ABSTRACT
Suicidal behaviour among adolescents is
a prevalent issue in almost every part of the globe. Suicidal ideation being a
significant primordial behavior to suicide attempts and completion should
therefore be the point of intervention for any public health action to be
effective. This study aimed to assess psychosocial factors as they relate to
suicidal ideation among undergraduate university students.
The study adopted the cross-sectional
research design. Multistage sampling technique was used to select 426
undergraduates of Babcock university, Ilishan-Remo, Ogun state, Nigeria.
Validated instrument was used to measure psychosocial constructs of optimism on
an 18-point rating scale, perceived social support on an 18-point rating scale,
general self-efficacy on a 15-point rating scale, self-esteem on a 15-point
rating scale as independent variables, while suicidal ideation, the dependent variable
was measured on a 27-point rating scale. Data collected was analyzed and
expressed as frequency distributions of responses, summaries of descriptive
statistics of means and standard deviation and inferential statistics of
Pearson’s correlation and regression analysis was used to characterize
cause-effect relationships between independent and dependent variables.
The mean age of respondents was 19.32±2.22,
36.8% of respondents were males, 62.3% were females. Among respondents, the
mean score of the independent variables show optimism was 12.36±2.79, perceived
social support was 12.16±3.07, general self-efficacy was 10.71±2.42 and
self-esteem was 9.58±2.95.Findings show that suicidal
ideation had a mean score of 3.11±4.93 among respondents on a
27-point rating scale, however about 37.3% of them claimed to have thought
about suicide in recent times. The result of Pearson’s bivariate
correlation analysis showed negative relationships between psychosocial factors
and suicidal ideation and that they were statistically significant
(p-value<0.01) excluding general self-efficacy whose p-value was greater
than 0.05 (p-value> 0.05). Self-esteem was the most correlated variable to
suicidal ideation among respondents (r = -0.321). Lower levels of self-esteem
depicted higher levels of suicidal ideation among respondents. Optimism was
also significantly related (r = -0.286) to suicidal ideation and may serve as a
protective factor against suicidal ideation among respondents. Perceived social
support gave a significant inverse relationship Pearson’s correlation value (r
= -0.220) to suicidal ideation and may infer social support as a protective
factor against suicidal ideation.
In conclusion, this study shows that
suicidal ideation although very low, is prevalent among the students of the
study population and the identified psychosocial factors could serve as
protective factors against suicidal behaviour. Possible interventions would
require creating awareness to reduce stigmatization on suicidal behaviorand
make it easy for students to seek help for their mental health.
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Suicide is a multifaceted
self-annihilating behavior resulting from a complicated interaction of several
factors on a personal and environmental level. As a result of a steady rise in
suicide rates over the past 50 years, the World Health Organization established
suicide as a key global public health concern. Suicide with a worldwide
mortality rate of 16 per 100,000 otherwise translated to one death every 40
seconds’ totaling the death of almost one million people every year (WHO, 2011)
and as such constitute an important public health concern. According to WHO(2014),
it was estimated that about 804,000 suicide deaths occurredglobally in 2012. It
was alsoreported that a yearlyworldwide age-standardized suicide rate of 11.4
per 100,000 population (8.0 for females; 15.0 for males) have been documented.
The concept of suicidal ideation depicts
thoughts that one’s life is not worth living, it may range in intensity from
passing thoughts to actual well figured-out plans for killing oneself or a
total fixation with self-annihilation. Substance Abuse and Mental Health
Services Administration (SAMHSA) of the United States of America, in 2013 gave
estimates in a research of about 17.0% of students vigorously considering
attempting suicide in the previous 12 months (22.4% of females and 11.6% of
males); 13.6% of some students made plans about how they would attempt suicide
in the previous 12 months (16.9% of females and 10.3% of males).
These suicidal behaviors and thoughts
are common among young people. However, studies on suicidal behavioral patterns
in Africa have been scarce which may be due to cultural beliefs that perceive
suicide to be an abomination. Omigbodun, Dogra, Esan and Adedokun, (2008)
conducted a study in Nigeria that indicates suicidal behavior is relatively
common in Nigeria. The study reported that the one year prevalence of suicidal
attempts among adolescents in southwest Nigeria is 12%. According to the WHO
Mortality Database, about 75% of suicides in the world occur in low and middle
income countries, although national-level data are unavailable for most of
these countries (WHO, 2014), most of which are developing countries in Asia,
Africa and South America. According to Randall, Doku, Wilson and Peltzer, 2014,
the true scope of the issue in Nigeria and West Africa as a whole is hidden by
incomplete surveillance and probable socio-cultural issues surrounding suicide
and its related stigma.
Suicidal behaviors as with other disease
outcomes are mediated by factors which could improve or degrade the quality of
life of the individuals that are affected. The mental state of the individual
is a function of psychology which may be influenced by several social
associations between the individual and the components of the environment. This
interaction is termed psychosocial and as such serve as factors (psychosocial
factors) that affect the mental health of the individual. The term
“psychosocial factors” is developed from two words “psychological” and
“social”; by combining the Merriam-Webster’s dictionary (1997) definitions of
psychological, “of or relating to the state of mind and behavior of an
individual or a group”; social “of or relating to human society” and factor “an
agent” or “something that actively contributes to a result”. The definition of
psychosocial factors is then: an agent of the mind or behavior of an individual
or group that actively contributes to a result. The concept of psychosocial
factors is complex to grasp because it reflects the individuals’ perception,
experiences and reflects many considerations unique to that particular
individual. Some of these considerations refer to the state of mind of the
individual i.e. psychology, while others relate to the social setting in which
they find themselves hence the concept of psychosocial factors.
These factors either increase the risk
of an individual developing a particular disorder that may be addictive (risk
factors) or that reduce such risks (protective factors). Psychosocial
interactions have been shown to be responsible for certain outcomes such as:
anxiety, depression and substance abuse which are common among in-school
adolescents (WHO, 2014). However, these outcomes are known risk factors for
suicide. For the purpose of this study psychosocial factors would be
represented by four variables: Optimism (life’s orientation towards life’s
events), perceived social support, general self-efficacy and self-esteem; all
of which are significant phenomena experienced by students especially when
stressed by academic work load as well as the influence of significant others.Optimism
depict individuals who are optimistic and express expectations that all things
they will experience would be to their advantage. This facilitates to improving
one’s mental health and wellbeing. Lack of optimism, would deplete the
individuals’ mental health creating a situation that would establish depression;
a risk factor of suicide.
Perceived social support offered by
friends, peers and family members constitute a protective factor against
suicidal ideation (Sanchez-Teruel, Garcia-Leon & Muela-Martinez, 2013).
Feng, Li and Chen(2015), reinstated Bandura(1997), that self-efficacy is
believed to give the individual confidence that he or she can cope and act
effectively under stressful conditions, which is a trait of an individual with
good mental health and wellbeing. Self-esteem is also a psychosocial factor
that gives a sense of self-worth for an individual and depicts how much the
individual values his or her life in present circumstances. It has been reported
to be a mediator of suicidal ideation especially among students in the
university (Eskin, 2012).
Suicide has unique epidemiological
characteristics that make it an important public health concern. It is the
fourth leading cause of death globally among youths 15 to 19 years of age and
the tenth leading cause of death for adolescents 10–14 years of age (WHO, 2014).
However, these figures do not include suicide attempts, which are up to 20
times more frequent than completed suicide (WHO, 2011) which implies that
suicidal ideation or thoughts would be more frequent than attempted suicide.
People who experience suicidal ideation and those who make suicide plans are at
increased risk of suicide attempts, and people who experience all forms of
suicidal thoughts and behaviors are at greater risk of completed suicide
(Handley, Inder, Kay-Lambkin, Stain, Fitzgerald, Lewin, Attia & Kelly,
2012). Considerably, the majority of young people who experience suicidal
ideation will not go on to take their lives initially.
According to a publication of The Youth
Coalition of the ACT(2016),from the result of focus group discussions it could
be inferred that young people are typically reluctant to seek professional help
for mental health problems and as suicidal ideation increases, their intention
to seek help decreases further, thus the difficulty in detecting individuals
with suicidal thoughts. However, any report of suicidal ideation should be
taken seriously. When suicidal ideation is mild, and is only discussed casually
between peers, it can be found to be associated with significant symptoms of
depression which is common and some other psychologicaloutcomeswhich includes
substance use or abuse that may be easily overlooked. Furthermore, young people
experiencing persistent, severe suicidal ideation are at increased risk of
attempting suicide.
Evidence from literature provides that
suicidal ideation and attempts among young persons in schools, homes or
communitiesare mediated byseveral psychosocial factors (Sanchez-Teruel,
Garcia-Leon & Muela-Martinez, 2013; Feng, Li & Chen, 2015).According to
the American association of suicidology, (2014) depression which is one of the
outcomes of psychosocial interactions, is associated with about 50% of suicide
worldwide. However,literature search for studies conducted in Nigeria are yet
to elucidate predisposing issues (suicidal ideation), its’ dynamics, the
factors responsible or how it may have led to suicidal plans, attempts or
suicide itself which is said to be under-reported. At this rate,interventions
cannot be effectively carried out as any concept without a framework would lack
empirical support for any intervention to be effective.This study intends to
assess psychosocial factors (Optimism, Social Support, General Self-efficacy
and Self-esteem) related to suicidal ideation among students of Babcock
University, Ilishan-Remo, Ogun state.
The
main objective of this study is to assess the psychosocial factors related to
suicidal behaviour and suicidal ideation among students of Babcock University,
Ilishan-Remo, Ogun State.
The
specific objectives are to:
1. determine
the level of suicidal ideation across socio-demographic factors among the students;
2. assess
the level of Optimism (level of attitudinal disposition of students towards
life events) among the students;
3. evaluate
the level of Perceived social support among the students;
4. measure
the level of General Self-efficacy among the students;
5. determine
the level of Self-esteem among the students and
6. identify
which of the psychosocial factors play a significant role in determining
suicidal ideation among the students.
1.
Is there a significant difference in the
level of suicidal ideation across socio-demographic
factors of the students?
2.
What is the level of Optimism (level of
attitudinal disposition of students towards life events) among the students?
3.
What is the level of Perceived social
support among the students?
4.
What is the level of General
self-efficacy among the students?
5.
What is the level of self-esteem among
the students?
6.
Which of the psychosocial factors play a
significant role in determining suicidal ideation among students?
Research on suicidal ideation is
particularly scanty in Nigeria. However, a previous study aimed to assess the
prevalence and correlates of suicidal behaviour done in Nigeria showed a 20%
prevalence of suicidal behaviour among a sample of adolescents aged 10-17
(Omigbodun, Dogra, Esan & Adedokun, 2008). This validates that suicidal
behaviour constitutes a course for concern among public health professionals
regarding vulnerability of youths to poor mental health outcome and mortality.
Hence, this study intends to provide a better understanding of the behavioural
pattern called suicidal ideation and the influence of its related psychosocial
risk factors.
Generally, research on suicidal
behaviour has been conducted amiss conceptual frameworks based on behavioural
theories to identify human actions or inactions and associated factors that
contribute to suicidal behaviour. This study would attempt to assess, using a
well-structured instrument, common psychosocial risk factors leading to
suicidal ideation among university students based on behavioural theories that
would provide understanding for primary preventive measures or primordial care
against suicide. Also, measures would be taken to elucidate protective factors
that may prevent suicide or suicide attempts even though suicidal ideation may
be evident among students of Babcock University, Ilishan, Ogun state.
At the end of this study, the
findings would provide a better understanding for the dynamics of psychosocial
factors known to be associated with suicidal ideation. The study may provide
rationale as to why in-school students experiencing suicidal ideation would
rather not commit suicide despite its burden on their mental health. This would
go a long way to provide basis for an intervention to promote mental health for
students experiencing suicidal ideation and also improve their living
conditions by enabling them make conscious decisions to prevent suicide.
This study would enlighten health
workers or professionals alike in understanding factors responsible or that
influence suicidal ideation and show where the need for an intervention would
be required among students. The results would also be useful for other
researchers interested in understanding mental health or setting up health
programs for mental health.
The study hypothesizes
that;
H1:There
is a significant relationship between Optimism (the level of attitudinal
disposition ofstudents towards life events) and suicidal ideation among the students.
H2:There
is a significant relationship between Perceived social support and suicidal
ideation among the students.
H3:There
is a significant relationship between Self-efficacy and suicidal ideation among
the students.
H4:There
is a significant relationship between Self-esteem and suicidal ideation among
the students.
Suicidal
Ideation
Suicidal ideation refers to thoughts
that life is not worth living, ranging in intensity from fleeting thoughts
through to concrete, well thought-out plans for killing oneself, or a complete
preoccupation with self-destruction.
Psychosocial
Factors
For this study; psychosocial factors
refer to variables of optimism, perceived social support and self-efficacy that
may influence the development of suicidal ideation culminating into distinct
suicidal behavior.
a.
Optimism: Optimism is the
generalized positive outcome expectancy of the student towards life’s events.
b.
Perceived social support: It is the
student’s subjective view of how other people, in particular families or peers,
are available to meet and/or assist with meeting the individual’s needs for
comfort and support.
c.
General Self-efficacy: It is the
student’s assessment and subsequent ability to respond to life events and/or
changes in the environment.
d.
Self-esteem: It is the student’s
reasoning regarding self-worth either negatively (low self-esteem) or
positively (high self-esteem).
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