Predictors of suicidal behaviors among school-going adolescents: a cross sectional study in Indonesia

ackground Adolescents are a high-risk age group for committing suicide, and the risk substantially increases
from early to late adolescence. Adolescence also serves as critical time period for early detection and intervention
to prevent suicidal behaviors. This study aimed to assess the prevalence of suicidality and identify significant predic�tors of suicidality among adolescents.
Methods A cross-sectional observational study was conducted between January-December 2023. Adolescents aged
14–18 years old (n=2317) were consecutively recruited from 15 high schools across four provinces on Java Island
in Indonesia. Self-reported validated instruments in Indonesian were used to assess sociodemographic profiles, self�esteem (RSES), hopelessness (BHS), loneliness (ULS-3), perceived social support (MSPSS), depression (PHQ-9), resilience
(CD-RISC-10), suicidality (SBQ-R). With adjusted odds ratio (AOR) and 95% confidence interval (CI), binary logistic
regression analysis was used to determine significant predictors of suicidality.
Results The prevalence of lifetime suicide ideation was 26.5%, lifetime suicide plans were 18.2%, lifetime suicide
threat was 14.1%, and lifetime suicide attempt was 4.4%. The prevalence of 12-month suicide ideation was 43.1%. The
following variables were identified and significantly associated with suicidality (p<0.05): female students (AOR=1.912;
95%CI:1.507–2.425), chronic illness (AOR=2.886; 95%CI:1.545–5.389), low resilience (AOR=1.347; 95%CI:1.036–1.750),
low self-esteem (AOR=2.020; 95%CI:1.578–2.585), low family support (AOR=3.532; 95%CI:2.486–5.017), loneliness
(AOR=1.611; 95%CI:1.211–2.143), depression (AOR=4.882; 95%CI=3.861–6.175), and hopelessness (AOR=1.602;
95%CI:1.154–2.224). Nagelkerke R square was 0.364 indicating the regression model explained 36.4% of variance
in suicidality.
Conclusions Our study revealed several significant predictors of suicidality among adolescents which can be tar�geted to develop suicide prevention strategies