Gender in the Suicidal Experience: A Qualitative Study among Adolescents.

BACKGROUND: Teenaged boys die more often than girls by suicide, although they report fewer suicide attempts and seek less care. The aim of this work is to explore the subjective experience of adolescent suicidal behavior to determine the aspects that are common to adolescent girls and boys and those that are specific to one gender. METHOD: The study included 22 adolescents receiving care for suicidal behavior. The semi-structured interviews were analyzed according to the methods of Interpretative Phenomenological Analysis. RESULTS: Three themes of experience emerged: the experience of suffering, connection to others, and courage. The individual and interpersonal dimensions highlight feelings that they are not understood by others and are isolated. Young boys experience relationship difficulties more as rejection, and young girls describe a fear of being abandoned, for which they feel responsible. Boys and girls have different definitions of courage: boys sometimes appear to value the courage to risk death, while girls perceived risk-and therefore courage-in seeking help. DISCUSSION: Specific prevention programs must focus on the perception of care and its representations. By positioning the experience of adolescents as expertise, these programs would thus better respond to the expectations and the reluctance of this audience. Gender attitudes that are harmful to the use of care can be addressed and worked on. By separating the reception of care from the demeaning representation common among teens, these can be linked to a notion of shared vulnerability and interdependence and enable earlier recourse to treatment.

"We Thought We Were Alone": The Subjective Experience of the Siblings of Anorexic Adolescent Patients.

Objective: The siblings of patients suffering from Anorexia Nervosa (AN) are potentially affected by a disturbed emotional experience that often remains undetected. In order to bring them a psychological support, the Maison de Solenn proposed a support group program for these siblings. The current research explores their mental representations of AN and their emotional experience in the support group named "sibling group." Method: This exploratory study is based on a phenomenological and inductive qualitative method. Four girls and three boys aged between 6 and 19 participating in the "sibling group" were included in a one-time focus group session using a semi-structured interview guide. The thematic data analysis was performed by applying the methods of interpretative phenomenological analysis. Results: Themes that emerged from the interview fall into four categories: AN explained by siblings; the individual emotional experience of siblings; the family experience of siblings and the experience inside the "sibling group." Discussion: According to our participants, the "sibling group" thus functions as a good compromise between keeping an active role in the anorexic patient's care and taking a step back to avoid being eaten up by the illness. Sibling-group participants retrieved a sense of belonging, which is normally one of the functions of being a sibling. It is important to note that the "sibling group" is part of the comprehensive (or global) family-based approach included in an institutional multidisciplinary integrative care framework.

[Adolescence and definition of family, the complexity of new family configurations]. / Adolescence et définition de la famille, la complexité des nouvelles configurations familiales.

When a family is recomposed or reconstituted, this brings new developmental tasks into play. The period of entry into puberty for adolescents is the beginning of a new family life cycle that challenges the tasks and roles of each individual. Family therapy can help to assemble individual fantasies into collective fantasies and allows for the rewriting of a family narrative that is meaningful to all members.

The Quest for Meaning Around Self-Injurious and Suicidal Acts: A Qualitative Study Among Adolescent Girls.

Introduction: Suicide and non-suicidal self-injury (NSSI) are major problems in adolescent psychiatry and share numerous clinical characteristics. The principal objective of this study is to describe the subjective experience of adolescent girls and young women who present NSSI and/or suicidal behaviors and to determine the common aspects and the specificities of each experience. Method: This exploratory study is based on a procedure that is qualitative, phenomenological, and inductive. The data were collected from two semi-structured interviews each of 18 girls and young women aged 12-21 years, who were receiving care from a psychiatrist specializing in adolescents and who at least once had harmed themselves by NSSI or attempted suicide, or both. The thematic data analysis was performed by applying the methods of interpretative phenomenological analysis. Results: The results are described around four superordinate themes: relationships with the self, with others/otherness, with the body, and with death; they are then subdivided into 13 themes. Several themes appeared common to both types of behavior, especially the relational dimension of self-harming acts. The process of separation-individuation seems complex for these youth. Conclusion: The results underline the relational aspects of the self-harming behavior (NSSI or suicidal) among adolescent girls. These aspects also appear to be expressed in the family sphere, the social sphere, in contact with peers, and also at a societal level when the community no longer addresses adolescents' difficulties. When the process of subjectification does not appear to reach completion, self-aggressive behavior is seen as an ultimate attempt to regain a feeling of autonomy.

[Links between self-harm and suicidal behaviour in adolescents]. / Liens entre conduites automutilatoires et suicidaires chez les adolescents.

Nonsuicidal self-injury (NSSI) and suicidal behaviour (SB) are both important issues in adolescent health care. The fact that they frequently coexist means that it is important to consider the nature of the link between them and the ways they are understood. Suicide and self-injury share the same risk factors. Integrated models envisage NSSI as a gateway enabling teenagers to acquire a capability for suicide. The act short-circuits the thought process and the intention to die underlying the act appears difficult to assess.

Relations between Nonsuicidal Self-Injury and Suicidal Behavior in Adolescence: A Systematic Review.

Nonsuicidal self-injury (NSSI) and suicidal behaviors, both important issues in adolescent health care, are frequently associated and possibly clinically related. Our objective was to explore the views of relations between nonsuicidal self-injury and suicidal behaviors during adolescence and young adulthood (11-25 years) expressed in the scientific (medical and psychological) literature. We adopted a textual approach to the process of synthesis to tell the story of the findings from the included studies. Our narrative systematic review of 64 articles found that they share the same risk factors. Integrated models envision nonsuicidal self-injury as a gateway enabling teens to acquire the capability for suicide. Because suicidal behavior short-circuits thought, it is difficult to conceive an intention to die during adolescents' acts of self-injury. Intention is constructed by the narrative of the act, influenced by numerous elements from the psychopathologic, cultural, religious, and philosophic context. Techniques of mentalizing-based treatments and work on the meaning that adolescents attribute to their behaviors might improve care.