Rfw. Diekstra et N. Garnefski, ON THE NATURE, MAGNITUDE, AND CAUSALITY OF SUICIDAL BEHAVIORS - AN INTERNATIONAL PERSPECTIVE, Suicide & life-threatening behavior, 25(1), 1995, pp. 36-57
The central questions addressed in this paper are whether present gene
rations of adolescents and adults worldwide are at greater risk of dev
eloping suicidal reactions than previous generations were and what the
possible causal mechanisms involved are. On the basis of data from in
ternational and national data banks as well as an extensive review of
the literature, it is concluded that a true increase in suicide mortal
ity and morbidity has occurred over the larger part of this century am
ong the White urban adolescent and young adult populations of North Am
erica and Europe, particularly among (young) males over the last three
decades. Among the possible causal mechanisms identified are (1) the
corresponding increase in the prevalence of depressive disorders; (2)
the corresponding increase in the prevalence of substance (ab)use and
substance abuse disorders, and a lowering of age of onset of (ab)use;
(3) psychobiological changes, in particular the dramatic lowering of t
he age of puberty; (4) an increase in the number of social stressors w
ith extensive consequences for youth; (5) changes in attitudes towards
suicidal behaviors and the related increased availability of suicidal
models.