social welfare, juvenile justice) has been of little interest empirically. However, the majority of studies that have been conducted have emphasized the vulnerable condition in which these youths find themselves. A large portion of these children present a high prevalence of suicidal behavior and have suffered numerous experiences of victimization before and during their relationship with these institutions, creating grave psychological problems that are of interest to social policies. This thesis presents two original empirical studies of scientific investigations that address the relationship between the accumulation of victimization experiences or poly- victimization, resilience, and suicidal behavior in adolescents in the protection and juvenile justice systems in Spain. Both works have been published in journals indexed in the Journal Citation Reports (JCR), which are detailed farther below with the corresponding references: - Article 1: Suárez-Soto, E., Guilera, G., & Pereda, N. (2018). Victimization and suicidality among adolescents in child and youth-serving systems in Spain. Children and Youth Services Review, 91, 383-389. doi.org/10.1016/j.childyouth.2018.06.037 - Article 2: Suárez-Soto, E., Pereda, N., & Guilera, G. (2019). Poly-victimization, resilience, and suicidality among adolescents in child and youth-serving systems. Children and Youth Services Review, doi.org/10.1016/j.childyouth.2019.104500 In addition, a complementary lecture (see appendices, Annex I) on understanding victimization in this collective along with a third published work, which explored the sociodemographic characteristics, victimological profile, and externalized symptomatology of youths with case files with both the protection and juvenile justice systems as well as youths with case files in only the juvenile justice system, have been included. Complementary article: Suárez-Soto, E., Pereda, N., Guilera, G., & Catalan, N. (2018). Victims or delinquents?: Adolescents involved in the child welfare and juvenile justice systems in Catalonia: An exploratory study. Revista de Victimología, 8, 103-130. doi:10.12827/RVJV.8.04 The study sample included 227 adolescents between 12 and 17 years of age (M = 15.26, DT = 1.54, 145 males and 82 females). Of these, 126 adolescents were recruited from 18 different residential installations administrated by the Direcció General d’Atenció a la Infància i l’Adolescència (DGAIA, Directorate-General for Care of Children and Adolescents in Catalunya, Spain). Similarly, 101 adolescents were recruited from three detention centers (77.2%) and five open prisons (22.8%) administered by the Direcció General d’Execucció Penal a la Comunitat i de Justícia Juvenil (DGEPCJJ, Directorate-General for Penal Enforcement in the Community and for Juvenile Justice). In general, the results highlight the significant burden of interpersonal violence to which adolescents in these groups are exposed and show that young people rarely experience a single episode of victimization in isolation, but rather live different experiences of victimization. It is also noted that suicidal behavior is common among young people served by public administrations; suicidal ideation occurs with a high frequency. The condition of poly-victims or being a victim of sexual abuse increases the likelihood of presenting suicidal behavior compared to other types of victimization. In addition, the female gender and participation in the child welfare system are related to the presence of suicidal behavior (suicidal ideation/self-harming behavior). Another glaring result that is that young people with suicidal behaviors have a lower resilience in different domains (i.e., self, family, peers, school, community) than young people without these behaviors. Second, the resilience factors associated with individual dominance (for example, emotional insight) would be the most relevant in preventing suicidal behavior in these young people. These findings highlight the importance of own resources as a key intervention objective in adolescents with suicidal behaviors and poly-victimization. The results suggest that working on how adolescents view their own resources, specifically their ability to regulate their emotions in a positive way, can help them develop their resilience in the face of adversity. This research aims to be a useful scientific contribution for clinicians and other professionals in the field of health and social sciences, which promotes the implementation of measures to prevent suicide by observing factors significantly related to suicidal behavior that reduce risk (i.e., personal resources) or increase it (e.g., poly-victimization).

Thesis (M.A.)--University of the Witwatersrand, Faculty of Humanities, 1991.
This study examines factors associated with attempted suicide during adolescence. The sample consists of 10 Black adolescent girls who atempted suicide in the past year, and were admitted to Baragwanath Hospital. Each subject was questioned on demographic information and completed the Separation Anxiety Test (Hansburg, 1972) and Section 1 of the Inventory of Parent and Peer Attachment (Armsden and Greenberg, 1987), which assesses attachment to a parent. Subjects were also required to answer questions on their choice of responses. Common trends were found to exist among adolescent girls who attempt suicide. Adolescent girls who attempt suicide have disruptive home environments where parents experience marital problems. They show a low degree of attachment, high degree of hostility, stress avoidance during the stage of identity crisis, and they maintain a poor attachment-individuation balance. These findings suggest that the most common treatment strategy, ie. crisis intervention is not sufficient as it does not deal with underlying problems of adolescent suicide.

M.Ed.
The increase in suicides and suicide attempts by adolescents makes it essential that the subject be looked into intensively as to why these increases occur and how the problem can be identified and prevented. The suicide problem can be traced back to the disintegration of inter-personal communication, either in the family, peergroup or society. In consequence it is apparent that parents, teachers and the community should listen more intensively, actively and with empathy to the problem. The problem is that the "distress call" is sometimes ignored. On account of these different "calls for help" not being heard, it is clear why the futile "why" questions are asked afterwards by the people left behind' after a suicide has been committed, and when it is too late to prevent. Since the problem of suicide and suicide attempts affect our society in so many sectors, the data regarding this phenomenon has been obtained from several sources. The method used in obtaining the necessary information is binary of nature. On the one hand it consists of an intensive literature study of the subject and on the other hand an empirical investigation through questioning as technique. As per De Groot (1961: 29) the present investigation may be described as explorative research, but in terms of Helmstadter's theory (1970: 31-32), as implemented, it is library-scouting and field research. The literature study covers the occurrence of suicide and suicide attempts within the society with special emphasis on the adolescent. The study also covers the causes thereof and how suicide and suicide attempts are embedded in society, taking into account the adolescent's relationship with parents, siblings (family), schools, the peergroup, the community and the society at large. This report is an attempt to view the problem of suicide and suicide attempts of adolescents from a sociopedagogical perspective. The empirical component of the research includes, firstly interviews with concerned parties of actual suicide cases and secondly the studying of police and hospital documents and files of actual suicide cases and suicide attempts. As a result of this research the following emerged: in the case of the majority of adolescents who commit suicide three dominating feelings are present, namely uselessness, despair and depression. Linked with these three dominating feelings the lack of communication is a major problem that faces the suicidal adolescent. Persons with suicidal tendencies are of a negative nature towards themselves and others and non-committal to life in general, resulting in disturbed relations with fellow man. It is necessary that pedagogical assistance and guidance must be intensive, active and empathetic : "Suicide prevention in adolescence is probably best served by general care, tenderness, understanding and support for all unhappy adolescents, rather than searching for suicide specific predictor traits All unhappy adolescents should arise within us the fear of possible self initiated death". (Davis, 1983: 55.)

Suicidal thoughts and behaviors (STBs) are a problem among young adults. Problem solving deficits have been implicated in suicide outcomes and may be especially relevant to young adults given the developmental demands and increased risk for STBs during this life stage. Emerging research suggests that problem solving and related cognitive processes (e.g., episodic memory) can be modified through a brief cognitive training session, hereafter referred to as the specificity induction. However, it is unknown whether benefits of this specificity induction extend to suicidal populations. The present study tested a web-based version of the specificity induction intended to improve problem solving skills, episodic memory and divergent thinking among suicidal young adults. We recruited and consented a sample of 105 young adults with past year STBs and randomly assigned them to receive either the specificity induction or a control condition (i.e., general impressions induction). Regarding feasibility of conducting an online study with this population 81.90% (n=86) of those who provided informed consent completed the study protocol. Regarding clinical acceptability of the web-based specificity induction, the majority of participants which received this cognitive training rated that they would be unlikely to “use again”, while endorsing that it was “easy to use” across several items of a user experience self-report questionnaire. Contrary to hypotheses,young adults assigned to complete the specificity induction did not show improvement in their performance on measures of problem solving and related cognitive processes compared to those assigned to the control condition. Through post-hoc analyses we investigated candidate sources of systematic variability in task performance (e.g., attention, mood, task order effects), but none were found to account for participants’ demonstrated problem solving performance. In sum, we conclude that testing this brief cognitive training through an online experimental study was feasible, the cognitive training was modestly acceptable in its online format, and it does not immediately improve suicidal young adults’ problem solving or related cognitive processes. By demonstrating what does not necessarily work with suicidal young adults, there remains room for future research to pursue alternative design or modes of single session interventions.

You, Jianing.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2009.
Includes bibliographical references (p. 72-79).
Abstract also in Chinese.
List of Tables --- p.vi
List of Figures --- p.vii
Chapter Chapter 1 --- Introduction --- p.1
Chapter Chapter 2 --- Method --- p.24
Chapter Chapter 3 --- Results --- p.30
Chapter Chapter 4 --- Discussion --- p.56
References --- p.65

The present study aimed to investigate the role of self-oriented and socially prescribed perfectionism in conjunction with stressful life experiences in suicidal ideation, potential, and prior attempts among depressed adolescents. Self-oriented perfectionism involves striving to meet one's own unrealistically high standards and evaluating one's performance stringently. Socially prescribed perfectionism involves the perception that significant others have very high expectations for oneself, which the perfectionist strives to meet. This study examined correlations between these perfectionism dimensions and suicidal ideation, potential or risk, and prior attempts in addition to investigating whether either perfectionism dimension accounted for additional variance in suicide outcomes beyond the established risk factors depression and hopelessness. Also examined was a moderational model whereby dimensions of perfectionism were hypothesized to interact with stress to predict suicide outcomes. A sample of 55 adolescents (41 females, 14 males) who met the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV; APA, 1994) criteria for Major Depression (65.5%), Dysthymia (16.4%), or Depressive Disorder NOS (18.2%) completed self-report measures of perfectionism, daily hassles, depression, hopelessness, suicidal ideation, suicide potential, and prior suicidal attempts. Additionally, adolescents and one of their parents completed a diagnostic interview and a stress interview measuring major stressful experiences. Results revealed that self-oriented perfectionism was not correlated with any aspect of suicide; however, socially prescribed perfectionism was associated with suicide potential. Hierarchical regression analyses indicated that self-oriented perfectionism did not account for unique variance in suicide outcomes, whereas, socially prescribed perfectionism predicted additional variance in suicide potential once depression and hopelessness were controlled. Regarding the moderational model, both self-oriented and socially prescribed perfectionism were found to interact with aspects of stress to predict suicidality. More specifically, self-oriented perfectionism interacted with daily hassles to predict suicide potential/risk. Socially prescribed perfectionism interacted with subjective and objective ratings of major stressful experiences and with daily hassles to predict suicide potential/risk. Neither perfectionism dimension interacted with stress to predict suicidal ideation or prior suicide attempts. Taken together, these findings suggest that among depressed adolescents, socially prescribed perfectionism is correlated with suicide risk and predicts unique variance in this suicide outcome beyond other established risk factors. Additionally, both selforiented and socially prescribed perfectionism act as vulnerability factors that are predictive of suicide potential when adolescents experience elevated levels of stress. As these relationships were apparent even after controlling for the contributions of depression and hopelessness to suicide, the results of this study highlight the importance of considering perfectionistic tendencies when evaluating suicide risk among youth.
Arts, Faculty of
Psychology, Department of
Graduate

Afrikaans: In hierdie navorsingstuk en proefskrif word die probleem van adolessente selfmoord en selfmoordgedrag binne ‘n sosiaal-konstruksionistiese paradigma met die klem op ‘n pastoraal narratiewe terapeutiese benadering ondersoek. Met hierdie doelstelling voor oë word die verhale van adolessente met selfmoordgedrag aangehoor en in gesprek gebring met literêre verhale oor adolessente, selfmoord en selfmoordgedrag. Hierdie studie soek terselfdertyd na 'n gepaste terapeutiese werkswyse deur middel waarvan daar met hierdie tieners in interaktiewe verhoudings getree kan word. In die terapeutiese proses wat uit hierdie wedersydse samewerking ontwikkel, kan daar aan hulle betekenisvolle berading verleen word. In die sensitiewe interaksie tussen die vertel van en luister na noodverhale word dit progressief duidelik dat adolessente selfmoord en selfmoordgedrag spruit uit ‘n integrasie van oorkoepelende komplekse omstandighede en verhale wat in negatiewe wisselwerking ten opsigte van mekaar staan. Die noodwendige gevolg hiervan is ‘n gevoel van sinloosheid en gevangenheid in die lewe wat uitloop op selfmoord en selfmoordgedrag. • Die algemene tendens is om adolessente te tipeer as "blote tieners". Hierdie kategorisering het tot gevolg dat alle adolessente as gesamentlike groep hanteer word. Met in agneming van die verskillende adolessente se verhale, blyk dit duidelik dat die individu in sy uniekheid en eksentrisiteit totaal binne hierdie tiperingsraamwerk verdwyn. Die narratiewe benadering tot en beskouing van adolessente selfmoord en selfmoordgedrag skep ‘n onbevooroordeelde platvorm waarop elke unieke lewensverhaal van die individu aangehoor kan word. • Normaalweg vra ouers vrae oor die rede of motief waardeur die adolessent tot ‘n selfmoordpoging gedryf is. Hulle aanvaar summier dat slegs een gebeurtenis die oorsaak of probleem kan vaspen. Hierdie studie toon aan dat dit ‘n kumulatiewe opeenhoping van oorsake is wat uiteindelik tot so ‘n desperate poging of daad aanleiding gee. Die narratiewe benadering skep die ruimte vir die aanhoor van die individueel unieke verhaal binne die vervlegte verhale. • Die invloed van die groter samelewingsdiskoers ("grand narrative") is ook ‘n aspek wat in die studie uitgelig word as ‘n besonders bydraende faktor tot adolessente selfmoord en selfmoordgedrag. Die pastoraal narratiewe beskouing van adolessente selfmoord en selfmoordgedrag het nie al die antwoorde nie, maar stel ten slotte die vraag na die begrip selfmoord aan die orde. Is dit "self” en is dit "moord"? English: In this research study and thesis the problem of adolescent suicide and suicidal behavior is examined within a social - constructionist paradigm with the emphasis on a pastoral narrative therapeutic approach. With this purpose in mind, the stories of adolescents with suicidal behavior are listened to and brought into conversation with literary tales of adolescents' suicide and suicidal behavior. At the same time the study seeks for an appropriate therapeutic approach by means of which interactive relationships can be established with these teenagers. In the therapeutic process that results from this mutual collaboration, meaningful counseling can be provided. During the sensitive interaction between the telling of and listening to stories of distress, it progressively becomes clear that adolescent suicide and suicidal behavior is a result of the integration of complex circumstances and stories that have a negative reciprocal impact on each other. • The general tendency is to label adolescents as "mere teenagers". This categorisation results in all adolescents being treated as a collective group. In consideration of the different adolescents' stories, it becomes clear that the individual uniqueness and eccentricity totally disappears within this typifying framework. The narrative approach to and contemplation of adolescent suicide and suicide behavior creates an unprejudiced platform from which each unique life-story can be listened to. • Generally parents ask questions about the reason or motive that drove an adolescent to suicide. They summarily assume that only one incident can identify the cause or problem. This study shows that it is a cumulative conglomeration of causes that eventually leads to such a desperate attempt or action. The narrative approach provides a wide scope for listening to each unique story within the interwoven stories. • The influence of the greater social discourse (grand narrative) is also an aspect that is highlighted in the study as a particular contributive factor to adolescent suicide and suicidal behavior. The pastoral narrative approach to adolescent suicide and suicidal behavior does not have all the answers, but concludes with the question: Is it "self' (sui) and is it "murder" (cidium)?
Thesis (PhD (Practical Theology: Pastoral Family Therapy))--University of Pretoria, 2006.
Practical Theology
unrestricted

Adolescent clients presenting to Child and Adolescent Mental Health Services (CAMHS) with suicidal behaviour, depression and Borderline Personality Disorder (BPD) represent a highly complex and compromised group of consumers. Their risk for ongoing suicidal behaviour and mental illness requires timely access to effective treatment programs. The current study describes the design, development and implementation of a comprehensive DBT program with a focus on evaluating initial clinical outcomes. Dialectical Behaviour Therapy for suicidal adolescent clients was identified as a comprehensive treatment most capable of providing for the needs of adolescent clients and their families presenting to ACT CAMHS. DBT is an established outpatient treatment for adult clients presenting with suicidal behaviour and multiple social and emotional difficulties. The CAMHS DBT program was based on standardised DBT with additional adaptations developed for adolescent populations and their parents. The intent was to make the treatment as adherent as possible to the standardised model in order to maximise the potential for the program to assist clients and families to change. The 20 week program consisted of weekly individual therapy, skills group, team consultation group, as needed phone coaching and family therapy sessions. Some amendments were required due to the service characteristics of CAMHS. The development of the program included identifying and problem solving a number of barriers to implementation. Barriers to successful implementation of DBT included lack of access to skills based training for clinicians and limited clinical supervision, limited leadership and lack of treatment fidelity. After identifying these barriers and their potential to impact deleteriously on implementation, an implementation strategy was designed including a numbers of phases and concurrent practices. The implementation strategy included exploring and then adopting a treatment design, workforce development, pilot implementation and evaluation. A program evaluation was undertaken to measure the initial clinical effectiveness of the program. The primary outcome for the current study was to reduce suicidal and non-suicidal self-injurious behaviour. Secondary outcomes consisted of reducing symptoms of depression, core clinical features of Borderline Personality Disorder and increasing factors protective against suicide such as concerns about suicidal behaviour and future hopefulness. At follow-up, CAMHS clients who completed the program reported both clinical and statistically significant reductions in suicidal behaviour, depression and core clinical features of Borderline Personality Disorder such as: interpersonal chaos, impulsivity, emotion dysregulation and confusion about self. Apart from concerns about suicidal behaviour no other statistically significant increases in protective factors were found. Limitations of the current study are described. Overall, the clinical results of the current study provide encouraging initial evidence for the ongoing use, program development and evaluation of DBT within CAMHS.

The purpose of this research is to discover the extent to which there is a typology of students’ health risk behaviors and to what extent are those typologies associated with academic achievement using the 2019 national Youth Risk Behavior Survey (YRBS) dataset. This is a secondary data analysis study using a national representative sample (n=11,410) of high school students, grades 9 to 12, in the United States. YRBS is a national school-based, paper-based 99-item survey used to assess 121 health-related behaviors among all high school students in the United States and is biennially conducted by the Centers for Disease Control and Prevention (CDC, 2020). While research efforts on health and academic achievement is vastly growing, there is a limited number of studies that are analyzing multiple health-risk behaviors concurrently as well as exploring their potential impacts on educational outcomes. Furthermore, previous studies have utilized cluster and/ or factor analyses. However, this statistical approach will show how students are clustered into groups and does not provide information such as the probability that a given student is bullied or suicidal. A 3-step Latent Class Analysis (LCA) was conducted to identify and understand the various profiles of students who experienced and/ or were exposed to certain health-risk behaviors. The health-risk behaviors of interest, the latent variables, were school-related violence, physical activity, screen time, and sleep. Using LCA, results show that there are four significantly different typologies, or profiles, of student health-risk behaviors: Level 1 The Most Support Needed (TMSN), Level 2 Suicide Prevention Needed (SPN), Level 3 Coping Mechanism for Bullying Needed (CMBN), Level 4 Least Support Needed (LSN). In tandem, contextual factors such as age, sex, grade level, race and ethnicity were significantly associated with the odds of belonging to some of the groups. This study is connected to longer-term work. Implications of these groupings on school policies, student health outcomes, and building a school-based coordinated health system will be discussed.

Depressed mood is one of the most common of all psychiatric symptoms occurring in children and adolescents. Population studies suggest a point prevalence of between 10 to 15% of children and adolescents having symptoms of depression. Further, depressed adolescents are also significantly more apt to demonstrate suicidal ideation accompanied by a concomitant sense of helplessness and hopelessness. The overall aim of the study was to identify and characterize profiles of depression and suicidal behavior within the adolescents of the USA in the past 10 years. This study utilized epidemiological, cross-sectional, data from the Youth Risk Behavior Surveillance System (YRBSS), a biennial census that monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth. Latent classes of the indicators were generated utilizing latent class regression modeling. Predictors were then regressed on class membership in a multinomial logistic regression simultaneously to assess significance. Finally, a juxtaposition of the profiles and significant predictors followed to allow for observation of differences in number of profiles and other qualities (i.e., proportions of sample in each class, etc.) as well as to visualize and note “carryover” predictors across the past 10 years. Findings revealed a relatively stable pattern of profiles and predictors over the years with the exception of 2015. In the analysis of demographic variables, membership of the “low- risk non-depressed” class was consistently or more frequently associated with being male, older, not of an ethnic minority, and non-ethnically bi-or multiracial, across all time points. Three clusters of behaviors and factors emerged as significant predictors of depressed mood and suicidality. The first cluster consisted of typical adolescent risk behaviors that includes delinquent behaviors (i.e., fight, weapon carrying, or use of over-the-counter drugs), smoking, alcohol use, as well as consensual (non-violent) sexual activity. The second cluster of predictors that was significant consisted of experiences of traumatic events such as bullying, sexual assault, and intimate partner violence. Finally, a third cluster that showed significance consisted of self destructive behavior such as the use of illicit or hard drugs and maladaptive dieting, restricting or purging behavior. Several protective factors such as having sufficient physical activity and getting at least 8 hours of sleep daily also emerged as significant. Limitations to the YRBS and this study were discussed, and recommendations that tie to the implications of the findings were proposed. Future directions for research were also presented in light of the limitations of the study.

The purpose of the study was to highlight the extent of teenage suicide/parasuicide in selected areas in the West Rand. An exploratory descriptive survey was used to determine the extent of teenage suicide/parasuicide, identify existing programmes for the prevention of suicide, determine the involvement of the community health nurses in such programmes and make recommendations for the development of suicide prevention programmes in areas where they do not exist. Structured interview schedules were used to collect data. The study was undertaken in various clinics in Gauteng Province. The study results suggest that suicide/parasuicide is a common occurrence amongst teenagers and young adults aged between 15 and 24 years, suicide/parasuicide do not seem to be accurately recorded in most clinics, that community health nurses are not adequately involved in suicide prevention programmes and finally that available suicide prevention programmes are not fully utilised. Recommendations based on the findings are given.
Health Studies
M.A. (Nursing Science)

The present study compared the suicidal behaviour and related measures of adolescents in high school in Germany (N=318) and South Africa (N=299). Participants completed a series of self-report measures of the SPS (Suicide Probability Scale), PSS-Fa (Perceived Social Support From Family Scale), PSS-Fr (Perceived Social Support From Friends Scale), SIB (Scale Of Interpersonal Behaviour) and a number of demographic questions. Analyses were conducted using content analysis, correlation coefficients and logistic regression to determine variables related to previous suicide attempts, stepwise multiple regression to account for variables predicting currents suicidal risk; and multivariate analysis of variance (MANOVA) to examine differences among the groups and among suicide attempters and non-attempters. 36 German (11.3%) and 48 South African (16.1%) adolescents reported that they had made previous suicide attempts. German adolescents reported 45 (14.2%) suicide attempts in the family and 82 (25.8%) suicide attempts by friends. South African adolescents reported 43 (14.4%) suicide attempts in the family and 92 (30.7%) suicide attempts by friends. The following variables were associated with previous suicide attempts in the German sample: attempted suicide by friends, a life-threatening event, previous psychiatric contact, the death of a friend, low perceived family support, female gender, attempted suicide in the family, suicide of a friend, and low perceived friend support. The following variables were associated with previous suicide attempts in the South African sample: low perceived family support, death of a friend, attempted suicide by friends, female gender, a life-threatening event, previous psychiatric contact, suicide of friends, and attempted suicide in the family. The following variables for the German sample were found to be significant predictors of current suicidal risk: low perceived family and friend support, previous suicide attempts, suicide attempts in the family, a life-threatening event, suicide attempts of friends, suicide of friends, female gender, and previous psychiatric contact. The following variables for the South African sample were found to be significant predictors of current suicidal risk: previous suicide attempts, low perceived family and friend support, death of a friend, a life-threatening event, previous psychiatric contact, suicide attempts in the family, suicide of friends, and suicide attempts of friends. These findings show that suicidal behaviour is frequent in both countries. Suicidal deaths of friends and family is more prevalent in Germany, whereas religion or belief in god does not protect against suicide attempts in both countries. Results indicate that perceived support from family is a strong protective factor against suicide attempts.
Psychology
M.A. (Psychology)

The high incidence of violent suicides by young males is well documented. But why does a young man choose death? Why does he choose darkness over light? My thesis investigates by way of a novel, the problem of youth suicide and its relation to the meaning of human existence. There were two subsidiary aims of the thesis. First, to establish an intimate narrative tone. Second, to explore the technique of ''magic realism' which David Lodge defines as 'when marvellous and impossible events occur in what otherwise purports to be a realistic narrative.' Due to the method of analysis and the interactive nature of a novel, conclusions were not cut and dried, as my Afterword suggests. Answers were discovered creatively, not clinically or empirically. Nevertheless, the important role of parents, the healing nature of story, the need to seek one's spirituality, the ability to express one's own feelings and to have and show compassion to others - all emerged as the main answers to the problem of youth suicide and its relationship to the meaning of human existence.

Adolescent suicide and attempted suicide is an unhealthy practice that involves mental illness which led the suicidal behavior to be an important public health problem globally and in Africa. Suicide prevalence rates in young people in South Africa and in all major ethnic groups are a significant cause for concern. The adolescent mental illness causes sleepless nights on the education system. Though much research has been done on this problem it still remains one of the leading causes of death amongst adolescent learners locally and globally. As a parent and an educator reading news articles, attending memorial services and funerals of adolescent learners who took their own lives, gave me enough reason for actions to be taken in order to find out what is causing adolescents to commit suicide. During this emotional experience as the researcher, I have discovered that the adolescent stage is a very fragile stage. I also discovered that when life stresses strike, coping as an adolescent becomes difficult. This study focuses on an in-depth study of the causative factors of suicide and attempted suicide amongst the adolescent learners of Tshwane North (D3) area. The topic was investigated by means of a literature study and an empirical investigation using a qualitative approach. Data was collected by means of focus group discussion and one to one interview using a tape recorder and taking notes. Participant's answers were analysed individually and compared with all others. Findings shows that adolescent suicide and attempted suicide is a mental disorder that need to be addressed by including physicians and psychologists, upon realizing the warning signs of suicide in order to minimalize the practice. It is also clear that adolescence is a fragile stage of growth and adolescents struggle to cope with life challenges such as peer pressure, parent separations, socialization, pregnancy, chronic illness and academic pressure. It is recommended that NGOs in collaboration with the Health and Education Departments need to take action by organizing workshops to address causative factors of suicide and how to find help when realizing a suicidal adolescent learner. The department of education needs to ensure that adolescent suicide and attempted suicide preventative strategies should be taught from primary school level and be added to life skills subject in all grades. Life Orientation educator's to be trained about adolescent suicide to be well equipped to teach learners on how to recognize warning signs in their peers and friends.
Inclusive Education
M. Ed. (Inclusive Education)

Rebelliousness is the act of defying lawful authority or a resistant way of relating to authority. It is seen by many as a normal way of development. The development of rebellious behavior actually starts in childhood and progresses through to adulthood. The study focuses on the manner in which the family and school handle the rebellious child and the negative effects that these have on the child's development. These problems may manifest in truancy, delinquency, negativism, runaway, antisocial behavior, alcohol and substance abuse and gang involvement. The results of the study prove that the environment in which the adolescent lives, contribute greatly to the development and the maintenance of rebellious behavior. Guidelines were written for parents, teachers and psychologists regarding the handling of the rebellious child.
Psychology of Education
M.Ed. (Guidance and Counselling)