Introduction

It is commonly accepted that there are risk factors and personal vulnerabilities that make a person more likely to attempt suicide or to commit suicide. These factors include sociocultural and individual influences. Durkheim (1897) considered social and cultural factors to be the major influence on suicidal behavior. In fictional literature, such as Shakespeare's story of Romeo and Juliet, the stress of personal relationships was often foregrounded as a powerful influence. Freud also considered suicide to be a psychological act, with personal problems and sociocultural pressures, such as school expectations, contributing to the outcome. The literature continues to debate the relative importance of individual, psychiatric, and environmental stressors in explaining suicidal behavior; the following review highlights the complexity of the interrelationships among these factors.

Environmental Variables

STRESSFUL LIFE EVENTS

Stressful life events or recent family difficulties have been found to precede most adolescent suicide attempts. The most common problems that occur in the weeks before an adolescent suicide or suicide attempt include relationship breakups, interpersonal conflict, and difficulties with discipline and the law (Shaffer & Piacentini, 1994). Unresolved conflict within the family and a lack of closeness between family members are also commonly reported (Kosky, Silburn, & Zubrick, 1990b; Watt & Sharp, 2001). This implies that many suicidal adolescents do not feel supported by their family when they feel at their most vulnerable.