Resumen
Antecedentes: En España, el suicidio constituye la segunda causa de muerte en jóvenes de 15 a 29 años. Es imperativa la detección de casos con riesgo suicida para una intervención temprana. El objetivo del estudio fue examinar la presencia autoinformada de indicadores del espectro suicida en adolescentes mediante una escala de respuesta tricotómica: no, sí, no deseo contestar. Incluir esta última alternativa pretendía salvaguardar la naturaleza sensible del fenómeno y explorar su carácter clínico. Método: 5,528 adolescentes conformaron la muestra definitiva (12-18 años; M ± DT = 14,20 ± 1,53; 50,74% mujeres). Resultados: Las prevalencias alcanzaron el 15.38% en ideación, 9,32% en planificación y 3,65% en tentativas suicidas previas. Las mujeres duplicaron las cifras de los hombres. La suicidalidad mostró una tendencia a incrementar con la edad. Adolescentes con presencia de indicadores suicidas (sí) y omisión de respuesta (no deseo contestar) obtuvieron, de forma equivalente, niveles inferiores en fortaleza socioemocional y bienestar subjetivo, y superiores en psicopatología, frente al grupo con ausencia de marcadores (no). Conclusiones: No deseo contestar constituye una categoría de respuesta que incrementa la sensibilidad del autoinforme, permitiendo una identificación más precisa de casos con alto riesgo suicida que pasarían desapercibidos mediante el sistema dicotómico tradicional (no-sí).
Citas
Al-Halabí, S., & Fonseca-Pedrero, E. (2021). Suicidal behavior prevention: The time to act is now. Clínica y Salud, 32(2), 89-92. https://doi.org/10.5093/clysa2021a17
Al-Halabí, S., Sáiz, P. A., Burón, P., Garrido, M., Benabarre, A., Jiménez, E., Cervilla, J., Navarrete, M. I., Díaz-Mesa, E. M., García-Álvarez, L., Muñiz, J., Posner, K., Oquendo, M. A., García-Portilla, M. P., & Bobes, J. (2016). Validation of a Spanish version of the Columbia-Suicide Severity Rating Scale (C-SSRS). Revista de Psiquiatría y Salud Mental, 9(3), 134–142. https://doi.org/10.1016/j.rpsm.2016.02.002
Allen, P., & Bennett, K. (2008). SPSS for the Health & Behavioural Sciences (1st ed.). Thomson.
Alqueza, K. L., Pagliaccio, D., Durham, K., Srinivasan, A., Stewart, J. G., & Auerbach, R. P. (2021). Suicidal Thoughts and Behaviors Among Adolescent Psychiatric Inpatients. Archives of Suicide Research, 1–14. Advance online publication. https://doi.org/10.1080/13811118.2021.1999874
Anseán, A. (2014). Suicidios: manual de prevención, intervención y postvención de la conducta suicida [Suicide: manual of prevention, intervention and postvention of suicidal behavior]. Fundación Salud Mental España.
Barzilay, S., Klomek, A. B., Apter, A., Carli, V., Wasserman, C., Hadlaczky, G., Hoven, C. W., Sarchiapone, M., Balazs, J., Keresteny,A., Brunner, R., Kaess, M., Bobes, J., Saiz, P., Cosman, D., Haring, C., Banzer, R., Corcoran, P., Kahn, J. P., … & Wasserman, D. (2017). Bullying victimization and suicide ideation and behavior among adolescents in Europe: A 10-country study. Journal of Adolescent Health, 61(2), 179-186. https://doi.org/10.1016/j.jadohealth.2017.02.002
Batterham, P. J., Ftanou, M., Pirkis, J., Brewer, J. L., Mackinnon, A. J., Beautrais, A., Fairweather-Schmidt, A. K., & Christensen, H. (2015). A systematic review and evaluation of measures for suicidal ideation and behaviors in population-based research. Psychological Assessment, 27(2), 501–512. https://doi.org/10.1037/pas0000053
Blasco, M. J., Castellví, P., Almenara, J., Lagares, C., Roca, M., Sesé, A., Piqueras, J. A., Soto-Sanz, V., Rodríguez-Marín, J., Echeburúa, E., Gabilondo, A., Cebrià, A. I., Miranda-Mendizábal, A., Vilagut, G., Bruff R., Auerbach, R. P., Kessler, R. C., Alonso, J., & UNIVERSAL study group (2016). Predictive models for suicidal thoughts and behaviors among Spanish University students: rationale and methods of the UNIVERSAL (University & mental health) project. BMC Psychiatry, 16, 122. https://doi.org/10.1186/s12888-016-0820-y
Castellví, P., Lucas-Romero, E., Miranda-Mendizábal, A., Parés-Badell, O., Almenara, J., Alonso, I., Blasco, M. J., Cebrià, A., Gabilondo, A., Gili, M., Lagares, C., Piqueras, J. A., Roca, M., Rodríguez-Marín, J., Rodríguez- Jimenez, T., Soto-Sanz, V., & Alonso, J. (2017). Longitudinal association between self-injurious thoughts and behaviors and suicidal behavior in adolescents and young adults: Asystematic review with meta-analysis. Journal of Aff Disorders, 215, 37–48. https://doi.org/10.1016/j.jad.2017.03.035
Cohen, J. (1973). Eta-squared and partial eta-squared in fi factor ANOVA designs. Educational and Psychological Measurement, 33, 107-112. https:// doi.org/10.1177/001316447303300111
Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587
Consejería de Educación, Juventud y Deportes. (2017). Resolución por la que se dictan instrucciones para la mejora de la convivencia escolar en los centros educativos no universitarios sostenidos con fondos públicos de la Comunidad Autónoma de la Región de Murcia [Resolution issuing instructions for the improvement of school coexistence in non-university educational centers supported with public funds of Comunidad Autónoma de la Región de Murcia]. Boletín Oficial de la Región de Murcia 21-11- 2017, 269, 32070-32073. https://www.borm.es/services/anuncio/ano/2017/numero/7800/pdf?id=762430
Consejo General de Colegios Oficiales de Psicólogos de España. (2010). Código Deontológico [Deontological Code]. https://www.cop.es/pdf/Codigo-Deontologico-Consejo-Adaptacion-Ley-Omnibus.pdf
Conselleria de Educación, Investigación, Cultura y Deporte, & Conselleria de Sanidad Universal y Salud Pública. (2017). Resolución conjunta por la que se dictan instrucciones para la detección y la atención precoz del alumnado que pueda presentar un problema de salud mental (2017/11874) [Resolution issuing instructions for the early detection and care of students who may present a mental health problem]. Diario Oficial de la Generalitat Valenciana 22-12-2017, 8196, 48164. https://dogv.gva.es/datos/2017/12/22/pdf/2017_11874.pdf
Cortes Generales de España. (2018). Ley Orgánica 3/2018, de 5 de diciembre, de Protección de Datos Personales y Garantías de los Derechos Digitales (RCL 2018/1629) [Organic Law 3/2018, of December 5, Personal Data Protection and Guarantees of Digital Rights]. Boletín Oficial del Estado 6-12-2018, 294, 119857. https://www.boe.es/eli/es/lo/2018/12/05/3/dof/spa/pdf
Cortes Generales de España. (2021). Ley Orgánica 8/2021, de 4 de junio, de Protección Integral a la Infancia y la Adolescencia frente a la violencia (RCL 2021/9347) [Organic Law 8/2021, of June 4, Comprehensive Protection of Children an Adolescents from Violence]. Boletín Ofi del Estado 4-6-2021, 134, 68657. https://www.boe.es/boe/dias/2021/06/05/pdfs/BOE-A-2021-9347.pdf
Díez, A., Pérez-Albeniz, A., Fonseca-Pedrero, E., & Al-Halabí, S. (2022, January 4). El papel de los institutos en la prevención del suicidio [The role of schools in suicide prevention]. The Conversation. https://theconversation.com/el-papel-de-los-institutos-en-la-prevencion-del-suicidio-174212
Díez-Gómez, A., Pérez-Albéniz, A., Ortuño-Sierra, J., & Fonseca-Pedrero, E. (2020). SENTIA: An Adolescent Suicidal Behavior Assessment Scale. Psicothema, 32(3), 382–389. https://doi.org/10.7334/psicothema2020.27
Domínguez-García, E., & Fernández-Berrocal, P. (2018). The Association Between Emotional Intelligence and Suicidal Behavior: A Systematic Review. Frontiers in Psychology, 9, Article 2380. https://doi.org/10.3389/fpsyg.2018.02380
Domínguez-Lara, S. (2018). Magnitud del efecto, una guía rápida [Effect size, a quick guide]. Educación médica, 19(4), 251-254. https://doi.org/10.1016/j.edumed.2017.07.002
Fonseca-Pedrero, E., Inchausti, F., Pérez, L., Aritio, A., Ortuño-Sierra, J., Sánchez-García, A., Lucas-Molina, B., Domínguez, C., Foncea, D., Espinosa, V., Gorría, A., Urbiola-Merina, E., Fernández, M., Merina, C., Gutiérrez, C., Aures, M., Campos, M., Domínguez-Garrido, E., & Pérez de Albéniz, A. (2018). Suicidal ideation in a community-derived sample of Spanish adolescents. Revista de Psiquiatría y Salud Mental, 11(2), 76-85. https://doi.org/10.1016/j.rpsmen.2018.02.008
Fonseca-Pedrero, E., Lemos-Giráldez, S., Paino, M., Villazón-García, U., & Muñiz, J. (2009). Validation of the Schizotypal Personality Questionnaire Brief form in adolescents. Schizophrenia Research, 111, 53-60. https://doi.org/10.1016/j.schres.2009.03.006
Fonseca-Pedrero, E., & Pérez-Albéniz, A. (2020). Evaluación de la conducta suicida en adolescentes: a propósito de la escala Paykel de Suicidio [Evaluation of suicidal behavior in adolescents: The Paykel Suicide Scale]. Papeles del Psicólogo, 41(2), 106-115. https://doi.org/10.23923/pap.psicol2020.2928
Fonseca-Pedrero, E., Pérez-Álvarez, M., Al-Halabí, S., Inchausti, F., Muñiz, J., López-Navarro, E., Pérez-Albéniz, A., Lucas-Molina, B., Debbané, M., Bobes-Bascarán, M. T., Gimeno-Peón, A., Prado-Abril, J., Fernández- Álvarez, J., Rodríguez-Testal, J. F., González-Pando, D., Díez-Gómez, García-Montes, J. M., García-Cerdán, L., Osma, J., … & Marrero, R. J. (2021). Evidence-Based Psychological Treatments for Adults. Psicothema, 33(2), 188-197. https://doi.org/10.7334/psicothema2020.426
Furlong, M. J., You, S., Renshaw, T. L., Smith, D. C., & O’Malley, M. D. (2014). Preliminary Development and Validation of the Social and Emotional Health Survey for Secondary School Students. Social Indicators Research, 117(3), 1011-1032. https://doi.org/10.1007/s11205-013-0373-0
García-Nieto, R., Blasco-Fontecilla, H., Yepes, M. P., & Baca-García, E. (2013). Translation and validation of the “Self-injurious thoughts and behaviors interview” in a Spanish population with suicidal behaviour. Revista de Psiquiatría y Salud Mental, 6(3), 101-108. https://doi.org/10.1016/j.rpsm.2012.07.001
Gardner,W., Murphy, M., Childs, G., Kelleher, K., Pagano, M., Jellinek, M., Mclnerny, T. K., Wasserman, R. C., Nutting, P., & Chiappetta, L. (1999). The PSC-17: a brief pediatric symptom checklist with psychosocial problem subscales. A report from PROS and ASPN. Ambulatory Child Health, 5, 225-236.
Harmer, B., Lee, S., Duong, T., & Saadabadi, A. (2021). Suicidal Ideation. In StatPearls. StatPearls Publishing.
IBM Corp. Released. (2020). IBM® SPSS® Statistics for Windows, Version 27.0 [Software]. Armonk, NY: IBM Corp.
Instituto Nacional de Estadística. (2017). Principales series de población desde 1998. Provincias. Población por provincias, edad (año a año), sexo y año [Main population series since 1998. Provinces. Population by provinces, age (year to year), gender and year] [Data set]. INE. https://www.ine.es/jaxi/Tabla.htm?path=/t20/e245/p08/l0/&file=03003.px&L=0
Instituto Nacional de Estadística. (2019). Defunciones por suicidios 2019: Resultados nacionales [Suicide deaths 2019: National results] [Data set]. INE. https://www.ine.es/dynt3/inebase/es/index.htm?padre=7924
Instituto Nacional de Estadística. (2020). Defunciones por suicidios 2020: Resultadosnacionales[Suicidedeaths2020: Nationalresults][Dataset].INE. https://www.ine.es/dynt3/inebase/es/index.htm?padre=8277&capsel=8278
Keyes, C. L M., Wissing, M., Potgieter, J. P., Temane, M., Kruger, A., & van Rooy, S. (2008). Evaluation of the mental health continuum-short form (MHC-SF) in Setswana-speaking South Africans. Clinical Psychology & Psychotherapy, 15(3), 181–192. 192. https://doi.org/10.1002/cpp.572
Kimberlin, C. L., & Winterstein, A. G. (2008). Validity and reliability of measurement instruments used in research. American Journal of Health- System Pharmacy, 65(23), 2276–2284. https://doi.org/10.2146/ajhp070364
Klonsky, E. D., May, A. M., & Saffer, B. Y. (2016). Suicide, suicide attempts,and suicidal ideation. Annual Review of Clinical Psychology, 12, 307-330. https://doi.org/10.1146/annurev-clinpsy-021815-093204
Kyron, M. J., Podlogar, M. C., Joiner, T. E., McEvoy, P. M., Page, A. C., & Lawrence, D. (2020). Allowing nondisclosure in surveys with suicide content: Characteristics of nondisclosure in a national survey of emergency services personnel. Psychological Assessment, 32(12), 1106–1117. https://doi.org/10.1037/pas0000949
Lim, K., Wong, C., McIntyre, R., Wang, J., Zhang, Z., Tran, B., Wanqiu, T., Ho, C., & Ho, R. (2019). Global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents between 1989 and 2018: a meta-analysis. International Journal of Environmental Research and Public Health, 16 (22), 4581. https://doi.org/10.3390/ijerph16224581
Louzán-Mariño, R. (2020). Improving the quality of psychosocial risk assessments based on the identification and control of bias. Archivos de Prevención de Riesgos Laborales, 23(1), 68-81. https://doi.org/10.12961/aprl.2020.23.01.06
Miranda-Mendizabal, A., Castellví, P., Parés-Badell, O., Alayo, I., Almenara, J., Alonso, I., Blasco, M. J., Cebrià, A., Gabilondo, A., Gili, M., Lagares, C., Piqueras, J. A., Rodríguez-Jiménez, T., Rodríguez-Marín, J., Roca, M., Soto-Sanz, V., Vilagut, G., & Alonso, J. (2019). Gender differences in suicidal behavior in adolescents and Young adults: Systematic review and meta-analysis of longitudinal studies. International Journal of Public Health, 64, 265-283. https://doi.org/10.1007/s00038-018-1196-1
Montero, I., & León, O. G. (2007). A guide for naming research studies in Psychology. International Journal of Clinical and Health Psychology, 7(3), 847-862. https://www.redalyc.org/pdf/337/33770318.pdf
Navarro-Gómez, N. (2017). El suicidio en jóvenes en España: cifras y posibles causas. Análisis de los últimos datos disponibles [Suicide in young people in Spain: fi and posible causes. Analysis of the latest available data]. Clínica y Salud, 28(1), 25-31. https://doi.org/10.1016/j.clysa.2016.11.002
Nock, M. K., Holmberg, E. B., Photos, V. I., & Michael, B. D. (2007). Self- Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample. Psychological Assessment, 19(3), 309-317. https://doi.org/10.1037/1040-3590.19.3.309
Nock, M. K., Millner, A. J., Ross, E. L., Kennedy, C. J., Al-Suwaidi, M., Barak- Corren, Y., Castro, V. M., Castro-Ramirez, F., Lauricella, T., Murman, N., Petukhova, M., Bird, S. A., Reis, B., Smoller, J. W., & Kessler, R. C. (2022). Prediction of Suicide Attempts Using Clinician Assessment, Patient Self-report, and Electronic Health Records. JAMA Network Open, 5(1), e2144373. https://doi.org/10.1001/jamanetworkopen.2021.44373
O’Connor, R. C., & Nock, M. K. (2014). The psychology of suicidal behaviour. The Lancet Psychiatry, 1, 73-85. https://doi.org/10.1016/S2215-0366(14)70222-6
O’Connor,R.,&Pirkis,J.(2016).TheInternationalHandbookofSuicidePrevention (2nd ed.). John Wiley & Sons. https://doi.org/10.1002/9781118903223
O’Shea, N., & McHayle, Z. (2022). Time for action. Investing in comprehensive mental health support for children and young people. Centre for Mental Health. https://cypmhc.org.uk/wp-content/uploads/2021/12/CentreforMH_TimeForAction.pdf
Piqueras, J. A., Rodríguez-Jiménez, T., Marzo, J. C., Rivera-Riquelme, M., Martínez-González, A. E., Falcó, R., & Furlong, M. J. (2019). Social Emotional Health Survey-Secondary (SEHS-S): A Universal Screening Measure of Social-Emotional Strengths for Spanish-Speaking Adolescents. International Journal of Environmental Research and Public Health, 16(24), 4982. https://doi.org/10.3390/ijerph16244982
Piqueras, J. A., Vidal-Arenas, V., Falcó, R., Moreno-Amador, B., Marzo, J. C., Holcomb, J., & Murphy, M. (2021). Short Form of the Pediatric Symptom Checklist-Youth Self-Report (PSC-17-Y): Spanish Validation Study. Journal of Medical Internet Research, 23(12), 31127. https://doi.org/10.2196/31127
Piqueras, J. A., Vidal-Arenas, V., Falcó, R., Moreno-Amador, B., Marzo, J. C., & Keyes, C. (2022). Validation of the Mental Health Continuum-Short Form (MHC-SF) for multidimensional Assessment of subjective well-being in Spanish adolescents. Psicothema, 34(2), 332-343. https://doi.org/10.7334/psicothema2021.240
Podlogar, M. C., Rogers, M. L., Chiurliza, B., Hom, M. A., Tzoneva, M., & Joiner, T. (2016). Who are we missing? Nondisclosure in online suicide risk screening questionnaires. Psychological Assessment, 28(8), 963–974. https://doi.org/10.1037/pas0000242
Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., & Mann, J. J. (2011). The Columbia-Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings From Three Multisite Studies With Adolescents and Adults. American Journal of Psychiatry, 168(12), 1266- 1277. https://doi.org/10.1176/appi.ajp.2011.10111704
Ribeiro, J. D., Franklin, J. C., Fox, K. R., Bentley, K. H., Kleiman, E. M., Chang, B. P., & Nock, M. K. (2016). Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: a meta-analysis of longitudinal studies. Psychological Medicine, 46(2), 225-236. https://doi.org/10.1017/S0033291715001804
Sheehan DV, & Giddens J. M. (2016). Suicidality Assessment and Documentation for Healthcare Providers: A Brief, Practical Guide (1st ed.). Harm Research Press.
Solmi, M., Radua, J., Olivola, M., Croce, E., Soardo, L., Salazar de Pablo, G., Il Shin, J., Kirkbride, J. B., Jones, P., Kim, J. H., Kim, J. Y., Carvalho, A. F., Seeman, M. V., Correll, C. U., & Fusar-Poli, P. (2022). Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Molecular psychiatry, 27(1), 281–295. https://doi.org/10.1038/s41380-021-01161-7
Soto-Sanz, V., Castellví, P., Piqueras, J. A., Rodríguez-Marín, J., Rodríguez- Jiménez, T., Miranda-Mendizábal, A., Parés-Badell, O., Almenara, J., Alonso, I., Blasco, M. J., Cebrià, A., Gabilondo, A., Gili, M., Lagares, C.,
Roca, M., & Alonso, J. (2019a). Internalizing and externalizing symptoms and suicidal behaviour in young people: a systematic review and meta- analysis of longitudinal studies. Acta Psychiatrica Scandinavica, 140(1), 5–19. https://doi.org/10.1111/acps.13036
Soto-Sanz, V., Piqueras, J. A., Rodríguez-Marín, J., Pérez-Vázquez, M. T., Rodríguez-Jiménez, T., Castellví, P., Miranda-Mendizábal, A., Parés-Badell, O., Almenara, J., Blasco, M. J., Cebrià, A., Gabilondo, A., Gili, M., Roca, M., Lagares, C., & Alonso, J. (2019b). Self-esteem and suicidal behaviour in youth: A meta-analysis of longitudinal studies. Psicothema, 31(3), 246-254. https://dx.doi.org/10.7334/psicothema2018.339
Stanley, I. H., Marx, B. P., Nichter, B., & Pietrzak, R. H. (2022). Non- response to questions about suicide ideation and attempts among veterans: Results from the National Health and Resilience in Veterans Study. Suicide and Life-Threatening Behavior, 52, 763-772. https://doi.org/10.1111/sltb.12860
Thompson, A. H., Dewa, C. S., & Phare, S. (2012). The suicidal process: age of onset and severity of suicidal behaviour. Social Psychiatry and Psychiatric Epidemiology, 47(8), 1263–1269. https://doi.org/10.1007/s00127-011-0434-0
Turecki, G., & Brent, D. A. (2016). Suicide and suicidal behaviour. The Lancet Psychiatry, 387(10024), 1227-1239. https://doi.org/10.1016/S0140-6736(15)00234-2
Voss, C., Ollmann, T. M., Miché, M., Venz, J., Hoyer, J., Pieper, L., Höfler, M., & Beesdo-Baum, K. (2019). Prevalence, Onset, and Course of Suicidal Behavior Among Adolescents and Young Adults in Germany. JAMA Network Open, 2(10), e1914386. https://doi.org/10.1001/jamanetworkopen.2019.14386
World Health Organization. (2014). Preventing Suicide: A Global Imperative. WHO. https://www.who.int/publications/i/item/9789241564779
World Health Organization. (2021). Live life: an implementation guide for suicide prevention in countries. WHO. https://apps.who.int/iris/handle/10665/341726