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Research Trends

Early Adolescence and Suicidal Ideations in Croatia

Sociodemographic, Behavioral, and Psychometric Correlates

Published Online:https://doi.org/10.1027/0227-5910/a000107

Background/Aims: Suicidal ideations (SI) indicate and predict psychological distress. We examined the prevalence of SI among early adolescents and its association with parental war participation, personal, behavioral, and sociodemographic characteristics. Methods: We performed a cross-sectional questionnaire study on 803 12-year-old adolescents. Data were collected using a sociodemographic questionnaire, the Junior Eysenck Personality Questionnaire and Children Depression Inventory. Unintentional injuries, physical fighting, and involvement in bullying behavior were assessed using questions from the World Health Organization (WHO) survey Health Behavior in School-aged Children. Suicidal ideations were assessed with three dichotomous items. Results: There were no gender differences in SI prevalence. SI in males were associated with lower maternal education, crowded families, birth order, parental war participation, physical fighting, being bullied, and substance use. In females, we found associations with lower parental educational level, number of brothers, lower perception of the relationship with parents, parental relationship, family cohesion and parental control, negative attitude toward school, rare church attendance, fighting, and being bully or bullied. Depressive symptoms and SI were associated in both genders. Conclusions: SI showed gender-specific associations that may partially be explained with parental war involvement. These findings may have potentially important clinical and preventive implications.

References

  • Afifi, T. O. , Cox, B. J. , Katz, L. Y. (2007). The associations between health risk behaviors and suicidal ideation and attempts in a nationally representative sample of young adolescents. Canadian Journal of Psychiatry, 52, 666–674. First citation in articleMedlineGoogle Scholar

  • Andrews, J. A. , Lewinsohn, P. M. (1992). Suicidal attempts among older adolescents: Prevalence and co-occurrence with psychiatric disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 655–662. First citation in articleCrossref MedlineGoogle Scholar

  • Angold, A. , Costello, E. J. (2006). Puberty and depression. Child and Adolescent Psychiatric Clinics of North America, 15, 919–937, ix. First citation in articleCrossref MedlineGoogle Scholar

  • Angold, A. , Worthman, C. W. (1993). Puberty onset of gender differences in rates of depression: A developmental, epidemiologic and neuroendocrine perspective. Journal of Affective Disorders, 29, 145–158. First citation in articleCrossref MedlineGoogle Scholar

  • Angold, A. , Costello, E. J. , Worthman, C. M. (1998). Puberty and depression: The roles of age, pubertal status and pubertal timing. Psychological Medicine, 28, 51–61. First citation in articleCrossref MedlineGoogle Scholar

  • Beautrais, A. (2005). Suicidality in preadolescence and early adulthood is associated with psychosocial and psychiatric problems in young adulthood. Evidence-based Mental Health, 8, 48. First citation in articleCrossref MedlineGoogle Scholar

  • Beautrais, A. L. (2002). Gender issues in youth suicidal behavior. Emergency Medicine (Fremantle), 14, 35–42. First citation in articleCrossref MedlineGoogle Scholar

  • Brent, D. A. , Baugher, M. , Bridge, J. , Chen, T. , Chiappetta, L. (1999). Age- and sex-related risk factors for adolescent suicide. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1497–1505. First citation in articleCrossref MedlineGoogle Scholar

  • Bridge, J. A. , Goldstein, T. R. , Brent, D. A. (2006). Adolescent suicide and suicidal behavior. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 47, 372–394. First citation in articleCrossref MedlineGoogle Scholar

  • Burless, C. , De Leo, D. (2001). Methodological issues in community surveys of suicide ideators and attempters. Crisis, 22, 109–124. First citation in articleLinkGoogle Scholar

  • Cohen, P. , Cohen, J. , Kasen, S. , Velez, C. N. , Hartmark, C. , Johnson, J. , ... Streuning, E. L. (1993). An epidemiological study of disorders in late childhood and adolescence – I. Age- and gender-specific prevalence. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 34, 851–867. First citation in articleCrossref MedlineGoogle Scholar

  • Crawford, T. N. , Cohen, P. , Midlarsky, E. , Brook, J. S. (2001). Internalizing symptoms in adolescents: Gender differences in vulnerability to parental distress and discord. Journal of Research on Adolescence, 11, 95–118. First citation in articleCrossrefGoogle Scholar

  • CROSTAT. (2001). Census of population, households and dwellings on 31th March 2001. Republic of Croatia: Central Bureau of Statistics. Retrieved from www.dzs.hr/. First citation in articleGoogle Scholar

  • Currie, C. , Hurrelmann, K. , Settertobulte, W. , Smith, R. , Todd, J. (2000). Health and health behavior among young people (International report from the HBSC 1997/98 Survey). WHO Policy Series: Health Policy for Children and Adolescents Series, No. 1. Retrieved from www.hbsc.org. First citation in articleGoogle Scholar

  • Davidson, A. C. , Mellor, D. J. (2001). The adjustment of children of Australian Vietnam veterans: Is there evidence for the transgenerational transmission of the effects of war-related trauma? The Australian and New Zealand Journal of Psychiatry, 35, 345–351. First citation in articleCrossref MedlineGoogle Scholar

  • De Leo, D. , Burgis, S. , Bertolote, J. M. , Kerkhof, A. J. , Bille-Brahe, U. (2006). Definitions of suicidal behavior: Lessons learned from the WHO/EURO Multicentre Study. Crisis, 27, 4–15. First citation in articleLinkGoogle Scholar

  • Dervic, K. , Akkaya-Kalayci, T. , Kapusta, N. D. , Kaya, M. , Merl, E. , Vogel, E. , ... Friedrich, M. H. (2007). Suicidal ideation among Viennese high school students. Wiener klinische Wochenschrift, 119, 174–180. First citation in articleCrossref MedlineGoogle Scholar

  • Dubow, E. F. , Tisak, J. (1989). The relation between stressful life events and adjustment in elementary school children: The role of social support and social problem-solving skills. Child Development, 60, 1412–1423. First citation in articleCrossref MedlineGoogle Scholar

  • Evans, E. , Hawton, K. , Rodham, K. (2004). Factors associated with suicidal phenomena in adolescents: A systematic review of population-based studies. Clinical Psychology Review, 24, 957–979. First citation in articleCrossref MedlineGoogle Scholar

  • Eysenck, H. J. , Eysenck, S. B. G. (1975). Manual of the Eysenck personality questionnaire (adult and junior). London: Hodder & Stoughton. First citation in articleGoogle Scholar

  • Eysenck, H. J. , Eysenck, S. B. G. (1994). Manual of the Eysenck personality questionnaire (adult and junior) – Croatian standardization norms (in Croatian). Jastrebarsko: Naklada Slap. First citation in articleGoogle Scholar

  • Fergusson, D. M. , Lynskey, M. T. (1995). Suicide attempts and suicidal ideation in a birth cohort of 16-year-old New Zealanders. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1308–1317. First citation in articleCrossref MedlineGoogle Scholar

  • Fergusson, D. M. , Horwood, L. J. , Ridder, E. M. , Beautrais, A. L. (2005). Suicidal behavior in adolescence and subsequent mental health outcomes in young adulthood. Psychological Medicine, 35, 983–993. First citation in articleCrossref MedlineGoogle Scholar

  • Fergusson, D. M. , Woodward, L. J. , Horwood, L. J. (2000). Risk factors and life processes associated with the onset of suicidal behavior during adolescence and early adulthood. Psychological Medicine, 30, 23–39. First citation in articleCrossref MedlineGoogle Scholar

  • Fotti, S. A. , Katz, L. Y. , Afifi, T. O. , Cox, B. J. (2006). The associations between peer and parental relationships and suicidal behaviors in early adolescents. Canadian Journal of Psychiatry, 51, 698–703. First citation in articleMedlineGoogle Scholar

  • Franciskovic, T. , Stevanovic, A. , Jelusic, I. , Roganovic, B. , Klaric, M. , Grkovic, J. (2007). Secondary traumatization of wives of war veterans with posttraumatic stress disorder. Croatian Medical Journal, 48, 177–184. First citation in articleMedlineGoogle Scholar

  • Fundudis, T. , Berney, T. P. , Kolvin, I. , Famuyiwa, O. O. , Barrett, L. , , Bhate, S. , Tyrer, S. P. (1991). Reliability and validity of two self-rating scales in the assessment of childhood depression. The British Journal of Psychiatry, 11(Suppl), 36–40. First citation in articleGoogle Scholar

  • Garrison, C. Z. , Jackson, K. L. , Addy, C. L. , McKeown, R. E. , Waller, J. L. (1991). Suicidal behaviors in young adolescents. American Journal of Epidemiology, 133, 1005–1014. First citation in articleMedlineGoogle Scholar

  • Gmitrowicz, A. , Szymczak, W. , Kropiwnicki, P. , Rabe-Jablonska, J. (2003). Gender influence in suicidal behavior of Polish adolescents. European Child and Adolescent Psychiatry, 12, 205–213. First citation in articleCrossref MedlineGoogle Scholar

  • Goldney, R. D. , Fisher, L. J. , Wilson, D. H. , Cheok, F. (2001). Suicidal ideation and health-related quality of life in the community. The Medical Journal of Australia, 175, 546–549. First citation in articleMedlineGoogle Scholar

  • Gould, M. S. , King, R. , Greenwald, S. , Fisher, P. , Schwab-Stone, M. , Kramer, R. , ... Shaffer, D. (1998). Psychopathology associated with suicidal ideation and attempts among children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 915–923. First citation in articleCrossref MedlineGoogle Scholar

  • Groleger, U. , Tomori, M. , Kocmur, M. (2003). Suicidal ideation in adolescence–an indicator of actual risk? The Israel Journal of Psychiatry and Related Sciences, 40, 202–208. First citation in articleMedlineGoogle Scholar

  • Juon, H. S. , Nam, J. J. , Ensminger, M. E. (1994). Epidemiology of suicidal behavior among Korean adolescents. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 35, 663–676. First citation in articleCrossref MedlineGoogle Scholar

  • Kashani, J. H. , Orvaschel, H. , Rosenberg, T. K. , Reid, J. C. (1989). Psychopathology in a community sample of children and adolescents: A developmental perspective. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 701–706. First citation in articleCrossref MedlineGoogle Scholar

  • Kashani, J. H. , Suarez, L. , Luchene, L. , Reid, J. C. (1998). Family characteristics and behavior problems of suicidal and nonsuicidal children and adolescents. Child Psychiatry and Human Development, 29, 157–168. First citation in articleCrossref MedlineGoogle Scholar

  • Kerr, D. C. , Preuss, L. J. , King, C. A. (2006). Suicidal adolescents’ social support from family and peers: Gender-specific associations with psychopathology. Journal of Abnormal Child Psychology, 34, 103–114. First citation in articleCrossref MedlineGoogle Scholar

  • Kim, Y. S. , Koh, Y. J. , Leventhal, B. (2005). School bullying and suicidal risk in Korean middle school students. Pediatrics, 115, 357–363. First citation in articleCrossref MedlineGoogle Scholar

  • Kim, Y. S. , Leventhal, B. L. , Koh, Y. J. , Hubbard, A. , Boyce, W. T. (2006). School bullying and youth violence: Causes or consequences of psychopathologic behavior? Archives of General Psychiatry, 63, 1035–1041. First citation in articleCrossref MedlineGoogle Scholar

  • King, C. A. , Merchant, C. R. (2008). Social and interpersonal factors relating to adolescent suicidality: A review of the literature. Archives of Suicide Research, 12, 181–196. First citation in articleCrossref MedlineGoogle Scholar

  • King, C. A. , Segal, H. G. , Naylor, M. , Evans, T. (1993). Family functioning and suicidal behavior in adolescent in patients with mood disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 1198–1206. First citation in articleCrossref MedlineGoogle Scholar

  • King, R. A. , Schwab-Stone, M. , Flisher, A. J. , Greenwald, S. , Kramer, R. A. , Goodman, S. H. , ... Gould, M. S. (2001). Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 837–846. First citation in articleCrossref MedlineGoogle Scholar

  • Knight, D. , Hensley, V. R. , Waters, B. (1988). Validation of the Children’s Depression Scale and the Children’s Depression Inventory in a prepubertal sample. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 29, 853–863. First citation in articleCrossref MedlineGoogle Scholar

  • Kovacs, M. (1985). The Children’s Depression Inventory (CDI). Psychopharmacology Bulletin, 21, 995–998. First citation in articleMedlineGoogle Scholar

  • Kovacs, M. (1992). Children’s Depression Inventory. CDI. Manual. Toronto: Multi-Health Systems. First citation in articleGoogle Scholar

  • Kovacs, M. , Goldston, D. , Gatsonis, C. (1993). Suicidal behaviors and childhood-onset depressive disorders: A longitudinal investigation. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 8–20. First citation in articleCrossref MedlineGoogle Scholar

  • Kozaric-Kovacic, D. , Kocijan-Hercigonja, D. , Jambrosic, A. (2002). Psychiatric help to psychotraumatized persons during and after war in Croatia. Croatian Medical Journal, 43, 221–228. First citation in articleMedlineGoogle Scholar

  • Kuperman, S. , Schlosser, S. S. , Lidral, J. , Reich, W. (1999). Relationship of child psychopathology to parental alcoholism and antisocial personality disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 686–692. First citation in articleCrossref MedlineGoogle Scholar

  • Lieberman, E. J. (1993). Suicidal ideation and young adults. The American Journal of Psychiatry, 150, 171. First citation in articleMedlineGoogle Scholar

  • Light, J. M. , Grube, J. W. , Madden, P. A. , Gover, J. (2003). Adolescent alcohol use and suicidal ideation: A nonrecursive model. Addictive Behaviors, 28, 705–724. First citation in articleCrossref MedlineGoogle Scholar

  • Miotto, P. , De Coppi, M. , Frezza, M. , Petretto, D. , Masala, C. , Preti, A. (2003). Suicidal ideation and aggressiveness in school-aged youths. Psychiatry Research, 120, 247–255. First citation in articleCrossref MedlineGoogle Scholar

  • Pfeffer, C. R. (2001). Diagnosis of childhood and adolescent suicidal behavior: Unmet needs for suicide prevention. Biological Psychiatry, 49, 1055–1061. First citation in articleCrossref MedlineGoogle Scholar

  • Pfeffer, C. R. (2002). Suicidal behavior in children and adolescents: Causes and management. In M. Lewis, (Ed.), Child and adolescent psychiatry a comprehensive textbook (3rd ed., pp. 796–805). Philadelphia, PA: Lippincott Williams & Wilkins. First citation in articleGoogle Scholar

  • Reinherz, H. Z. , Giaconia, R. M. , Silverman, A. B. , Friedman, A. , Pakiz, B. , Frost, A. K. , Cohen, E. (1995). Early psychosocial risks for adolescent suicidal ideation and attempts. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 599–611. First citation in articleCrossref MedlineGoogle Scholar

  • Reinherz, H. Z. , Tanner, J. L. , Berger, S. R. , Beardslee, W. R. , Fitzmaurice, G. M. (2006). Adolescent suicidal ideation as predictive of psychopathology, suicidal behavior, and compromised functioning at age 30. The American Journal of Psychiatry, 163, 1226–1232. First citation in articleCrossref MedlineGoogle Scholar

  • Ruscio, A. M. , Weathers, F. W. , King, L. A. , King, D. W. (2002). Male war-zone veterans’ perceived relationships with their children: The importance of emotional numbing. Journal of Traumatic Stress, 15, 351–357. First citation in articleCrossref MedlineGoogle Scholar

  • Samm, A. , Tooding, L. M. , Sisask, M. , Kolves, K. , Aasvee, K. , Varnik, A. (2010). Suicidal thoughts and depressive feelings among Estonian schoolchildren: Effect of family relationship and family structure. European Child & Adolescent Psychiatry, 19, 457–468. First citation in articleCrossref MedlineGoogle Scholar

  • Samm, A. , Varnik, A. , Tooding, L. M. , Sisask, M. , Kolves, K. , von Knorring, A. L. (2008). Children’s Depression Inventory in Estonia. Single items and factor structure by age and gender. European Child & Adolescent psychiatry, 17, 162–170. First citation in articleCrossref MedlineGoogle Scholar

  • Sourander, A. , Helstela, L. , Haavisto, A. , Bergroth, L. (2001). Suicidal thoughts and attempts among adolescents: A longitudinal 8-year follow-up study. Journal of Affective Disorders, 63, 59–66. First citation in articleCrossref MedlineGoogle Scholar

  • Steinhausen, H. C. , Metzke, C. W. (2004). The impact of suicidal ideation in preadolescence, adolescence, and young adulthood on psychosocial functioning and psychopathology in young adulthood. Acta Psychiatrica Scandinavica, 110, 438–445. First citation in articleCrossref MedlineGoogle Scholar

  • Steinhausen, H. C. , Bosiger, R. , Metzke, C. W. (2006). Stability, correlates, and outcome of adolescent suicidal risk. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 47, 713–722. First citation in articleCrossref MedlineGoogle Scholar

  • Stewart, S. M. , Lam, T. H. , Betson, C. , Chung, S. F. (1999). Suicide ideation and its relationship to depressed mood in a community sample of adolescents in Hong Kong. Suicide & Life-Threatening Behavior, 29, 227–240. First citation in articleMedlineGoogle Scholar

  • Thorlindsson, T. , Bernburg, J. G. (2009). Community structural instability, anomie, imitation and adolescent suicidal behavior. Journal of Adolescence, 32, 233–245. First citation in articleCrossref MedlineGoogle Scholar

  • Varnik, A. , Kolves, K. , Allik, J. , Arensman, E. , Aromaa, E. , van Audenhove, ... Hegerl, U. (2009). Gender issues in suicide rates, trends and methods among youths aged 15–24 in 15 European countries. Journal of Affective Disorders, 113, 216–226. First citation in articleGoogle Scholar

  • Wade, T. J. , Cairney, J. , Pevalin, D. J. (2002). Emergence of gender differences in depression during adolescence: National panel results from three countries. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 190–198. First citation in articleCrossref MedlineGoogle Scholar

  • Wunderlich, U. , Bronisch, T. , Wittchen, H. U. , Carter, R. (2001). Gender differences in adolescents and young adults with suicidal behavior. Acta Psychiatrica Scandinavica, 104, 332–339. First citation in articleCrossref MedlineGoogle Scholar

  • Zemaitiene, N. , Zaborskis, A. (2005). Suicidal tendencies and attitude toward freedom to choose suicide among Lithuanian schoolchildren: Results from three cross-sectional studies in 1994, 1998, and 2002. BMC Public Health, 5, 83. First citation in articleCrossref MedlineGoogle Scholar

  • Zivcic, I. (1993). Emotional reactions of children to war stress in Croatia. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 709–713. First citation in articleCrossref MedlineGoogle Scholar