Risk Factors in Suicidal Behavior

Risk factors refer to individual or environmental characteristics, which increase the probability that a person may commit a suicidal act. Some factors may outweigh others, and especially the combination of several risk factors. In this PsychologyOnline article, we will talk about the Risk Factors in Suicidal Behavior.

Index

1. Main risk factors
2. Suicidal risk factors in childhood
3. Suicidal risk factors in adolescence
4. Suicidal risk factors in adults
5. Suicidal risk factors in old age

Although the data have some differences (WHO, 2001; García de Jalón, 2002; Pascual Pascual and others, 2005; Maris, Berman and Silverman, 2000); WHO (2009), in general it could be established that the following are risk factors:

• Have no religious ideals. Lower suicide rates have been found in believers and practitioners compared to non-believers.
• Living in areas with social isolationl (especially in depressed areas of large cities, but also in unpopulated rural areas).
• Suffering from mental disorder: In more than 90% of cases there is concomitant psychiatric illness (Moscicki, 2001).

In order of frequency we have:

• Mood disorders (affective): The risk of suicide is 15% to 20%, being higher in major depression and bipolar disorder. Suicide is more likely in bipolar disorder than in unipolar disorder and much less in chronic forms. It is less frequent in the first stage of affective complaints. The risk increases in severe forms (major depression) and with age (depression in the elderly). An increased risk of suicide is also observed when starting antidepressant treatment, since it improves psychomotor inhibition before depressed mood.
• Seasonal depressions they can also influence the relationship between depression and suicide and explain the slight increase in suicide in spring and autumn (Lee, 2006).
• Drug addiction: In alcoholism there is a suicide rate of 15%. The incidence is somewhat lower in other drug addictions (10%), such as the use of opiates and cocaine. Thus, the abuse of alcohol and psychoactive substances influence 25% of suicides and facilitate the appearance of suicidal ideas.
• Schizophrenia: The suicide rate is 10% and 30% of schizophrenic subjects make suicide attempts (Gómez Macias et al., 2007). It is associated with hallucinatory activity and depression. Schizophrenic disorders are moments of special risk in the first years of the illness or in the weeks following discharge from hospital. It occurs more in young people, in the first four years of disease evolution and associated with repeated exacerbations of the disease and attempts at self-harm (Robinson et al., 2010).
• Personality disorders: The disorders with the highest risk are the dissocial type and borderline or borderline personality disorder and those disorders that are characterized by impulsive behaviors.
• Eating disorder and body dysmorphic ranges between 16% and 39% (Toro and Castro, 2005).
• Organic mental syndromes: Dementia and Parkinson's disease are included, mainly.

• Have a history of suicide attempts and threats:

• There is a history of previous attempts between 25% and 50% of the completed acts.
• There is a tendency to repeat the same suicidal gestures.

• Being in the age group that corresponds to youths (15-34 years) or at seniors (> 65 years) (Qin, Agerbo & Mortensen, 2003) (Qin, 2005).
• In men, the frequency increases with age, with a maximum incidence at 75 years. They consume suicide 2-3 times more than women.
• In women, the age of highest incidence is between 55 and 65 years. They try to commit suicide 2-3 times more than men.
• Be engaged in the following social groups (Qin, Agerbo and Mertensen, 2003) (Qin, 2005):

• Marital status: Single, widowed, separated and divorced.
• Loneliness: Living alone, loss or failure of a love relationship in the last year.
• Loss of role or social status.
• Being an immigrant or recently uprooted and marginalized.
• Unemployment.
• Belonging to the white race.

• Have serious problems in the family area (loss of loved ones, family members with mental disorders or drug abuse, family members with suicidal behavior, physical and psychological violence or sexual in the family), in the social area (social isolation) or in the workplace (loss of job, economic bankruptcy, harassment-conflict labor).
• Presence of Firearms In the home.
• To be imprisoned or recently released.
• Suffer a physical illness that presents with chronic pain or a disease that generates disability or is chronic or terminal (cancer, HIV, multiple sclerosis, motor, visual or hearing disabilities ...) or a disabling injury or deforming.

Suicide risk factors vary according to age, gender and cultural and social influences, and they can be modified over time. Suicide risk factors are usually presented in combination. Here are some of the risk factors that can occur:

In childhood, risk factors should be detected, mainly, in the family environment in which the minor lives. It is necessary to take into account if it was a desired child or not, because in the latter case they will exist to a greater or lesser degree, explicitly or covertly, different manifestations of rejection, with the logical psychological repercussion on the less.

On the one hand, parents who are too young can have children with problems with their child's education due to psycho-affective immaturity. On the other hand, parents who are too old may have difficulties in caring for their children due to the decrease in vital energy that prevents satisfying the child's demands, which causes attitudes that can range from the most extreme overprotection to permissiveness absolute.

The metal disorder (Conduct personality disorder or emotional instability or a depressive disorder or drug dependence or schizophrenia) of either parent may be a risk factor in children.

The child with psychological characteristics of dysphoria, aggressiveness, hostility, manifestations of impulse control disorder, with poor frustration tolerance, unable to delay satisfaction of their desires, demanding of attention and affection, with previous suicidal attempts, manipulative, who assume the role of victim; jealous of siblings, susceptible and spiteful, who express ideas of dying or suicidal, shy, with poor self-esteem and passive are more susceptible to commit a suicidal act.

The serious mental pathologies in children it is also a risk factor.

The emotional climate in which the minor lives is another risk factor, since a disorganized family environment, a broken home, with frequent arguments and fights between parents or where there is psychological abuse in the form of open rejection, humiliation and humiliation, or a home without rules of conduct for each member of the family can generate a breeding ground for the realization of a suicidal act.

The presence of family members, mainly parents, siblings and grandparents, with a history of suicidal behavior must also be assessed, due to the possibility of learning by imitation. The existence of friends or schoolmates with such behavior, can also predispose to the performance of this act.

In addition, other risk factors can be:

• Impaired affective relationships (parental divorce, separation, death of a loved one).
• Problems at school with classmates or teachers.
• Wanting to claim affection and attention.
• Wanting to punish others.
• Reunite with a deceased loved one.

The existence of a motive does not usually trigger a suicidal act immediately, by impulse, but the child begins to give a series of signals in her behavior that in a way They generally manifest themselves in changes in behavior at home or at school, in eating habits, in sleeping habits, in mood, in games and leisure.

Adolescence is a stressful developmental period full of major changes: changes in the body, changes in ideas, and changes in feelings. The intense stress, confusion, fear and uncertainty, as well as the pressure for success, and the ability to think about things from a new point of view influences the adolescent's abilities to solve problems and make decisions. For some adolescents, normal developmental changes, sometimes accompanied by other events or changes in the family such as divorce or moving to a new community, changing friendships, difficulties in school, or other losses can cause great disturbance and result overwhelming. Problems can be seen as too violent or difficult to cope with. For some, suicide may seem like a solution

At home, in addition to the risk factors mentioned in childhood, we must take into account those who leave it permanently very young; identification with suicidal, depressed or alcoholic family members; living with a mentally ill person as the only relative; socioeconomic difficulties; permissiveness in the home of certain antisocial behaviors, which reinforce them; presence among the direct relatives of antisocial personalities, criminals... (Buendía Vidal, 2004).

In the social aspect, the media they can influence the presentation of behavior as a role model or admirable if it is invested with a positive quality. It can also be increased by the lack of social support, the possibility of acquiring drugs, firearms, etc.

Another risk factor in adolescence is debut of mental disorder such as depressive disorder, bipolar disorder, schizophrenic disorder, or drug abuse.

Adolescence is the age or period in which the schizophrenic disorder or drug dependence most frequently begins.

So some of the risk factors that can occur in adolescence are:

• Mental disorder or drug dependence.
• Impulsive behaviors.
• Unwanted stressful life events or recent losses (family breakdown, parental separation, and lack of communication with parents).
• Family history of mental disorder or drug dependence.
• Family history of suicide.
• Family violence (physical, sexual or verbal / emotional abuse).
• Previous suicide attempt.
• Presence of firearms in the home.
• Incarceration.
• Exposure to suicidal behavior by other people, including family, friends, in the news or in fictional stories.

Therefore, for the adolescent it should be valued as a suicide risk (Pérez Barrero, 2002):

1. Suicidal behavior (suicidal idea, gestures, threats and suicide plan, method to be used, circumstances in which it would be carried out, etc.).
2. Family climate (disharmonious relationships with parents, family violence, parents with mental illness, relatives with suicidal behavior).
3. Clinical picture (Mental illness, especially depression, schizophrenia and previous suicidal behavior of the adolescent).
4. Psychological state (hopelessness, feelings of loneliness, anguish, feelings of guilt, drug use, depression, anger, aggressiveness ...).
5. Stressful life events (death of a family member, love failure with loss of affective relationship, conflicts with friends, at school, family problems, etc.).

It has been claimed that hopelessness is more important than depression to explain suicidal ideations, although both are relevant variables in the face of the suicidal act (Beck et al., 1993).

The suicidal act in adolescence should be considered as a point in the continuum of the behavioral problems in question and the need to establish differences between chronic stressors of their lives and acute stressors that can precipitate suicidal behavior.

Teens may not seek help for suicidal thoughts because they think nothing will help or are reluctant to tell someone who has problems or thinks that seeking help is a sign of weakness or does not know where they can go for help (Pérez Barrero, 2002).

On the other hand, it has been shown that direct or indirect exposure to suicide or suicidal behaviors precedes the increase in suicidal behaviors (contagion or triggering) in people at risk of suicide especially in adolescents and young people.

Suicidal risk factors in adults are made up of those who crawl from childhood and adolescence plus those inherent to this stage of life.

1. History of psychiatric treatment, either on an outpatient or inpatient basis.
2. Possessing a conduct disorder of the personality.
3. Abusing alcohol or other drugs.
4. Bankruptcy of the company or business.
5. Previous suicide attempt.
6. Unemployment, especially in the first year, can be a predisposing factor, as well as professional failure.
7. Criminal history (injuries, homicide, robbery, etc.).

Among the risk factors in adults is alcoholism.

The following characteristics predispose the suicidal act in alcoholics:

1. Have low socioeconomic status.
2. Belonging to the male sex.
3. Have poor social support.
4. Not having a job.
5. Living alone.
6. Having suicidal thoughts
7. Abusing alcohol from a young age.
8. Having physical illness.
9. Comorbidity with major depression, diisocial personality disorder, or anxiety disorder.
10. Having family members with a history of suicide attempt.

The depressive disorders continue to be a risk factor in adults, especially if they meet the following characteristics:

• Suicidal behavior (threats, gestures, suicidal ideation ...).
• Chronic sleep disorders.
• Inhibition of effects and aggressiveness.
• Depressive phase that ends.
• Chronic illness.
• Comorbidity with alcoholism.
• Family problems during childhood and adolescence.
• Loss of affective relationships.
• Professional or financial difficulties.
• Absence or loss of religious belief.

It is considered that association of hopelessness, feelings of guilt, worthlessness, various delusions with a depressive mood pose a great suicide risk.

In relation to the schizophrenia in the adult, It is considered that there are two groups of suicides:

1. People with improvement and without positive symptoms (hallucinations, delusions), but with feelings of frustration and hopelessness.
2. People whose symptoms are anxiety, agitation, hallucinations and delusions.

Adults who in their profession or in their business have had a suicide risk are also at risk. scandal they have caused.

For some people, mostly women, a marital relationship that doesn't meet expectations can become a risk factor for suicide. The single woman has less risk of committing a suicidal act than the single man, while the married man has less suicide risk than the married woman.

Seniors are the ones with the highest suicide rates and constitute a growing segment of the population. It is foreseeable that the absolute number of their suicides will continue to increase, so it is necessary to delve into the risk factors in old age.

It is known that this behavior in the elderly has the following distinctive features:

1. They make fewer suicide attempts.
2. They use deadly methods.
3. Reflect fewer warning signs.
4. Such acts are premeditated, thoughtful.
5. They can take the form of passive suicides (to allow oneself to die).

The following profile has been described: widower, with deteriorated health, isolated, with little social support and depressed, that is shot with a firearm (Matusevich and Pérez Barrero, 2009).

Aging brings with it the abandonment of the profession or other goals, reduction of physical vigor, change in sensual pleasures and a awareness of unknown death in previous stages. Also physical problems that the elderly person must face, such as: arthritic pathology, which affects locomotion; cardiovascular diseases, which limit physical exercise; neurological disease, which compromises intellectual function, and cancer, which causes pain, dependence and death (Matusevich and Pérez Barrero, 2009).

Emotional problems include some depression and impaired self-esteem, to which are added the own pressures resulting from retirement, dependency, death of family and friends, loss of economic security, among other

As evidenced, there are enough conditions inherent to old age that are a suitable breeding ground for this behavior to manifest itself.

Thus, among the risk factors in old age are:

1. Chronic diseases, terminal, painful, disabling, and disabling, such as Parkinson's, Alzheimer's dementia, or other such as chronic obstructive pulmonary disease.
2. Depressions of any etiology, drug or alcohol abuse, chronic sleep disorders, paranoid disorders with great mistrust and agitation, and mental confusion.
3. Feelings of loneliness and uselessness, inactivity, boredom, lack of vital projects and tendency to remember the past.
4. Loss of loved ones by natural deaths or by suicide. The first year after the death of the spouse is a critical time because the stressful life event can trigger a depression and alter the immune system, which facilitates somatic pathology, mainly the infectious.
5. Admission to a nursing home for the elderly, as it can trigger a feeling of abandonment, loneliness and helplessness that precipitates a suicidal act.
6. The retirement.
7. Social isolation (loneliness, lack of communication).
8. The hostile, pejorative or contemptuous attitude of society towards the elderly.
9. Loss of prestige.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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