Herrera A, Dahlblom K, Dahlgren L, Kullgren G
Department of Preventive Medicine and Public Health, León University, León, Nicaragua.
Soc Sci Med. 2006 Feb;62(4):805-14. doi: 10.1016/j.socscimed.2005.06.055. Epub 2005 Aug 11.
Adolescent girls are the most frequent suicide attempters worldwide. However, there is little knowledge about pathways leading to suicidal behaviour among young people, in particular in low-income countries. This study explores the motives and processes related to suicidal behaviour among young girls in Nicaragua. Individual in-depth interviews were conducted with eight girls aged between 12 and 19 admitted to hospital after attempting suicide. The audio-taped interviews lasted 2-4 h and were transcribed, translated into English and coded for content. Grounded theory and content analysis were used to construct a theory of the mechanisms behind their suicidal behaviour. A tentative model exploring pathways to suicidal behaviour is described with four main categories: structuring conditions, triggering events, emotions and actions taken. The model illustrates the dialectic interplay between structure and actions taken. Actions taken were categorized as problem solving or various forms of escape where failure with either of these strategies resulted in a suicide attempt. Dysfunctional families, absent fathers and lack of integration into society were some of the structuring conditions that lead to emotional distress. Abuse, deaths in the family, break-up with boyfriends or suicide among friends acted as triggering events. A striking finding was the obvious narrative competence of the girls. Our findings indicate that suicide prevention programmes for young people must offer support from professionals, independent of their family and social networks. Institutions in the community in contact with young people with suicidal behaviour must develop communicative skills to offer a trusting environment mobilising the resources that young people have.
青少年女性是全球自杀未遂的高发群体。然而，对于年轻人尤其是低收入国家年轻人的自杀行为路径，我们知之甚少。本研究探讨了尼加拉瓜年轻女孩自杀行为的动机和过程。对8名年龄在12至19岁之间的自杀未遂后住院的女孩进行了个人深度访谈。录音访谈持续2至4小时，访谈内容被转录、翻译成英文并进行内容编码。运用扎根理论和内容分析法构建了她们自杀行为背后机制的理论。描述了一个探索自杀行为路径的初步模型，该模型有四个主要类别：结构性条件、触发事件、情绪及采取的行动。该模型说明了结构与所采取行动之间的辩证相互作用。所采取的行动分为解决问题或各种形式的逃避，若这些策略中的任何一个失败，就会导致自杀未遂。功能失调的家庭、父亲缺位以及融入社会困难是导致情绪困扰的一些结构性条件。虐待、家人离世、与男友分手或朋友自杀等事件成为触发事件。一个显著的发现是这些女孩明显的叙事能力。我们的研究结果表明，针对年轻人的自杀预防项目必须提供来自专业人员的支持，且独立于他们的家庭和社会网络。与有自杀行为的年轻人接触的社区机构必须培养沟通技巧，以营造一个信任的环境，调动年轻人自身拥有的资源。
