When reviewing the literature regarding adolescence, it is clear that it is a very difficult term to define. There seems to be no strict age at which adolescence begins or ends, and many authors who write on the subject of adolescence fail to provide a succinct definition of adolescence. This is perhaps because no clear definition can be given, as the transition from childhood to adulthood is such an individual, diverse phenomenon that to even begin to define it is futile.
Most people would probably think of adolescence as the teenage years, from thirteen through to nineteen, but every individual develops, both physically, psychologically and emotionally, at different rates. As Steinberg states, “it is obvious that generalising about the nature of adolescence is no easy task” (p. 3, Steinberg, 1993). He goes on to describe adolescence as a time of transitions, both biological, psychological, social and economic, and comments that it is an exciting period of life, where adolescents are allowed to start work, get married, and to vote, and at some stage are expected to become financially independent.
Steinberg also correctly remarks that establishing the beginning and end of adolescence comes down to a matter of opinion, rather than fact. For these reasons, this essay will not attempt to offer a definitive explanation of adolescence, but rather will point out that it can be one of the most difficult times of change in a person’s life, and that this is important to bear in mind when working with this group. During this period in life of huge change and transition, it is not surprising that many individuals experience some level of suicidal ideation at some point during adolescence (Geldard ; Geldard, 1999).
According to many recent studies, the levels of stress, anxiety and depression are increasing in young people in Western culture, and this is leading to an increase in suicidal ideation, attempted suicide and completed suicide (Dacey ; Kenny, 1997). Levels of self-harm are also thought to be increasing, and have been referred to as reaching epidemic proportions (Hawton, 1986). In 1990, the suicide rates per million for 15-19 year olds in England and Wales for males and females were 57 and 14 respectively.
This is almost definitely an under-estimate due to the reluctance of Coroner’s to give a verdict of suicide, unless they are one hundred per cent certain. The steep rise in the number of male adolescent suicides is even more concerning as, between 1980 and 1990, they rose by 78%. The rates for females and for all other age groups, however, are declining (Flisher, 1999). Rutter (1991) defines suicide as, “self-chosen behaviour intended to bring about one’s death on the short(est) term” (p. 214).
It is important to recognise, however, that suicidal behaviour is not always carried out by people with the intention of ending their own life, but that often it is meant only to express or communicate feelings of despair, hopelessness or anger. For this reason, suicidal behaviour can be divided into three categories. Suicidal ideation, that can range from fleeting thoughts that life is not worth living anymore, to a very certain well-planned strategy for killing oneself, to a very intense delusional preoccupation with ending ones life (Godney et al. , 1989).
Parasuicide refers to behaviour that can vary from manipulative attempts and suicidal gestures, to serious but unsuccessful attempts to kill oneself. This can also be referred to as self-harm ( Kreitman, 1977). The third category is suicide, which Maris (1991) refers to as, “any death that is the direct or indirect result of a positive or negative act accomplished by the victim, knowing or believing the act will produce this result” (p. 215). Little is known about the factors that precipitate or protect against transformations from suicide ideation to parasuicide, and from parasuicide to actual suicide.
This is a very important area, and one that needs to be researched more. If these factors could be identified, then counsellors would have specific material to work with and to look for when working with adolescents who present as being in one of the stages of suicide mentioned above. So what are the risk factors that make one adolescent more likely to commit or attempt suicide or self-harm than another? An adolescents coping strategies and resources will determine whether or not they see suicide as an option, and whether or not they actually choose to take this option.
It is thought that adolescents are particularly vulnerable to self-harm and suicide if they are already suffering from depression (Geldard & Geldard, 1999; Rutter, 1995; Steinberg, 1993). Obviously, adolescents who choose suicide as their coping strategy are experiencing severe psychological distress, possibly as a result of stress, anxiety or depression, or alternatively due to a psychotic illness or substance abuse. A depressed mood, which is one of the main characteristics distinguishing adolescents who are referred for clinical help from those who are not, is generally not associated with frequent suicidal wishes or thoughts.
Depressive syndrome and major depressive disorder, however, both tend to include frequent thoughts about death and/or suicide, suicide plans, or suicidal acts (Achenbach, 1991). According to Geldard & Geldard (1999), adolescents who attempt suicide share some common characteristics. They tend to have very intense interpersonal relationships with only a few people, and to express their feelings by acting out rather than by communicating them verbally. It is also likely that they have an external locus of control regarding their situation, and that they express high levels of hopelessness, thinking that things are unlikely to ever improve.
This is also suggested by research that has shown that the cognitive characteristic of hopelessness is the single best predictor of eventual suicide (Freeman & Dattilio, 1992). Additionally, adolescents who are more likely to commit suicide are inclined to overreact to things, and can be hypersensitive. Dacey & Kenny (1997) also point out that adolescents who attempt and complete suicide frequently have more stressful lives, less coping strategies and poor school performance.
Suicide can be related to any number of problems that that person is experiencing at that time in their life, but specific problems that are often experienced by adolescents who attempt or commit suicide or self-harm are family problems, especially those which threaten the stability of the family, such as parental separation; a serious lack of communication between the adolescent and their parents or care givers; problems within peer relationships; not belonging to a group or having any friends; and what they perceive to be a failure to live up to expectation of others, such as parents (Geldard & Geldard, 1999).