Suicide Attempters and Repeaters: Depression and Coping-a Prospective Study of Early Adolescents Fol

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  Background: It is not known whether depression or coping develops first among suicidal adolescents.Cross-sectional and prospective studies have found that differences in coping between suicidal and non-suicidal adolescents disappear when adjusted for depression.Prospective studies have so far covered short time spans, from 6 weeks to one year.Most studies on coping and depression in suicidal adolescents have focussed on problem-solving coping skills.It is not known whether adolescent non-attempters, attempters and repeaters differ in coping traits.Such knowledge is important in designing preventive strategies.Objective: To examine relationships between depression and coping among non-attempters, attempters and repeaters of suicidal acts across adolescence.Methods: A representative sample of students (T1, n =2464, mean age =13.7 years, 50.8% female, 88.3% participation) was reassessed with the same questionnaire after one year (T2Q).Depression was measured by the Mood and Feelings Questionnaire (MFQ); those who scored 25 or more were considered high-scorers on depression.These high scorers were randomly matched by gender and age with the low and middle scorers.The subset so formed was assessed within 3 weeks by diagnostic interviews at T2l (n =345, 94% participation) and five years later with the same interview and questionnaire (T3, n =252, mean age =20.0 years, 73% participation).The Coping Inventory for Stressful Situations measures three stable traits: avoidant coping, emotional coping and task-oriented coping.Among these coping traits, the last one is conceptually closest to problem-solving skills.Coping was measured at T1, T2 and T3 when the participants were at ages 14, 15 and 20 respectively.Group means were compared using t-tests.Bivariate and multivariate linear regression analyses were used to examine explanations of covariance.Results: Stable differences in levels of depression emerged prior to coping differences.Among attempters, depression scores at T1 predicted the scores of emotional coping at T2: F (1, 50) =6.2, p < 0.05, R2=0.11.The best model of the relationship between emotional coping and concurrent depression was found among attempters at T1: F (1, 50) =34.2, p < 0.0005, R2=0.40, and then among repeaters at T2: F (1, 21) =11.1, p < 0.01, R2=0.34.Repeaters reported higher depression than non-attempters: at 14 years of age, 26.8 (11.6) vs.15.2 (10.8), t (2, 249) =4.5, p < 0.01, d =1.0; and at 15 years of age, 35.1 (12.2) vs.23.0 (13.9), t (2, 55.4) =4.3, p < 0.01, d =0.9.They also reported lesser task-oriented coping than non-attempters at 15 years of age, 8.6 (2.0) vs.10.0 (2.4), t (2, 249) =2.4, p < 0.05, d =0.6; and at 20 years of age, 9.6 (2.3) vs.11.1 (2.4), t (2, 249) =4.3, p < 0.05, d =0.6.Antecedent depression predicted decreased task-oriented coping and increased emotional coping at age 20, among all participants.Conclusion: Coping traits changed partly with age, depression and attempt status.Repeaters reported lowered task-oriented coping and consistently higher depression scores as they grew up into adulthood.
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