Graduation Year

2010

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Nursing

Major Professor

Patricia A. Burns, Ph.D.

Co-Major Professor

Ona Z. Riggin, Ed.D.

Committee Member

Lois Gonzalez, Ph.D.

Committee Member

Robert Friedman, Ph.D.

Committee Member

Judith Karshmer, Ph.D.

Keywords

alienation, communication, parenting, qualitative, nursing science

Abstract

Adolescent suicide has become a national health crisis. Suicide now ranks as a leading cause of adolescent death in the U.S. In response to this, the National Strategy for Suicide Prevention (2001b) recommended the promotion and support of research into suicide and prevention, particularly high-risk groups such as adolescents. However, due to concerns for safety and liability, there have been few studies of highly suicidal individuals, specifically adolescents. Leading suicidologists have agreed that studying the qualities of the near-fatal suicide attempt can most resemble the completed suicide.

This case study explored the phenomenon of the near-fatal suicide attempt through the lived experiences of seven adolescent females. Open-ended interviews that candidly expressed adolescent emotions and understanding of events surrounding the attempt were analyzed. Burnard's method of thematic content analysis of these provocative interviews revealed a collective adolescent voice.

Interviews were conducted on a locked in-patient psychiatric unit for adolescents. During the one-year enrollment, nine eligible adolescents were hospitalized after an attempted suicide with high intentionality and low rescuability, a level of lethality that is considered serious/near-lethal on the Risk-Rescue Suicide Assessment Scale. Two individuals-both male-declined to participate.

A model was developed based on the content analysis of interviews with seven adolescent females in the case study. The model of a path of an adolescent near-fatal suicide attempt illustrated estrangement and eventual alienation from the adolescent's two major social support groups: parents and peers. A lack of a self-identity to cope with stressful experiences in a more rational manner contributed to the pathway. Parenting issues were highlighted by the adolescent's perception of non-supportive communication. Peer issues contributed to the subjects' perception of a lack of social support through their rejection and ridicule of the subjects. Coupled with the impulsivity of youth and mental illness, these subjects were not able to withstand the perception of extreme stress. Resultant near-fatal suicide attempts were initiated with significant ambivalence and no prior communication of intent. Alienation and a lack of appropriate coping skills placed these adolescents at high risk of a near-fatal suicide attempt.

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