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  • Introduction Suicide is the leading cause of

    2018-10-24

    Introduction Suicide is the leading cause of death among young people in Australia, accounting for 25% of all deaths in the age groups 15–30 years (ABS, 2012). Non-fatal suicidal behaviours are also particularly prevalent among young people (Martin, Swannell, Hazell, Harrison, & Taylor, 2010). A number of important risk factors for suicide among young people have been identified, including a psychiatric diagnosis, family history of suicide, stressful life events, and access to means (Gould, Greenberg, Velting, & Shaffer, 2003). However, there is relatively limited research on protective factors for suicide. Social connections (a person׳s subjective sense of having close and positively experienced relationships with others) (Seppala, Rossomando, & Doty, 2013, p. 412) are potential protective factors for suicide. At an individual level, family (closeness and caring from family) and school connections (a feeling of connection to the school environment) have been found to be associated with lower risk of suicide attempt in a cross-sectional survey of young people in the United States (Hall-Lande, Eisenberg, Christenson, & Neumark-Sztainer, 2007). Lower levels of social connections were associated with an increased risk of suicide attempt in a hospital-based case control study of adults (Compton, Thompson, & Kaslow, 2005). A longitudinal cohort of male health professionals by Kawachi et al. (1996), found that socially isolated men (not married, fewer than six friends or relatives, no membership in church or histone deacetylase inhibitors groups) were at increased risk of death from accidents and suicides compared to men with the highest level of social networks. This suggests that people with a greater number of social connections may have lower risk of suicide than those with fewer social connections. Social connections at the wider neighbourhood and societal level may also be protective factors for suicide, although there may be some differences across different cultural contexts. An ecological study, set in Japan, found that areas with higher feelings of social trust had lower suicide rates than areas those with lower social trust (Okamoto, Kawakami, Kido, & Sakurai, 2013), while a Dutch study found that higher levels of neighbourhood attachment, degree of interaction with neighbours, and responsibility for the environment were associated with lower suicide rates at an area level (Kunst, van Hooijdonk, Droomers, & Mackenbach, 2013). Social support is a multifactorial “metaconstruct” comprised of several different theoretical constructs (Vaux, 1988). Four of the main constructs studied in social support research include emotional (demonstrations of love and caring, esteem and value, encouragement, and sympathy), informational (provision of facts or advice), instructional (offering or supplying behavioural or material assistance with practical tasks or problems), and appraisal support (the communication of information that which is relevant to self-evaluation). These different types of support may operate separately or together (Thoits, 2011). For example it is likely that social support provides an avenue for persons to feel as though they matter to others, leading to greater self-esteem. Advice from others about problems may also lead to behavioural changes and reduce perceived life problems and stressors. Other perspectives relevant to the social support literature (particularly measurement of social support) is whether the support is received or perceived. Measures of received social support refer to the specific supportive behaviours provided to recipients by their support networks (Haber, Cohen, Lucas, & Baltes, 2007). Perceived social support measures refer to a recipients’ perception of the general availability of support and/or global satisfaction with support provided (Haber et al., 2007). There is considerable evidence that perceived social connections have a greater influence on health outcomes than received social support (Thoits, 2011; Turner & Marino, 1994).