Abstract
Youth suicide is a personal and social tragedy generally understood as an individual phenomenon while sociocultural approaches are overlooked. This meta-analysis of 26 qualitative research articles maps the theories and concepts of youth suicide applied within social scientific research, contributing to a social meta-theory of how youth suicide is approached and explained. The findings reveal that social scientific approaches bring forth the lack of a sense of belonging associated with youth suicide, either within society as a whole, within specific subgroups, or in family relationships. The main conclusion of the study is that the social frames of youth suicide research define the space occupied by youth as becoming independent members in society. Struggles related to young people’s search for an adult identity within various social roles and expectations can engender desperate emotions, sometimes leading to harmful decisions such as taking one’s own life as a means of escape.
Background
Youth suicide is both a personal and social tragedy. Among 15–29-year-olds, suicide is the fourth leading cause of death, which makes it a growing cause for concern (World Health Organization, 2021). In modern suicidology, medicine, especially psychiatry, has played a predominant role, positing that suicide is strongly associated with psychopathology. Throughout the psychiatric era, composed of the last five decades, suicide has been understood mainly as an individual problem, which has led to a focus on individual-level risk factors and prevention strategies (Wray et al., 2011). For example, in a review of psychosocial risk factors for suicide in paediatric populations, Carballo et al. (2019) identified three main categories: (a) psychological factors, such as depression (Goldston et al., 2009), (b) adverse life events (e.g., Bruffaerts et al., 2010) and (c) personality traits, such as impulsivity (Dougherty et al., 2009). On the other hand, in their qualitative review, Grimmond et al. (2019) also devoted attention to the influences of family and peer relations when identifying four types of risk factors for youth suicide: (a) behaviours, such as difficulties with communication (Holliday & Vandermause, 2015), (c) feelings/emotions, such as worthlessness (Gulbas et al., 2015), (b) family influences (e.g., Sukhawaha et al., 2016) and (c) peer influences (e.g., Keyvanara & Haghshenas, 2011). While such empirical studies provide valuable information about individual or family/peer-group-related factors influencing youth suicide, their approach neglects the wider social and cultural structures that shape young people’s lives and place in society.
To increase our understanding of suicide as not only individual or psychosocial but also a cultural and structural phenomenon, the social sciences offer fruitful approaches. They generally build on Durkheim’s (1897/1951) seminal work, and the subsequent discourse has continued where Durkheim left off, showing that the external social world can be characterized by network structures and shared cultures that impact individuals’ suicidal behaviour (Mueller et al., 2021). This article aims to map the sociocultural aspects of youth suicide via a meta-analysis based on social scientific research. Overall, a meta-analysis contributes to the creation of a novel understanding of a topic, especially through the building, strengthening, or broadening of the paradigmatic discussion about the studied phenomenon (Levitt, 2018). The meta-analysis in this article is theoretical in nature. That is, instead of focusing on the empirical findings of the research articles, the theories that they use to frame youth suicide are examined. By focusing on theories, this study distances itself from the concrete risk factors for youth suicide and reveals the typically hidden social meanings and structures that often have effects on youth suicide. In previous research, the major streams of the social explanations of suicide can be briefly encapsulated as a lack of meaningful social ties and connectedness on one hand and inequality and discrimination on the other (Mueller et al., 2021; Wray et al., 2011). These dimensions obviously also concern suicidal behaviour among youth. However, as these studies do not specifically focus on youth, they presumably overlook something about those factors that are especially important during youth and matter in terms of youth suicidality.
Paterson et al. (2001) present the concept of meta-theory, which is intended to expose the studied phenomenon in its larger contexts, uncover the underlying assumptions of the associated theories and propose alternative ways to frame and interpret the phenomenon. This article was intended to provide a novel perspective on youth suicide by developing a meta-theory that identifies the major paradigms in which youth suicide is approached within the social sciences. Following Paterson et al.’s (2001) view and prior studies on the theoretical groundings of suicide research (Mueller et al., 2021; Wray et al., 2011), a preliminary hypothesis presented in this article is that the studied social scientific theories, together, expose the underlying commonalities in young people’s social domains that predispose them to consider suicide and, in the worst cases, die by suicide in order to escape unbearable situations. The following research questions were developed to guide the analysis:
RQ1. How is youth suicide conceptually or theoretically framed and approached in the social sciences?
RQ2. What unifying elements underlie these conceptual and theoretical approaches to youth suicide research?
The findings of this analysis can thus help acknowledge the social, cultural and structural factors that affect the risk of youth suicide and, in turn, promote prevention practices.
Data Search and Management
The data search was conducted in the four most common databases for social science research: Scopus (limited to the Social Sciences and Arts and Humanities), ProQuest, EBSCO, and the Web of Science (limited to the Social Science Citation Index). The primary search was performed using the following search phrase:
‘suicid* AND youth OR adolescent* OR young adults AND theor* OR framework OR concept* AND qualitative’
Depending on the options provided by each database, the search focused on either the articles’ titles or abstracts. The inclusion criteria for the articles were as follows: (a) peer-reviewed and published in a scholarly journal and (b) written in English. No specific timeframe was set, as the preliminary test searches revealed that the total number of articles published that met the abovementioned conditions was already narrow and therefore manageable. The search was conducted on 15–16 August 2023. Figure 1 shows a standard preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram of the data search process (see Moher et al., 2009).
A PRISMA Diagram of the Data Search Process.
The initial search yielded 164 articles. After duplicates were removed, each article’s abstract was read to evaluate the relevance of its content. Articles that concerned youth suicide only cursorily were excluded. Articles that appeared to be quantitative, rather than qualitative, were also excluded, leaving 34 articles.
Next, the full texts of these 34 articles were read carefully and considered in terms of their relevance to the meta-analysis. As the focus of this article is the theoretical choices made when constructing the research setting, all articles that did not involve a clear theoretical or conceptual deductive approach were excluded. Three review articles were also removed, but two articles in their reference lists ultimately proved to be relevant to this meta-analysis and were thus included in the sample. Finally, the reference lists of all the thus-far-selected 22 articles were read, leading to four more articles that met the inclusion criteria. After all the data search stages, the final sample consisted of 26 articles.
Characteristics of Youth Suicide in the Study Sample
The 26 articles included in this meta-analysis applied 24 different theoretical or conceptual frameworks for youth suicide. Some theories were present in several articles, whereas some of the articles constructed their theoretical frameworks based on two other frameworks. In the articles, youth were defined in several ways. Some focused only on adolescents, but most focused on young adults. The ages covered by the articles ranged from 12 to 35 years, which shows the way in which youth is generally conceived and how far into adult life it stretches. The perspectives on youth suicide also varied. Suicidal behaviour was reported by young people with suicidal ideation and those who had attempted suicide, the parents of young people who had died by suicide, or healthcare professionals who had treated suicidal youths.
The articles mainly represent a Western understanding of the social contexts of youth suicide. Most of the studies were conducted in North America (14 in the US, five in Canada). Two of the studies were conducted in Australia, two in the UK and one in each of the following countries: Sweden, China and Sri Lanka. The articles included in the final sample were from the fields of (social) psychology and sociology. In the final sample, purely sociological research settings were minor, regardless of whether the data search was directed towards the largest and most common social sciences databases.
Results
Most of the theories outlined in the studied articles approached youth suicidality as a phenomenon stemming from a kind of fracture in the relationship between the individual and society. They explored individuals’ belongingness in a community at three levels: society as a whole, specific subgroups and family relationships. In addition, some of the theories—with or without the component of belonging—provided an approach to negative emotional reactions that precipitate youth suicide or strategies that can help young people overcome suicidality. Table 1 presents the research articles included in the study sample, along with their conceptual or theoretical approaches and emphases regarding belongingness, emotional reactions and protective factors.
Research Articles and Their Theoretical Framings for Youth Suicide.
Belongingness Within Society as a Whole
In the articles, the frameworks that conceive young people as affiliated within society as a whole included the sociological study of suicide (Durkheim, 1897/1951), the interpersonal theory of suicide (IPTS) (Joiner, 2005), the integrative framework of a sense of belonging (Allen et al., 2021) and the socioecological framework (Bronfenbrenner, 1977). These approaches are explored further in this section.
Durkheim’s (1897/1951) sociological study of suicide has stood the test of time and is still employable in current contexts. His central insight is that the varying levels of social integration and moral regulation provided by society determine the prevalence of suicide within a population. Based on these two dimensions, he identified four types of suicide: egoistic, altruistic, anomic and fatalistic. Thus, suicide is fundamentally linked to one’s connectedness within society. Using Durkheim’s work as a foundation, Mueller and Abrutyn (2016) elaborated on the typology of suicide in a small community in the US that persistently struggled with adolescent suicide. They posited that the dimensions of integration and regulation depend not only on the density but also on the quality of social ties. These ties do not always nurture people’s social and emotional needs, but they can occasionally be disruptive. As the authors show, in small communities, thick social ties not only enhance social cohesion but also catalyse informal social monitoring and sanctions. This perspective offers a complement to Durkheim’s theory, revealing the context-specific nature of integration and regulation based on social connectedness.
Another well-known theory in suicidology is the IPTS, developed by Joiner (2005). It consists of three components that contribute to suicidal behaviour. Thwarted belongingness indicates a feeling of having few or no social connections. Perceived burdensomeness refers to the perception of being an unreasonable burden to others. The hopelessness caused by the simultaneous presence of both these components is associated with suicidal desire. Based on the IPTS, Zullo et al. (2021; 2022) developed an intervention model for adolescents with suicide-related problems in the US. They found that perceived burdensomeness generates thwarted belongingness, but not necessarily vice versa. Thus, mitigating the experiences of burdensomeness by intervening in the burdening aspects of interpersonal behaviour can relieve experiences of thwarted belongingness. This increases the motivation to connect with others, thus enhancing the sense of belongingness and, in turn, decreasing the risk of suicide.
Adams et al. (2021) adapted the IPTS to assess suicidality among young Black US men and revealed how racism-induced stress affects thwarted belongingness, as it increases the experiences of hopelessness that contribute to suicidality. Similarly, American scholars Hill et al. (2019) used the IPTS when mapping contexts in which adolescents feel like a burden to others. These contexts are typically characterized by limited personal resources, perceptions of failure and conflicts in relationships. Because they create the experience of burdensomeness, these situations are associated with an increased risk of suicide.
Belonging is also explicitly embedded in Allen et al.’s (2021) integrative framework, in which a sense of belonging is founded on social interactions comprising four interrelated components: competencies needed to belong (social, emotional, or cultural), opportunities to belong (groups, people, time and space), motivations to belong (needs and desires) and perceptions of belonging (experiences of success/failure to connect with others). Marlin et al. (2023) found that a poor sense of belonging is a significant risk factor for suicidality among rural queer young adult Australians. Given Allen et al.’s (2021) quadripartite framework, individuals’ perceptions of their competencies, motivations and opportunities to belong contribute to how inclusive they believe their social environments to be. Sometimes, belongingness was pursued by managing their identities and behaviour to better comply with local norms. These attempts inhibited their freedom to act in accordance with their self-image, which was associated with an elevated risk of suicide.
Bronfenbrenner’s (1977) socioecological framework characterizes society as a nexus of inter-affecting systems within which people are situated. The microsystem comprises the immediate environment and a person’s relationships, whereas the exosystem comprises those social structures and major institutions that do not constitute one’s immediate environment but nonetheless influence one’s life (governments, mass media, or service systems). The mesosystem encompasses the interrelations between these major settings, whereas the macrosystem covers the overarching institutional and ideological patterns that ultimately determine other systems (laws, customs and everyday practices). Such a conception of society as a multisystem entity was adopted in several studies that explore youth suicide. Utilizing that framework, Libon et al.’s (2023) study of small Canadian communities revealed that barriers that prevent suicidal young people’s access to services exist at many systemic levels. This means that improvements should also be considered at these levels, such as community leading, policymaking and the media continuing to increase public awareness of mental health issues.
Gulbas et al. (2019) also applied Bronfenbrenner’s (1977) approach when exploring Latina adolescent suicide attempters in New York. According to their findings, adolescents experienced multilevel risk factors, with family conflicts being examples of micro-level risk factors, and discrimination, housing insecurity and neighbourhood violence being examples of exo- and macro-level risk factors. That framework was also used, although loosely, in Chung and Lesorogol’s (2019) study, in which they aimed to better understand Korean–American women’s experiences with suicidality during adolescence, revealing many personal and community-level hardships, including problems within family relationships, inadequate mental health awareness, a lack of help seeking and high academic achievement goals.
Belongingness Within Specific Subgroups
Concepts characterizing belongingness as identification with a minority or other subgroup included minority stress (Meyer, 1995), race-based discrimination (Goodwill et al., 2021), ethnic identity (Amoah, 2014; Phinney & Ong, 2007), the interactionist view on culture (Kleinman & Kleinman, 1991), historical trauma (Evans-Campbell, 2008), unwanted gender identity (Ferguson et al., 2000) and gendered ‘shame-fear’ (Obeyesekere, 1984).
The concept of minority stress (Meyer, 1995) applies to the discrimination faced by gender and sexual minorities having adverse impacts on their mental well-being. Minority stressors include internalized homophobia, stigma and experiences of discrimination and violence. Applying the minority stress concept, McDermott et al. (2017) studied the social determinants of suicide risk in LGBT youth in the UK. In addition to stressors typical among young adults, such as academic pressures, belonging to gender or sexual minorities generates specific distress that contributes to suicide risk. As examples of the minority stress experienced among LGBT youth, the authors reported having been bullied at school and wariness regarding disclosing their sexual identities to other people.
Discrimination was also explored in Goodwill et al.’s (2021) study, based on the concept of everyday discrimination by Essed (1991). They suggested that racial discrimination occurs covertly in everyday situations and practices. Combining Goodwill et al.’s idea with the IPTS (Joiner, 2005), Adams et al. (2021) used a real-time smartphone application to explore how racism-related stressors influence suicidality among young Black American men. The method provided an opportunity to determine the temporality of the stressors related to racism in the study participants’ everyday environments.
Ethnicity was also addressed in the works of Amoah (2014) and Phinney and Ong (2007), who have both contributed to the concept of ethnic identity. Ethnic identity can be defined as a shared sense of identity within a certain group determined by cultural values, traditions and behaviours (Phinney & Ong, 2007). In a new host country, cultural encounters create challenges that require negotiations throughout the identity construction process (Amoah, 2014). Combining the abovementioned viewpoints, Mude and Mwanri (2020), in their study of African youths in Australia, suggest that these identity negotiations may involve the risk of suicide. Being disconnected from one’s former social networks due to migration creates challenges regarding one’s identity work processes.
A corresponding approach is embedded in conceiving of culture as manifesting in social interaction (e.g., Kleinman & Kleinman, 1991). This is how Gulbas and Zayas (2015) contextualized the cultural influence on the suicidal behaviour of American Latina teens. While grappling with different or even contradictory social and cultural worlds, the girls described feeling isolated and alone if they lacked meaningful social ties, which then intensified in the form of psychological pain.
The concept of historical trauma (Evans-Campbell, 2008) has been used to explain intergenerational predispositions to traumatic events within Indigenous communities. The term ‘historical’ refers to the oppressive policies and colonization that began long ago and persist today. Historical trauma influences community members at three interrelated levels: individual, family and community. Walls et al. (2014), who employed the framework of historical trauma when studying North American Indigenous youth, assert that the complex dynamics of stressors, traumas and social problems function as elemental determinants of increased suicidality. The authors emphasize that these factors have deep historical and structural roots and thus cannot be viewed as individualized problems.
One way to approach belongingness theoretically focuses on social subgroups determined by gender. For example, Ferguson et al. (2000) assert that an unwanted gender identity is the quintessential antecedent of shame. Experiences of an unwanted identity actualize when people perceive themselves as possessing characteristics that degrade their internalized self-ideals, which are gendered, so men and women feel ashamed differently. Interviewing the parents of young persons who died by suicide in Sweden, Werbart Törnblom et al. (2015) found that suicidal acts were chosen as a final ‘emergency exit’ from unbearable emotions, especially those caused by gender-specific shame. They interpreted their findings through the lens of an unwanted gender identity.
Sri Lankan anthropologist Obeyesekere (1984) demonstrates how powerful technique of societal control gendered shame can be. Through the socialization of ‘shame-fear’, Sri Lankan children learn sexual and gendered norms at an early age. For females, these norms mean that breaking expected sexual modesty results in heavy social sanctions, including discrediting the family’s reputation. Jordal et al. (2013) studied how unmarried young Sri Lankan women handled single motherhood. These women were aware of having violated gendered sexual norms, and for some of them, the fear of social condemnation led to suicide contemplation or attempts as a means of escaping from this shameful situation.
Belongingness Within Family Relations
One belonging category with which youth suicide was approached concerns young people’s family relations. These kinds of conceptualizations comprised the attachment theory extended to adolescence (Allen & Land, 1999), the psychosocial development of identity (Erikson, 1968), emerging adulthood (Arnett, 2000), parenting styles (Baumrind, 1971), the family management style (FMS) framework (Knafl & Deatrick, 1990), parental aspirations (Glick & White, 2003) and the feminist family theory (Few-Demo et al., 2014).
When exploring child–parent relations, Bowlby’s (1979) pioneering theory of attachment during a child’s early years often functions as a baseline. Allen and Land (1999) broadened the scope of Bowlby’s theory by proposing that as people develop from childhood to adolescence, their primary caregivers become less important and peer relationships become more important as sources of intimacy, proximity and partnership. Adolescence thus represents a transitional period during which their autonomy increases and their attachment patterns change. This period was explored in Bostik and Everall’s (2007) study focusing on how Canadian adolescents perceive the support of their attachment relationships while overcoming suicidal feelings. They found that secure attachment relationships characterized by trust, warmth, support, closeness and comfort play an essential role in recovering from suicidality.
Erikson’s (1968) theory of the psychosocial development of identity was naturally included in the sample. Erikson describes an individual’s development as a continuum of stages from early childhood to young adulthood. In this lifecycle approach, late adolescence, or young adulthood, represents a time of identity confusion that involves a crisis of interpersonal intimacy. In Werbart Törnblom et al.’s (2015) study of Swedish youths, suicide is regarded as a breakdown in the process of psychosocial development, especially gender identity development, which they explore by employing the above-presented concept of unwanted identity (Ferguson et al., 2000). They argue that such breakdowns originally resulted from insufficient support from parents and society to allow youth to resolve their gender-specific identity crises.
Arnett’s (2000) concept of emerging adulthood is built on Erikson’s identity development theory. In Arnett’s view, youths’ identity work is completed only in their late twenties. Today’s young adults go through many developmental stages, such as completing graduate school, engaging in career development, finding a mate and starting a family, at a later age than previous generations. This prolonged period of youth, which he calls emerging adulthood, is a time of independence when the responsibilities of a normative adult life have been postponed, meaning that there is still partial reliance on parents, combined with gradually increasing autonomy. Focusing on Canadian young people aged 15–24, Everall, Bostik, and Paulson (2006) note that emergent adulthood is a vulnerable period characterized by an increase in mental instability associated with a higher incidence of suicidality as compared to other periods.
Emergent adulthood was also adopted, in addition to the above-mentioned framework of belonging (Allen et al., 2021), in Marlin et al.’s (2023) study of queer youth in rural Australia. A greater risk of mental health problems, including suicidality, in emerging adulthood was also identified in their study. Especially concerning the foundation of sexual identities, individuals’ first same-sex encounters are experienced during this period, as well as coming out to other people.
Perspectives on parenting were included in some studies. Baumrind’s (1971) classic conceptualization of parenting styles as authoritarian, authoritative, or permissive was seen as requiring reframing in a culturally specific context in a study of young Asian-American women by Hahm et al. (2014). They identified five forms of disempowering parenting styles: abusive, burdening, culturally disjointed, disengaged and gender-prescriptive parenting, which involve the risk of developing fractured identities and may even lead to suicide.
Related to parenting styles, Knafl and Deatrick (1990) developed the FMS framework to understand how a family responds to a child’s illness. Gulbas et al. (2011) applied the FMS framework when studying how family tensions affect suicidality among young US Latinas. They found that the family relationships of these youths were asymmetrical or detached and lacking in reciprocity.
Parental aspirations are one dimension of what Glick and White (2003) define as expressions of potentially unrealistic educational expectations. In some situations, parents’ future aspirations for their offspring can be heavily incongruent with the youths’ own aspirations, as Hausmann-Stabile et al. (2013) show in their study of Latina adolescent suicide attempters in the US. In some cases, these girls found that their parents’ expectations for them differed considerably from the American mainstream values they had adopted, leading to conflicts within the family, which were associated with suicidal behaviour.
The feminist family theory developed by Few-Demo et al. (2014) offers insights into the unequal power relations that are maintained and reproduced in families. These power hierarchies are inclined to normalize certain family roles and processes while marginalizing others. The feminist family framework, therefore, provided Morrow and McGuire (2023) with a useful framework to examine how housing insecurity and suicidality are connected within transgender youth in the US. They found that homelessness was not the primary reason for young trans peoples’ suicides; rather, their unsafe and dysfunctional family environments (due to deviating from heteronormative standards) were associated with housing instability, which indirectly increased the risk of suicide.
Emotional Reactions as Triggers and Protective Factors as Alleviators of Suicidal Acts
The actual triggers of suicide are rarely determined by social structures or identities but rather by emotions that are experienced as insuperable. Many of the above-mentioned frameworks already capture this kind of emotional component (hopelessness, trauma, shame and stress), and some of the theories focus solely on conceptualizing certain emotional reactions. Moreover, protective factors against youth suicide have been conceptualized by different forms of resilience (Hauser, 1999; Masten, 2014; Rasmus et al., 2014; Rutter, 1987).
The feeling of hopelessness is included in the IPTS (Joiner, 2005), which was applied by Zullo et al. (2021; 2022), Adams et al. (2021) and Hill et al. (2019). The IPTS posits that hopelessness due to thwarted belongingness and perceived burdensomeness is an actual risk factor for suicide. Trauma experiences, in turn, were linked to Indigenous youth suicides (Walls et al., 2014) within the framework of historical trauma (Evans-Campbell, 2008), whereas unbearable shame due to a failure to comply with gender roles (Ferguson et al., 2000; Obeyesekere, 1984) was understood as a trigger for suicide in Werbart Törnblom et al.’s (2015) and Jordal et al.’s (2013) studies. In addition, the social dynamics of shame were the basis of Fullagar’s (2003) approach, in which shame is a result of failing to abide by cultural norms, thus producing self-hatred. This conception was embraced by McDermott et al. (2008), who focused on how homophobic attitudes influence self-destructiveness and suicide among LGBT youth in the UK.
Various perspectives on stress experiences were commonly used in explaining youth suicidal behaviour. Minority stress (Meyer, 1995) was adopted by McDermott et al. (2017), while the concept of racism-related stress (Goodwill et al., 2021) was used by Adams et al. (2021). Moreover, stress was conceptualized in Wheaton’s (1999) model, divided into the micro, meso and macro levels. Micro-stressors are unanticipated life events that occur in an individual’s personal life, while macro-stressors are structural and social processes and demands above the individual level. Meso-stressors operate as mediators between the micro and macro levels. Wheaton’s stress levels were applied to complement the framework of historical trauma (Evans-Campbell, 2008) in Walls et al.’s (2014) study, providing a reminder that the intersection of multilevel stressors influences suicidal behaviour, even though it is often erroneously understood as an individual pathology. Stress was also a central factor in Hewitt et al.’s (2014) diathesis-stress model, according to which socially prescribed perfectionism is linked with adolescent suicide; that is, the desire to be perfect may lower one’s threshold of stress tolerance. This ‘paradox of perfection’ was adopted, in connection with the socioecological system theory (Bronfenbrenner, 1977), as the basis of Chung and Lesorogol’s (2019) study of suicidal Korean–American female adolescents who strived to be perfect in the eyes of their parents.
Lastly, the strain theory of suicide (Zhang & Lester, 2008; first published in Chinese by Zhang, 2005), which builds on Merton’s (1957/1968) classic strain theory, identifies various sources of strain that precede suicidal behaviour. Within this approach, strain can be understood as a form of psychological pain that results from conflicting pressures related to values, aspirations, deprivation and coping. When this pain becomes overwhelming, suicide emerges as a means of escaping it. Zhang et al. (2009) tested this theory in the context of rural Chinese youth and found a direct link between strain experiences and suicide.
Instead of negative emotions being understood as the proximal triggers of suicidal acts, some articles focused on protective factors that can help young people recover from suicidality. In these articles, the concept of resilience was defined and applied. For example, according to Hauser (1999), protective factors are key constructs of resilience, as they operate by fostering one’s ability to rebound from misfortunes, individual vulnerabilities, or environmental hazards. Although protective factors are mostly considered individual capabilities, Hauser draws attention to the community-related aspects of individuals’ protective processes. Referring to Hauser’s (1999) resilience framework, Everall, Altrows, and Paulson (2006) studied the protective processes that help Canadian adolescent girls overcome suicidality. They identified four interlinking domains of resilience: (a) social processes encompassing close interactions with other people, (b) emotional processes related to the capability to identify and express feelings, (c) cognitive processes that allowed one to shift one’s perspective and thus gain a greater sense of personal control over the situation and (d) purposeful action that enhances independence, positive identity and future prospects.
The interplay between risk and protective factors also appears in other definitions of resilience. In Masten’s (2014) definition of resilience, risks as factors predict a high probability of some undesirable outcomes. Rutter (1987), on the other hand, points out that protective factors have the potential to change an adverse life course from risks to adaptation by reducing the effects of risks, promoting self-esteem and creating opportunities. In a study conducted in the US, Matel-Anderson and Bekhet (2016) adopted these viewpoints when examining the protective processes that contributed to overcoming suicidal feelings among adolescents. They found that open communication with other people and being able to express their negative emotions enhanced young people’s sense of connection, which protected them from suicidal thoughts and future suicidal acts.
Finally, Rasmus et al. (2014) introduced the concept of community resilience, which can be defined as a dynamic process that operates beyond the individual level and involves system-level capacities. Community resilience comprises networks, relationships, linkages and transactions that transform and distribute resources across a community and thus strengthen adaptation in the face of adversities. This perspective was employed in Anang et al.’s (2019) study, in which the researchers shifted the focus from intergenerational trauma experiences to community-level resilience in order to identify strategies via which to reduce the high suicide rate among Inuit youth in Canada. To enhance young people’s resilience, the entire community must act, which involves re-establishing the waning communication between youth and community elders to work for common goals.
Discussion
The social origins of suicide have been overlooked in contemporary suicidology, which generally views it through a psychiatric lens (Wray et al., 2011). The aim of this article is to map the sociocultural aspects of youth suicide via a meta-analysis based on social scientific research, with the intention of identifying the major paradigms in which youth suicide is approached within the social sciences. Based on 26 qualitative research articles, the social framings applied in youth suicide research were analysed by asking how youth suicide is conceptually or theoretically framed and approached in the social sciences and what unifying elements underlie these conceptual and theoretical approaches.
The theoretical framings applied in the articles often describe youth suicide as a phenomenon that occurs because of a lack of a sense of belonging. While some theoretical approaches conceive young people as affiliated within society as a whole or as identifying with social and cultural subgroups within it, others have explored young people’s roles within family relationships. In general, this is in line with what Durkheim (1987/1951) and subsequent scholars (Mueller et al., 2021; Wray et al., 2011) have previously stated regarding the lack of meaningful social ties and connectedness in society as a source of suicidal behaviour. However, regarding suicide, especially among young people, the concepts and theories that explain it in the context of family relations appear critical (e.g., Few-Demo et al., 2014; Glick & White, 2003; Knafl & Deatrick, 1990). Consequently, concerning the underlying social and structural elements of youth suicide, this meta-analysis reveals the intersecting belongings of youth, both within family relations and as independent members of society and its subgroups during the transition to adult life. This viewpoint has not been addressed clearly in previous studies of youth suicide in general (Carballo et al., 2019; Grimmond et al., 2019) or those exploring suicide within the social sciences (Mueller et al., 2021; Wray et al., 2011).
The analysis also shows that belonging to certain groups relates to the identity development process, which is conceived of as being based on internalized meanings embedded in the social structure. When mapping the social roots of suicide, Mueller et al. (2021) addressed how the prevailing social structures affect the kinds of opportunities, subcultures, roles and obligations available for individuals to use in constructing their identities. Indeed, complicated and socially determined identity formation processes were clearly seen as contributors to suicidal desires in several of the theoretical approaches used in the articles studied (Amoah, 2014; Erikson, 1968; Ferguson et al., 2000; Phinney & Ong, 2007). Regarding contradictory social expectations, incongruent identity structures between family obligations and other roles in society were explicitly demonstrated by Morrow and McGuire (2023), who employed the feminist family theory (Few-Demo et al. 2014) on suicidality among transgender youth, and Hausmann-Stabile et al. (2013) in their study of parental aspirations (Glick & White 2003) for Latina adolescent suicide attempters.
Moreover, in the theories included in this analysis, the emotions associated with suicidality are ultimately located within social frames. That is, some of the theories described suicidal thoughts and acts in terms of emotional reactions, such as stress (Goodwill et al., 2021; Hewitt et al., 2014; Meyer, 1995; Wheaton, 1999), shame (Ferguson et al., 2000; Fullagar, 2003; Obeyesekere, 1984), hopelessness (Joiner, 2005), trauma (Walls et al., 2014) and strain (Zhang & Lester, 2008), to situations in which young people perceive themselves as not having achieved the expected states in relation to their social environments. As the results show, these expectations are grounded in social and cultural structures, norms and values and socially reproduced, maintained and internalized through the socialization process. However, the protective factors against suicidality are also social in nature (e.g., resilience theories; Hauser, 1999; Masten, 2014; Rasmus et al., 2014; Rutter, 1987). Accordingly, relationships with families and other groups, when positive, appear to increase youths’ resilience, prevent suicide attempts and help youths recover from them, as shown in some articles (Anang et al., 2019; Everall, Altrows, & Paulson, 2006).
To conclude, the contribution of this meta-analysis to the social sciences is its participation in meta-theory construction for youth suicide. Following Paterson et al.’s (2001) proposal to create a meta-theory, the theoretical attempts to address youth suicide were set in wider contexts to expose the profoundly social nature of young people’s sense of belonging, identity formation and emotions. Together, these theories shape a space for youth at the crossroads of becoming an independent adult member of society while remaining emotionally attached to their childhood families. This contribution thus complements the prevailing social scientific paradigms regarding suicide (Durkheim, 1987/1951; Mueller et al., 2021; Wray et al., 2011). This is crucial to enhancing our understanding of youth suicide and promoting prevention and treatment strategies, along with psychological and psychiatric approaches (e.g., Carballo et al., 2019; Goldston et al., 2009). Consequently, these kinds of sociocultural angles may direct service professionals to consider new routes when mapping the origins of young people’s suicidal thoughts and acts.
This study has some limitations. As the data search was conducted in the databases best known within the social sciences, it is possible that relevant literature with appropriate theoretical approaches would have been found in other databases, such as Medline or PsycInfo. Also, narrowing the search to only qualitative studies certainly left out relevant articles that used quantitative methods. Because the scope of the social sciences indicated more social psychological than purely sociological research settings, more research on sociocultural macro-structures, politics and ideologies would further strengthen the understanding of the social nature of youth suicide. Finally, regarding the generalizability of the findings, the prolonged youth transition, conceptualized, for example, as an emerging adulthood (Arnett, 2000), characterizes Western societies in particular, rather than all youth in a global sense. The transition in non-Western contexts, with its various stages, roles and obligations, could also guide future research on youth suicide.
Footnotes
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
This study is a part of the Out of Despair research project funded by the Strategic Research Council established in the Academy of Finland under a grant for the Out of Despair project (no. 352600) and the Tampere University (no. 352602).