Qualitative Content Analysis of Coping Strategies among Adolescents with Suicidal Thoughts

Bazrafshan, Mohammad-Rafi; Mansouri, Amir; Faramarzian, Zohreh; Soufi, Omid; Delam, Hamed; Masmouei, Behnam; Kavi, Esmaeil

doi:10.30476/intjsh.2022.93804.1200

Document Type : Research Article (s)

Authors

¹ Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran

² Department of Paramedical School, Gerash University of Medical Sciences, Gerash, Iran

³ Student of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

⁴ Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran

⁵ School of Nursing Hazrat Zahra (P.B.U.H) Abadeh, Shiraz University of Medical Sciences, Shiraz, Iran

https://doi.org/10.30476/intjsh.2022.93804.1200

Abstract

Background: Adolescence can be a critical period during which individuals begin to cope with self-harm behaviors, and the increasing prevalence of suicide and suicidal attempts in this period is quite tangible in different communities. Given the lack of awareness concerning tolerance strategies in individuals with suicidal behavior, we investigated coping strategies in adolescents with suicidal thoughts.
Methods: This qualitative research was conducted during January and February 2019 in which we used the method of qualitative content analysis. In this study, 17 adolescents with suicidal ideation referred to Larestan welfare centers, Fars province were interviewed. In addition, one psychologist and 17 parents of the adolescents participated in this research. Purposeful sampling was done. Data collection continued through semi-structured deep interviews until data saturation.
Results: Two main themes, namely effective coping strategies with 16 sub-themes and ineffective coping strategies with 12 subthemes were extracted from the data.
Conclusions: It was concluded that using appropriate plans to strengthen positive strategies in adolescents, providing them with new positive strategies, and omitting negative strategies can be conducive to preventing suicidal thoughts.

Keywords

References

1. Simon M, Chang ES, Zeng P, Dong X. Prevalence of suicidal ideation, attempts, and completed suicide rate in Chinese aging populations: a systematic review. Arch Gerontol Geriatr. 2013;57(3):250-6. doi: 10.1016/j.archger.2013.05.006. PubMed PMID: 23791030; PubMed Central PMCID: 3750072. ## 2. Abraham ZK, Sher L. Adolescent suicide as a global public health issue. Int J Adolesc Med Health. 2017;31(4). doi: 10.1515/ijamh-2017-0036. PubMed PMID: 28686572. ## 3. Brent DA, McMakin DL, Kennard BD, Goldstein TR, Mayes TL, Douaihy AB. Protecting adolescents from self-harm: a critical review of intervention studies. J Am Acad Child Adolesc Psychiatry. 2013;52(12):1260-71. doi: 10.1016/j.jaac.2013.09.009. PubMed PMID: 24290459; PubMed Central PMCID: PMC3873716. ## 4. Fuller-Thomson E, Hamelin GP, Granger SJ. Suicidal ideation in a population-based sample of adolescents: implications for family medicine practice. ISRN Family Med. 2013;2013:282378. doi: 10.5402/2013/282378. PubMed PMID: 24967322; PubMed Central PMCID: 4041249. ## 5. Anisi J, Majdian M, Mirzamani SM. The factors associated with suicide ideation in Iranian soldiers. Iran J Psychiatry. 2010;5(3):97-101. PubMed PMID: 22952500; PubMed Central PMCID: 3430507. ## 6. Ferrara M, Terrinoni A, Williams R. Non-suicidal self-injury (Nssi) in adolescent inpatients: assessing personality features and attitude toward death. Child Adolesc Psychiatry Ment Health. 2012;6:12. doi: 10.1186/1753-2000-6-12. PubMed PMID: 22463124; PubMed Central PMCID: 3342109. ## 7. Greydanus DE, Shek D. Deliberate self harm and suicide in adolescents. Keio J Med. 2009;58(3):144-51. doi: 10.2302/kjm.58.144. PubMed PMID: 19826208. ## 8. Ziaei R, Viitasara E, Soares J, Sadeghi-Bazarghani H, Dastgiri S, Zeinalzadeh AH, et al. Suicidal ideation and its correlates among high school students in Iran: a cross-sectional study. BMC Psychiatry. 2017;17(1):147. doi: 10.1186/s12888-017-1298-y. PubMed PMID: 28427369; PubMed Central PMCID: 5397734. ## 9. Kostenuik M, Ratnapalan M. approach to adolescent suicide prevention. Can Fam Physician. 2010;56(8):755-60. PubMed PMID: 20705879; PubMed Central PMCID: 2920774. ## 10. Moradi AR, Moradi R, Mostafavi E. A survey of the rate and effective factors on suicide in Bahar. Journal of Research in Behavioural Sciences. 2011;10(21):50-8. Persian. ## 11. Carpiniello B, Pinna F. The Reciprocal Relationship between Suicidality and Stigma. Front Psychiatry. 2017;8:35. doi: 10.3389/fpsyt.2017.00035. PubMed PMID: 28337154; PubMed Central PMCID: PMC5340774. ## 12. Vedana KGG, Magrini DF, Miasso AI, Zanetti ACG, de Souza J, Borges TL. Emergency Nursing Experiences in Assisting People With Suicidal Behavior: A Grounded Theory Study. Arch Psychiatr Nurs. 2017;31(4):345-51. doi: 10.1016/j.apnu.2017.04.003. PubMed PMID: 28693869. ## 13. Talseth AG, Gilje FL. Responses of persons at risk of suicide: A critical interpretive synthesis. Nurs Open. 2018;5(4):469-83. doi: 10.1002/nop2.169. PubMed PMID: 30338092; PubMed Central PMCID: PMC6178355. ## 14. Farzaneh E, Mehrpour O, Alfred S, Hassanian Moghaddam H, Behnoush B, Seghatoleslam T. Self poisoning suicide attempts among students in Tehran, Iran. Psychiatr Danub. 2010;22(1):34-8. PubMed PMID: 20305588. ## 15. Ames H, Glenton C, Lewin S. Purposive sampling in a qualitative evidence synthesis: a worked example from a synthesis on parental perceptions of vaccination communication. BMC Medical Research Methodology. 2019;19. doi: 10.1186/s12874-019-0665-4. ## 16. Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research. Adm Policy Ment Health. 2015;42(5):533-44. doi: 10.1007/s10488-013-0528-y. PubMed PMID: 24193818; PubMed Central PMCID: PMC4012002. ## 17. Lincoln YS, Guba EG. Naturalistic inquiry. SAGE Publications; 1985. ## 18. Grasdalsmoen M, Eriksen HR, Lønning KJ, Sivertsen B. Physical exercise, mental health problems, and suicide attempts in university students. BMC Psychiatry. 2020;20(1):175. doi: 10.1186/s12888-020-02583-3. PubMed PMID: 32299418; PubMed Central PMCID: PMC7164166. ## 19. Spencer RJ, Ray A, Pirl WF, Prigerson HG. Clinical correlates of suicidal thoughts in patients with advanced cancer. Am J Geriatr Psychiatry. 2012;20(4):327-36. doi: 10.1097/jgp.0b013e318233171a. PubMed PMID: 21989317; PubMed Central PMCID: PMC3258476. ## 20. Gallagher ML, Miller AB. Suicidal thoughts and behavior in children and adolescents: an ecological model of resilience. Adolesc Res Rev. 2018;3(2):123-154. doi: 10.1007/s40894-017-0066-z. PubMed PMID: 29904718; PubMed Central PMCID: PMC5995470. ## 21. Memon AM, Sharma SG, Mohite SS, Jain S. The role of online social networking on deliberate self-harm and suicidality in adolescents: A systematized review of literature. Indian J Psychiatry. 2018;60(4):384-392. doi: 10.4103/psychiatry.IndianJPsychiatry_414_17. PubMed PMID: 30581202; PubMed Central PMCID: 6278213. ## 22. Gillies D, Christou MA, Dixon AC, Featherston OJ, Rapti I, Garcia-Anguita A, et al. Prevalence and characteristics of self-harm in adolescents: meta-analyses of community-based studies 1990–2015. J Am Acad Child Adolesc Psychiatry. 2018;57(10):733-41. doi: 10.1016/j.jaac.2018.06.018. PubMed PMID: 30274648. ## 23. Grimmond J, Kornhaber R, Visentin D, Cleary M. A qualitative systematic review of experiences and perceptions of youth suicide. PloS One. 2019;14(6):e0217568. doi: 10.1371/journal.pone.0217568. PubMed PMID: 31188855; PubMed Central PMCID: 6561633. ## 24. O'Connor RC, Smyth R, Williams JMG. Intrapersonal positive future thinking predicts repeat suicide attempts in hospital-treated suicide attempters. J Consult Clin Psychol. 2015;83(1):169-76. doi: 10.1037/a0037846. PubMed PMID: 25181026; PubMed Central PMCID: 4321534. ## 25. Bazrafshan MR, Jahangir F, Mansouri A, Kashfi SH. Coping strategies in people attempting suicide. Int J High Risk Behav Addict. 2014;3(1):e16265. doi: 10.5812/ijhrba.16265. PubMed PMID: 24971300; PubMed Central PMCID: 4070193. ## 26. Hosseinpour M, Ghaffari SM, Mehrabizadeh M. A study on the incentives of suicide attempts among adolescents referred to golestan hospital of ahwaz in 1379-1380. Jundishapur Scientific Medical Journal. 2004;41:24-30. Persian. ## 27. Shamsi khani S, Rahgoo A, Fallahi Khoshknab M, Rahgozar M. Effects of problem solving training on coping skills of suicidal clients. IJNR. 2007;1(3):31-9. Persion. ## 28. Gibbs LM, Dombrovski AY, Morse J, Siegle GJ, Houck PR, Szanto K. When the solution is part of the problem: problem solving in elderly suicide attempters. Int J Geriatr Psychiatry. 2009;24(12):1396-404. doi: 10.1002/gps.2276. PubMed PMID: 19405045; PubMed Central PMCID: PMC3044335. ## 29. Pollock LR, Williams JMG. Problem-solving in suicide attempters. Psychol Med. 2004;34(1):163-7. doi: 10.1017/s0033291703008092. PubMed PMID: 14971637. ## 30. Bazrafshan MR, Jahangir F, Shokrpour N. What protects adolescents from suicidal attempt: A qualitative study. Shiraz E-Med J. 2017;18(9):e57574. doi: 10.5812/semj.57574. ## 31. Bapiri OA, Bahamin Gh, Feyz Elahi A. Impact of Group Problem Solving Training on Some Psychological Characteristics of Adolescents Attempting Suicide. Journal of Ilam University of Medical Sciences. 2010;18(1):16-22. Persion. ## 32. Marty MA, Segal DL, Coolidge FL. Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults. Aging Ment Health. 2010;14(8):1015-23. doi: 10.1080/13607863.2010.501068. PubMed PMID: 21069608. ## 33. Bazrafshan MR, Sharif F, Molazem Z, Mani A. Cultural concepts and themes of suicidal attempt among Iranian adolescents. Int J High Risk Behav Addict. 2015;4(1):e22589. doi: 10.5812/ijhrba.22589. PubMed PMID: 25883919; PubMed Central PMCID: PMC4393560. ## 34. Carlen P, Bengtsson A. Suicidal patients as experienced by psychiatric nurses in inpatient care. Int J Ment Health Nurs. 2007;16(4):257-65. doi: 10.1111/j.1447-0349.2007.00475.x. PubMed PMID: 17635625. ## 35. Zhang P, Roberts RE, Liu Z, Meng X, Tang J, Sun L, et al. Hostility, physical aggression and trait anger as predictors for suicidal behavior in Chinese adolescents: A school-based study. PloS One. 2012;7(2):e31044. doi: 10.1371/journal.pone.0031044. PubMed PMID: 22359563; PubMed Central PMCID: 3281042. ## 36. Conner KR, Meldrum S, Wieczorek WF, Duberstein PR, Welte JW. The association of irritability and impulsivity with suicidal ideation among 15-to 20-year-old males. Suicide Life Threat Behav. 2004;34(4):363-73. doi: 10.1521/suli.34.4.363.53745. PubMed PMID: 15585458. ## 37. Huh Y, Cho H-J. Associations between the type of tobacco products and suicidal behaviors: a nationwide population-based study among Korean adolescents. Int J Environ Res Public Health. 2021;18(2):367. doi: 10.3390/ijerph18020367. PubMed PMID: 33418893; PubMed Central PMCID: 7825150. ## 38. Obando Medina C, Dahlblom K, Dahlgren L, Herrera A, Kullgren G. I keep my problems to myself: pathways to suicide attempts in Nicaraguan young men. Suicidology Online. 2011;2:17-28. ## 39. Hamza CA, Stewart SL, Willoughby T. Examining the link between nonsuicidal self-injury and suicidal behavior: a review of the literature and an integrated model. Clin Psychol Rev. 2012;32(6):482-95. doi: 10.1016/j.cpr.2012.05.003. PubMed PMID: 22717336. ## 40. Nock MK, Prinstein MJ, Sterba SK. Revealing the form and function of self-injurious thoughts and behaviors: A real-time ecological assessment study among adolescents and young adults. J Abnorm Psychol. 2009;118(4):816-27. doi: 10.1037/a0016948. PubMed PMID: 19899851; PubMed Central PMCID: PMC5258190. ## 41. Otsuki M. Youth suicide. Southern california center of excellence on youth violence prevention: University of California, Riverside; 2002. ## 42. Gvion Y, Apter A. Suicide and Suicidal Behavior. Public Health Reviews. 2012;34(2):1-20. ## 43. Hjelmeland H, Nordvik H, Bille-Brahe U, De Leo D, Kerkhof JF, Lönnqvist J, et al. A cross-cultural study of suicide intent in parasuicide patients. Suicide Life Threat Behav. 2000;30(4):295-303. PubMed PMID: 11210055. ##

International Journal of School Health

Qualitative Content Analysis of Coping Strategies among Adolescents with Suicidal Thoughts

References

References

Volume 9, Issue 1 - Serial Number 32
January 2022
Pages 63-72

Qualitative Content Analysis of Coping Strategies among Adolescents with Suicidal Thoughts

References

References

Volume 9, Issue 1 - Serial Number 32January 2022Pages 63-72

Volume 9, Issue 1 - Serial Number 32
January 2022
Pages 63-72