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Teenagers' Attitudes About Coping Strategies and Help-Seeking Behavior for Suicidality

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ABSTRACT

Objective

To identify youths' attitudes about coping and help-seeking strategies for suicidal ideation/behavior and examine their demographic and clinical correlates.

Method

A self-report survey was completed by high school students (N = 2,419) in six New York State schools from 1998 through 2001. The relationship between suicide attitudes and gender, depression, substance problems, serious suicidal ideation/behavior, and first-hand experience with a suicidal peer was examined.

Results

Two factors that approximate avoidance and approach coping responses, maladaptive coping strategies and help-seeking strategies, respectively, were identified. Boys scored higher than girls (t = 7.96, df = 2341, p < .001), and depressed youths (t = 15.56, df = 2323, p < .001), students with substance problems (t = 11.07, df = 2340, p < .001), and suicidal youths (t = 15.14, df = 2341, p < .001) scored significantly higher than their healthy counterparts on the maladaptive coping strategies factor. Students with first-hand experience with a suicidal peer scored significantly higher on the maladaptive coping strategies factor than those without this experience (t = 7.95, df = 2321, p < .001). Lower risk groups scored significantly higher on an adaptive help-seeking strategies factor.

Conclusions

High-risk adolescents' attitudes are characterized by core beliefs that support the use of maladaptive coping strategies in response to depression and suicidal thoughts and behaviors. Targeting such attitudes is a recommended component of youth suicide prevention efforts.

Section snippets

Subjects

Adolescents aged 13 through 19 years, enrolled in the ninth through 12th grades in six high schools in Nassau, Suffolk, and Westchester counties in New York, were the targeted population for this study. These schools were selected as controls for a ā€œpostventionā€ study examining the impact of a student's suicide (Gould, unpublished). A control school was within a school district noncontiguous to a case school (i.e., where a student had committed suicide), was within the same or adjacent county

RESULTS

The factor analysis yielded an interpretable three-factor model, which accounted for 30.3% (14.7, 8.3, and 7.3) of the total variance (see Table 1). The reliability estimates (Cronbach Ī± coefficient) were .54, .60, and .40 for the three factors, respectively. The first two factors included coping strategies reflecting either maladaptive or adaptive attitudes, labeled maladaptive coping strategies (MCS) and help-seeking strategies (HSS), respectively. The third factor, labeled suicide

DISCUSSION

Two factors that approximate attitudes consistent with avoidance and approach coping strategies, respectively (Beutler et al., 2003), were identified. The MCS factor reflected dysfunctional attitudes that would appear to support isolative behaviors, and the HSS factor consisted of items endorsing healthy coping strategies that involved actively seeking advice and appropriate services from others for a suicidal person. Similar to other studies, most adolescents generally endorsed healthy

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    Supported by NIMH grants R01MH52827, K20MH01298, and T32MH16434. The authors gratefully acknowledge Dr. Rachel Kramer's assistance in the project's early phases.

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