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Continuity and commitment in adolescence : a cognitive-developmental study of suicidal and nonsuicidal youth Ball, Lorraine Vivien

Abstract

This research was conducted in the hope of making some contribution to the emerging field of developmental psychopathology through an examination of the relations between progressive movement toward social-cognitive maturity and socioemotional adjustment in adolescence. The two developmental matters of particular concern were the contrastive ways in which suicidal and nonsuicidal adolescents undertake to secure a sense of their own personal continuity across time, and a sense of conviction in the face of growing skeptical doubts. Alternative accounts of suicidal behaviour generally fail to offer any explanatory framework with which to account for the sudden and dramatic increase in suicidal behaviour during the adolescent years. It is argued in this thesis that the self-destructive tendencies of suicidal youth may be better understood as behavioural manifestations of difficulties in dealing with the developmental matters of personal continuity and nascent skeptical doubt More specifically, the arguments presented in this thesis lead to the hypotheses that suicidal adolescents are less able than their nonsuicidal age-mates to 1) adequately warrant their own and others' persistent identity across time, and 2) make use of more mature strategies for dealing with issues of uncertainty and doubt. To test these predictions, 29 psychiatrically hospitalized suicidal adolescents, who were subsequently categorized in to either a high suicide risk group (n=13) or a low suicide risk group (n =16), and an age- and sex-matched group of 29 high school students were individually administered: (1) The Continuity Measure, comprised of 2 stories and a semi-structured interview procedure which inquires into how subjects warrant their own and others' personal continuity in the face of dramatic personal change; (2) The Nascent Skeptical Doubt Interview, also comprised of 2 stories and an associated semi-structured interview procedure aimed at determining subjects' characteristic strategies for dealing with uncertainty; and (3) The Nascent Skeptical Doubt Questionnaire, which permits the placement of respondents along an objectivist-relativist dimension. The results of this study indicate that, in comparison to their nonhospitalized age-mates, the psychiatrically hospitalized suicidal adolescents did evidence difficulties both in their abilities to understand how they and others could be said to remain continuous or self-same persons throughout time, and in their ability to cope with questions of uncertainty and doubt. In addition, adolescents at high risk for suicide were distinguished from other psychiatrically hospitalized individuals at low risk to suicide, and from their high school age-mates by: 1) their unique inability to find any workable means of justifying persistent identity across change; and 2) by their more extreme endorsement of absolutistic views in the face of uncertainty. These findings are seen to lend support to the general theoretical attempt of this thesis to interpret certain socioemotional difficulties experienced by adolescents as arising from a developmental asynchrony between progressive movement toward the more abstract, relativized, and self-reflective modes of thought associated with cognitive maturity, and the task of securing more mature strategies for dealing with the reconceptualizations of the problems of continuity and doubt which these cognitive advances necessitate. In addition, a number of theoretical, diagnostic, and treatment implications which are seen to follow from the results of this study are discussed.

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