Psychiatric Annals

Adolescent Suicide 

Personal Reflections: Adolescent Suicide

Howard P Rome, MD

Abstract

Suicide is a transliterated euphemism for sell-murder, and as such, has been a source of grizzly fascination for centuries. Reams have been written attesting to its justification; substantiating speculations about the gross and subtle reasons for it; collecting demographic and epidemiological indices; reporting ostensible causes to validate this or that theory; and invoking legal, moral and ethical dicta. The act itself has been parsed in terms ranging from technical descriptions to religious indictments and extolled in poetry, drama, and song. Its phenomenology has been medicalized.

Among these efforts at categorization are the elements of human behavior and its myriad causes, which are the concern of psychiatry. In an extensive diagnostic inquiry, psychiatric speculation has analyzed data from such investigations. They include a wide range of sociocultural factors. Then too. there arc the profound influences of earlier personal psychological traumata. Also, educational deficiencies that create vulnerability play a major role.

Death from suicide has a different connotation than death from socalled natural causes. The distinction is, at first glance, manifest at least in the person *s active conscious participation in the decision Io terminate life. However, on second glance, there are more cryptic antecedent behaviors that accomplish the same fatal end. albeit by indirect means. Specifically, these include a number oi potentially life-threatening, high-risk behaviors that run a gamut from the great variety of substance abuses to indulging in voluntary exposures to equally lethal "recreational" behaviors that share the protective coloration of a social endorsement.

Dr. Ieanne Spurlock and her contributors have sketched a panoramic overview of suicidal behavior among youth. The national media have given public notice to this latest expression of social disenchantment - anomie. Of grave concern is the existential question of why these young people seem to be suffering from the same emotional quandary that, in times past, was the unhappy fate of their seniors.

Adolescence and young adulthood these days incur the high risk of trying to cope effectively with the accelerating pace of each successive endeavor. Experience with a modicum of success buffers imptilsivity. lessens fluctuations of mood leading to discord in affective relationships, and moderates a high level of tension seen as restlessness. Indecision is a behavioral expression of a stymied perplexity - to be or not to be. Associated with this ambivalence is the liability to socially inappropriate ways of attempting to palliate stress. Consequently, instability motivates today's youth to search constantly for succorance - to quest for relief from uncertainty. Instability is the proximal cause of the seemingly thoughtless, high-risk destructive behavior. Inherent in all of this is a compelling need for affiliation, and bonding is the anchor that presentday youth requires. In our fastmoving society with its high premium on those attributes that create surrogate bonding and that promise to vouchsafe a sense of belonging is the danger of impetuous choices. These often court disaster.

Seen from an ecological viewpoint, today's trends arc accelerated and include coping with the demands of a burgeoning technology. This necessitates greater personal competence in the attainment of necessary skills, and the well-knit structure of family ties disappears. Many derivatives of this are to be seen in a narcissistic deprivation. Ephemeral unstable relationships contribute to the sense of floundering. Collectively, these elemental factors are analogous to the seismic upheavals that randomly wreak their destructive forces and convulse every subsystem of the societal body politic. In a general way. this catches the young at a time in their development when they are most vulnerable. Consequently, the most vulnerable - the minorities - are the most liable to turbulence from internal and external happenings. In the final analysis,…

Suicide is a transliterated euphemism for sell-murder, and as such, has been a source of grizzly fascination for centuries. Reams have been written attesting to its justification; substantiating speculations about the gross and subtle reasons for it; collecting demographic and epidemiological indices; reporting ostensible causes to validate this or that theory; and invoking legal, moral and ethical dicta. The act itself has been parsed in terms ranging from technical descriptions to religious indictments and extolled in poetry, drama, and song. Its phenomenology has been medicalized.

Among these efforts at categorization are the elements of human behavior and its myriad causes, which are the concern of psychiatry. In an extensive diagnostic inquiry, psychiatric speculation has analyzed data from such investigations. They include a wide range of sociocultural factors. Then too. there arc the profound influences of earlier personal psychological traumata. Also, educational deficiencies that create vulnerability play a major role.

Death from suicide has a different connotation than death from socalled natural causes. The distinction is, at first glance, manifest at least in the person *s active conscious participation in the decision Io terminate life. However, on second glance, there are more cryptic antecedent behaviors that accomplish the same fatal end. albeit by indirect means. Specifically, these include a number oi potentially life-threatening, high-risk behaviors that run a gamut from the great variety of substance abuses to indulging in voluntary exposures to equally lethal "recreational" behaviors that share the protective coloration of a social endorsement.

Dr. Ieanne Spurlock and her contributors have sketched a panoramic overview of suicidal behavior among youth. The national media have given public notice to this latest expression of social disenchantment - anomie. Of grave concern is the existential question of why these young people seem to be suffering from the same emotional quandary that, in times past, was the unhappy fate of their seniors.

Adolescence and young adulthood these days incur the high risk of trying to cope effectively with the accelerating pace of each successive endeavor. Experience with a modicum of success buffers imptilsivity. lessens fluctuations of mood leading to discord in affective relationships, and moderates a high level of tension seen as restlessness. Indecision is a behavioral expression of a stymied perplexity - to be or not to be. Associated with this ambivalence is the liability to socially inappropriate ways of attempting to palliate stress. Consequently, instability motivates today's youth to search constantly for succorance - to quest for relief from uncertainty. Instability is the proximal cause of the seemingly thoughtless, high-risk destructive behavior. Inherent in all of this is a compelling need for affiliation, and bonding is the anchor that presentday youth requires. In our fastmoving society with its high premium on those attributes that create surrogate bonding and that promise to vouchsafe a sense of belonging is the danger of impetuous choices. These often court disaster.

Seen from an ecological viewpoint, today's trends arc accelerated and include coping with the demands of a burgeoning technology. This necessitates greater personal competence in the attainment of necessary skills, and the well-knit structure of family ties disappears. Many derivatives of this are to be seen in a narcissistic deprivation. Ephemeral unstable relationships contribute to the sense of floundering. Collectively, these elemental factors are analogous to the seismic upheavals that randomly wreak their destructive forces and convulse every subsystem of the societal body politic. In a general way. this catches the young at a time in their development when they are most vulnerable. Consequently, the most vulnerable - the minorities - are the most liable to turbulence from internal and external happenings. In the final analysis, suicide is an intensely personal response to an existential quandary, the unique details of which can only be glimpsed in the commonality of shared experiences.

In the following pages, Dr. Spurlock and colleagues have surveyed the major elements that comprise the corpus of psychosocial data judged to be relevant concerning the etiology, epidemiology, incidence, and prevalence of suicide and suicidal behavior in the young.

10.3928/0048-5713-19900301-04

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