Suicidal ideation among Lebanese adolescents: scale validation, prevalence and correlates

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Abstract

Background

In addition to the unstable political situation, Lebanon had experienced a cycle of wars, local armed conflicts, terrorist attacks, and crises (lack of clean water, recurrent power failure, and waste mismanagement, in addition to the growing number of unemployed people, as the number of Syrian refugees has dramatically increased, and led to competition for jobs with locals. All these factors make the Lebanese population prone to mental disorders, particularly suicide, without clear management policies. This study aims to validate the Columbia-Suicide Severity Rating Scale (CSSRS), and determine the prevalence of suicidal ideation and associated factors among a Lebanese nationally representative sample of adolescents from 9th to 12th grades.

Methods

Participants were 1810 adolescents who enrolled in this cross-sectional study (January–May 2019), using a proportionate random sample of schools from all Lebanese Mohafazat. The Columbia-Suicide Severity Rating Scale was used to screen for suicidal ideation.

Results

The results showed that 28.9% had some type of suicidal ideation [95% CI 26.7–31.1%]. The CSSRS items converged on a one-factor solution, accounting for a total of 85.40% of the variance (α _Cronbach = 0.966). Higher psychological abuse (Beta = 0.041), child physical abuse (Beta = 0.030), alcohol dependence (Beta = 0.062), social fear (Beta = 0.028), victimization/bullying score (Beta = 0.028), impulsivity (Beta = 0.028) and internet addiction (Beta = 0.010) scores were significantly associated with higher suicidal ideation. Same applies to adolescents whose parents are separated compared to living together (Beta = 0.992) and in females compared to males (0.311). On another hand, a higher age (Beta = − 0.182) was significantly associated with lower suicidal ideation.

Conclusion

This study provides insights about suicidal ideation among Lebanese adolescents and related risk factors, such as child psychological and physical abuse, alcohol use disorders, social fear, bullying and victimization, impulsivity, and internet addiction.

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Most cited references 76

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Varieties of impulsivity.

J Evenden (1999)

The concept of impulsivity covers a wide range of "actions that are poorly conceived, prematurely expressed, unduly risky, or inappropriate to the situation and that often result in undesirable outcomes". As such it plays an important role in normal behaviour, as well as, in a pathological form, in many kinds of mental illness such as mania, personality disorders, substance abuse disorders and attention deficit/hyperactivity disorder. Although evidence from psychological studies of human personality suggests that impulsivity may be made up of several independent factors, this has not made a major impact on biological studies of impulsivity. This may be because there is little unanimity as to which these factors are. The present review summarises evidence for varieties of impulsivity from several different areas of research: human psychology, psychiatry and animal behaviour. Recently, a series of psychopharmacological studies has been carried out by the present author and colleagues using methods proposed to measure selectively different aspects of impulsivity. The results of these studies suggest that several neurochemical mechanisms can influence impulsivity, and that impulsive behaviour has no unique neurobiological basis. Consideration of impulsivity as the result of several different, independent factors which interact to modulate behaviour may provide better insight into the pathology than current hypotheses based on serotonergic underactivity.

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Mental Disorders, Comorbidity and Suicidal Behavior: Results from the National Comorbidity Survey Replication

MK Nock, Irene I. L. Hwang, NA Sampson … (2009)

Mental disorders are among the strongest predictors of suicide attempts. However, little is known about which disorders are uniquely associated with suicidal behavior due to high levels of psychiatric comorbidity. We examined the unique associations between individual disorders and subsequent suicidal behavior (suicide ideation, plans, and attempts) using data from the National Comorbidity Survey Replication, a nationally representative household survey of 9,282 US adults. Results revealed that approximately 80% of suicide attempters in the US have a temporally prior mental disorder. Anxiety, mood, impulse-control, and substance disorders all significantly predict subsequent suicide attempts in bivariate analyses (odds ratios=2.7-6.7); however, these associations decrease substantially in multivariate analyses controlling for comorbidity (odds ratios=1.5-2.3) but remain statistically significant in most cases. Disaggregation of the observed effects reveals that depression predicts suicide ideation, but not suicide plans or attempts among those with ideation. Instead, disorders characterized by severe anxiety/agitation (e.g., PTSD) and poor impulse-control (e.g., conduct disorder, substance disorders) predict which suicide ideators go on to make a plan or attempt. These results advance understanding of the unique associations between mental disorders and different forms of suicidal behavior. Future research must further delineate the mechanisms through which people come to think about suicide and progress from suicidal thoughts to attempts.

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10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden.

E. Jane Costello, Helen Egger, Adrian Angold (2005)

To review recent progress in child and adolescent psychiatric epidemiology in the area of prevalence and burden. The literature published in the past decade was reviewed under two headings: methods and findings. Methods for assessing the prevalence and community burden of child and adolescent psychiatric disorders have improved dramatically in the past decade. There are now available a broad range of interviews that generate DSM and ICD diagnoses with good reliability and validity. Clinicians and researchers can choose among interview styles (respondent based, interviewer based, best estimate) and methods of data collection (paper and pencil, computer assisted, interviewer or self-completion) that best meet their needs. Work is also in progress to develop brief screens to identify children in need of more detailed assessment, for use by teachers, pediatricians, and other professionals. The median prevalence estimate of functionally impairing child and adolescent psychiatric disorders is 12%, although the range of estimates is wide. Disorders that often appear first in childhood or adolescence are among those ranked highest in the World Health Organization's estimates of the global burden of disease. There is mounting evidence that many, if not most, lifetime psychiatric disorders will first appear in childhood or adolescence. Methods are now available to monitor youths and to make early intervention feasible.

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Author and article information

Contributors

Souheil Hallit:

ORCID: http://orcid.org/0000-0001-6918-5689

souheilhallit@hotmail.com

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 15 June 2020

Publication date PMC-release: 15 June 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 304

Affiliations

[1 ]GRID grid.444434.7, ISNI 0000 0001 2106 3658, Faculty of Medicine and Medical Sciences, , Holy Spirit University of Kaslik (USEK), ; Jounieh, Lebanon

[2 ]INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon

[3 ]GRID grid.411324.1, ISNI 0000 0001 2324 3572, Faculty of Pharmacy, , Lebanese University, ; Hadat, Lebanon

[4 ]GRID grid.411324.1, ISNI 0000 0001 2324 3572, Faculty of Medicine, , Lebanese University, ; Hadat, Lebanon

[5 ]Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon

[6 ]GRID grid.497275.a, Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d’Epidémiologie et de Neurologie Tropicale, ; GEIST, 87000 Limoges, France

[7 ]Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon

[8 ]GRID grid.444421.3, ISNI 0000 0004 0417 6142, School of Pharmacy, , Lebanese International University, ; Beirut, Lebanon

[9 ]GRID grid.444434.7, ISNI 0000 0001 2106 3658, Faculty of Arts and Sciences, , Holy Spirit University of Kaslik (USEK), ; Jounieh, Lebanon

Author information

Souheil Hallit http://orcid.org/0000-0001-6918-5689

Article

Publisher ID: 2726

DOI: 10.1186/s12888-020-02726-6

PMC ID: 7296775

PubMed ID: 32539735

SO-VID: 2b3719b3-8ab9-4450-a441-5b4c67f0df6c

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 22 January 2020

Date accepted : 9 June 2020

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ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: suicidal ideation,adolescents,child abuse,alcohol use disorder,bullying,internet addiction,impulsivity,social fear

Data availability:

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: suicidal ideation, adolescents, child abuse, alcohol use disorder, bullying, internet addiction, impulsivity, social fear

Suicidal ideation among Lebanese adolescents: scale validation, prevalence and correlates

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Background

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Conclusion

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Journal of Behavioral Addictions

Most cited references 76

Varieties of impulsivity.

Mental Disorders, Comorbidity and Suicidal Behavior: Results from the National Comorbidity Survey Replication

10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden.

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Affiliations

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