Joseph Hanna Bar, Reznik Ilya, Mester Roberto
District Outpatient Mental Health Clinic, 80 Remez Street, Rehovot, Israel.
Isr J Psychiatry Relat Sci. 2003;40(3):209-19.
In the last two decades the incidence of adolescent suicides has been very high (though it has been on the decrease in the U.S.A. over the last four years), giving rise to a multitude of empirical and theoretical studies. The extensive knowledge that has accumulated regarding adolescent suicidal behavior has led to a more differentiated attitude. Many studies try to clarify specific needs, motivations and the conceptualization of death and suicide in various adolescent subgroups (minorities, females, homosexuals), thereby enabling more specific and exact methods of evaluation, prevention and intervention. Adolescent girls' suicidal behavior is different in many aspects from boys' suicidal behavior: Girls mortality rate from suicide is a 3-5 times lower rate than boys, but their attempted suicide rate is four to hundreds time higher. Girls suicide mainly by drugs and their suicide is mainly in reaction to interpersonal difficulties. Their motivation is often a cry for help. The comorbidity of suicide and depression is much higher for adolescent girls than boys. These differences generate a different understanding and separate treatment strategies. Two theoretical approaches that may explain the profile which characterizes suicidal girls will be presented. One has a psychological developmental context, and the other a social cultural context. Implications for specific prevention measures include legal action on pack sizes of analgesics, compulsory registration of attempted suicide and more gender specific treatment and prevention programs.
在过去二十年中，青少年自杀率一直很高（尽管在过去四年里美国的自杀率有所下降），引发了大量实证研究和理论研究。积累的关于青少年自杀行为的广泛知识导致了一种更加差异化的态度。许多研究试图阐明不同青少年亚群体（少数族裔、女性、同性恋者）的具体需求、动机以及对死亡和自杀的概念化，从而能够采用更具体、精确的评估、预防和干预方法。青少年女性的自杀行为在许多方面与男性不同：女性自杀死亡率比男性低3至5倍，但她们的自杀未遂率却高出4至数百倍。女性主要通过服药自杀，她们的自杀主要是对人际困难的反应。她们的动机往往是求救信号。青少年女性自杀与抑郁症的共病率比男性高得多。这些差异产生了不同的理解和不同的治疗策略。将介绍两种可能解释自杀女性特征的理论方法。一种具有心理发展背景，另一种具有社会文化背景。具体预防措施的影响包括对镇痛药包装规格采取法律行动、对自杀未遂者进行强制登记以及开展更多针对性别的治疗和预防项目。
