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Reasons for living and gender

as determinants of adolescent suicidal ideation in Ghana

Foster S. Nanewortor | Doctor of Psychology | Part 1/2

Abstract
Suicide remains a global public health concern. It is estimated to be the leading cause of death among the youth 12-24 years. Studies on suicide is gaining popularity in Ghana unlike the past when the topic is mostly avoided. In order to broaden the knowledge base on suicide among young people in Ghana, the present study investigated the relationship between reasons for living, gender and suicidal ideations. Three hundred and eighty-three (383) senior high students between the ages of 13 and 19 years completed Reasons for Living Inventory for adolescents (RFL-A) and Suicidal Ideation scale. Partial correlation and Hierarchical regression were used to analyze the data collected. The results revealed significant negative relationships between the reasons for living (i.e., self -acceptance, family alliance, peer acceptance and support, future optimism and Suicide related concerns) and adolescent suicidal ideation.

Furthermore, the results showed that the relationship between reasons for living and suicidal ideations were significantly moderated by gender. The results also established that gender as an independent factor influences suicidal ideation. It was concluded that suicide management professionals such as clinical psychologist, counsellors should consider reasons for living in adolescents.

Introduction
The pain and the guilt of surviving the death of a family member through suicide is traumatic and the associated experience may differ from other types of grieve (DeLeo, Bertolote, & Lester, 2002; Jordan, 2001; Young, et al., 2012). All deaths resulting directly or indirectly from the positive or negative act of the victim, with his or her prior knowledge of causing death is termed as suicide (Ramsden & Wilson, 2014). Simply put, suicide means killing oneself or a person intentionally indulging in behaviours that will cost his or her life. Further, Seroff (2010) referred to suicidal behavior as any deliberate behavior or action with potentially life-threatening consequences, such as taking a drug overdose, jumping of high heights or deliberately crashing a car. The method of suicide can be relatively nonviolent (such as poisoning or overdose) or violent (such as shooting oneself).

Many suicide cases are likely not to be reported, because of the difficulty to identify nonviolent and indirect suicides especially in developing countries where autopsy is new. Families are not willing to report suicide cases due to the criminality associated with it in some countries such as Ghana. But this notwithstanding, suicide is a major public health concern, nearly 1 million people die by suicide globally each year (DeLeo, Bertolote, & Lester, 2002; World Health Organization, 2009; Young, et al., 2012). Suicide ranks as the suicide ranks among the three leading causes of death among adolescents and young adults and the eleventh leading cause of death in the United States (NIMH, 2008). Data from the National Center for Health Statistics, USA (2005) indicated that 8.5% of high school students reported attempting suicide in the past year, and 16.9% reported having seriously considered it. According to Dali (2009), suicide rates in Ghana are becoming very alarming with more than 1,556 cases involving 1,129 males and 427 females in the year 2008 alone. He released the figures in a speech at a ceremony to mark the International Suicide Prevention Day-2009, stating that suicide is becoming a menace in Ghana.

The current trends on suicide resonates with the World Health Organization (1999) projection that the global suicide rate by the year 2020 would approximate 1.53 million. Bertolote and Fleischmann (2002) reported that the highest suicide rates for both men and women are found in Europe, more particularly in Eastern Europe, in a group of countries that share similar historical and socio-cultural characteristics, such as Estonia, Latvia, Lithuania and, to a lesser extent, Finland, Hungary and the Russian Federation. Suicide literature has implicated gender as a significant risk factor in suicide and attempted suicide. The evidence suggest that males of all ages commit suicide at a higher rate than females although females attempt suicide more often than males (Norhayati, Amit, Che Din, & Ong, 2017). Lewinsohn, Rohde, Seeley, and Baldwin (2001), however, asserted that eventhough suicide is high among males, suicial thoughts and attempt were high among female adolescents. The suicide ratio among males and females ranges from 2:1 to 7:1 respectively (Kumar & Signh, 2006).

This difference can be attributed to differences in the nurturing of males and females that forms the basis for gender roles. Psychosocial correlates of suicidal ideation has been suggested to account for the differences. Whereas Females had greater fear of death/injury; males had greater fear of social disapproval over having suicidal thoughts. On the other side of the suicide spectrum lies the reason for living. Reasons for living (RFL) are beliefs or expectancies thought to mitigate risk for suicide, and include survival and coping beliefs, responsibility to family, child-related concerns, fear of social disapproval, and moral objections (Kwok & Shek, 2010).

There are varied and individual specific reasons why people live and these reasons propel them to stay alive even in the face of unbearable difficulties. Other factors such as future optimism, suicide-related concerns (fear of death by suicide), peer acceptance and support, and self-acceptance have been implicated as protective factors against suicide (Linehan et al. 1983). This means that persons with stronger future optimism, stronger peer acceptance and support, and closer family alliance are less likely to harbour suicidal thoughts. The relationship between reasons for living and suicide is well established in the suicide literature. A significantly negative relationship has been found to exist between reasons for living and suicide. To this end, the two constructs are polarized to the extent that the resurgence of one tame the other to the minimal level (Norhayati, Amit, Che Din, & Ong, 2017). This is to say that the stronger the reasons for living, the weaker suicidal thoughts and behaviours.

In a study to compare the gender differercne in suicidal ideations and to determine its related risk factors. Norhayati, Amit, Che Din, and Ong (2017) found suicidal ideations to be higher for males than females. Also, whereas age predicted male suicidal ideations, depression, loss of motivation and hopelessness predicted female suicidal ideations. Eshun (2003) also investigated socio-cultural determinants of suicide ideation among Ghana and American college students. This study revealed that gender was a significant determinant for suicide ideation among Ghanaians. A study by Kumar and Signh (2006) among 400 adolescents drawn from various Government Senior Secondary schools by using the multi-stage random sampling in India reveals that female adolescents scored significantly higher on the measures of suicidal ideation, whereas male adolescents have more psychological impairment on psychopathic deviation.

Studies conducted in the developing countries of the African continent show that the trend of more attempted suicides by women was maintained but the rates for completed suicide for men were higher. In South Africa for instance 76.8% of all suicide attempts were made by women (Sukhai, Harris, Moorad & Dada, 2010). In Nigeria the ratio for completed suicide for men to women was 3.6 to 1, while a study in Cairo, Egypt conducted in 1975 reported that there was no major difference between the two sexes when it came to suicide attempts (Nwosu & Odesanmi, 2001) Batigün (2005) conducted a study to determine reasons why people live by randomly selecting 683 adolescents and adults between the ages of 15-65. The results of the study revealed that participants aged between 15-25 years indicated limited reasons for living, higher suicide probability, more hopelessness and loneliness compared with old age. A further regression analyses suggest that level of education, hopelessness, loneliness and reasons for living were found to predict suicide probability. Significant inverse relationship has been found to exist among hope, total reasons for living and suicidal ideation and attempts (Luo, Wang, Wang, & Cai, 2016). The foregoing evidence about suicide predictors form the basis for wealth of suicide prevention strategies (Zampora, Seburn, Brackenbury, & Tagalik, 2005). Although substantial efforts have been made to understand what risk factors contribute to suicide and suicidal behaviour, less attention has been paid to clinical features that may protect against the emergence of suicidal behaviour (Malone, et al., 2000). This article documents particular risk factors that propel suicidal ideations and specific protective factors that can mitigate against adolescent suicidal ideations from progressing to suicide attempts. The objectives of the study therefore was to; • To identify which reasons for living (e.g., family alliance, peer acceptance and support, self-acceptance, fear of death by suicide and future optimism) are stronger in predicting suicidal ideation • To find out whether gender will moderate the relationship between reasons for living and suicidal ideation

Hypotheses
1. There would be a significant negative relationship between overall scores on Reasons for Living Scale and suicidal ideation. 2. All subscales on Reasons for Living Scale (Future Optimism, family alliance, Fear of death by suicide, Peer acceptance and Support, and Self-acceptance) would significantly predict adolescents’ suicide ideation. 3. Gender would moderate the relationship between suicidal ideation and reasons for living.

Methodology
Design The research design was mainly correlational in nature. The main variables that were investigated in the study are: reasons for living, gender and suicidal ideation. The research investigated the relationship that each variable (reasons for living and gender) individually have with suicidal ideation and how they contribute together in influencing the level of suicidal ideation.

Participants
Three hundred and eightythree (383) adolescents were randomly recruited to participate in the study. This consisted of 182 males and 201 females. Their ages ranged between 13 and 19 years with an average age of 16.46 years with a standard deviation of 1.4. There were participants from all the ten (10) regions of Ghana who reside in various towns and villages. The 383 participants are justified based on the recommendations made by Krejcie and Morgan (1970). According to Krejcie and Morgan (1970), in order to obtain results that are a true representation of the population of about 6000 people, (with 95 % level of confidence), at least 361 participants should be chosen.

Measures
Reasons for Living Inventory for Adolescents (RFL-A) Scale Reasons for Living Inventory for adolescents (RFL-A) (Osman, Downs, Kopper, Barrios, Bessett et al ,1998). The RFL–A is a 32-item self-report measure designed specifically to assess adolescents’ adaptive reasons for not committing suicide. It is comprised of five subscales: Future Optimism (FO), Suicide- Related Concerns (SRC), Family Alliance (FA), Peer Acceptance and Support (PAS) and Self- Acceptance (SA). The alpha coefficients for the RFL–A scales were as follows: FA = .88, SRC = .92, SA = .91, PAS = .89 and FO = .90. The Cronbach’s alpha index for the RFL–A total scale was .93. The result of retest after 2 weeks on the sample yielded a reliability coefficient of .87. The RFL-A follows a six point Likert scale scoring system. The responses are scored as follows: 1 = Not at all important, 2 = Quite unimportant, 3 = Somewhat unimportant, 4 = Somewhat important, 5 = Quite important and 6 = Extremely important. This implies that scores on the scale range from 32 to 192. Lower score means weaker reasons for living while higher scores indicate stronger reasons for living.

Procedure
Prior to questionnaire, the researcher trained research assistance to assist in questionnaire administration. The training components involved objectives of the study, ethical issues pertaining to the study and questionnaire administration. Further, participants indicated their acceptance to partake in the study by endorsing the consent form. Owing to the large number of participants, the questionnaire was administered in groups at the schools assembly hall. On a whole, questionnaire was completed between 6-10 minutes.

Data Analysis
Hypotheses one and two were analysed using partial correlation because these hypotheses involve finding the relationship between the variables involved. In order to determine the mediating role of gender, the Hierarchical Multiple Regression Analyses was used in testing hypothesis two.
To be continued

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Carl Sagan and our tiny world

By Dr. Rosa Hilda Lora M. Advisor at AIU | rosa@aiu.edu

Carl Sagan, astrophysicist, cosmologist and disseminator of science. He was a professor at Harvard University. He was also a NASA advisor receiving the awards for Exceptional Scientific Merits, twice, and for Distinguished Public Service.

NASA distinguished him with the Apollo Achievement Award. The American Astronautics Society awarded him the John F. Kennedy Prize and the National Academy of Sciences awarded him the highest distinction: the Public Welfare Medal. He also received the Pulitzer Prize. At Cornell University he was director of the Planetary Studies Laboratory. He published more than 20 scientific papers. He refers to our planet as the pale blue dot.

That pale blue dot is motivated by the photography of the Earth from Voyager I, at a distance of 6,000 million km. The photograph was taken on February 14, 1990. The following text was recited by him at Cornell University for the first time and appears in the book he wrote “Pale Blue Dot, A Vision Of The Human Future In Space” published in 1994. According to: “From this distant vantage point, the Earth might not seem of any particular interest. But for us, it’s different. Consider again that dot. That’s here. That’s home. That’s us. On it everyone you love, everyone you know, everyone you ever heard of, every human being who ever was, lived out their lives. The aggregate of our joy and suffering, thousands of confident religions, ideologies, and economic doctrines, every hunter and forager, every hero and coward, every creator and destroyer of civilization, every king and peasant, every young couple in love, every mother and father, hopeful child, inventor and explorer, every teacher of morals, every corrupt politician, every ‘superstar,’ every ‘supreme leader,’ every saint and sinner in the history of our species lived there —on a mote of dust suspended in a sunbeam. The Earth is a very small stage in a vast cosmic arena. Think of the rivers of blood spilled by all those generals and emperors so that in glory and triumph they could become the momentary masters of a fraction of a dot. Think of the endless cruelties visited by the inhabitants of one corner of this pixel on the scarcely distinguishable inhabitants of some other corner.

How frequent their misunderstandings, how eager they are to kill one another, how fervent their hatreds. Our posturing, our imagined self-importance, the delusion that we have, some privileged position in the universe, are challenged by this point of pale light. Our planet is a lonely speck in the great enveloping cosmic dark.

In our obscurity —in all this vastness— there is no hint that help will come from elsewhere to save us from ourselves. The Earth is the only world known, so far, to harbor life. There is nowhere else, at least in the near future, to which our species could migrate. Visit, yes. Settle, not yet. Like it or not, for the moment, the Earth is where we make our stand. It has been said that astronomy is a humbling and character-building experience. There is perhaps no better demonstration of the folly of human conceits than this distant image of our tiny world.

To me, it underscores our responsibility to deal more kindly with one another and to preserve and cherish the pale blue dot, the only home we've ever known”. (Sagan, Pale Blue Dot, a vision of the Human Future in Space, The New York Times Bestseller, 1994) We could say that it’s a wonderful poem, but the wonder is what our planet means in the life of each one of us. Sagan tells us that in that little blue point there are so many activities that have been done that anyone would say is a huge star and it turns out that it is not so: we’re a blue point in space.

This wonderful writing leaves us, rather we would say wonderful poem, the world we build. That world built in such a small space is great for what we do.

The greatness of our world is the greatness of our actions. Sagan also sees the not very good things we do. This poem should make us reflect on how much we can do as human beings; build a world as big as we want, build the world that seems to be needed.

We live in a world where the communication is instantly and we see and hear events and not very good news. With the greatness that we have, what we must do is build an ever better world. What are you going to do to make this pale blue dot better and better for you? What do you intend to do to make this pale blue dot better and better for others? Do you study to have life quality? Are you studying to build a happy life for you and yours? Do you think about your work as the opportunity to contribute something to society?

Do you think about your community as the space in which you have to do something for a better life for everyone? In that tiny pale blue dot suspended in space is our life and we have to make it a major point in our minds even if it is so small in reality. Never forget how small we are in space but how great that with our daily living we can make our “pale blue dot”.

BIBLIOGRAPHY. Sagan, Carl (2003). El Punto azul Pálido, una visión del futuro humano en el espacio. México: Planeta. Retrieved from: https://lasteologias.files.wordpress.com/2008/06/sagan-carl-unpunto- azul-palido-una-vision-del-futuro-humano-en-el-espacio.pdf

AIU’s first Virtual conference

IT WAS CELEBRATED LAST OCTOBER

Great news to our AIU community members. Last October we offered our first Virtual conference called “Education in the 21st Century” Date: October 16, Wednesday Time: From 9 am to 7 pm. (Eastern Time of the USA) Theme: Education in the 21st Century. https://aiuwebinars.clickmeeting.com/aiuconferencia- de-la-educacion-del-siglo-21 Conference Coordinator:
Dr. Edward Lambert

SCHEDULE
9:00 am Dr. Jack Rosenzweig Introduction

9:15 am Miguel Angel Gonzalez Cernuda Applied Knowledge: The Competitive Advantage in the Digital World

10:00 am Pascual Nunez Internet Breaks Paradigms and Idiomatic Borders

11:00 am Ana María Torres Hernández Sustainable Development from the Construction of a Social and Solidarity Territory

12:00 pm Maria Laura Gianfri From Convergent Thought to Divergent Thought

1:00 pm Fernando Antonio Espinar La Torre Applied Ethics in Higher Education

2:00 pm Rosa Linda Gutiérrez Vital Crises: Proposals for Management and Overcoming

3:00 pm Hernando Murillo Gómez What to Teach in the Knowledge Society?

4:00 pm Pedro de León Rivera Professional Life with Success

5:00 pm José Rubén Aguilar Sánchez Analysis of Torsion Efforts in Rugo-Interference through the Finite Element Method

6:00 pm Dr. Franklin Valcin Conclusion

In case you are interested in any of these topics you may contact your tutor for more information

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