ON THE NATURE, MAGNITUDE, AND CAUSALITY OF SUICIDAL BEHAVIORS - AN INTERNATIONAL PERSPECTIVE

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.