Factors Associated with Depression, Suicidal Ideation, and Suicide Attempts in Adolescents: Modifying Effects of Well-being Based on the Positive Psychology Framework
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Abstract
Objective: This study aims to analyze factors associated with depression, suicidal ideation, and suicide attempts among adolescents in Chiang Mai - Thailand, as well as to examine the influence of well-being, as measured by the EPOCH framework developed from positive psychology, on these associations.
Methods: A descriptive analytical study was conducted among 240 students aged 10 - 18 years from three schools in Chiang Mai. Data were collected using a basic demographic questionnaire, the Patient Health Questionnaire for Adolescents (PHQ-A) to assess depression, and the EPOCH Measure of Adolescent Well-being. Univariate analyses using Pearson’s Chi-square and independent t-test were performed to identify factors associated with depression, suicidal ideation, and suicide attempts. Subsequently, multivariate analyses and interaction effect tests between well-being (EPOCH) and relevant factors were conducted using binary logistic regression.
Results: Univariate analysis showed that depression was significantly associated with LGBTQ (p < .001) and parents not living together (p = 0.034). Suicidal ideation was linked to LGBTQ (p < .001) and parents not living together (p = 0.015). Suicide attempts were associated with parents not living together (p = 0.004). Multivariate analysis revealed: Depression was associated with LGBTQ (OR 6.04, 95% CI 2.37 - 15.38, p < .001). Suicidal ideation was associated with LGBTQ (OR 15.78, 95% CI 5.61 - 44.37, p < .001) and parents not living together (OR 2.39, 95% CI 1.09 - 5.25, p = 0.030). Suicide attempts were associated with parents not living together (OR 4.42, 95% CI 1.62 - 12.11, p = 0.004). Regarding the interaction effects between EPOCH well-being and the associated risk factors, EPOCH did not significantly alter the relationships overall. However, there was a trend suggesting that Engagement may interact with LGBTQ in predicting depression (interaction OR 0.71, p = 0.061), and Connectedness may interact with parental status in predicting suicidal ideation (interaction OR 1.27, p = 0.056).
Conclusion: The study indicates that LGBTQ and family structure (parents not living together) significantly increase risks of depression, suicidal ideation, and suicide attempts among adolescents. The positive psychology components, particularly Engagement and Connectedness, may play a preventive role in this vulnerable group, which warrants further investigation for future applications in mental health prevention and treatment.
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