Life adversities of clients seeking advice for suicidal ideation from an online peer counseling service: Characteristics and associations with outcomes

Anja Hildebrand, Maren Weiss, Mark Stemmler

Abstract


Objective: [U25] Germany is a low-threshold, anonymous and free-of-charge online suicide prevention service for people up to 25 years of age. Its special feature is that counseling is provided by trained and continuously supervised voluntary peers. This study addresses the following research questions: (1) Which life adversities are reported by the clients of [U25]? (2) Are the life adversities intercorrelated? (3) According to patients, do life adversities change during the counseling process? (4) What are the associations between life adversities and outcome measures (e.g., reduction in suicidality or improvement in general situation)?


Method: Data was collected through an online survey (n = 318). To measure psychological burden, the presence of 16 life adversities (e.g., problems in relationships) was assessed retrospectively. As the dependent variable, the change in suicidality was measured by means of three newly created items. In addition, a short form of the Bochum Change Questionnaire 2000 (BCQ 2000) was used to assess the patients’ subjectively perceived change due to counseling.


Results: Regarding life adversities, the clients were heavily burdened. Throughout the course of counseling, many clients’ situations improved, at least concerning several adversities. Some life adversities significantly correlate with each other, but the correlation is mostly small to moderate. Suicidality is positively correlated with self-harming behaviors and loss of someone close to the advice seekers.


Conclusions: Possible starting points for improving online counseling for suicidal adolescents and young adults are discussed.


Keywords


Suicide prevention; Online counseling; Peer counseling; Adolescence; Life adversities.

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References


Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help seeking. American Psychologist, 58(1), 5–14. https://doi.org/10.1037/0003-066X.58.1.5

Ajdacic-Gross, V. (2015). Suizid - Generelle Aspekte, Epidemiologie, Risikofaktoren [Suicide - background, epidemiology, risk factors]. Therapeutische Umschau. Revue therapeutique, 72(10), 603–609. https://doi.org/10.1024/0040-5930/a000726

Bachmann, S. (2018). Epidemiology of Suicide and the Psychiatric Perspective. International Journal of Environmental Research and Public Health, 15(7). https://doi.org/10.3390/ijerph15071425

Bahk, Y.‑C., Jang, S.‑K., Choi, K.‑H., & Lee, S.‑H. (2017). The Relationship between Childhood Trauma and Suicidal Ideation: Role of Maltreatment and Potential Mediators. Psychiatry Investigation, 14(1), 37–43. https://doi.org/10.4306/pi.2017.14.1.37

Berardis, D. de, Martinotti, G., & Di Giannantonio, M. (2018). Editorial: Understanding the Complex Phenomenon of Suicide: From Research to Clinical Practice. Frontiers in Psychiatry, 9, 61. https://doi.org/10.3389/fpsyt.2018.00061

Beurs, D. P. de, Bosmans, J. E., Groot, M. H. de, Keijser, J. de, van Duijn, E., Winter, R. F. de, & Kerkhof, A. J. (2015). Training mental health professionals in suicide practice guideline adherence: Cost-effectiveness analysis alongside a randomized controlled trial. Journal of Affective Disorders, 186, 203–210. https://doi.org/10.1016/j.jad.2015.07.028

Bowersox, N. W., Jagusch, J., Garlick, J., Chen, J. I., & Pfeiffer, P. N. (2021). Peer-based interventions targeting suicide prevention: A scoping review. American Journal of Community Psychology, 68(1-2), 232–248. https://doi.org/10.1002/ajcp.12510

Braun-Scharm, H., Goth, K., Freisleder, F. J., & Althoff, A. (2004). Jugendliche in stationärer psychiatrischer Behandlung: Parasuizidale Symptome und psychische Störungen [Adolescent psychiatric inpatients: Parasuicidal symptoms and psychiatric disorders]. Kindheit Und Entwicklung, 13(1), 26–37. https://doi.org/10.1026/0942-5403.13.1.26

Carballo, J. J., Llorente, C., Kehrmann, L., Flamarique, I., Zuddas, A., Purper-Ouakil, D., Hoekstra, P. J., Coghill, D., Schulze, U. M. E., Dittmann, R. W., Buitelaar, J. K., Castro-Fornieles, J., Lievesley, K., Santosh, P., & Arango, C. (2020). Psychosocial risk factors for suicidality in children and adolescents. European Child & Adolescent Psychiatry, 29(6), 759–776. https://doi.org/10.1007/s00787-018-01270-9

Cha, C. B., Franz, P. J., M Guzmán, E., Glenn, C. R., Kleiman, E. M., & Nock, M. K. (2018). Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 59(4), 460–482. https://doi.org/10.1111/jcpp.12831

Chu, C., Buchman-Schmitt, J. M., Stanley, I. H., Hom, M. A., Tucker, R. P., Hagan, C. R., Rogers, M. L., Podlogar, M. C., Chiurliza, B., Ringer, F. B., Michaels, M. S., Patros, C. H. G., & Joiner, T. E [Thomas E.] (2017). The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychological Bulletin, 143(12), 1313–1345. https://doi.org/10.1037/bul0000123

Coveney, C. M., Pollock, K., Armstrong, S., & Moore, J. (2012). Callers' Experiences of Contacting a National Suicide Prevention Helpline: Report of an Online Survey. Crisis, 33(6), 313–324. https://doi.org/10.1027/a000001

Crandall, A., Allsop, Y., & Hanson, C. L. (2018). The longitudinal association between cognitive control capacities, suicidality, and depression during late adolescence and young adulthood. Journal of Adolescence, 65, 167–176. https://doi.org/10.1016/j.adolescence.2018.03.009

Deutsche Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie (DGKJP) et al. (2016). Leitlinie Suizidalität im Kindes- und Jugendalter. http://www.awmf.org/leitlinien/detail/ll/028-031.html

Dunn, E. C., Soare, T. W., Raffeld, M. R., Busso, D. S., Crawford, K. M., Davis, K. A., Fisher, V. A., Slopen, N., Smith, A. D. A. C., Tiemeier, H., & Susser, E. S. (2018). What life course theoretical models best explain the relationship between exposure to childhood adversity and psychopathology symptoms: Recency, accumulation, or sensitive periods? Psychological Medicine, 48(15), 2562–2572. https://doi.org/10.1017/S0033291718000181

Dunn, O. J. (1961). Multiple Comparisons Among Means. Journal of the American Statistical Association, 56(293), 52–64. https://www.jstor.org/stable/2282330

Glischinski, M. von, Teismann, T., Prinz, S., Gebauer, J. E., & Hirschfeld, G. (2016). Depressive Symptom Inventory Suicidality Subscale: Optimal Cut Points for Clinical and Non-Clinical Samples. Clinical Psychology & Psychotherapy, 23(6), 543–549. https://doi.org/10.1002/cpp.2007

Gómez, A. S. (2020). Psychosocial factors and clinical predictors of suicide risk in college students. Mediterranean Journal of Clinical Psychology, 8(3). https://doi.org/10.6092/2282-1619/mjcp-2602

Gould, M. S., King, R., Greenwald, S., Fisher, P., Schwab-Stone, M., Kramer, R., Flisher, A. J., Goodman, S., Canino, G., & Shaffer, D. (1998). Psychopathology associated with suicidal ideation and attempts among children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 37(9), 915–923. https://doi.org/10.1097/00004583-199809000-00011

Hildebrand, A., Weiss, M., Braun-Scharm, H., & Stemmler, M. (2022). Wirken Online-Peer-Suizidpräventionsprogramme? Zeitschrift Für Klinische Psychologie Und Psychotherapie, 51(2), 117–126. https://doi.org/10.1026/1616-3443/a000663

Hildebrand, A., Weiss, M., & Stemmler, M. (2019). Online-Peer-Suizid-Präventionsprogramme bei Jugendlichen und jungen Erwachsenen: Eine systematische Übersichtsarbeit [Online peer suicide prevention for adolescents and young adults: A systematic review]. Zeitschrift Für Psychiatrie, Psychologie Und Psychotherapie, 67, 221–229. https://doi.org/10.1024/1661-4747/a000392

Hom, M. A., Stanley, I. H., & Joiner, T. E. (2015). Evaluating factors and interventions that influence help-seeking and mental health service utilization among suicidal individuals: A review of the literature. Clinical Psychology Review, 40, 28–39. https://doi.org/10.1016/j.cpr.2015.05.006

Joiner, T. E . (2005). Why People Die by Suicide. Harvard University Press.

Joiner, T. E., Pfaff, J. J., & Acres, J. G. (2002). A brief screening tool for suicidal symptoms in adolescents and young adults in general health setting: Reliability and validity data from the Australian National General Practice Youth Suicide Prevention Project. Behaviour Research and Therapy, 40, 471–481. https://doi.org/10.1016/s0005-7967(01)00017-1

King, R. A., Schwab-Stone, M., Flisher, A. J., Greenwald, S., Kramer, R. A., Goodman, S. H., Lahey, B. B., Shaffer, D., & Gould, M. S. (2001). Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. Journal of the American Academy of Child and Adolescent Psychiatry, 40(7), 837–846. https://doi.org/10.1097/00004583-200107000-00019

Lee, B.‑H., & Kim, Y.‑K. (2006). Neurobiological Factors Associated with Suicidal Behavior. Psychiatry Investigation, 3(2), 23–35.

Markson, L., Lamb, M. E., & Lösel, F. (2016). The impact of contextual family risks on prisoners' children's behavioural outcomes and the potential protective role of family functioning moderators. The European Journal of Developmental Psychology, 13(3), 325–340. https://doi.org/10.1080/17405629.2015.1050374

Meehl, P. E. (1990). Why summaries of research on psychological theories are often uninterpretable. Psychological Reports(66), 195–244. https://doi.org/10.2466/PR0.66.1.195-244

Myles, L. A. M., Connolly, J., & Stanulewicz, N. (2020). The Mediating Role of Perceived Control and Desire for Control in the Relationship between Personality and Depressive Symptomology. Mediterranean Journal of Clinical Psychology, 8(3). https://doi.org/10.6092/2282-1619/mjcp-2589

Myles, L. A. M., & Johnson, P. (2023). Parsimony: A Forgotten Principle in Clinical Psychology and Classics. Mediterranean Journal of Clinical Psychology, 11(1). https://doi.org/10.13129/2282-1619/mjcp-3715

Myles, L. A. M., Merlo, E., & Obele, A. (2021). Desire for Control Moderates the Relationship between Perceived Control and Depressive Symptomology. Journal of Mind and Medical Sciences, 8(2), 299–305. https://doi.org/10.22543/7674.82.P299305

Orben, A., & Lakens, D. (2020). Crud (Re)Defined. Advances in Methods and Practices in Psychological Science, 3(2), 238–247. https://doi.org/10.1177/2515245920917961

Perry, Y., Werner-Seidler, A., Calear, A., & Christensen, H. (2016). Web-based and mobile suicide prevention interventions for young people: A systematic review. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 25(2), 73–79.

Sallee, E., Ng, K.‑M., & Cazares-Cervantes, A. (2021). Interpersonal Predictors of Suicide Ideation and Attempt Among Early Adolescents. Professional School Counseling, 25(1). https://doi.org/10.1177/2156759X211018653

Simmons, J. P., Nelson, L. D., & Simonsohn, U. (2011). False-positive psychology: Undisclosed flexibility in data collection and analysis allows presenting anything as significant. Psychological Science, 22(11), 1359–1366. https://doi.org/10.1177/0956797611417632

Stallard, P., Spears, M., Montgomery, A. A., Phillips, R., & Sayal, K. (2013). Self-harm in young adolescents (12-16 years): Onset and short-term continuation in a community sample. BMC Psychiatry, 13, 328. https://doi.org/10.1186/1471-244X-13-328

Stanley, I. H., Hom, M. A., Christensen, K., Keane, T. M., Marx, B. P., & Björgvinsson, T. (2021). Psychometric properties of the Depressive Symptom Index-Suicidality Subscale (DSI-SS) in an adult psychiatric sample. Psychological Assessment, 33(10), 987–997. https://doi.org/10.1037/pas0001043

Stewart, J. G., Shields, G. S., Esposito, E. C., Cosby, E. A., Allen, N. B., Slavich, G. M., & Auerbach, R. P. (2019). Life Stress and Suicide in Adolescents. Journal of Abnormal Child Psychology, 47(10), 1707–1722. https://doi.org/10.1007/s10802-019-00534-5

Störr, A.‑K. (2013). "Ihr seid meine letzte Hoffnung": Die Wirkung und Nachhaltigkeit der Online-Beratung für junge Menschen am Beispiel [U25]-Freiburg. E-Beratungsjournal.Net, 9(2), Artikel 7.

Townsend, E., Ness, J., Waters, K., Rehman, M., Kapur, N., Clements, C., ... & Hawton, K. (2022). Life problems in children and adolescents who self‐harm: findings from the multicentre study of self‐harm in England. Child and adolescent mental health, 27(4), 352-360. https://doi.org/10.1111/camh.12544

Victor, S. E., Hipwell, A. E., Stepp, S. D., & Scott, L. N. (2019). Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset. Child and Adolescent Psychiatry and Mental Health, 13, 1. https://doi.org/10.1186/s13034-018-0261-0

Vonderlin, E., Haffner, J., Behrend, B., Brunner, R., Parzer, P., & Resch, F. (2011). Welche Probleme berichten Jugendliche mit selbstverletzendem Verhalten? Ergebnisse einer repräsentativen Schülerbefragung [Problems reported by adolescents with self-harming behavior: Results of a representative school sample]. Kindheit Und Entwicklung, 20(2), 111–118. https://doi.org/10.1026/0942-5403/a000047

Weinhardt, M. (2006). Krisenberatung online - Erfahrungen aus dem Modellprojekt www.youth-life-line.de. Suizidprophylaxe, 33(3), 122–126.

Weiss, M., Hildebrand, A., Braun-Scharm, H., Weckwerth, K., Held, D., & Stemmler, M. (2020). Werden suizidgefährdete junge Menschen durch Online-Beratung erreicht? Bewertung der Zielgruppenerreichung der [U25]-Online-Suizidprävention [Are young people with suicidal ideation reached by online-counselling? Evaluation of the program outreach of [U25] online-peer-counselling]. Zeitschrift Für Kinder- Und Jugendpsychiatrie Und Psychotherapie, 48, 204–2014. https://doi.org/10.1024/1422-4917/a000712

Wiencke, C., Lehr, D., Ebert, David, D., Sieland, B., Riper, H., & Berking, M. (2014). Internetbasierte Ansätze in der Prävention und Behandlung von depressiven Beschwerden bei Jugendlichen und jungen Erwachsenen [Internet-based approaches in prevention and treatment of depressive symptoms in adolescents and young adults]. Praxis der Kinderpsychologie und Kinderpsychiatrie, 63(5), 395–415. https://doi.org/10.13109/prkk.2014.63.5.395

Willutzki, U., Ülsmann, D., Schulte, D., & Veith, A. (2013). Veränderungsmessung in der Psychotherapie. Der Bochumer Veränderungsbogen-2000 (BVB-2000) [Direct measurements of change on psychotherapy. The Bochum Change Questionnaire 2000 (BCQ 2000)]. Zeitschrift Für Klinische Psychologie Und Psychotherapie, 42(4), 256–268. https://doi.org/10.1026/1616-3443/a000224

Wisłowska-Stanek, A., Kołosowska, K., & Maciejak, P. (2021). Neurobiological Basis of Increased Risk for Suicidal Behaviour. Cells, 10(10). https://doi.org/10.3390/cells10102519

World Health Organisation. (2014). Preventing Suicide: A Global Imperative. World Health Organization. https://ebookcentral.proquest.com/lib/kxp/detail.action?docID=1810127

Wunderlich, U., Bronisch, T., Wittchen, H.‑U., & Carter, R. (2001). Gender differences in adolescents and young adults with suicidal behaviour. Acta Psychiatrica Scandinavica, 104(5), 332–339. https://doi.org/10.1111/j.1600-0447.2001.00432.x

Yacaman-Mendez, D., Hallgren, M., Forsell, Y., Yacaman-Mendez, D., Hallgren, M., & Forsell, Y. (2019). Childhood adversities, negative life events and outcomes of non-pharmacological treatments for depression in primary care: A secondary analysis of a randomized controlled trial. Journal of Psychiatric Research, 110, 152–158. https://doi.org/10.1016/j.jpsychires.2019.01.004

Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J., Saiz, P., Lipsicas, C., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. The Lancet Psychiatry, 3(7), 646–659. https://doi.org/10.1016/S2215-0366(16)30030-X




DOI: https://doi.org/10.13129/2282-1619/mjcp-3721

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