Major Finding: Girls in high school are more likely than boys to report depression and having seriously considered suicide, made a suicide plan, or attempted suicide in the previous 12 months. Boys are more likely to report injury with a suicide attempt.
Data Source: Analysis of five Youth Risk Behavior Surveillance System Surveys between 1999 and 2007.
Disclosures: None was reported.
ORLANDO — Girls in high school are more likely than are boys, regardless of age or race/ethnicity, to report being depressed, having seriously considered suicide, making a suicide plan, or attempting suicide in the past 12 months.
However, “when there is a suicide attempt, males are more likely to be injured than are females,” according to Robert M. Fernquist, Ph.D., “Males, when they do it, tend to do it more severely.”
In addition, a history of abuse emerged as the greatest predictor of suicidal behavior in these children.
“Rarely is suicide spontaneous—often there is a plan,” said Dr. Fernquist, professor of sociology at the University of Central Missouri in Warrensburg. “If there is a trajectory, there is probably depression first, then considering it, then making a plan.”
For that reason, Dr. Fernquist focused on specific questions asked in five Youth Risk Behavior Surveillance System (YRBSS) surveys conducted between 1999 and 2007. He assessed answers to five questions that asked whether, during the last 12 months, the responder had been depressed, considered suicide, made a suicide plan, and/or attempted suicide; and of those who had attempted suicide, if they had been injured as a result (defined as requiring medical attention).
An average of 154 high schools and 14,424 students in grades 9-12 participated in the survey, for a total of approximately 70,000 responses. The Centers for Disease Control and Prevention established the YRBSS to assess health-related behaviors in youth. Every other year, YRBSS researchers survey a nationally representative sample of public and private high school students.
Dr. Fernquist classified the students by sex as well as by age and race or ethnicity. For example, he compared responses from students aged 13-15 years with those aged 16-18 years because “younger teens … are mentally different than older, more mature teens.”
The percentage of high school students who had felt depressed in the previous 12 months was higher among girls across all groupings. “In every case, females were significantly more depressed than males,” Dr. Fernquist said.
For example, among students aged 13-15 years, 33% of black girls and 20% of black boys reported depression, as did 30% of Asian girls and 18% of Asian boys.
“Certainly not everyone who is depressed attempts suicide,” Dr. Fernquist said. Overall, a weighted average of 14.5% of high school students said they had seriously considered attempting suicide during the previous 12 months.
Again, there was a female predominance for consideration of suicide across all age and racial or ethnic comparisons. Among students aged 16-18 years, 25% of American Indian girls and 17% of American Indian boys said they had considered suicide, as did 22% of Hispanic girls and 13% of Hispanic boys.
Girls also were more likely than were boys in all groups to report they had made a suicide plan. For example, among 13- to 15-year-olds, 19% of white girls and 11% of white boys said they had made a plan, as did 15% of girls and 9% of boys in the Hawaiian and Pacific Islander group.
Dr. Fernquist also assessed the percentage of high school students who made at least one suicide attempt. “For the most part, females are more likely, regardless of age and ethnicity … to attempt.”
To assess the responses to the question about injury as a result of a suicide attempt, Dr. Fernquist grouped all the students into one age category because the numbers were small.
“Black, Hispanic, Hawaiian and Pacific Islander, and white males were all significantly more likely to attempt with injury [than were females].” The only exception was among Asian students, where girls were more likely to report injury with a suicide attempt than were their male counterparts.
Dr. Fernquist also assessed the data to determine variables associated with increased risk of suicide. “Regardless of the suicidal type of behavior involved, using drugs, being abused, or having a poor body image increase risk of suicidal behavior,” he said.
However, abuse dominated the regression models. In every case, it was abuse that had the biggest effect on a person's depression or likelihood of having a suicide plan, Dr. Fernquist said.
“One thing I will come away with from this study is that if you have a history of abuse—being hit by a boyfriend or girlfriend or being abused at school—you will have increased risk of suicidal behavior,” he said.