Suicidal behavior in adolescents and intrafamilial and gender violence: a narrative review

Conduta suicida em adolescentes e violências intrafamiliares e de gênero: revisão narrativa

Abstract

Objective

This study is a narrative review to consider how intrafamilial and gender violence can engender psychological suffering and suicidal behavior in adolescents.

Method

The Portal de Periódicos Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Literatura Latino-Americana e do Caribe em Ciências da Saúde, and Scientific Electronic Library Online databases were searched for publications about risk factors for suicide attempts and suicidal ideation in adolescents, between 2010 and 2020.

Results

Intrafamilial violence was found to be a risk factor. Most suicide attempts occur between 15 and 19 years and are mainly due to drug intake. Gender violence, especially homophobia, is a risk factor for ideation and suicide attempts among adolescents, especially bisexual adolescents.

Conclusion

Interventions concerning sexual education in schools, promotion of spaces for dialogues about suicide, and modification of the binary bias in studies about adolescent sexualities are necessary.

Keywords
Adolescent; Sexuality; Suicide

Resumo

Objetivo:

Trata-se de uma revisão narrativa com o objetivo de pensar sobre como as violências intrafamiliares e de gênero podem engendrar sofrimento psíquico e conduta suicida em adolescentes.

Método:

As bases de dados Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Literatura Latino Americana e do Caribe em Ciências da Saúde e Scientific Eletronic Library Online foram consultadas em busca de publicações sobre fatores de risco para tentativas de suicídio e ideação suicida em adolescentes, no período de 2010 a 2020.

Resultados:

Verificou-se a violência intrafamiliar como fator de risco para ideação e tentativas de suicídio em adolescentes. A maioria das tentativas de suicídio são de adolescentes entre 15 e 19 anos, principalmente por ingestão de fármacos. Evidenciou-se que a violência de gênero, sobretudo a homofobia, constitui-se um fator de risco para ideação e tentativas de suicídio entre adolescentes, sobretudo no que se refere aos adolescentes bissexuais.

Conclusão:

Há a necessidade de promover intervenções relativas à educação sexual nas escolas, além de espaços de diálogos acerca do suicídio e modificação do viés binário nos estudos acerca das sexualidades adolescentes.

Palavras-chave
Adolescente; Sexualidade; Suicídio

Youth represents continuity for a more human world in the current context, in which many lives are claimed by the Coronavirus Disease 2019 (COVID-19) pandemic, large-scale natural disasters, and increasingly technological wars. Estimates indicate that suicide is the second leading cause of death globally. Each year, approximately 800,000 deaths by suicide occur worldwide, which represents one death every 40 seconds, among which are young people aged 15 to 29 years (Cicogna et al., 2019; Oliveira et al., 2017; Penso & Sena, 2020; Picarelli et al., 2020).

However, it is necessary to differentiate suicide attempt, suicidal ideation, and suicidal behavior since the latter can be represented by the continuum: ideation, attempt, and suicide itself. These elements can be represented, respectively, through the categories: (a) thoughts of self-destruction (suicidal ideation), (b) self-aggression, manifested by suicidal gestures and suicide attempts, and, finally, (c) the consummation of suicide (W. S. S. Santos et al., 2016). Thus, any act by which individuals injure themselves, regardless of the degree of lethality, can be considered suicidal behavior.

Psychological disorders – especially depression (Brás et al., 2016), alcohol and other drug use, violence (sexual, psychological, and gender), dysfunctional family structure, history of suicide in the family, feelings of rejection, economic instability, residing in violent communities, unhealthy working conditions, and stressful experiences (Correia et al., 2019; Pereira et al., 2018; Hernández-Bello et al., 2020) have been indicated among the risk factors for suicidal behavior (including suicide attempts, suicidal ideation, and consummated suicide).

Although the concept is used as a synonym for domestic violence and violence against women, in this study, the term gender violence refers to the forms of violence (physical, sexual, psychological, symbolic, etc.) committed against individuals in vulnerable situations due to their gender identity and sexual orientation (Ministério da Saúde, 2013). Concerning gender differences, suicide attempts are more frequent in girls, while consummated suicide is higher among boys since they use more aggressive means in their attempts (Correia et al., 2019; Hernández-Bello et al., 2020; Pereira et al., 2018). However, each person can react differently to these factors. Although there is a lack of systematic, integrative, and narrative studies regarding this correlation, Nafaguchi and Adorno (2016) emphasize that suicide, as a social and cultural act, cannot be reduced to the use of the expression suicidal behavior, highlighting that it is difficult to be alive when your sexual orientation (orientation of affective-sexual desire – or lack thereof) and your gender identity are constantly put to the test by society.

This study aimed to address how intrafamilial and gender violence can engender psychological distress and, consequently, trigger suicidal ideation and suicide attempts in adolescents. Specifically, it seeks to identify the characteristics, meanings, and risk factors associated with suicide, as it becomes possible to access information about violence in interrelation with suicide through identification.

The theoretical perspective adopted for discussion and analysis of the studies consists of critical social psychology, especially in its view of adolescence as a phenomenon in becoming, in addition to biological and developmental issues (Berni & Roso, 2014; Campos et al., 2017; Ozella & Aguiar, 2008).

Method

This study is part of the master’s research “Information and Communication Technologies and Identity construction: dialogues with adolescents in a school”, approved by the Research Ethics Committee of (CAAE: 37234120.3.0000.5346). This is a narrative review of scientific articles published in indexed journals. Narrative reviews are broad publications appropriate to describe and discuss the development or “state of the art” of a specific subject, consisting of analysis of scientific writings, followed by interpretation and critical analysis, with a main contribution of deepening the understanding of a specific topic (Greenhalgh et al., 2018), assuming generic, integrative, and critical styles.

Procedures

From a critical design, the review had the definition of the research question (Stage 1): What factors are potential triggers of suicide attempts and the emergence of suicidal ideation among adolescents? Subsequently, we defined the descriptors for the search of the studies: “Adolescência”, “Tentativas de Suicídio”, “Ideação suicida”, and “Suicídio”, combined or not (Stage 2).

Next, the stage concerning the identification and selection of studies was undertaken (Stage 3) in the Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and the Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) database in July 2020, and Scientific Electronic Library Online (SciELO) in September. Inclusion (peer-reviewed journals, articles in full, published between 2010 and 2020, and published in Spanish and Portuguese) and exclusion criteria (study not conducted with adolescents and relatives of adolescents, partially available articles, and duplicate studies) were also applied as a search strategy.

The search for the studies initially took place in July 2020. The “search by subject” tool was selected in the CAPES Portal, using the “advanced search” option as a research strategy for the studies to reach articles that answered the research problem. The first stage was using the descriptors “Adolescence” and “Suicide Attempt”, operated by boolean AND. The result was 13,783 articles. Subsequently, exclusion criteria were applied, computing ten articles.

The LILACS search was conducted using the “Advanced Search” tool. The descriptors “adolescence”, “suicide attempt”, “suicidal ideation”, and “suicide” were used, operated by the boolean AND, performing combinations between the descriptors, resulting in 267 articles. The results were then refined based on the exclusion criteria, resulting in eight articles.

In addition to the searches conducted with the CAPES and Lilacs Portals in July 2020, a new search for studies with the same descriptors was carried out in September 2020 in the SciELO database. The search conducted in the SciELO database is justified by the COVID-19 pandemic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which may have triggered more attempts and ideations, and encouraged the publication of new studies. The initial result of the search indicated 22 articles, reaching five articles after reading in full and submitting to the exclusion criteria. Integrating all stages of the research resulted in a corpus of 23 studies.

Results

Suicide (attempts): Characteristics, Meanings, and Risk Factors

The highest prevalence of suicide attempts occurs between the ages of 8 and 16 (Bella, 2012; López & Vázquez, 2010). Similar data are indicated by Teixeira-Filho and Ronsini (2012), who found most suicide attempts between 14 and 16 years when considering the age of adolescents when they thought about suicide for both sexes, regardless of sexual orientation.

Inzunza et al. (2012) and S. A. Santos et al. (2009) indicate that the most significant prevalence of suicide attempts occurred among female adolescents aged between 14 and 16 years. Pacheco et al. (2010) found a higher incidence of suicide attempts among female adolescents aged 15 years, data corroborated by Collado et al. (2014), who list a higher prevalence in adolescents living in urban areas.

The intake of drugs is the means most used by adolescents, nationally and internationally, due to the ease of access (Azevedo & Dutra, 2012; Collado et al., 2014; Inzunza et al., 2012; S. A. Santos et al., 2009). There are similarities in the studies conducted by Bravo et al. (2012), S. A. Santos et al. (2009), González et al. (2017) and Inzunza et al. (2012), who indicated suicide attempts by drug intoxication of 100%, with most of the attempts committed by adolescents.

Regarding the meanings attributed to suicide, at first, the suicide attempt is experienced as something immediate, responding to a feeling of unbearable suffering. However, the conflicts faced by adolescents who attempt suicide, the feeling of shame and judgment resulting from the act, the difficulty of finding spaces to dialogue about the act, the way the attempt mobilizes the family, the discontent for having tried to take their own life are also important (Azevedo & Dutra, 2012).

The risk factors (social, environmental, and individual characteristics contributing to intensifying the risk situation) for pointed suicide attempts differ. We highlight those related to socioeconomic aspects, the school environment, those of a psychic order, and the family context, explained below.

Concerning risk factors related to social and economic aspects, extremely low socioeconomic levels are drivers of suicidal behavior, appearing as aggravating factors to the psychological state of adolescents with suicidal ideation (López & Vázquez, 2010; Mirabal & Bernal, 2015). In turn, S. A. Santos et al. (2009) indicate a low educational level, having a history of previous suicide attempts or previous psychiatric/psychological treatment, and alcohol/drug use at the time of the injury concerning sociodemographic and clinical-epidemiological characteristics with greater frequency. However, unemployment and low socioeconomic status increase the risk of suicide and suicide attempts in vulnerable individuals and those with a history of suicide attempts, with a low educational level and history of previous attempts considered significant factors.

Concerning the school context, the risk factors for the emergence of suicidal ideation and suicide attempts are abuse due to expressed exclusion, fear of being excluded by the peer group, group pressure to commit suicide, failure in school performance, high demands of parents and teachers during the exam period, suffering death threats or beatings, and suffering provocations at school. Disciplinary issues at school or legal situations to which the adolescent must respond, and academic stress, psychological, sexual, and physical abuse, with emphasis on beatings, are also risk factors (Álfaro, 2013; Bella & Fernández, 2010; Bravo et al., 2012; Pacheco et al., 2010; Valadez et al., 2011).

The school, as a space for socialization, has reproduced homophobic perspectives on sexualities and genders since there are few informative materials produced at the government level (or not) for the LGBTQIA+ youth population, and teachers do not know or are not prepared to address topics such as non-heteronormative sexualities in school.

In this sense, W. B. Santos and Dinis (2018) maintain that compulsory heteronormativity leads to valuing the homosexual, who is socially represented as one who takes an active role in the sexual relationship between men, to the detriment of demerit to what is seen as adopting a passive posture. Thus, the authors report expected standards of masculinity and different aesthetics, with the sexuality of adolescents restricted to the scope of scientific discourses and practices, taken as the final words society accepts, disseminates, and values.

Receiving psychiatric treatment, the presence of mental disorders, and psychopathological antecedents, especially mood disorders, with emphasis on depression and previous suicide attempts, are psychic risk factors (García-Rábago et al., 2010; Inzunza et al., 2012; Valadez et al., 2011). Still, studies also cite physical aggression, humiliation, the feeling of rejection, vulnerability to chaotic environments, low self-esteem, feelings of loneliness, and social isolation (Alfaro, 2013; Bella & Fernández, 2010; Bravo et al., 2012; García et al., 2011; Inzunza et al., 2012; Pacheco et al., 2010; Valadez et al., 2011).

Considering these factors, we will deepen the issue of intrafamilial violence and, subsequently, gender violence. Both forms of violence are sociocultural constructs and constitute risk factors for suicide.

Intrafamilial and Gender-Based Violence

Espinoza-Gomez et al. (2010) and Garcia et al. (2011) found an association between sexual abuse committed in the home and suicidal behavior, although the aggressor is not specified. The study also indicates that physical violence can lead to suicidal behavior and, eventually, consummation of suicide. The same authors noted that conflictive relationships between parents and children lead to suicidal ideation.

Alfaro (2013) states that adolescents who commit suicide usually come from families with economic, social, and cultural vulnerabilities and changes in relationships within and outside the family group or what could be called multiform families. In addition, they consist of families that, due to their intrafamilial characteristics or the environment in which they live, can be classified as high risk due to poor access to education and exposure to adverse family situations. Espinoza-Gómez et al. (2010) also found associations between low socioeconomic status and a certain positive association with suicidal behavior and the perception of domestic violence in all its forms, especially with sexual abuse.

In this perspective, Pavez et al. (2009) found significant statistical associations between family risk factors and suicidal ideation in adolescents, indicating the family context and the suicidal intention of another family member as important elements. Likewise, Azevedo and Dutra (2012) indicate that the presence of a family environment marked by the disruption of its main nuclei, such as the loss of a loved one or the separation of parents, marks the lives of adolescents.

Problematic family dynamics and an environment without harmony, cohesion, affectivity, and good communication are risk factors for suicidal ideation (Alfaro, 2013; Bella & Fernández, 2010; González et al., 2017; Inzunza et al., 2012; Mirabal & Bernal, 2015). Similarly, Correia et al. (2019) warn of the interface between suicidal behavior and the feeling of contempt and rejection and reveal that sexual violence committed by people of “trust” and power in family ties, physical aggression perpetrated by parents can result in mental suffering and possibly unfold in self-destructive and suicidal behaviors.

Thinking about interpersonal family relationships as risk factors for suicidal behavior, Rossi et al. (2019) indicate that, when experienced violently, these relationships can trigger or appear to cause psychic suffering in their different forms. The authors emphasize that the lack of access to social support networks and exposure to various types of intrafamily violence for prolonged periods, be it physical, psychological, sexual, or neglect, are associated with self and hetero-aggressiveness and difficulties in impulse control with possible suicidal behavior.

From this perspective, Bravo et al. (2012) warn that child and adolescent suicidal behaviors have long been delegitimized and associated with bad behaviors and reactive expressions in the face of family conflict situations. This interpretation, in the authors’ understanding, led to a delayed understanding of the different factors that intervene in the mental health of these individuals. Experiences of physical and verbal violence and sexual abuse at home were associated with suicidal ideation (Espinoza-Gómez et al., 2010; González et al., 2017; López & Vázquez, 2010; Pérez-Amezcua et al., 2010).

Souto et al. (2017) observed a statistically significant difference in almost all variables regarding the prevalence of gender violence compared to the proportions of pregnancy characteristics, childbirth, and babies born to girls aged up to 13 years, with and without rape notification. Homosexual adolescents are more likely to think about and attempt suicide compared to heterosexual adolescents, as pointed out by Teixeira-Filho and Rondini (2012). Homosexual individuals are three times more likely to attempt suicide than heterosexuals, with emphasis on those who consider themselves bisexual or who have not yet defined themselves.

In this sense, Teixeira-Filho et al. (2011) warn that many non-heterosexual adolescents who have thought about suicide have been victims of discrimination and aggression perpetrated by close people and in various places where they circulate. Adolescents who came out suffered more discrimination in these same spaces compared to those who did not come out, and bisexual adolescents, whether they came out or not, most thought about killing themselves, followed by those who did not come out.

Thus, violence (in this case, homophobia) is naturalized in the discourse and gender education of these young women as an internalized and constitutive factor of subjectivities in our society, with homophobic discourses and practices responsible for placing LGBTQIA+ young women at risk (Teixeira-Filho et al., 2011)

Espinoza-Gómez et al. (2010) warn that suicidal ideation and the perception of violence, in all its forms, have significantly greater consequences among women, treating suicidal ideation and suicide attempts as a public health issue among university adolescents, especially regarding the higher frequency among adolescents, in close relationship with domestic violence. Similar information was reported by Teixeira-Filho et al. (2011), Ventura-Juncá et al. (2010), and Pacheco et al. (2010), who observed the prevalence of suicidal thoughts and suicide among adolescents, focusing on gender as a significant factor.

Considering oneself male was also shown to be a risk factor for suicide in children under 12 years of age (Alfaro, 2013; Bella, 2012) since the construction of the masculine as an experience triggers suffering, restlessness, and can contribute to an increase in the suicide rate among adolescent boys aged between 14 and 24 years (W. B. Santos & Dinis, 2018).

Discussion

Effects of Gender on Adolescents and their Relationship with Suicidal Behavior

Considering the primary objective of the review, we sought to verify how gender violence can engender psychological distress and, consequently, trigger suicidal behaviors in adolescents. A careful reading of all the articles analyzed allowed us to specifically identify gender violence as a significant risk factor, focusing on its occurrence in the family and school context. This makes us question the impacts of heteronormativity on adolescents. To this end, we must understand how science, families, and societies have thought/represented adolescence.

From a critical social perspective of the adolescent process (Berni & Roso, 2014; Campos et al., 2017; Ozella & Aguiar, 2008), we understand that the studies analyzed mostly use a theoretical scope with a developmental biological bias in understanding adolescence. However, adolescence must be understood as a process that involves more than physical, psychological, and social transformations. It must be considered a social fabrication, a process of becoming, transforming, and metamorphosing, constructed and modified through experiences permeated by the sociocultural context.

Although some articles criticize the binary model, there is a predominance of a theoretical/epistemological framework based on gender binarism (female and male sex) in most of the studies evaluated. The understanding of gender is mostly linked to sex, dividing the relationships between men and women into two distinct and disconnected axes, male = man and female = woman. Thus, in addition to the (bio)physiological elements, the sociocultural, structural, institutional, and subjective dimensions fabricating multiple modes of gender expression are disregarded (M. R. Santos, 2018).

Binarism culminates in ways of seeing and representing masculinities and femininities, contributing to maintaining compulsory heteronormativity, sustained and operated through social representations of gender as a biological category relative to the female and male sex, as “natural, stable, and opposite”. This scenario has led to a significant increase in suicide attempts and completed suicides among adolescents, especially women, who would be “more susceptible” due to personality traits (Saraiva et al., 2020; Schlichting & Moraes, 2018). Thus, it is relevant to expand the possibilities of understanding gender beyond sex=gender and hegemonic and compulsory heterosexuality to the distorted and commonplace use of the term “gender ideology”, used in conservative discourses in the current Brazilian political scenario (Reis & Eggert, 2017).

Therefore, supported by the view of Critical Social Psychology and, in particular, in the assumptions of Martin-Baró (2003), we understand that violence comes from the social and historical conditions experienced by the human being and is, thus, related to the form of social organization. Adopting the author’s critical perspective, violence constitutes a social phenomenon expressed in many ways. Therefore, violence can be considered plural, and, despite some specificities, it is not an individual problem.

In this sense, what violence is will fundamentally depend on the period of social development. Considering the political scenario of Brazil, waves of conservatism sustained by the expansion of the evangelical caucus in the political sphere, among other reasons, have triggered a series of setbacks concerning gender issues and sex education policies. Such setbacks can be considered violence that has spread through public policies, especially in education and health.

From the socio-political and economic context, it is understood that intrafamilial violence has its origins in the hierarchical constitution (and the “remnants” of the traditional colonial crystal family) of the family, through which many parents think they are “owners” of the adolescent’s experience and place it under their beliefs and ideas. In their descriptive sectional study, Pinto et al. (2020) demonstrate that family members were the most frequent authors of violence reported in LGBTQIA+ adolescents ages 10-14 and 15-19.

However, considering the critical perspective, social determinants also consist of important elements. In this bias, regarding low socioeconomic status and its association (as a risk factor) with suicidal ideation and conduct, it should be noted that suicide has been associated with precarious work, unemployment, and outsourcing, among others (Cassorla, 2017). Thus, social and working conditions and the current economic system should be studied to reach higher complexities in discussing socioeconomic level as a risk factor.

Resuming the issue of gender violence directed at adolescents declared homosexual, in addition to families, the school, as a political space of socialization, becomes conniving with (and promotes) violence against homosexuals and bisexuals when “indecisive” and “promiscuous”, failing to address sexual differences, often based on the social logic of compulsory heterosexuality.

The critical perspective shows that the perpetrators of violence, especially gender violence, and those who suffer such violence are subjects immersed in a racist, sexist, capitalist, and homophobic culture perpetuated for generations, being producers and reproducers of such culture. The need to assume that culture is more a map than a set of imposed prescriptions follows. This map “guides people and makes them combine the prescriptions in their concrete relationships with others and the world” (Gregori, 1993, p. 201). This theory also addresses how those populations are not recognized as lives worthy of being lived in our society.

Heterosexuality is considered the majority social representation in the world. These are couples of men and women that we see on television and in magazines. When parents discover they will have a child, they picture a couple with opposing genders. This is what Christianity, one of the pillars of society, approves of. All these cultural conditions leave no loopholes for sexuality (and subjectivity) different from the institutionalized norm, generating a violent and often fatal strangeness for people who live their love for the same gender explicitly (Silva & Tílio, 2018). Such consequences are embedded in culture, in the innermost depths of the psychic.

Final Consideration

This study aimed to address how intrafamilial and gender violence can engender psychological distress and, consequently, trigger suicidal ideation and suicide attempts in adolescents. It was demonstrated that violence, especially gender violence, has a strictly direct relationship with developing suicidal ideation and, consequently, suicide attempts among adolescents. Violence experienced in the family environment emerges as a risk factor for suicidal ideation, suicide attempts, and the consummation of adolescent suicide, especially when relationships are marked by gender violence.

We found that certain risk factors are prominent in suicidal behavior, such as having low self-esteem, feeling alone and socially isolated, the presence of mental disorders, especially mood disorders, with emphasis on depression, and being in psychiatric treatment. The age group between 15 and 19 seems to be the most susceptible. The use of drugs is indicated as one of the most commonly used methods to commit suicide, especially among adolescent girls. The use of sharp objects, hanging, and pesticides/agrochemicals (especially in rural areas) are also frequent practices.

Protective factors (social, environmental, and individual characteristics that can mitigate the risk) were also identified, such as a healthy work environment, prevention and treatment of depression and alcohol and psychoactive substance abuse, good relationship with the environment, and good relationship and communication with the family. Other examples of protective factors are encouraging the development of good social skills/relationships, self-confidence, social integration, and good affective bonds with schoolmates, teachers, and other adults.

Possible prevention measures in the school context and in other public spaces include changing the educational system, considering that it is still bound to heterocentric norms and rules, hindering the free expression of non-hetero-normativized desires and behaviors, reinforcing homophobia, gender inequities, and school exclusion. The need for training professionals who have contact with adolescents is also indicated so that they can identify suicidal thoughts and self-destructive behaviors of adolescents inserted in the context of domestic abuse (intrafamilial violence) by qualified listening, considering individual needs in times of crisis.

Despite the suggestions and recommendations, much must be advanced concerning suicide. Thus, it is necessary to replace exclusively medical-centered practices with those that give movement to the plot that permeates the senses regarding the crisis experienced by adolescents who experience psychological suffering to mitigate the repercussions of these experiences.

The period chosen (last ten years) stands out as a limitation of this study, although studies carried out in other Latin American contexts have been contemplated. Further studies must be conducted, especially on the relationship between gender and suicide attempts, since the present investigation identified heteronormativity as a significant risk factor. In addition, the increase in studies on the impacts of homophobia on mental health can be one of the possible and important solutions.

• Article based on the dissertation of C. SANTOS, entitled “Tecnologias da Informação e Comunicação (TIC): diálogos com adolescentes em uma escola”. Universidade Federal de Santa Maria, 2021.
• How to cite this article: Santos, C., Roso, A., Dalcanal, A. L., Pedroso, E.C., & Araujo, L. V. (2023). Suicidal behavior in adolescents and intrafamilial and gender violence: a narrative review. Estudos de Psicologia (Campinas), 40, e200246. https://doi.org/10.1590/1982-0275202340e200246

• Support

  Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Process nº 88882.428024/2019-01) and Conselho Nacional de Desenvolvimento Científico e Tecnológico / Productivity Scholarship in Research of the second author (Process nº 302684/2019-0).

References

• Alfaro, A. C. (2013). Conducta suicida adolescencia y riesgo. Revista Cubana de Medicina General Integral, 30(1), 132-139.
• Berni, V. L., & Roso, A. (2014). A adolescência na perspectiva da psicologia social crítica. Psicologia & Sociedade, 26(1), 126-136. https://doi.org/10.1590/S0102-71822014000100014
  » https://doi.org/10.1590/S0102-71822014000100014
• Azevedo, A. K. S., & Dutra, E. M. S. (2012). Relação amorosa e tentativa de suicídio na adolescência: uma questão de (des)amor. Revista da Abordagem Gestáltica, 18(1), 20-29. http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1809-68672012000100004
  » http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1809-68672012000100004
• Bella, M. E. (2012). Comportamientos de riesgo para la salud en niños y adolescentes con intentos de suicidio y en sus familiares. Revista Médica do Chile, 140(11), 1417-1424. http://dx.doi.org/10.4067/S0034-98872012001100006
  » https://doi.org/10.4067/S0034-98872012001100006
• Bella, M. E., & Fernández, R. A. (2010). Identificación de factores de riesgo en intentos de suicidio en niños y adolescentes. Revista Argentina de Salud Pública, 1(3), 24-29.
• Brás, M., Jesus, S., & Carmo, C. (2016). Fatores psicológicos de risco e protetores associados à ideação Suicida em Adolescentes. Psicologia, Saúde & Doenças, 17(2), 132-149. http://dx.doi.org/10.15309/16psd170203
  » https://doi.org/10.15309/16psd170203
• Bravo, V., Román, M., Bettini, P. C., Mieres, J. J., Paris, E., & Rios, J. C. (2012). Caracterización de la ingestión por sobredosis de paracetamol. Reporte de un centro de información toxicológica chileno. Revista Médica do Chile, 140(3), 313-318. http://dx.doi.org/10.4067/S0034-98872012000300005
  » https://doi.org/10.4067/S0034-98872012000300005
• Campos, H. M., Paiva, C. G. A., Mourthé, I. C. A., Ferreira, Y. F., & Fonseca, M. C. (2017). Direitos humanos, cidadania sexual e promoção de saúde: diálogos de saberes entre pesquisadores e adolescentes. Revista Saúde Debate, 41(113), 658-669. https://doi.org/10.1590/0103-1104201711324
  » https://doi.org/10.1590/0103-1104201711324
• Cassorla, R. M. S. (2017). Suicídio: fatores inconscientes e aspectos socioculturais Blucher.
• Cicogna, J. I. R., Hillesheim, D., & Hallal, A. L. L. C. (2019). Mortalidade por suicídio de adolescentes no Brasil: tendência temporal de crescimento entre 2000 e 2015. Jornal Brasileiro de Psiquiatria, 68(1), 1-7. https://doi.org/10.1590/0047-2085000000218
  » https://doi.org/10.1590/0047-2085000000218
• Collado, J. P., Collado, T. P., Collado, M. A., & Martínez, G. M. (2014) Intento suicida en adolescentes, un problema de salud en la comunidad. Revista Cubana de Investigaciones Biomédicas, 33(1), 70-80.
• Correia, C. M., Gomes, N. P., Diniz, N. M. F., Andrade, I. C. S., Romano, C. M. C., & Rodrigues, G. R. S. (2019). Child and adolescent violence: oral story of women who attempted suicide. Revista Brasileira de Enfermagem, 72(6), 1525-1532. http://dx.doi.org/10.1590/0034-7167-2017-0814
  » https://doi.org/10.1590/0034-7167-2017-0814
• Espinoza-Gomez, F., Zepeda-Pamplona, V, Bautista-Hernández, V., Hernández-Suárez, C., M., Newton-Sánchez, O. A., & Plasencia-García, G. R. (2010). Violencia doméstica y riesgo de conducta suicida en universitarios adolescentes. Salud Publica, 52(3), 213-219.
• García, J. E. G. A., Montoya, R. Q., Loyo, L. M. S., López, T. M., & Gaitán, J. I. C. (2011). Consenso Cultural sobre el Intento de Suicidio en Adolescentes. Revista Colombiana de Psicología, 20(2), 167-179. http://www.scielo.org.co/scielo.php?script=sci_abstract&pid=S012154692011000200002&lng=pt&nrm=iso&tlng=es
  » http://www.scielo.org.co/scielo.php?script=sci_abstract&pid=S012154692011000200002&lng=pt&nrm=iso&tlng=es
• García-Rábago, H., Sahagún-Flores, J. E., Ruiz-Gómez, A., Sánchez-Ureña, J. M., Tirado-Vargas, J. C., & González-Gámez, J. G. (2010). Factores de riesgo, asociados a intento de suicídio, comparando factores de alta y baja letalidad. Revista Médica de Chile, 12(5), 713-721. https://doi.org/10.1590/S0124-00642010000500002
  » https://doi.org/10.1590/S0124-00642010000500002
• González, R. M., García, L. M., & Lozano, D. M. F. (2017). Funcionamiento familiar e intento suicida en escolares. Revista Cubana de Medicina General Integral, 33(3), 281-295. https://www.medigraphic.com/pdfs/revcubmedgenint/cmi-2017/cmi173b.pdf
  » https://www.medigraphic.com/pdfs/revcubmedgenint/cmi-2017/cmi173b.pdf
• Greenhalgh, T., Thorne, S., & Malterud, K. (2018). Time to challenge the spurious hierarchy of systematic over narrative reviews? European Journal Clinical Investigation, 48, e12931. https://doi.org/10.1111/eci.12931
  » https://doi.org/10.1111/eci.12931
• Gregori, M. F. (1993). Cenas e queixas: um estudo sobre mulheres, relações violentas e a prática feminista Paz e terra.
• Hernández-Bello, l., Hueso-Montoro, C., Gómez-Urquiza, J. L., & Cogollo-Milanés, Z. (2020). Prevalencia y factores asociados a la ideacion e intento de suicidio en adolescentes revisión sistematica. Revista Española de Salud Pública, 94(10), 1-15, e202009094. https://www.sanidad.gob.es/biblioPublic/publicaciones/recursos_propios/resp/revista_cdrom/VOL94/REVISIONES/RS94C_202009094.pdf
  » https://www.sanidad.gob.es/biblioPublic/publicaciones/recursos_propios/resp/revista_cdrom/VOL94/REVISIONES/RS94C_202009094.pdf
• Inzunza, C. C., Nava, F., & Brehme, C. A. (2012). Conducta suicida en niños y adolescentes ingresados en un hospital general: análisis descriptivo. Revista Medica de Chile, 140(6), 751-762. https://doi.org/10.4067/S0034-98872012000600009
  » https://doi.org/10.4067/S0034-98872012000600009
• López, J. N., & Vázquez, M. (2010). Factores de riesgo de intento suicida en adolescentes. Medisan, 14(3), 353-358. https://www.redalyc.org/pdf/3684/368445239011.pdf
  » https://www.redalyc.org/pdf/3684/368445239011.pdf
• Martin-Baró, I. (2003). Las raíces estructurales de la violencia. In I. Martin-Baró (Ed.), Poder, Ideologia y violencia Trotta.
• Ministério da Saúde (Brasil). (2013). Política nacional de saúde integral de lésbicas, gays, bissexuais, travestis e transexuais https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_saude_lesbicas_gays.pdf
  » https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_saude_lesbicas_gays.pdf
• Mirabal, L. C. H., & Bernal, I. L. (2015). Principales características psicosociales de adolescentes con intento suicida. Revista Cubana de Medicina General Integral, 31(2), 182-189. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S086421252015000200007
  » http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S086421252015000200007
• Nafaguchi, T., & Adorno, R. C. F. (2016). Suicídio, Gênero e Sexualidade na era digital. Saúde & Transformação Social, 7(3), 22-35. http://incubadora.periodicos.ufsc.br/index.php/saudeetransformacao/article/view/4199
  » http://incubadora.periodicos.ufsc.br/index.php/saudeetransformacao/article/view/4199
• Oliveira, A. M., Bicalho, C. M. S., Teruel, F. M., Kahey, L. L., & Botti, N. C. L. (2017). Comportamento suicida entre adolescentes: revisão integrativa da literatura nacional. Adolescência & Saúde, 14(1), 88-96. http://adolescenciaesaude.com/detalhe_artigo.asp?id=639
  » http://adolescenciaesaude.com/detalhe_artigo.asp?id=639
• Ozella, S., & Aguiar, W. M. J. (2008). Desmistificando a concepção de adolescência. Cadernos de Pesquisa. 38(133), 97-125. https://doi.org/10.1590/S0100-15742008000100005
  » https://doi.org/10.1590/S0100-15742008000100005
• Pacheco, P. B., Lizana, P. C., & Celhay, I. S. (2010). Diferencias clínicas entre adolescentes hospitalizados por intento suicida y adolescentes hospitalizados por outra causa psiquiátrica. Revista Médica de Chile, 138(2), 160-167. http://dx.doi.org/10.4067/S003498872010000200003
  » https://doi.org/10.4067/S003498872010000200003
• Pavez, P., Santandera, N., Carranza, J., & Vera-Villarro, P. (2009). Factores de riesgo familiares asociados a la conducta suicida en adolescentes con trastorno depresivo. Revista Médica do Chile, 137(2), 226-233. http://dx.doi.org/10.4067/S0034-98872009000200006
  » https://doi.org/10.4067/S0034-98872009000200006
• Penso, M. A., & Sena, D. P. A. (2020). A desesperança do jovem e o suicídio como solução. Sociedade & Estado, 35(1), 61-81. http://dx.doi.org/10.1590/s0102-6992-202035010004
  » https://doi.org/10.1590/s0102-6992-202035010004
• Pereira, A. S., Rodrigues, S., Willhelm, A. R., Koller, S. H., & Almeida, R. M. M. (2018). Fatores de risco e proteção para tentativa de suicídio na adultez emergente. Ciência & Saúde Coletiva, 23(11), 3767-3777. https://doi.org/10.1590/1413-812320182311.29112016
  » https://doi.org/10.1590/1413-812320182311.29112016
• Pérez-Amezcua, B., Rivera-Rivera, L., Atienzo, E. E., Castro, F., Leyva-López, A., & Chávez-Ayala, R. (2010). Prevalencia y factores asociados a la ideación e intento suicida en adolescentes de educación media superior de la República mexicana. Salud Pública de México, 52(4), 324-333. http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S003636342010000400008
  » http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S003636342010000400008
• Picarelli, C., Hübner, C., & Rodrigues, C. (2020). Prevenção de suicídio: modificando percepção e conhecimento de estudantes de medicina. Psicologia, Saúde & Doenças, 21(2), 446-455. http://dx.doi.org/10.15309/20psd210219
  » https://doi.org/10.15309/20psd210219
• Pinto, I. V., Andrade, S. S. A., Rodrigues, K. L., Santos, M. A. S., Marinho, M. M. A., Correia, R. S. de B., Benigno, L. A., Polidoro, M., & Canavese, D. (2020). Perfil das notificações de violências em lésbicas, gays, bissexuais, travestis e transexuais registradas no Sistema de Informação de Agravos de Notificação, Brasil, 2015 a 2017. Revista Brasileira de Epidemiologia, 23, 1-13. https://doi.org/10.1590/1980549720200006.supl.1
  » https://doi.org/10.1590/1980549720200006.supl.1
• Reis, T., & Eggert, E. (2017). Ideologia de gênero: uma falácia construída sobre os planos de educação brasileiros. Revista Educação e Sociedade, 38(138), 9-26. https://doi.org/10.1590/ES0101-73302017165522
  » https://doi.org/10.1590/ES0101-73302017165522
• Rossi, L. M., Marcolino, T. Q., Speranza, M., & Cid, M. F. B. (2019). Crise e saúde mental na adolescência: a história sob a ótica de quem vive. Cadernos de Saúde Pública, 35(3), 1-12. https://doi.org/10.1590/0102-311x00125018
  » https://doi.org/10.1590/0102-311x00125018
• Santos, M. R. (2018). Gênero e cultura material: a dimensão política dos artefatos cotidianos. Revista Estudos Feministas, 26(1), 1-8. http://dx.doi.org/10.1590/18069584.2018v26n137361
  » https://doi.org/10.1590/18069584.2018v26n137361
• Santos, S. A., Lovisi, G., Legay, l., & Abelha, L. A. (2009). Prevalência de transtornos mentais nas tentativas de suicídio em um hospital de emergência no Rio de Janeiro, Brasil. Cadernos de Saúde Pública, 25(9), 2064-2074. https://doi.org/10.1590/S0102-311X2009000900020
  » https://doi.org/10.1590/S0102-311X2009000900020
• Santos, W. B., & Dinis, N. F. (2018). Violência e risco de suicídio na construção de masculinidades adolescentes. Cadernos Pagu, 52, 1-36. http://dx.doi.org/10.1590/18094449201800520018
  » https://doi.org/10.1590/18094449201800520018
• Santos, W. S. S., Ulisses, S. M., Costa, T. M., Farias, M. G., & Moura, D. P. F. (2016). A influência de fatores de risco e proteção frente à ideação suicida. Psicologia, Saúde & Doenças, 17(3), 515-526. http://dx.doi.org/10.15309/16psd170316
  » https://doi.org/10.15309/16psd170316
• Saraiva, L. A. S., Santos, L. T., & Pereira, J. F. F. (2020). Heteronormativity, masculinity and prejudice in mobile apps: the case of grindr in a Brazilian city. Brazilian Business Review, 17(1), 115-131. https://doi.org/10.15728/bbr.2020.17.1.6
  » https://doi.org/10.15728/bbr.2020.17.1.6
• Schlichting, C. A., & Moraes, M. C. L. (2018). Mortalidade por suicídio na adolescência: uma revisão. Revista Família, Ciclos de Vida e Saúde no Contexto Social, 6(1), 357-363. https://doi.org/10.18554/refacs.v6i0.2922
  » https://doi.org/10.18554/refacs.v6i0.2922
• Silva, B. C. A., & Tilio, R. (2018). O segredo de Brokeback Mountain e boi Neon: paisagens, masculinidades e normatividades de gênero. La Ventana, 6(48), 168-205.
• Souto, R. M. C. V., Porto, D. L., Pinto, I. V., Vidotti, C. C. F., Barufaldi, L. A., Freitas, M. G., Silva, M. M. A., & Lima, C. M. (2017). Estupro e gravidez de meninas de até 13 anos no Brasil: características e implicações na saúde gestacional, parto e nascimento. Ciência & Saúde Coletiva, 22(9), 2909-2918. https://doi.org/10.1590/1413-81232017229.13312017
  » https://doi.org/10.1590/1413-81232017229.13312017
• Teixeira-Filho, F. S., Rondini, C. A., & Bessa, J. C (2011). Reflexões sobre homofobia e educação em escolas do interior paulista. Educação e Pesquisa, 37(4), 725-742. https://doi.org/10.1590/S1517-97022011000400004
  » https://doi.org/10.1590/S1517-97022011000400004
• Teixeira-Filho, F. S., & Rondini, C. A. (2012). Ideações e tentativas de suicídio em adolescentes com práticas sexuais hetero e homoeróticas. Saúde e Sociedade, 21(3), 651-667. http://dx.doi.org/10.1590/S0104-12902012000300011
  » https://doi.org/10.1590/S0104-12902012000300011
• Valadez, I., Amezcua, R., González, N., Montes, R., & Vargas, V. (2011). Maltrato entre iguales e intento suicida en sujetos adolescentes escolarizados. Revista Latinoamericana de Ciencias Sociales, Niñez y Juventud, 9(2), 783-796. https://www.redalyc.org/articulo.oa?id=77321592020
  » https://www.redalyc.org/articulo.oa?id=77321592020
• Ventura-Juncá, R. D., Carvajal, C., Undurragaa, S., Vicuña, P., Egaña, J., & Garib, M. J. (2010). Prevalencia de ideación e intento suicida en adolescentes de la región metropolitana de Santiago de Chile. Revista Médica de Chile, 138, 309-315. http://dx.doi.org/10.4067/S0034-98872010000300008
  » https://doi.org/10.4067/S0034-98872010000300008

Edited by

Editor

Raquel Souza Lobo Guzzo

Publication Dates

• Publication in this collection
  10 Nov 2023
• Date of issue
  2023

History

• Received
  11 Jan 2021
• Reviewed
  04 Apr 2023
• Accepted
  18 July 2023