Social Determinants and Developmental Factors Influencing Suicide Risk and Self-Injury in Healthcare Contexts
Abstract
1. Introduction
2. Method
2.1. Participants
2.2. Instruments
- Sexual violence: “Has anyone ever forced you to engage in or witness acts of a sexual nature against your will?”
- Domestic violence: “Have you witnessed physical aggression between family members within your home?”
- School violence: “Have you been a victim of physical aggression (hitting, pushing, damage to your belongings) at school?”.
2.3. Procedure
2.4. Results Analysis
2.5. Ethical Considerations
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Maple, M.; Cerel, J.; Sanford, R.; Shand, F.; Batterham, P.J.; Bhullar, N. Suicide Exposure Experience Screener for Use in Therapeutic Settings: A Validation Report. Suicide Life Threat. Behav. 2022, 52, 975. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Suicide; World Health Organization: Geneva, Switzerland, 2021. [Google Scholar]
- Borges, G.; Nock, M.K.; Abad, J.M.H.; Hwang, I.; Sampson, N.A.; Alonso, J.; Andrade, L.H.; Angermeyer, M.C.; Beautrais, A.; Bromet, E.; et al. Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys. J. Clin. Psychiatry 2010, 71, 1617–1628. [Google Scholar] [CrossRef] [PubMed]
- Gunnell, D.; Lewis, G. Studying Suicide from the Life Course Perspective: Implications for Prevention. Br. J. Psychiatry 2005, 187, 206–208. [Google Scholar] [CrossRef]
- Santo, R.S.Q.; Fernández, A.L. Ciberacoso y Su Relación Con La Intencionalidad Suicida En Adolescentes de 12 a 17 Años. Pro Sci. Rev. Prod. Cienc. Investig. 2021, 5, 103–112. [Google Scholar] [CrossRef]
- Tamayo, O.; Pérez, V.; Acosta, E.; Molina, I.; E, A. Caracterización Del Suicidio y Su Incidencia En La Provincia de Tungurahua: Estudio Descriptivo y Análisis Estadístico. Rev. Cient. UISRAEL 2022, 9, 81–99. [Google Scholar] [CrossRef]
- Gerstner, R.; Soriano, I.; Sanhueza, A.; Caffe, S.; Kestel, D. Epidemiología Del Suicidio En Adolescentes y Jóvenes En Ecuador. Rev. Panam. Salud Publica 2018, 42, 100. [Google Scholar] [CrossRef]
- Gerstner, R.M.; Lara Lara, F. Análisis de Tendencias Temporales Del Suicidio En Niños, Adolescentes y Adultos Jóvenes En Ecuador Entre 1990 y 2017. An. Sist. Sanit. Navar. 2019, 42, 9–18. [Google Scholar] [CrossRef]
- Ortiz-Prado, E.; Simbaña, K.; Gómez, L.; Henriquez-Trujillo, A.R.; Cornejo-Leon, F.; Vasconez, E.; Castillo, D.; Viscor, G. The Disease Burden of Suicide in Ecuador, a 15 Years’ Geodemographic Cross-Sectional Study (2001–2015). BMC Psychiatry 2017, 17, 342. [Google Scholar] [CrossRef]
- Lapo-Talledo, G.J.; Talledo-Delgado, J.A.; Portalanza, D.; Rodrigues, A.L.S.; Siteneski, A. Suicide Rates in Ecuador: A Nationwide Study from 2011 until 2020. J. Affect. Disord. 2023, 320, 638–646. [Google Scholar] [CrossRef]
- Lacomba-Trejo, L.; Valero-Moreno, S.; Coello, M.F.; Montoya-Castilla, I.; Pérez-Marín, M. Mental Health, Suicide Risk and the Important Role of Self-Esteem in Adolescents before and during Coexistence with COVID-19 in Ecuador. Rev. Latinoam. Psicol. 2023, 55, 130–139. [Google Scholar] [CrossRef]
- Arnon, S.; Brunstein Klomek, A.; Visoki, E.; Moore, T.M.; Argabright, S.T.; Didomenico, G.E.; Benton, T.D.; Barzilay, R. Association of Cyberbullying Experiences and Perpetration With Suicidality in Early Adolescence. JAMA Netw. Open 2022, 5, e2218746. [Google Scholar] [CrossRef] [PubMed]
- Corrigan, P.W.; Sheehan, L.; Al-Khouja, M.A.; Lewy, S.A.; Major, D.; Mead, J.; Redmon, M.; Rubey, C.T.; Weber, S. Making Sense of the Public Stigma of Suicide. Crisis 2017, 38, 351–359. [Google Scholar] [CrossRef] [PubMed]
- Fox, K.R.; Huang, X.; Guzmán, E.M.; Funsch, K.M.; Cha, C.B.; Ribeiro, J.D.; Franklin, J.C. Interventions for Suicide and Self-Injury: A Meta-Analysis of Randomized Controlled Trials across Nearly 50 Years of Research. Psychol. Bull. 2020, 146, 1117–1145. [Google Scholar] [CrossRef] [PubMed]
- Miranda-Mendizábal, A.; Castellví, P.; Parés-Badell, O.; Almenara, J.; Alonso, I.; Blasco, M.J.; Cebrià, A.; Gabilondo, A.; Gili, M.; Lagares, C.; et al. Sexual Orientation and Suicidal Behaviour in Adolescents and Young Adults: Systematic Review and Meta-Analysis. Br. J. Psychiatry 2017, 211, 77–87. [Google Scholar] [CrossRef]
- Roley-Roberts, M.E.; Hill, R.M.; Layne, C.M.; Goldenthal, H.; Kaplow, J.B. Cause of Caregiver Death and Surviving Caregiver Coping Style Predict Thwarted Belongingness in Bereaved Youth. Arch. Suicide Res. 2019, 23, 455–470. [Google Scholar] [CrossRef]
- Llamocca, E.N.; Yeh, H.H.; Miller-Matero, L.R.; Westphal, J.; Frank, C.B.; Simon, G.E.; Owen-Smith, A.A.; Rossom, R.C.; Lynch, F.L.; Beck, A.L.; et al. Association Between Adverse Social Determinants of Health and Suicide Death. Med. Care 2023, 61, 744–749. [Google Scholar] [CrossRef]
- Zhang, K.; Szanto, K.; Clark, L.; Dombrovski, A.Y. Behavioral Empathy Failures and Suicidal Behavior. Behav. Res. Ther. 2019, 120, 103329. [Google Scholar] [CrossRef]
- O’Brien, K.H.M.M.; Nicolopoulos, A.; Almeida, J.; Aguinaldo, L.D.; Rosen, R.K. Why Adolescents Attempt Suicide: A Qualitative Study of the Transition from Ideation to Action. Arch. Suicide Res. 2021, 25, 269–286. [Google Scholar] [CrossRef]
- Maple, M.; Frey, L.M.; McKay, K.; Coker, S.; Grey, S. “Nobody Hears a Silent Cry for Help”: Suicide Attempt Survivors’ Experiences of Disclosing During and After a Crisis. Arch. Suicide Res. 2020, 24, 498–516. [Google Scholar] [CrossRef]
- Young, J.; Savoy, C.; Schmidt, L.A.; Saigal, S.; Boyle, M.H.; Van Lieshout, R.J. Adult Mental Health Outcomes of Preterm Survivors Experiencing Suicidal Ideation in Adolescence. Arch. Suicide Res. 2019, 23, 163–174. [Google Scholar] [CrossRef]
- Aiken, C.S.; Wagner, B.M.; Benjamin Hinnant, J. Observed Interactions in Families of Adolescent Suicide Attempters. Suicide Life Threat. Behav. 2019, 49, 104–119. [Google Scholar] [CrossRef] [PubMed]
- Dema, T.; Tripathy, J.P.; Thinley, S.; Rani, M.; Dhendup, T.; Laxmeshwar, C.; Tenzin, K.; Gurung, M.S.; Tshering, T.; Subba, D.K.; et al. Suicidal Ideation and Attempt among School Going Adolescents in Bhutan—A Secondary Analysis of a Global School-Based Student Health Survey in Bhutan 2016. BMC Public Health 2019, 19, 1605. [Google Scholar] [CrossRef] [PubMed]
- Freebairn, L.; Song, Y.J.C.; Occhipinti, J.A.; Huntley, S.; Dudgeon, P.; Robotham, J.; Lee, G.Y.; Hockey, S.; Gallop, G.; Hickie, I.B. Applying Systems Approaches to Stakeholder and Community Engagement and Knowledge Mobilisation in Youth Mental Health System Modelling. Int. J. Ment. Health Syst. 2022, 16, 20. [Google Scholar] [CrossRef] [PubMed]
- Ospina-Pinillos, L.; Skinner, A.; Sánchez-Nítola, M.N.; Shambo-Rodríguez, D.L.; Navarro-Mancilla, A.A.; Camacho, S.; Hilber, A.M.; Uribe-Restrepo, J.M.; Gomez-Restrepo, C.; Hickie, I.B.; et al. Systems Modelling and Simulation to Guide Targeted Investments to Reduce Youth Suicide and Mental Health Problems in a Low-Middle-Income Country. BMC Glob. Public Health 2024, 2, 70. [Google Scholar] [CrossRef]
- Hasegawa, T.; Fukuyama, K.; Okada, M. Relationships between Expenditure of Regional Governments and Suicide Mortalities Caused by Six Major Motives in Japan. Int. J. Environ. Res. Public Health 2021, 19, 84. [Google Scholar] [CrossRef]
- O’Connor, R.C.; Worthman, C.M.; Abanga, M.; Athanassopoulou, N.; Boyce, N.; Chan, L.F.; Christensen, H.; Das-Munshi, J.; Downs, J.; Koenen, K.C.; et al. Gone Too Soon: Priorities for Action to Prevent Premature Mortality Associated with Mental Illness and Mental Distress. Lancet Psychiatry 2023, 10, 452–464. [Google Scholar] [CrossRef]
- Goldston, D.B. Measuring Suicidal Behavior and Risk in Children and Adolescents; American Psychological Association (APA): Washington, DC, USA, 2004. [Google Scholar] [CrossRef]
- Mann, J.J.; Apter, A.; Bertolote, J.; Beautrais, A.; Currier, D.; Haas, A.; Hegerl, U.; Lonnqvist, J.; Malone, K.; Marusic, A.; et al. Suicide Prevention Strategies: A Systematic Review. JAMA 2005, 294, 2064–2074. [Google Scholar] [CrossRef]
- Goldman-Mellor, S.J.; Caspi, A.; Harrington, H.L.; Hogan, S.; Nada-Raja, S.; Poulton, R.; Moffitt, T.E. Suicide Attempt in Young People: A Signal for Long-Term Health Care and Social Needs. JAMA Psychiatry 2014, 71, 119–127. [Google Scholar] [CrossRef]
- Tong, B.; Kashdan, T.B.; Joiner, T.; Rottenberg, J. Future Well-Being Among People Who Attempt Suicide and Survive: Research Recommendations. Behav. Ther. 2021, 52, 1213–1225. [Google Scholar] [CrossRef]
- Chen, H.; Li, W.; Cao, X.; Liu, P.; Liu, J.; Chen, X.; Luo, C.; Liang, X.; Guo, H.; Zhong, S.; et al. The Association Between Suicide Attempts, Anxiety, and Childhood Maltreatment Among Adolescents and Young Adults With First Depressive Episodes. Front. Psychiatry 2021, 12, 745470. [Google Scholar] [CrossRef]
- Occhipinti, J.A.; Skinner, A.; Iorfino, F.; Lawson, K.; Sturgess, J.; Burgess, W.; Davenport, T.; Hudson, D.; Hickie, I. Reducing Youth Suicide: Systems Modelling and Simulation to Guide Targeted Investments across the Determinants. BMC Med. 2021, 19, 61. [Google Scholar] [CrossRef] [PubMed]
- Andoh-Arthur, J.; Adjorlolo, S. Macro-Level Mental Health System Indicators and Cross-National Suicide Rates. Glob. Health Action 2021, 14, 1839999. [Google Scholar] [CrossRef] [PubMed]
- Kim, S.Y.; Kim, Y.A.; Song, D.-Y.; Bong, G.; Kim, J.; Kim, J.H.; Yoo, H.J. State and Trait Anxiety of Adolescents with Autism Spectrum Disorders. Psychiatry Investig. 2021, 18, 257–265. [Google Scholar] [CrossRef] [PubMed]
- Sheehan, L.; Oexle, N.; Dubke, R.; Wan, H.T.; Corrigan, P.W. The Self-Stigma of Suicide Attempt Survivors. Arch. Suicide Res. 2020, 24, 34–47. [Google Scholar] [CrossRef]
- Oexle, N.; Herrmann, K.; Staiger, T.; Sheehan, L.; Rüsch, N.; Krumm, S. Stigma and Suicidality among Suicide Attempt Survivors: A Qualitative Study. Death Stud. 2019, 43, 381–388. [Google Scholar] [CrossRef]
- Shain, B. Suicide and Suicide Attempts in Adolescents. Pediatrics 2016, 138, e20161420. [Google Scholar] [CrossRef]
- Washburn, J.J.; Juzwin, K.R.; Styer, D.M.; Aldridge, D. Measuring the Urge to Self-Injure: Preliminary Data from a Clinical Sample. Psychiatry Res. 2010, 178, 540–544. [Google Scholar] [CrossRef]
- Bahamón, M.J.; Javela, J.J.; Bonilla-Cruz, N.J.; Rivera, D.; Vinaccia, S.; Forgiony-Santos, J. Psychometric Properties of the Alexian Brother Urge to Self-Injure (ABUSI) Spanish Version for Adolescents. Heliyon 2023, 9, e16167. [Google Scholar] [CrossRef]
- Suárez-Colorado, Y.; Palacio-Sañudo, J.; Caballero-Domínguez, C.C.; Pineda-Roa, C.A.; Suárez-Colorado, Y.; Palacio-Sañudo, J.; Caballero-Domínguez, C.C.; Pineda-Roa, C.A. Adaptación, Validez de Constructo y Confiabilidad de La Escala de Riesgo Suicida Plutchik En Adolescentes Colombianos. Rev. Latinoam. Psicol. 2019, 51, 145–152. [Google Scholar] [CrossRef]
- Trejos-Herrera, A.M.; Bahamón, M.J.; Alarcón-Vásquez, Y.; Vélez, J.I.; Vinacciac, S. Validity and Reliability of the Multidimensional Scale of Perceived Social Support in Colombian Adolescents. Psychosoc. Interv. 2018, 27, 56–63. [Google Scholar] [CrossRef]
- López-Pérez, B.; Fernández-Pinto, I.; Abad García, F.J. TECA: Test de Empatía Cognitiva y Afectiva/Belén López-Pérez, Irene Fernández-Pinto y Francisco José Abad García.; TEA: Madrid, Spain, 2008; ISBN 9788471749192. [Google Scholar]
- Maple, M.; Sanford, R.; Pirkis, J.; Reavley, N.; Nicholas, A. Exposure to Suicide in Australia: A Representative Random Digit Dial Study. J. Affect. Disord. 2019, 259, 221–227. [Google Scholar] [CrossRef] [PubMed]
- Linehan, M.M.; Comtois, K.A.; Ward-Ciesielski, E.F. Assessing and Managing Risk with Suicidal Individuals. Cogn. Behav. Pract. 2012, 19, 218–232. [Google Scholar] [CrossRef]
- Maple, M.; McKay, K.; Sanford, R. The Attempt Was My Own! Suicide Attempt Survivors Respond to an Australian Community-Based Suicide Exposure Survey. Int. J. Environ. Res. Public Health 2019, 16, 4549. [Google Scholar] [CrossRef] [PubMed]
- Nock, M.K.; Borges, G.; Bromet, E.J.; Alonso, J.; Angermeyer, M.; Beautrais, A.; Bruffaerts, R.; Wai, T.C.; De Girolamo, G.; Gluzman, S.; et al. Cross-National Prevalence and Risk Factors for Suicidal Ideation, Plans and Attempts. Br. J. Psychiatry 2008, 192, 98–105. [Google Scholar] [CrossRef]
- McClay, M.M.; Brausch, A.M.; O’Connor, S.S. Social Support Mediates the Association between Disclosure of Suicide Attempt and Depression, Perceived Burdensomeness, and Thwarted Belongingness. Suicide Life Threat. Behav. 2020, 50, 884–898. [Google Scholar] [CrossRef]
- Bahamón, M.J.; Javela, J.J.; Vinaccia, S.; Matar-Khalil, S.; Cabezas-Corcione, A.; Cuesta, E.E. Risk and Protective Factors in Ecuadorian Adolescent Survivors of Suicide. Children 2023, 10, 549. [Google Scholar] [CrossRef]
- Londoño-Cortés, M.A.; Idárraga-López, M.C.; Mercadillo, R.E.; Cudris-Torres, L.; Javela, J.J. Moral Emotions in the Latin-America: A Socio-Cultural and Socioeconomic Analysis. Curr. Psychiatry Res. Rev. 2022, 19, 147–158. [Google Scholar] [CrossRef]
- Brent, D.A.; Melhem, N.M.; Masten, A.S.; Porta, G.; Payne, M.W. Longitudinal Effects of Parental Bereavement on Adolescent Developmental Competence. J. Clin. Child Adolesc. Psychol. 2012, 41, 778–791. [Google Scholar] [CrossRef]
- Cerel, J.; Fristad, M.A.; Verducci, J.; Weller, R.A.; Weller, E.B. Childhood Bereavement: Psychopathology in the 2 Years Postparental Death. J. Am. Acad. Child Adolesc. Psychiatry 2006, 45, 681–690. [Google Scholar] [CrossRef]
- Nock, M.K.; Green, J.G.; Hwang, I.; McLaughlin, K.A.; Sampson, N.A.; Zaslavsky, A.M.; Kessler, R.C. Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior among Adolescents: Results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry 2013, 70, 300–310. [Google Scholar] [CrossRef]
- Jeong, Y.W.; Chang, H.J.; Kim, J.A. Development and Feasibility of a Safety Plan Mobile Application for Adolescent Suicide Attempt Survivors. CIN Comput. Inform. Nurs. 2020, 38, 382–392. [Google Scholar] [CrossRef] [PubMed]
- Borges, G.; Nock, M.K.; Medina-Mora, M.E.; Benjet, C.; Lara, C.; Chiu, W.T.; Kessler, R.C. The Epidemiology of Suicide-Related Outcomes in Mexico. Suicide Life-Threat. Behav. 2007, 37, 627–640. [Google Scholar] [CrossRef] [PubMed]
- Edeby, A.; San Sebastián, M. Prevalence and Sociogeographical Inequalities of Violence against Women in Ecuador: A Cross-Sectional Study. Int. J. Equity Health 2021, 20, 1–11. [Google Scholar] [CrossRef] [PubMed]
- Valdez-Santiago, R.; Híjar, M.; Rojas Martínez, R.; Ávila Burgos, L.; de la L. Arenas Monreal, M. Prevalence and Severity of Intimate Partner Violence in Women Living in Eight Indigenous Regions of Mexico. Soc. Sci. Med. 2013, 82, 51–57. [Google Scholar] [CrossRef]
- Javela, J.J.; Naranjo-Niño, B.; Ospina-Sánchez, D.J.; Bahamón, M.J.; Cuesta-Guzmán, M.; Sánchez-Villegas, M.; Moreno-Londoño, H. Aggression and Violence in Adolescents in the Iberoamerican Context, a Systematic Review. Gac. Med. Caracas 2022, 130, 475–484. [Google Scholar] [CrossRef]
- Holmes, K.; Sher, L. Dating Violence and Suicidal Behavior in Adolescents. Int. J. Adolesc. Med. Health 2013, 25, 257–261. [Google Scholar] [CrossRef]
- Brokke, S.S.; Bertelsen, T.B.; Landrø, N.I.; Haaland, V.Ø. The Effect of Sexual Abuse and Dissociation on Suicide Attempt. BMC Psychiatry 2022, 22, 29. [Google Scholar] [CrossRef]
- Brunstein Klomek, A.; Marrocco, F.; Kleinman, M.; Schonfeld, I.S.; Gould, M.S. Bullying, Depression, and Suicidality in Adolescents. J. Am. Acad. Child Adolesc. Psychiatry 2007, 46, 40–49. [Google Scholar] [CrossRef]
- Yang, Y. Suicide Attempt and Suicide Plan among U.S. Adolescents: The Role of Repeated and Co-Occurring Violence Experiences. Psychiatry Res. 2023, 320, 115040. [Google Scholar] [CrossRef]
- Turner, H.A.; Finkelhor, D.; Ormrod, R. The Effect of Lifetime Victimization on the Mental Health of Children and Adolescents. Soc. Sci. Med. 2006, 62, 13–27. [Google Scholar] [CrossRef]
- Zhang, X.; Rhubart, D.C.; Monnat, S.M. Social Infrastructure Availability and Suicide Rates among Working-Age Adults in the United States. Socius Sociol. Res. Dyn. World 2024, 10, 1–10. [Google Scholar] [CrossRef] [PubMed]
- Pitman, A.; Osborn, D.; King, M.; Erlangsen, A. Effects of Suicide Bereavement on Mental Health and Suicide Risk. Lancet Psychiatry 2014, 1, 86–94. [Google Scholar] [CrossRef] [PubMed]
- Clarke, S.; Allerhand, L.A.; Berk, M.S. Recent Advances in Understanding and Managing Self-Harm in Adolescents. F1000Research 2019, 8, 1974. [Google Scholar] [CrossRef] [PubMed]
- Khosravi, S.; Jalali, A.; Jalali, R.; Salari, N.; Alikhani, M. Personality Traits, Psychological Needs, and Social Support Among Suicide Attempters. OMEGA—J. Death Dying 2022, 84, 899–913. [Google Scholar] [CrossRef]
- Miller, A.B.; Esposito-Smythers, C.; Leichtweis, R.N. Role of Social Support in Adolescent Suicidal Ideation and Suicide Attempts. J. Adolesc. Health 2015, 56, 286–292. [Google Scholar] [CrossRef]
- Fulginiti, A.; Negriff, S.; Call, J.; Rice, E. Does the Source Matter? Social Support and Suicide Attempts among Homeless Youth. Death Stud. 2022, 46, 824–831. [Google Scholar] [CrossRef]
- Agyemang, D.O.; Madden, E.F.; English, K.; Venner, K.L.; Rod, H.; Singh, T.P.; Qeadan, F. A Trend Analysis of the Prevalence of Opioid Misuse, Social Support, and Suicide Attempt among American Indian/Alaska Native High School Students in New Mexico: 2009–2019 Youth Risk Resiliency Survey (YRRS). BMC Public Health 2022, 22, 370. [Google Scholar] [CrossRef]
Psychosocial Characteristics | Suicide Attempt Survivors NAS (No, n = 380) | Suicide Attempt Survivors AS (Yes, n = 58) | Total (N = 438) | |||
---|---|---|---|---|---|---|
n | (%) | N | (%) | n | (%) | |
Age | ||||||
12–14 years | 93 | (91.2) | 9 | (8.8) | 102 | (23.1) |
15–18 years | 287 | (85.5) | 49 | (14.5) | 336 | (76.8) |
Sex | ||||||
Women | 190 | (85.7) | 32 | (14.3) | 222 | (50.6) |
Men | 190 | (88.0) | 26 | (12.0) | 216 | (49.4) |
Psychosocial Characteristics | Suicide Attempt Survivors NAS (No, n = 380) | Suicide Attempt Survivors AS (Yes, n = 58) | Total (N = 438) | |||
---|---|---|---|---|---|---|
n | (%) | N | (%) | n | (%) | |
Gravity attempt | ||||||
Low | -- | (---) | 43 | (58.6) | --- | (---) |
High | -- | (---) | 15 | (41.3) | --- | (---) |
Family history of suicide attempt | ||||||
No | 322 | (90.3) | 35 | (9.7) | 357 | (81.6) |
Yes | 58 | (71.6) | 23 | (28.4) | 81 | (18.4) |
Family history of suicide | ||||||
No | 320 | (89.2) | 39 | (10.8) | 359 | (82.0) |
Yes | 60 | (75.9) | 19 | (24.1) | 79 | (18.0) |
Victim of domestic violence | ||||||
No | 331 | (89.3) | 40 | (10.7) | 371 | (84.7) |
Yes | 49 | (73.1) | 18 | (26.9) | 67 | (15.2) |
Victim of sexual violence | ||||||
No | 363 | (87.7) | 51 | (12.3) | 414 | (94.5) |
Yes | 17 | (70.8) | 7 | (29.2) | 24 | (5.4) |
Victim of school violence | ||||||
No | 335 | (88.2) | 45 | (77.6) | 380 | (86.8) |
Yes | 45 | (11.8) | 13 | (22.4) | 58 | (13.2) |
Perspective adoption | ||||||
Low | 171 | (87.8) | 24 | (12.2) | 196 | (44.7) |
High | 208 | (86.0) | 34 | (14.0) | 242 | (55.2) |
Emotional understanding | ||||||
Low | 138 | (87.4) | 20 | (12.6) | 158 | (31.6) |
High | 242 | (86.5) | 38 | (13.5) | 280 | (63.8) |
Empathic stress | ||||||
Low | 181 | (88.0) | 25 | (12.0) | 207 | (47.2) |
High | 198 | (85.8) | 33 | (14.2) | 231 | (52.7) |
Joy empathic | ||||||
Low | 160 | (85.2) | 28 | (14.8) | 188 | (42.9) |
High | 220 | (88.0) | 30 | (12.0) | 250 | (57.1) |
Impulse to self-injurious behavior | ||||||
Low | 328 | (92.2) | 28 | (7.8) | 356 | (81.1) |
High | 52 | (63.9) | 30 | (36.1) | 82 | (18.8) |
Suicide risk | ||||||
Low | 308 | (95.7) | 14 | (4.3) | 322 | (73.4) |
High | 72 | (62.4) | 44 | (37.6) | 116 | (26.5) |
Family social support | ||||||
Low | 170 | (80.7) | 41 | (19.3) | 211 | (48.1) |
High | 210 | (92.5) | 17 | (7.5) | 227 | (51.8) |
Social support friends | ||||||
Low | 207 | (86.3) | 33 | (13.7) | 240 | (54.7) |
High | 173 | (87.4) | 25 | (12.6) | 198 | (45.2) |
Social support others | ||||||
Low | 170 | (84.7) | 31 | (15.3) | 201 | (45.9) |
High | 209 | (88.6) | 27 | (11.4) | 236 | (53.8) |
Overall social support | ||||||
Low | 182 | (84.7) | 33 | (15.3) | 215 | (49.0) |
High | 198 | (88.8) | 25 | (11.2) | 223 | (50.9) |
Age Range | Psychosocial Characteristics | Suicide Attempt Survivors NAS (No, n = 380) | Suicide Attempt Survivors AS (Yes, n = 58) | ||
---|---|---|---|---|---|
n | (%) | N | (%) | ||
Gravity attempt | |||||
12–14 | Low | 0 | (0.0) | 98 | (96.1) |
High | 0 | (0.0) | 4 | (3.9) | |
15–18 | Low | 0 | (0.0) | 316 | (94.0) |
High | 0 | (0.0) | 20 | (6.0) | |
12–14 | Family history of suicide attempt | ||||
No | 83 | (89.2) | 91 | (89.2) | |
Yes | 10 | (10.8) | 11 | (10.8) | |
15–18 | No | 239 | (83.2) | 267 | (79.5) |
Yes | 48 | (16.7) | 69 | (20.5) | |
12–14 | Family history of suicide | ||||
No | 85 | (91.3) | 88 | (80.6) | |
Yes | 8 | (8.6) | 14 | (19.3) | |
15–18 | No | 235 | (81.8) | 271 | (81.0) |
Yes | 52 | (18.1) | 65 | (19.0) | |
12–14 | Victim of domestic violence | ||||
No | 88 | (94.6) | 94 | (92.2) | |
Yes | 5 | (5.4) | 8 | (7.8) | |
15–18 | No | 243 | (84.7) | 278 | (82.7) |
Yes | 44 | (15.3) | 58 | (17.3) | |
12–14 | Victim of sexual violence | ||||
No | 93 | (100) | 101 | (99.0) | |
Yes | 0 | (0) | 1 | (1.0) | |
15–18 | No | 270 | (94.0) | 313 | (93.2) |
Yes | 17 | (6.0) | 23 | (6.8) | |
12–14 | Victim of school violence | ||||
No | 85 | (91.3) | 92 | (90.2) | |
Yes | 8 | (8.7) | 10 | (9.8) | |
15–18 | No | 250 | (87.0) | 288 | (85.7) |
Yes | 37 | (13.0) | 48 | (14.3) | |
12–14 | Perspective adoption | ||||
Low | 36 | (38.7) | 38 | (37.3) | |
High | 57 | (61.3) | 64 | (62.7) | |
15–18 | Low | 137 | (47.7) | 158 | (47.0) |
High | 150 | (52.3) | 178 | (53.0) | |
12–14 | Emotional understanding | ||||
Low | 30 | (32.3) | 34 | (33.3) | |
High | 63 | (67.7) | 68 | (66.7) | |
15–18 | Low | 107 | (37.3) | 124 | (37.0) |
High | 180 | (62.7) | 212 | (64.0) | |
12–14 | Empathic stress | ||||
Low | 49 | (52.7) | 50 | (51.0) | |
High | 44 | (47.3) | 50 | (49.0) | |
15–18 | Low | 132 | (46.0) | 154 | (45.8) |
High | 155 | (54.0) | 182 | (54.2) | |
12–14 | Joy empathic | ||||
Low | 32 | (34.4) | 36 | (35.3) | |
High | 61 | (65.6) | 66 | (64.7) | |
15–18 | Low | 128 | (44.6) | 152 | (45.2) |
High | 159 | (55.4) | 184 | (54.8) | |
12–14 | Impulse to self-injurious behavior | ||||
Low | 83 | (89.2) | 88 | (86.3) | |
High | 10 | (10.7) | 14 | (13.7) | |
15–18 | Low | 244 | (85.0) | 268 | (79.3) |
High | 43 | (15.0) | 68 | (20.2) | |
12–14 | Suicide risk | ||||
Low | 76 | (81.7) | 78 | (76.5) | |
High | 17 | (18.3) | 24 | (23.5) | |
15–18 | Low | 231 | (80.5) | 245 | (72.9) |
High | 56 | (19.5) | 91 | (21.1) | |
12–14 | Family social support | ||||
Low | 35 | (37.6) | 40 | (39.2) | |
High | 58 | (62.4) | 62 | (61.0) | |
15–18 | Low | 136 | (47.4) | 171 | (50.9) |
High | 151 | (52.6) | 165 | (49.1) | |
12–14 | Social support friends | ||||
Low | 47 | (50.5) | 53 | (52.0) | |
High | 46 | (49.4) | 49 | (48.0) | |
15–18 | Low | 159 | (55.4) | 188 | (56.0) |
High | 128 | (44.6) | 148 | (44.0) | |
12–14 | Social support others | ||||
Low | 39 | (41.9) | 44 | (43.1) | |
High | 54 | (58.1) | 58 | (56.9) | |
15–18 | Low | 132 | (46.0) | 159 | (47.3) |
High | 155 | (54.0) | 177 | (52.7) | |
12–14 | Overall social support | ||||
Low | 40 | (43.0) | 45 | (44.1) | |
High | 53 | (57.0) | 57 | (55.9) | |
15–18 | Low | 142 | (49.5) | 171 | (50.9) |
High | 145 | (50.5) | 165 | (49.1) |
Predictor Variable | B | SE | OR | 95% CI | p-Value | |
---|---|---|---|---|---|---|
Lower | Upper | |||||
Constant | −2.581 | 0.208 | 0.076 | 0.00 | 0.00 | <0.001 ** |
Gravity attempt | 2.099 | 0.521 | 8.162 | 4.34 | 15.37 | <0.001 ** |
Family history of suicide attempt | 0.877 | 0.382 | 2.404 | 1.12 | 5.16 | 0.022 * |
Family history of suicide | 0.255 | 0.386 | 1.290 | 0.67 | 2.48 | 0.510 |
Victim of domestic violence | 0.395 | 0.439 | 1.484 | 0.69 | 2.48 | 0.368 |
Victim of sexual violence | 0.210 | 0.645 | 1.234 | 0.35 | 4.34 | 0.745 |
Victim of school violence | 0.423 | 0.461 | 1.527 | 0.64 | 3.64 | 0.358 |
Perspective adoption | 0.148 | 0.418 | 1.160 | 0.51 | 2.64 | 0.723 |
Emotional understanding | 0.215 | 0.421 | 1.240 | 0.53 | 2.87 | 0.609 |
Empathic stress | 0.139 | 0.350 | 1.149 | 0.58 | 2.28 | 0.692 |
Joy empathic | 0.040 | 0.403 | 1.041 | 0.50 | 2.16 | 0.921 |
Impulse to self-injurious behavior | 2.187 | 0.389 | 8.904 | 4.28 | 18.52 | <0.001 ** |
Suicide risk | 1.066 | 0.366 | 2.903 | 1.42 | 5.94 | 0.006 * |
Family social support | −1.010 | 0.525 | 0.364 | 0.15 | 0.91 | 0.055 |
Social support friends | 0.525 | 0.490 | 1.253 | 0.56 | 2.82 | 0.646 |
Social support others | 0.250 | 0.505 | 1.218 | 0.55 | 2.71 | 0.696 |
Overall social support | 0.819 | 0.694 | 2.268 | 0.61 | 8.46 | 0.238 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Bahamón, M.J.; Javela, J.J.; Ortega-Bechara, A.; Matar-Khalil, S.; Ocampo-Flórez, E.; Uribe-Alvarado, J.I.; Cabezas-Corcione, A.; Cudris-Torres, L. Social Determinants and Developmental Factors Influencing Suicide Risk and Self-Injury in Healthcare Contexts. Int. J. Environ. Res. Public Health 2025, 22, 411. https://doi.org/10.3390/ijerph22030411
Bahamón MJ, Javela JJ, Ortega-Bechara A, Matar-Khalil S, Ocampo-Flórez E, Uribe-Alvarado JI, Cabezas-Corcione A, Cudris-Torres L. Social Determinants and Developmental Factors Influencing Suicide Risk and Self-Injury in Healthcare Contexts. International Journal of Environmental Research and Public Health. 2025; 22(3):411. https://doi.org/10.3390/ijerph22030411
Chicago/Turabian StyleBahamón, Marly Johana, José Julián Javela, Andrea Ortega-Bechara, Shadye Matar-Khalil, Esteban Ocampo-Flórez, J Isaac Uribe-Alvarado, Andrés Cabezas-Corcione, and Lorena Cudris-Torres. 2025. "Social Determinants and Developmental Factors Influencing Suicide Risk and Self-Injury in Healthcare Contexts" International Journal of Environmental Research and Public Health 22, no. 3: 411. https://doi.org/10.3390/ijerph22030411
APA StyleBahamón, M. J., Javela, J. J., Ortega-Bechara, A., Matar-Khalil, S., Ocampo-Flórez, E., Uribe-Alvarado, J. I., Cabezas-Corcione, A., & Cudris-Torres, L. (2025). Social Determinants and Developmental Factors Influencing Suicide Risk and Self-Injury in Healthcare Contexts. International Journal of Environmental Research and Public Health, 22(3), 411. https://doi.org/10.3390/ijerph22030411