Stress, self-esteem, and suicidal ideation in late adolescents

Adolescence, Spring, 2005 by Victor R. Wilburn, Delores E. Smith

Adolescent suicide is a worldwide problem, but it is of particular concern in highly industrialized nations such as the United States (Conner, Duberstein, Conwell, Seidlitz, & Caine, 2001); Kurtz & Derevensky, 1993). The suicide rate in the United States has tripled since 1960, making it the third leading cause of death among adolescents and the second leading cause of death among the college-age population (National Mental Health Association, 1997). Although it is estimated that approximately 14 adolescents in the United States commit suicide each day, the actual number is two to three times higher (American Psychiatric Association, 1996; 1998). Understandably, these alarming statistics have stimulated great concern in the public at large and have led social scientists to warn of an impending rise in the number of suicides and suicidal attempts among adolescents (Berman & Jobes, 1994; Griffiths, Farley, & Fraser, 1986; Watt & Sharp, 2002). Much of the research literature appears to be focused on suicide per se. However, professionals are increasingly paying attention to the antecedent behaviors. According to Bush and Pargament (1995), suicidal behavior is often preceded by thoughts, threats, and unsuccessful attempts at suicide. Similarly, Cole, Protinsky, and Cross (1992) noted that suicide was the completed process of a continuum that began with suicidal ideation, followed by an attempt at suicide, and finally completed suicide. Suicidal ideation is a preoccupation with intrusive thoughts of ending one's own life (Cole, Protinsky, & Cross, 1992; Harter, Marold, & Whitesell, 1992) while suicide is the completed act of taking ones life (National Mental Health Association, 2002). Because of this progression from thought to action, it is fitting that researchers explore the notion of suicidal ideation in greater depth.

The current study examined the phenomenological relationship among stress, self-esteem, and suicidal ideation in adolescents. Much of the research to date has focused on the associations of stress and self-esteem to actual suicide but not to ideation. Moreover, the majority of studies have examined the relationships in clinical populations. Thus, we know little about the associations of these processes in nonclinical populations. The present study investigated the relationship among cumulative negative life experiences (stress), self-esteem, and suicidal ideation in a nonclinical population of college students. Selye (1974) defined stress as a response of the human body to any stimulus that disrupts the individual's homeostasis. Because these responses are unavoidable, individuals are faced with the constant urge to maintain internal balance. Accordingly, any experience that affects one's homeostasis is considered to be stress (Rice, 1992). Social scientists have expanded Hans Selye's notion of physiological stress to include social, cognitive, and psychological or mental stress. Mullis, Youngs, Mullis, and Rathge (1993) proposed that stress is a function of an individual's appraisal of a life stressor and therefore, a cognitive process. Similarly, Lazarus (1993) contended that the extent to which individuals experience stress is determined by their subjective evaluations of their experiences. Therefore, if individuals appraise an event as traumatic, they will experience more stress from the experience than will individuals who appraise the event as nonsignificant. Researchers (e.g., Bartle-Haring, Rosen, & Stith, 2002; Ferrer-Wreder, Lorente, Kurtines, Briones, Bussell, Berman, & Arrufat, 2002) have noted the importance of reducing stress by helping youth develop positive perceptions of the self in order to avoid catastrophic socioemotional outcomes such as suicidal behavior. Indeed, exposure to stress by youth has been linked to severe emotional and psychological problems (Bartle-Haring, Rosen, & Stith, 2002; Gonzales, Tein, Sandler, & Friedman, 2001), a known precursor to suicide (Teen suicide, 1998).

Stress and Suicidality

The search for identity, a naturally stressful demand on youth can be overwhelming to some adolescents and predispose them to thoughts of suicide (Teen suicide, 1998). Hence, the high incidence of adolescent suicide is assumed to be indicative of societal stress in the lives of young people (Griffiths, Farley, & Fraser, 1986; Turner, Kaplan, Zayas, & Ross, 2002). Several studies (e.g., Adams, Overholser, & Spirito, 1994; Clum & Febbraro, 1994; Peck, 1989; Simonds, McMahon, & Armstrong, 1991) have found that suicide attempts among adolescents do tend to increase as stress levels increase. Academic pressure, work-related problems, interpersonal difficulties, death of loved ones, illnesses, and loss of relationships have been found to be significant stressors on young people (Butler, Novy, Gagan, & Gates, 1994; Kurtz & Derevensky, 1993; Mullis, Youngs, Mullis, & Rathge, 1993).

Petzel and Riddle (1981) maintained that a poor or an overachieved academic performance can serve as a precursor to stress, subsequent depression, and suicidality. Henry, Stephenson, Hanson, and Hargett (1993) reported that serious suicide attempts seem to be higher among students who experience considerable academic success and less serious suicide attempts more indicative of students who are failing at school. Those researchers argued that academically successful students experience greater amounts of stress than do their less successful peers because more successful students feel more pressure to maintain their level of performance. This pressure may cause them to increase the lethality of their suicidal intent. However, students who have consistently exhibited a pattern of academic failure may simply engage in risk-taking behaviors (e.g., criminal acts, risky sexual activity) that predispose them to suicidality. On the other hand, Petzel and Riddle (1981) observed that the majority of suicidal students in both high school and college are receiving passing scores in their academic classes, an indication that academic performance is not the only significant factor that contributes to the occurrence of suicide.