Coping strategies, locus of control, and suicide risk in U.S. adolescents

Adolescence is a developmentally important period for suicide risk assessment, prevention, and intervention. It is important to better understand risk factors and correlates that will help identify at-risk youth, and predict when their risk may increase. The present study aimed to: 1) compare and contrast differences in adolescents’ use of coping strategies across varying suicide risk levels; and 2) evaluate locus of control orientation as a moderator of the association between coping and suicide risk. Data came from the National Comorbidity Survey Replication - Adolescent Supplement (NCS-A), a nationally representative survey that assessed the prevalence and correlates of DSM-IV mental disorders among adolescents in the United States (Kessler et al., 2009a; Kessler et al., 2009b). In the present study, groups were classified according to the following suicide risk factors: 1) no suicide ideation or behaviors (“No SI/SA”); 2) lifetime suicide ideation only (“Lifetime SI”); 3) past 12-month suicide ideation (“12-month SI”); 4) a lifetime suicide attempt (“Lifetime SA”); 5) a past 12-month suicide attempt (“12-month SA”). The groups were therefore mutually exclusive. Problem-focused coping generally appeared to be a protective factor, as the No SI/SA group endorsed higher levels of problem-focused coping than each of the suicide risk groups, and the highest risk 12-month SA group reported the lowest levels of problem-focused coping. Positive emotion-focused coping generally appeared to be a protective factor, as levels of positive emotion-focused coping tended to decrease as suicide risk increased, with some exceptions. Negative emotion-focused coping emerged as a risk factor for suicide, as adolescents with greater suicide risk generally demonstrated greater use of negative emotion-focused coping. Results indicated that low internal locus of control and high external locus of control amplify the protective effect of problem-focused coping. High internal locus of control was generally protective, but may exacerbate suicide risk in the context of positive emotion-focused coping. Together, these findings suggest that, locus of control moderates the relationship between coping and suicide risk and may therefore be a relevant treatment target.M.S.Includes bibliographical reference