Skip to main content

Advertisement

SpringerLink
Log in

The impact of psychological problems and adverse life events on suicidal ideation among adolescents using nationwide data of a school-based mental health screening test in Korea

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

The aim of this study was to investigate the risk factors for suicidal ideation in adolescents by gender and age. This study used 2013 nationwide school-based mental health screening test data from 591,303 seventh grade students and 618,271 tenth grade students in Korea. Suicidal ideation, four psychological problems, and three adverse life events were evaluated using the Adolescents Mental Health and Problem Behavior Screening Questionnaire-II. Of all students, 12.9–14.7% of the boys and 17.1–23.2% of the girls had suicidal ideation. Mood had the greatest impact on the risk for suicidal ideation and other factors also significantly increased the risk of suicidal ideation. Distractibility was positively related to suicidal ideation only in seventh grade students and behavioral problems increased suicidal ideation more in girls than in boys. Violence constituted the most powerful factor for suicidal ideation among the events; however, bullying constituted the most important event that increased suicidal ideation in seventh grade girls. All factors except ‘Distractibility’ increased the risk of severe suicidal ideation. The risk factors for suicidal ideation in adolescents differed by gender and age. Interventions should be made according to these characteristics to reduce suicidal ideation in adolescents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Deaths and Death rates by cause (103 item), sex, and age (five-year age) (2016) Statistics Korea. http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1B34E01&vw_cd=MT_ETITLE&list_id=&scrId=&seqNo=&language=en&obj_var_id=&itm_id=&conn_path=E3&path=%252Feng%252Fsearch%252Fsearch01_List.jsp#. Accessed Jul 07 2017

  2. OECD family database (2015) Teenage suicide (15-19 years old). http://www.oecd.org/els/family/database.htm. Accessed Jul 07 2017

  3. Miranda R, Ortin A, Scott M, Shaffer D (2014) Characteristics of suicidal ideation that predict the transition to future suicide attempts in adolescents. J Child Psychol Psychiatry 55(11):1288–1296. https://doi.org/10.1111/jcpp.12245

    Article  PubMed  PubMed Central  Google Scholar 

  4. Klonsky ED, May AM, Saffer BY (2016) Suicide, suicide attempts, and suicidal ideation. Annu Rev Clin Psychol 12:307–330. https://doi.org/10.1146/annurev-clinpsy-021815-093204

    Article  PubMed  Google Scholar 

  5. Prinstein MJ, Boergers J, Spirito A, Little TD, Grapentine WL (2000) Peer functioning, family dysfunction, and psychological symptoms in a risk factor model for adolescent inpatients’ suicidal ideation severity. J Clin Child Psychol 29(3):392–405. https://doi.org/10.1207/S15374424JCCP2903_10

    Article  CAS  PubMed  Google Scholar 

  6. Bridge JA, Goldstein TR, Brent DA (2006) Adolescent suicide and suicidal behavior. J Child Psychol Psychiatry 47(3–4):372–394. https://doi.org/10.1111/j.1469-7610.2006.01615.x

    Article  PubMed  Google Scholar 

  7. Gould MS, King R, Greenwald S, Fisher P, Schwab-Stone M, Kramer R, Flisher AJ, Goodman S, Canino G, Shaffer D (1998) Psychopathology associated with suicidal ideation and attempts among children and adolescents. J Am Acad Child Adolesc Psychiatry 37(9):915–923. https://doi.org/10.1097/00004583-199809000-00011

    Article  CAS  PubMed  Google Scholar 

  8. Mazza JJ (2000) The relationship between posttraumatic stress symptomatology and suicidal behavior in school-based adolescents. Suicide Life Threat Behav 30(2):91–103

    CAS  PubMed  Google Scholar 

  9. McGee R, Williams S, Nada-Raja S (2001) Low self-esteem and hopelessness in childhood and suicidal ideation in early adulthood. J Abnorm Child Psychol 29(4):281–291

    Article  CAS  Google Scholar 

  10. Mazza JJ, Reynolds WM (1998) A longitudinal investigation of depression, hopelessness, social support, and major and minor life events and their relation to suicidal ideation in adolescents. Suicide Life Threat Behav 28(4):358–374

    CAS  PubMed  Google Scholar 

  11. Conner KR, Meldrum S, Wieczorek WF, Duberstein PR, Welte JW (2004) The association of irritability and impulsivity with suicidal ideation among 15- to 20-year-old males. Suicide Life Threat Behav 34(4):363–373. https://doi.org/10.1521/suli.34.4.363.53745

    Article  PubMed  Google Scholar 

  12. King RA, Schwab-Stone M, Flisher AJ, Greenwald S, Kramer RA, Goodman SH, Lahey BB, Shaffer D, Gould MS (2001) Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. J Am Acad Child Adolesc Psychiatry 40(7):837–846. https://doi.org/10.1097/00004583-200107000-00019

    Article  CAS  PubMed  Google Scholar 

  13. Impey M, Heun R (2012) Completed suicide, ideation and attempt in attention deficit hyperactivity disorder. Acta Psychiatr Scand 125(2):93–102. https://doi.org/10.1111/j.1600-0447.2011.01798.x

    Article  CAS  PubMed  Google Scholar 

  14. Wu P, Hoven CW, Liu X, Cohen P, Fuller CJ, Shaffer D (2004) Substance use, suicidal ideation and attempts in children and adolescents. Suicide Life Threat Behav 34(4):408–420. https://doi.org/10.1521/suli.34.4.408.53733

    Article  PubMed  PubMed Central  Google Scholar 

  15. Klomek AB, Kleinman M, Altschuler E, Marrocco F, Amakawa L, Gould MS (2013) Suicidal adolescents’ experiences with bullying perpetration and victimization during high school as risk factors for later depression and suicidality. J Adolesc Health 53(1 Suppl):37–42. https://doi.org/10.1016/j.jadohealth.2012.12.008

    Article  Google Scholar 

  16. Ford JD, Hartman JK, Hawke J, Chapman JF (2008) Traumatic victimization, posttraumatic stress disorder, suicidal ideation, and substance abuse risk among juvenile justice-involved youth. J Child Adolesc Trauma 1(1):75–92. https://doi.org/10.1080/19361520801934456

    Article  Google Scholar 

  17. Fergusson DM, Lynskey MT (1995) Suicide attempts and suicidal ideation in a birth cohort of 16-year-old New Zealanders. J Am Acad Child Adolesc Psychiatry 34(10):1308–1317. https://doi.org/10.1097/00004583-199510000-00016

    Article  CAS  PubMed  Google Scholar 

  18. Brent DA, Baugher M, Bridge J, Chen T, Chiappetta L (1999) Age- and sex-related risk factors for adolescent suicide. J Am Acad Child Adolesc Psychiatry 38(12):1497–1505. https://doi.org/10.1097/00004583-199912000-00010

    Article  CAS  PubMed  Google Scholar 

  19. Franic T, Dodig G, Kardum G, Marcinko D, Ujevic A, Bilusic M (2011) Early adolescence and suicidal ideations in Croatia: sociodemographic, behavioral, and psychometric correlates. Crisis 32(6):334–345. https://doi.org/10.1027/0227-5910/a000107

    Article  PubMed  Google Scholar 

  20. Vander Stoep A, McCauley E, Flynn C, Stone A (2009) Thoughts of death and suicide in early adolescence. Suicide Life Threat Behav 39(6):599. https://doi.org/10.1521/suli.2009.39.6.599

    Article  PubMed Central  Google Scholar 

  21. Allison S, Allison S, Roeger L, Martin G, Keeves J (2001) Gender differences in the relationship between depression and suicidal ideation in young adolescents. Aust N Z J Psychiatry 35(4):498–503. https://doi.org/10.1046/j.1440-1614.2001.00927.x

    Article  CAS  PubMed  Google Scholar 

  22. Lewinsohn PM, Rohde P, Seeley JR, Baldwin CL (2001) Gender differences in suicide attempts from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry 40(4):427–434. https://doi.org/10.1097/00004583-200104000-00011

    Article  CAS  PubMed  Google Scholar 

  23. Reinherz HZ, Giaconia RM, Silverman AB, Friedman A, Pakiz B, Frost AK, Cohen E (1995) Early psychosocial risks for adolescent suicidal ideation and attempts. J Am Acad Child Adolesc Psychiatry 34(5):599–611. https://doi.org/10.1097/00004583-199505000-00012

    Article  CAS  PubMed  Google Scholar 

  24. Jung SA, Ahn DH, Chung SY, Jeong YG, Kim YY (2008) Development of screening test for adolescent mental health and problem behavior. J Korean Neuropsychiatr Assoc 47(2):168–176

    Google Scholar 

  25. Bhang S-Y, Yoo HK, Kim J-H, Kim BS, Bahn GH, Ahn DH, Suh D-S, Cho S-C, Hwang J-W, Lee YS (2011) Revision of adolescent mental health and problem behavior screening Questionnaire: development of adolescent mental health and problem behavior screening Questionnaire-II. J Korean Acad Child Adolesc Psychiatry 22(4):271–286

    Article  Google Scholar 

  26. Cummings EM, Koss KJ, Davies PT (2015) Prospective relations between family conflict and adolescent maladjustment: security in the family system as a mediating process. J Abnorm Child Psychol 43(3):503–515. https://doi.org/10.1007/s10802-014-9926-1

    Article  PubMed  PubMed Central  Google Scholar 

  27. Lewis A, Kremer P, Douglas K, Toumborou J, Hameed M, Patton G, Williams J (2015) Gender differences in adolescent depression: differential female susceptibility to stressors affecting family functioning. Aust J Psychol 67(3):131–139

    Article  Google Scholar 

  28. Heinze JE, Cook SH, Wood EP, Dumadag AC, Zimmerman MA (2018) Friendship attachment style moderates the effect of adolescent exposure to violence on emerging adult depression and anxiety trajectories. J Youth Adolesc 47(1):177–193. https://doi.org/10.1007/s10964-017-0729-x

    Article  PubMed  Google Scholar 

  29. Prinstein M, Boergers J, Spirito A, Little T, Grapentine WL (2000) Peer functioning, family dysfunction, and psychological symptoms in a risk factor model for adolescent inpatients’ suicidal ideation severity. J Clin Child Psychol 29(3):392–405

    Article  CAS  Google Scholar 

  30. Donenberg G, Baker BL (1993) The impact of young children with externalizing behaviors on their families. J Abnorm Child Psychol 21(2):179–198

    Article  CAS  Google Scholar 

  31. Eisenberg N, Cumberland A, Spinrad TL, Fabes RA, Shepard SA, Reiser M, Murphy BC, Losoya SH, Guthrie IK (2001) The relations of regulation and emotionality to children’s externalizing and internalizing problem behavior. Child Dev 72(4):1112–1134

    Article  CAS  Google Scholar 

  32. Eisenberg N, Sadovsky A, Spinrad TL, Fabes RA, Losoya SH, Valiente C, Reiser M, Cumberland A, Shepard SA (2005) The relations of problem behavior status to children’s negative emotionality, effortful control, and impulsivity: concurrent relations and prediction of change. Dev Psychol 41(1):193–211. https://doi.org/10.1037/0012-1649.41.1.193

    Article  PubMed  PubMed Central  Google Scholar 

  33. James A, Lai FH, Dahl C (2004) Attention deficit hyperactivity disorder and suicide: a review of possible associations. Acta Psychiatr Scand 110(6):408–415

    Article  CAS  Google Scholar 

  34. GrØHolt B, Ekeberg Ø, WichstrØM L, Haldorsen TOR (1998) Suicide among children and younger and older adolescents in norway: a comparative study. J Am Acad Child Adolesc Psychiatry 37(5):473–481. https://doi.org/10.1097/00004583-199805000-00008

    Article  PubMed  Google Scholar 

  35. Adrian M, Miller AB, McCauley E, Vander Stoep A (2016) Suicidal ideation in early to middle adolescence: sex-specific trajectories and predictors. J Child Psychol Psychiatry 57(5):645–653. https://doi.org/10.1111/jcpp.12484

    Article  PubMed  Google Scholar 

  36. Kerr DCR, Owen LD, Capaldi DM (2008) Suicidal ideation and its recurrence in boys and men from early adolescence to early adulthood: an event history analysis. J Abnorm Psychol 117(3):625–636. https://doi.org/10.1037/a0012588

    Article  PubMed  PubMed Central  Google Scholar 

  37. Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, Bruffaerts R, Chiu WT, de Girolamo G, Gluzman S, de Graaf R, Gureje O, Haro JM, Huang Y, Karam E, Kessler RC, Lepine JP, Levinson D, Medina-Mora ME, Ono Y, Posada-Villa J, Williams D (2008) Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry 192(2):98–105. https://doi.org/10.1192/bjp.bp.107.040113

    Article  PubMed  PubMed Central  Google Scholar 

  38. Chioqueta AP, Stiles TC (2003) Suicide risk in outpatients with specific mood and anxiety disorders. Crisis 24(3):105–112. https://doi.org/10.1027//0227-5910.24.3.105

    Article  PubMed  Google Scholar 

  39. Bjorkenstam C, Bjorkenstam E, Hjern A, Boden R, Reutfors J (2014) Suicide in first episode psychosis: a nationwide cohort study. Schizophr Res 157(1–3):1–7. https://doi.org/10.1016/j.schres.2014.05.010

    Article  CAS  PubMed  Google Scholar 

  40. Sanchez-Gistau V, Baeza I, Arango C, Gonzalez-Pinto A, de la Serna E, Parellada M, Graell M, Paya B, Llorente C, Castro-Fornieles J (2015) The affective dimension of early-onset psychosis and its relationship with suicide. J Child Psychol Psychiatry 56(7):747–755. https://doi.org/10.1111/jcpp.12332

    Article  PubMed  Google Scholar 

  41. Zalpuri I, Rothschild AJ (2016) Does psychosis increase the risk of suicide in patients with major depression? A systematic review. J Affect Disord 198:23–31. https://doi.org/10.1016/j.jad.2016.03.035

    Article  PubMed  Google Scholar 

  42. Boden JM, Fergusson DM, Horwood LJ (2007) Anxiety disorders and suicidal behaviours in adolescence and young adulthood: findings from a longitudinal study. Psychol Med 37(3):431–440. https://doi.org/10.1017/S0033291706009147

    Article  PubMed  Google Scholar 

  43. Sareen J, Houlahan T, Cox BJ, Asmundson GJ (2005) Anxiety disorders associated with suicidal ideation and suicide attempts in the National Comorbidity Survey. J Nerv Ment Dis 193(7):450–454

    Article  Google Scholar 

  44. Sullivan SA, Lewis G, Gunnell D, Cannon M, Mars B, Zammit S (2015) The longitudinal association between psychotic experiences, depression and suicidal behaviour in a population sample of adolescents. Soc Psychiatry Psychiatr Epidemiol 50(12):1809–1817. https://doi.org/10.1007/s00127-015-1086-2

    Article  PubMed  PubMed Central  Google Scholar 

  45. Merikangas KR, J-p He, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J (2010) Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Study-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 49(10):980–989. https://doi.org/10.1016/j.jaac.2010.05.017

    Article  PubMed  PubMed Central  Google Scholar 

  46. Shaffer D, Gould MS, Fisher P et al (1996) Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry 53(4):339–348. https://doi.org/10.1001/archpsyc.1996.01830040075012

    Article  CAS  PubMed  Google Scholar 

  47. Lowry R, Crosby AE, Brener ND, Kann L (2014) Suicidal thoughts and attempts among US. High school students: trends and associated health-risk behaviors, 1991-2011. J Adolesc Health 54(1):100–108. https://doi.org/10.1016/j.jadohealth.2013.07.024

    Article  PubMed  Google Scholar 

  48. Simons RL, Murphy PI (1985) Sex differences in the causes of adolescent suicide ideation. J Youth Adolesc 14(5):423–434. https://doi.org/10.1007/BF02138837

    Article  CAS  PubMed  Google Scholar 

  49. Stringaris A, Maughan B, Copeland WS, Costello EJ, Angold A (2013) Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the great smoky mountains study. J Am Acad Child Adolesc Psychiatry 52(8):831–840. https://doi.org/10.1016/j.jaac.2013.05.017

    Article  PubMed  PubMed Central  Google Scholar 

  50. Plattner B, The SS, Kraemer HC, Williams RP, Bauer SM, Kindler J, Feucht M, Friedrich MH, Steiner H (2007) Suicidality, psychopathology, and gender in incarcerated adolescents in Austria. J Clin Psychiatry 68(10):1593–1600

    Article  Google Scholar 

  51. Goodman G, Gerstadt C, Pfeffer CR, Stroh M, Valdez A (2008) ADHD and aggression as correlates of suicidal behavior in assaultive prepubertal psychiatric inpatients. Suicide Life Threat Behav 38(1):46–59. https://doi.org/10.1521/suli.2008.38.1.46

    Article  PubMed  Google Scholar 

  52. Goldney RD, Wilson D, Grande ED, Fisher LJ, McFarlane AC (2000) Suicidal ideation in a random community sample: attributable risk due to depression and psychosocial and traumatic events. Aust N Z J Psychiatry 34(1):98–106. https://doi.org/10.1046/j.1440-1614.2000.00646.x

    Article  CAS  PubMed  Google Scholar 

  53. Bahk Y-C, Jang S-K, Choi K-H, Lee S-H (2017) The relationship between childhood trauma and suicidal ideation: role of maltreatment and potential mediators. Psychiatry Investig 14(1):37–43. https://doi.org/10.4306/pi.2017.14.1.37

    Article  PubMed  Google Scholar 

  54. Afifi TO, Enns MW, Cox BJ, Asmundson GJG, Stein MB, Sareen J (2008) Population attributable fractions of psychiatric disorders and suicide ideation and attempts associated with adverse childhood experiences. Am J Public Health 98(5):946–952. https://doi.org/10.2105/AJPH.2007.120253

    Article  PubMed  PubMed Central  Google Scholar 

  55. Rose AJ, Rudolph KD (2006) A review of sex differences in peer relationship processes: potential trade-offs for the emotional and behavioral development of girls and boys. Psychol Bull 132(1):98–131. https://doi.org/10.1037/0033-2909.132.1.98

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, South Korea

    Dayoung Lee & Hyun Ju Hong

  2. Hallym University Suicide and School Mental Health Institute, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang, 14068, South Korea

    Dayoung Lee, Song Jung, Seongjun Park & Hyun Ju Hong

Authors
  1. Dayoung Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Song Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seongjun Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hyun Ju Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hyun Ju Hong.

Ethics declarations

Conflict of interest

This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2015S1A5B8A02061201).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, D., Jung, S., Park, S. et al. The impact of psychological problems and adverse life events on suicidal ideation among adolescents using nationwide data of a school-based mental health screening test in Korea. Eur Child Adolesc Psychiatry 27, 1361–1372 (2018). https://doi.org/10.1007/s00787-018-1130-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-018-1130-3

Keywords

Search

Navigation