Abstract
National surveys indicate high rates of suicidal ideation in youth, especially among females. Coping skill training programs hold promise as a potential intervention that can help young people better manage stress and not consider suicide as a solution to life’s problems. To assess the promise of this strategy, the present research examined which coping strategies (if any) predicted reduction in youth suicidal ideation over a 1-year follow-up, and explored the potential pathways through which their influence was channeled. Two waves of panel data from a nationally representative sample of youth, assessed 1 year apart (N = 710; Mean age = 18 years) were analyzed separately by gender using multiple group path analytic procedures. Four coping strategies, namely problem solving, emotional regulation, support seeking and acceptance were found to predict reduction in suicidal ideation among both males and females. However, the influence of these strategies (at baseline) was channeled through distinct pathways. The effect of emotional regulation (and acceptance) was channeled through its use at follow-up and was mediated by reductions in perceived stress and depressive symptoms, leading to reduction in suicidal ideation. The influence of support seeking was also channeled through its more recent use at follow-up, but directly predicted reduction in suicidal ideation, with no effect on perceived stress or depressive symptoms. The effect of problem solving on suicidal ideation was mediated by reduction in depressive symptoms, but was not channeled through its use at follow-up, suggesting a longer time course for the protective influence of this strategy. Finally, acceptance had a direct risk-enhancing effect on suicidal ideation. Coping strategies commonly used by youth can be effective in reducing suicidal ideation and therefore universal training in the effective use of these strategies should be considered. An understanding of the distinct pathways through which their effect on suicidal ideation is transmitted can better inform the design of youth suicide prevention interventions.
Similar content being viewed by others
References
Ang, R. P., & Huan, V. S. (2006). Relationship between academic stress and suicidal ideation: Testing for depression as a mediator using multiple regression. Child Psychiatry and Human Development, 37, 133–143. doi:10.1007/s10578-006-0023-8.
Barrios, L. C., Everett, S. A., Simon, T. R., & Brener, N. D. (2000). Suicide ideation among US college students: Associations with other injury risk behaviors. Journal of American College Health, 48, 229–233. doi:10.1080/07448480009599309.
Botvin, G. J., & Griffin, K. W. (2004). Life Skills Training: Empirical findings and future directions. The Journal of Primary Prevention, 25, 211–232. doi:10.1023/B:JOPP.0000042391.58573.5b.
Bridge, J. A., Goldstein, T. R., & Brent, D. A. (2006). Adolescent suicide and suicidal behavior. Journal of Child Psychology and Psychiatry, 47, 372–394. doi:10.1111/j.1469-7610.2006.01615.x.
Brunstein-Klomek, A., Marrocco, F., Kleinman, M., Schonfeld, I. S., & Gould, M. S. (2007). Bullying, depression, and suicidality in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 40–49. doi:10.1097/01.chi.0000242237.84925.18.
Brunwasser, S. M., Gillham, J. E., & Kim, E. S. (2009). A meta-analytic review of the Penn Resiliency Program's effect on depressive symptoms. Journal of Consulting and Clinical Psychology, 77, 1042–1054. doi:10.1037/a0017671.
Centers for Disease Control and Prevention (2011). Summary data quality report. Behavioral Risk Factor Surveillance System (BRFSS). Retrieved from ftp://ftp.cdc.gov/pub/Data/Brfss/2010_Summary_Data_Quality_Report.pdf.
Chang, E. C. (2002). Predicting suicide ideation in an adolescent population: Examining the role of social problem solving as a moderator and a mediator. Personality and Individual Differences, 32, 1279–1291. doi:10.1016/S0191-8869(01)00118-0.
Cheng, C. (2001). Assessing coping flexibility in real-life and laboratory settings: A multi-method approach. Journal of Personality and Social Psychology, 80, 814–833. doi:10.1037/0022-3514.80.5.814.
Clarke, A. T. (2006). Coping with interpersonal stress and psychosocial health among children and adolescents: A meta-analysis. Journal of Youth and Adolescence, 35, 10–23. doi:10.1007/s10964-005-9001-x.
Clum, G. A., Esposito, C. L., Hirai, M., & Nelson, W. A. (2000). The relative contribution of diagnostic and psychosocial variables to severity of suicidal ideation. Journal of Psychopathology and Behavioral Assessment, 22, 79–90. doi:10.1023/A:1007528632026.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396. doi:10.2307/2136404.
Compas, B. E., Connor-Smith, J. K., Saltzman, H., Thomsen, A. H., & Wadsworth, M. E. (2001). Coping with stress during childhood and adolescence: Problems, progress, and potential in theory and research. Psychological Bulletin, 127, 87–127. doi:10.1037/0033-2909.127.1.87.
Compas, B. E., Davis, G. E., Forsythe, C. J., & Wagner, B. M. (1987). Assessment of major and daily stressful events during adolescence: The Adolescent Perceived Events Scale. Journal of Consulting and Clinical Psychology, 55, 534–541. doi:10.1037//0022-006X.55.4.534.
Connell, D. K., & Meyer, R. G. (1991). The reasons for living inventory and a college population: Adolescent suicidal behaviors, beliefs, and coping skills. Journal of Clinical Psychology, 47, 485–489. doi:10.1002/1097-4679(199107)47:4<485::AID-JCLP2270470403>3.0.CO;2-8.
Connor-Smith, J. K., Compas, B. E., Wadsworth, M. E., Thomsen, A. H., & Saltzman, H. (2000). Responses to stress in adolescence: Measurement of coping and involuntary stress responses. Journal of Consulting and Clinical Psychology, 68, 976–992. doi:10.1037/0022-006X.68.6.976.
de Leo, D., & Heller, T. (2008). Social modeling in the transmission of suicidality. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 29, 11–19. doi:10.1027/0227-5910.29.1.11.
Ebata, A. T., & Moos, R. H. (1994). Personal, situational, and contextual correlates of coping in adolescence. Journal of Research on Adolescence, 4, 99–125. doi:10.1111/1532-7795.ep11301479.
Eggert, L. L., Thompson, E. A., Herting, J. R., & Nicholas, L. J. (1995). Reducing suicide potential among high-risk youth: Tests of a school-based prevention program. Suicide & Life-Threatening Behavior, 25, 276–296. doi:10.1111/j.1943-278X.1995.tb00926.x.
Eggert, L. L., Thompson, E. A., Randell, B. P., & Pike, K. C. (2002). Preliminary effects of brief school-based prevention approaches for reducing youth suicide risk behaviors, depression, and drug involvement. Journal of Child and Adolescent Psychiatric Nursing, 15, 48–64. doi:10.1111/j.1744-6171.2002.tb00326.x.
Enders, C. K. (2010). Applied missing data analysis. New York, NY: The Guilford Press.
Esposito, C. L., & Clum, G. A. (2003). The relative contribution of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation. Journal of Clinical Child & Adolescent Psychology, 32, 386–395. doi:10.1207/S15374424JCCP3203_07.
Fields, L., & Prinz, R. J. (1997). Coping and adjustment during childhood and adolescence. Clinical Psychology Review, 17, 937–976. doi:10.1016/S0272-7358(97)00033-0.
Gould, M. S., Greenberg, T., Velting, D. M., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 386–405. doi:10.1097/01.CHI.0000046821.95464.CF.
Greenberg, M. T., Kusche, C. A., Cook, E. T., & Quamma, J. P. (1995). Promoting emotional competence in school-aged children: The effects of the PATHS curriculum. Development and Psychopathology, 7, 117–136. doi:10.1017/S0954579400006374.
Grover, K. E., Green, K. L., Pettit, J. W., Monteith, L. L., Garza, M. J., & Venta, A. (2009). Problem solving moderates the effects of life event stress and chronic stress on suicidal behaviors in adolescence. Journal of Clinical Psychology, 65, 1281–1290. doi:10.1002/jclp.20632.
Hampel, P., & Petermann, F. (2006). Perceived stress, coping, and adjustment in adolescents. The Journal of Adolescent Health, 38, 409–415. doi:10.1016/j.jadohealth.2005.02.014.
Healthy People 2020 Objectives. (2011). U.S. Department of Health and Human Services. Retrieved from http://www.healthypeople.gov/hp2020/Objectives/files/Draft2009Objectives.pdf
Horwitz, A. G., Hill, R. M., & King, C. A. (2011). Specific coping behaviors in relation to adolescent depression and suicidal ideation. Journal of Adolescence, 34, 1077–1085. doi:10.1016/j.adolescence.2010.10.004.
It Gets Better Project. Retrieved July 10, 2011, from http://www.itgetsbetter.org/
Jaser, S. S., Champion, J. E., Reeslund, K. L., Keller, G., Merchant, M. J., Benson, M., & Compas, B. E. (2007). Cross-situational coping with peer and family stressors in adolescent offspring of depressed parents. Journal of Adolescence, 30, 917–932. doi:10.1016/j.adolescence.2006.11.010.
Johnson, J. G., Cohen, P., Gould, M. S., Kasen, S., Brown, J., & Brook, J. S. (2002). Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Archives of General Psychiatry, 59, 741–749. doi:10.1001/archpsyc.59.8.741.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer Publishing Company.
Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1994). Psychosocial risk factors for future adolescent suicide attempts. Journal of Consulting and Clinical Psychology, 62, 297–305. doi:10.1037/0022-006X.62.2.297.
Little, R. J. A., & Rubin, D. B. (1987). Statistical analysis with missing data. New York, NY: Wiley.
Lochman, J. E., & Wells, K. C. (2003). Effectiveness of the coping power program and of classroom intervention with aggressive children: Outcomes at a 1-year follow-up. Behavior Therapy, 34, 493–515. doi:10.1016/S0005-7894(03)80032-1.
Luk, J. W., Wang, J., & Simons-Morton, B. G. (2010). Bullying victimization and substance use among U.S. adolescents: Mediation by depression. Prevention Science, 11, 355–359. doi:10.1007/s11121-010-0179-0.
MacKinnon, D. P., Lockwood, C. M., Brown, C. H., Wang, W., & Hoffman, J. M. (2007). The intermediate endpoint effect in logistic and probit regression. Clinical Trials, 4, 499–513. doi:10.1177/1740774507083434.
Malone, K. M., Oquendo, M. A., Haas, G. L., Ellis, S. P., Li, S., & Mann, J. J. (2000). Protective factors against suicidal acts in major depression: Reasons for living. The American Journal of Psychiatry, 157, 1084–1088. doi:10.1176/appi.ajp.157.7.1084.
Muthén, L.K. and Muthén, B.O. (1998-2010). Mplus User’s Guide. Sixth Edition. Los Angeles, CA: Muthén & Muthén
National Center for Health Statistics Health, United States, 2008 with chartbook Hyattsville, MD: 2009. Retrieved from http://www.cdc.gov/nchs/data/hus/hus08.pdf
Newman, D. A. (2003). Longitudinal modeling with randomly and systematically missing data: A simulation of ad hoc, maximum likelihood, and multiple imputation techniques. Organizational Research Methods, 6, 328–362. doi:10.1177/1094428103254673.
Overholser, J. (2003). Predisposing factors in suicide attempts: Life stressors. In A. Spirito & J. Overholser (Eds.), Evaluating and treating adolescent suicide attempters: From research to practice (pp. 41–52). San Diego, CA: Academic.
Patton, G. C., Tollit, M. M., Romaniuk, H., Spence, S. H., Sheffield, J., & Sawyer, M. G. (2011). A prospective study of the effects of optimism on adolescent health risks. Pediatrics, 127, 308–316. doi:10.1542/peds.2010-0748.
Piquet, M. L., & Wagner, B. M. (2003). Coping responses of adolescent suicide attempters and their relation to suicidal ideation across a 2-year follow-up: A preliminary study. Suicide & Life-Threatening Behavior, 33, 288–301. doi:10.1521/suli.33.3.288.23212.
Poijula, S., Wahlberg, K. E., & Dyregrov, A. (2001). Adolescent suicide and suicide contagion in three secondary schools. International Journal of Emergency Mental Health, 3, 163–168.
Raykov, T. (1997). Estimation of composite reliability for congeneric measures. Applied Psychological Measurement, 21, 173–184. doi:10.1177/01466216970212006.
Reinherz, H. Z., Giaconia, R. M., Silverman, A. B., Friedman, A., Pakiz, B., Frost, A. K., & Cohen, E. (1995). Early psychosocial risks for adolescent suicidal ideation and attempts. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 599–611. doi:10.1097/00004583-199505000-00012.
Sadowski, C., & Kelley, M. L. (1993). Social problem solving in suicidal adolescents. Journal of Consulting and Clinical Psychology, 61, 121–127. doi:10.1037/0022-006X.61.1.121.
Sawyer, M. G., Harchak, T. F., Spence, S. H., Bond, L., Graetz, B., Kay, D., Patton, G., et al. (2010). School-based prevention of depression: A 2-year follow-up of a randomized controlled trial of the beyond blue schools research initiative. Journal of Adolescent Health, 47, 297–304. doi:10.1016/j.jadohealth.2010.02.007.
Schafer, J. L., & Olsen, M. K. (1998). Multiple imputation for multivariate missing-data problems: A data analyst’s perspective. Multivariate Behavioral Research, 33, 545–571. doi:10.1207/s15327906mbr3304_5.
Seiffge-Krenke, I. (2011). Coping with relationship stressors: A decade review. Journal of Research on Adolescence, 21, 196–210. doi:10.1111/j.1532-7795.2010.00723.x.
Seiffge-Krenke, I. (2000). Causal links between stressful events, coping style, and adolescent symptomatology. Journal of Adolescence, 23, 675–691. doi:10.1006/jado.2000.0352.
Seiffge-Krenke, I. (1995). Stress, coping, and relationships in adolescence. Mahwah, NJ: Lawrence Erlbaum Associates.
Shaffer, D., Gould, M. S., Fisher, P., Trautman, P., Moreau, D., Kleinman, M., & Flory, M. (1996). Psychiatric diagnosis in child and adolescent suicide. Archives of General Psychiatry, 53, 339–348. doi:10.1001/archpsyc.1996.01830040075012.
Shure, M. B., & Israeloff, R. (2001). “Raising a thinking preteen: The “I Can Problem Solve” program for 8- to 12- year-olds”. New York, NY: Henry Holt and Company, LLC.
Skapinakis, P., Bellos, S., Gkatsa, T., Magklara, K., Lewis, G., Araya, R., Stylianidis, S., et al. (2011). The association between bullying and early stages of suicidal ideation in late adolescents in Greece. BMC Psychiatry, 11, 1–9. doi:10.1186/1471-244X-11-22.
Skinner, E. A., Edge, K., Altman, J., & Sherwood, H. (2003). Searching for the structure of coping: A review and critique of category systems for classifying ways of coping. Psychological Bulletin, 129, 216–269. doi:10.1037/0033-2909.129.2.216.
Speckens, A. E., & Hawton, K. (2005). Social problem solving in adolescents with suicidal behavior: a systematic review. Suicide & Life-Threatening Behavior, 35, 365–387. doi:10.1521/suli.2005.35.4.365.
StataCorp. (2009). Stata Statistical Software: Release 11. College Station, TX: StataCorp LP.
Stewart, S. M., Kennard, B. D., Lee, P. W. H., Mayes, T., Hughes, C., & Emslie, G. (2005). Hopelessness and suicidal ideation among adolescents in two cultures. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 46, 364–372. doi:10.1111/j.1469-7610.2004.00364.x.
Taylor, S. E. (2006). Tend and befriend: Biobehavioral bases of affiliation under stress. Current Directions in Psychological Science, 15, 273–277. doi:10.1111/j.14678721.2006.00451.x.
Thompson, E. A., Mazza, J. J., Herting, J. R., Randell, B. P., & Eggert, L. L. (2005). The mediating roles of anxiety, depression, and hopelessness on adolescent suicidal behaviors. Suicide & Life-Threatening Behavior, 35, 14–34. doi:10.1521/suli.35.1.14.59266.
Thompson, E., Eggert, L., Randell, B., & Pike, K. (2001). Evaluation of indicated suicide risk prevention approaches for potential high school dropouts. American Journal of Public Health, 91, 742–752. doi:10.2105/AJPH.91.5.742.
Web-based Injury Statistics Query and Reporting System. (2011). Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved from www.cdc.gov/ncipc/wisqars
Yang, B., & Clum, G. A. (2000). Childhood stress leads to later suicidality via its effect on cognitive functioning. Suicide & Life-Threatening Behavior, 30, 183–198. doi:10.1111/j.1943-278X.2000.tb00985.x.
Youth Risk Behavior Surveillance (Surveillance Summaries No. 59). (2010). Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/mmwr/pdf/ss/ss5905.pdf
Zimmer-Gembeck, M. J., & Skinner, E. A. (2008). Adolescent coping with stress: Development and diversity. Prevention Researcher, 15, 3–7.
Zimmer-Gembeck, M. J., & Skinner, E. A. (2011). The development of coping across childhood and adolescence: An integrative review and critique of research. International Journal of Behavioral Development, 35, 1–17. doi:10.1177/0165025410384923.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Khurana, A., Romer, D. Modeling the Distinct Pathways of Influence of Coping Strategies on Youth Suicidal Ideation: A National Longitudinal Study. Prev Sci 13, 644–654 (2012). https://doi.org/10.1007/s11121-012-0292-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11121-012-0292-3