Journal of Adolescence xxx (2010) 1–8
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Journal of Adolescence
journal homepage: www.elsevier.com/locate/jado
Factors accounting for youth suicide attempt in Hong Kong: A model building Gloria W.Y. Wan a, Patrick W.L. Leung b, *
Clinical Psychology Service, Hong Kong Sheng Kung Hui Welfare Council, 5/F, Holy Trinity Bradury Center, 139 Ma Tau Chung Road, Kowloon, Hong Kong, China 3/F, Sino Building, Clinical and Health Psychology Centre, Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
a b s t r a c t
Keywords: Suicide ideation/attempt Family Psychopathology Life events/stressors Chinese youths
This study aimed at proposing and testing a conceptual model of youth suicide attempt. We proposed a model that began with family factors such as a history of physical abuse and parental divorce/separation. Family relationship, presence of psychopathology, life stressors, and suicide ideation were postulated as mediators, leading to youth suicide attempt. The stepwise entry of the risk factors to a logistic regression model deﬁned their proximity as related to suicide attempt. Path analysis further reﬁned our proposed model of youth suicide attempt. Our originally proposed model was largely conﬁrmed. The main revision was dropping parental divorce/separation as a risk factor in the model due to lack of signiﬁcant contribution when examined alongside with other risk factors. This model was cross-validated by gender. This study moved research on youth suicide from identiﬁcation of individual risk factors to model building, integrating separate ﬁndings of the past studies. Ó 2009 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Introduction Youth suicide, being one of the three leading causes of death in young people, has been a focus of research. Various individual risk factors have been identiﬁed (Gould, Greenberg, Velting, & Shaffer, 2003). Despite this success, not until recently are there attempts to develop complex theory-based models that draw together all those identiﬁed risk factors and depict their interplay (Bridge, Goldstein, & Brent, 2006; Mann, Waternaux, Haas, & Malone, 1999). Correspondingly, empirical studies in this area are few (e.g., Foley, Goldston, Costello, & Angold, 2006; Fortune, Stewart, Yadav, & Hawton, 2007; Prinstein et al., 2008; Reinherz, Tanner, Berger, Beardslee, & Fitzmaurice, 2006). Hence, we propose here a model of youth suicide attempt and test it in a sample of Chinese high school students. We aim at articulating and testing hypothetical pathways between family factors, psychopathology, life stressors, and suicidal behavior. Our model begins with consideration of family risk factors, including a history of physical abuse within the family, poor family relationship, and parental divorce/separation (Johnson et al., 2002; Gould, Fisher, Parides, Flory, & Shaffer, 1996; Gould, Shaffer, Prudence, & Robin, 1998; Liu, Sun, & Yang, 2008; Salzinger, Rosario, Feldman, & Ng-Mak, 2007). However, the latter’s association with youth suicidal behavior is no longer signiﬁcant or attenuated after controlled for parent-child or family relationship (Grøholt, Ekeberg, Wichstrøm, & Haldorsen, 2000). Family adversities are also known precursors of youth psychopathology (Fergusson, Woodward, & Horwood, 2000). The latter in turn is found to be a risk factor of suicidal behavior
* Corresponding author. Tel.: þ852 2609 6502; fax: þ852 2603 5019. E-mail address: firstname.lastname@example.org (P.W.L. Leung). 0140-1971/$ – see front matter Ó 2009 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.adolescence.2009.12.007
Please cite this article in press as: Wan, G.W.Y., Leung, P.W.L., Factors accounting for youth suicide attempt in Hong Kong: A model building, Journal of...