Psychosocial factors as predictors of suicidal ideation amongst adolescents in the Free State Province: a cross-cultural study - Du Plessis, Edwin Devon (University of the Free State, 2012)
The recently published National Youth Risk Behaviour Surveys highlighted an alarming increase in adolescent suicidal behaviour in South Africa. The death of a young person has a profound psychological and social effect on both the family and broader community. Moreover, the high incidence of adolescent suicides and suicide-related hospitalisations places a heavy burden on the service delivery of the South African health sector. Understanding the social-cultural context in which suicidal behaviour occurs is essential for public health efforts to reduce this behaviour amongst adolescents. The aim of this study was to investigate the role of underlying psychosocial factors in adolescent suicidal behaviour, as well as to explore ethnic differences in the stressors and resources as reported by a sample of black, white and coloured adolescents in the Free State province. Both quantitative and qualitative methods were used to collect and analyse data. Quantitatively, a cross-sectional, correlational, and criterion-group design was used, while thematic content analysis was used for the analysis of the qualitative data. A stratified, multi-ethnic sample of 1033 Grade 11 and 12 learners was included from eighteen schools in the Free State province. The Suicidal Ideation Questionnaire for Adolescents, the Social Stressors and Resources Inventory - Youth Form, the COPE Questionnaire, the South African Acculturation Scale, and a biographical questionnaire were used to gather information from the participants. Various statistical analyses were conducted such as a multivariance of analysis to compare the ethnic groups with regard to significant differences in suicidal ideation, stressors, resources, acculturation and coping strategies. A product- term analysis was also performed to investigate the role of coping strategies in the relationship between stressors and suicidal ideation, while hierarchical regression analyses were conducted to determine the unique contributions of stressors, resources, acculturation- and coping strategies to suicidal ideation. The qualitative data was gathered through the use of two open-ended statements that required participants to identify stressors and resources in their lives. Thematic content analysis was used to analyse these responses. The results from the quantitative study indicated that the level of suicidal ideation reported by the current sample was substantially higher than for a comparative American sample. Ethnic and gender differences were also found between groups, with coloured females reporting the highest levels of suicidal ideation. Parent-child relationship, peer relationships and financial constraints appear to be common stressors among coloured adolescents, while black adolescents reported financial constraints and romantic relationships as major sources of stress. For white adolescents, their parent-child relationship seemed to act as a major stressor. Coping strategies did not mediate the relationship between perceived life stressors and suicidal ideation amongst any of the three ethnic groups, on either the 1% or 5% level of statistical significance. Coping strategies, did, however, act as moderators in this relationship. Furthermore, coping strategies did not explain a statistically significant proportion of the variance in the suicidal ideation of either black or coloured adolescents in the current sample. The findings, however, suggested that active coping and alcohol and drug disengagement contributed significantly to the variance in suicidal ideation amongst the white adolescents. None of the acculturation scales contributed significantly to the variance in suicidal ideation for any of the three ethnic groups. The main findings of the qualitative data suggested ethnic differences in the reported experiences of stressors and resources. In terms of stressors, participants from all three ethnic groups identified negative self-perception, poor behaviour regulation and financial difficulties as major sources of stress in their lives. Black and coloured participants identified alcohol abuse in their communities and financial problems as major stressors and white participants identified the high levels of crime. Black adolescents identified a positive self-esteem as most important resource, while white participants identified the relationship with their families, as well as material resources as main resources. Coloured adolescents, on the other hand, showed stronger identification with religion as prominent resource. It is recommended that future research focuses on the inclusion of additional variables such as socio-economic status, as well as the use of longitudinal studies to explore the dynamics of adolescent suicidal behaviour. The implementation of programmes aimed at enhancing effective coping strategies and social skills of adolescents are also recommended.

Die onlangs gepubliseerde Nasionale Jeug Risikogedragopnames beklemtoon die dramatiese toename in adolessente selfmoordgedrag in Suid Afrika. Die dood van „n jong persoon het „n diepgaande sielkundige en sosiale effek op beide die gesin en breër gemeenskap. Die hoë voorkoms van adolessente selfmoord en selfmoordverwante hospitalisasie plaas „n bykomende las op dienslewering binne die Suid Afrikaanse gesondheidsorgsisteem. Die verkryging van „n beter begrip vir die sosiokulturele konteks waarin selfmoordgedrag plaasvind, lewer „n belangrike bydrae tot pogings van die gesondheidsorgsisteem om selfmoordgedrag onder adolessente te verminder. Die oorhoofse doelstelling van die studie was om die rol van psigososiale faktore in die voorkoms van adolessente selfmoord te ondersoek. Voorts poog die studie ook om etniese en geslagsverskille in die rapportering van stressore en hulpbronne in „n steekproef van wit, swart en bruin adolessente in die Vrystaat provinsie te identifiseer. Beide kwantitatiewe en kwalitatiewe metodes is gebruik in die insameling en analisering van data. „n Dwarssnit, korrelasionele en kriterium groepontwerp was gebruik in die kwantitatiewe gedeelte van die studie, terwyl tematiese inhoudsanalise gebruik is vir die analise van die kwalitatiewe data. „n Gestratifiseerde, multi-etniese steekproef van 1033 graad 11 en 12 leerders van 18 skole in die Vrystaat is ingesluit in die studie. Die Selfmoordideasie vraelys vir adolessente, die Sosiale Stressore en Hulpbronne vraelys – jeugweergawe, die COPE vraelys, die Suid Afrikaanse Akkulturasievraelys en „n biografiese vraelys was gebruik om die inligting van deelnemers in te samel. Verskeie statistiese metodes, waaronder „n meervoudige variansie ontleding, was gebruik om die beduidendheid van verskille tussen die etniese groepe te vergelyk met betrekking tot selfmoordideasie, stressore, hulpbronne, akkulturasie en copingstrategieë. „n Produkterm analise is uitgevoer om die rol van copingstrategieë in die verhouding tussen stressore en selfmoordideasie te ondersoek. „n Hierargiese regressie ontleding is uitgevoer om die unieke bydraes van stressore, hulpbronne, akkulturasie en copingstrategieë tot selfmoordideasie te ondersoek. Kwalitatiewe data is ingesamel deur gebruik te maak van twee oop einde stellings waarin deelnemers versoek is om die stressore en hulpbronne in hul lewens te identifiseer. Tematiese inhoudsanalise is gebruik om hierdie response te ontleed. Die resultate van die kwantatiewe studie suggereer dat die vlak van selfmoordideasie, soos gerapporteer deur die huidige steekproef, beduidend hoër is as vir „n vergelykende Amerikaanse steekproef. Etniese en geslagsverskille is ook gevind tussen die groepe met bruin vroulike deelnemers wat die hoogste vlak van selfmoordideasie gerapporteer het. Ouer-kind verhoudings, portuurgroepverhoudings en finansiële beperkinge blyk algemene stressore te wees onder bruin adolessente in die huidige steekproef. Swart adolessente, daarteenoor, rapporteer finansiële beperkinge en romantiese verhoudings as hoof bronne van stres, terwyl wit adolessente ouer-kind verhoudings as „n algemene stressor rapporteer. In terme van hulpbronne het swart en bruin deelnemers die skoolomgewing as groter hulpbron geidentifiseer, terwyl wit deelnemers meer met vriende geidentifiseer het as primêre hulpbron. Copingstrategieë het nie die verhouding tussen stressore en selfmoordideasie op beide die 1% of 5% vlak van statistiese beduidenheid gemedieer nie. Copingstrategieë het wel as beduidende moderator gefigureer in die verhouding tussen stressore en selfmoordideasie vir al drie etniese groepe. Voorts het copingstrategieë ook nie „n statistiese beduidende proporsie van die variansie in die selfmoordideasie van beide die swart en bruin groepe verklaar nie. Aktiewe copingstrategieë en Alkohol- en dwelmmiddelgebruik as disfunksionele strategie het wel „n substansiële bydrae gelewer het tot die verklaring in die variansie van selfmoordideasie onder wit adolessente. Geen van die akkulturasieskale het enige beduidende bydrae tot die verklaring in variansie van selfmoordideasie vir enige van die drie etniese groepe gelewer nie. Die hoofbevindinge van die kwalitatiewe data suggereer verskeie etniese verskille in die rapportering van stressore en hulpbronne. Negatiewe selfpersepsie, gebrekkige sosiale gedragsregulering en finansiële probleme is geidentifiseer as hoof stressore vir al drie etniese groepe. Swart en bruin deelnemers het die misbruik van alkohol in hul gemeenskappe en finansiële probleme as meer stresvol ervaar, terwyl die wit deelnemers die hoë vlak van misdaad as primêre stressor geidentifiseer het. Ten opsigte van hulpbronne het swart adolessente „n positiewe selfbeeld, wit adolessente die verhouding met hul gesin en materiële hulpbronne en bruin adolessente godsdiens as primêre hulpbronne geidentifiseer. Dit word aanbeveel dat toekomstige navorsing fokus op die insluiting van addisionele veranderlikes soos sosio-ekonomiese status sowel as die gebruik van longitudinale studies om die dinamika van adolessente selfmoordgedrag verder na te speur. Die implimentering van programme wat fokus op die ontwikkeling van effektiewe copingstrategieë en sosiale vaardighede onder adolessente word ook aanbeveel.
Thesis (Ph.D. (Psychology))--University of the Free State, 2012
Keywords: Teenagers -- Suicidal behavior -- Cross-cultural studies; Suicidal behavior -- Cross-cultural studies; Stress in adolescence -- Cross-cultural studies; Positive psychology; Free state province; Social ecological model; Moderator; Mediator; Acculturation strategies; Coping strategies; Stressors; Resources; Suicidal ideation; Adolescence