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Behavioral and Emotional Problems Among Peers of Suicide Completers and Attempters in Hong Kong

A group of Hong Kong psychiatrists and psychologists (T. P. Ho, P. W. L. Leung, S. F. Hung, C. C. Lee, C. P. Tang) used the CBCL/4-18, YSR, and other measures to assess 1,920 students attending high schools where there were recent student suicides or no suicides. In both kinds of schools, students were also identified who were peers of recent suicide attempters. Combining data from the CBCL and YSR, Ho et al. found that—among peers of suicide completers and attempters—twice as many scored in the clinical range (20 to 26%) on Internalizing, Externalizing, and total problems than among students who were not peers of suicide completers or attempters. Odds ratios showed that these differences remained highly significant at p < .001 after controlling for demographic and risk factors, including social adversity, poor parent-child relationships, and life events. In addition, youths having close relationships with suicide attempters had especially high Externalizing scores, whereas youths having close relationships with suicide completers had especially high Internalizing scores, after controlling for demographic and risk factors. Ho et al. concluded that mental health services are needed not only by peers of suicide completers but also by peers of suicide attempters. The findings showed that peers of suicide attempters have high levels of norm-violating Externalizing problems, whereas peers of suicide completers have high levels of Internalizing problems.

Reference: Ho, T. P., Leung, P. W. L., Hung, S. F., Lee, C. C., & Tang, C. P. (2000). The mental health of the peers of suicide completers and attempters. Journal of Child Psychology & Psychiatry, 41, 301-308.