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. 2020 Sep 11;7(9):e18383.
doi: 10.2196/18383.

Suicidal Thoughts and Behaviors and Their Associations With Transitional Life Events in Men and Women: Findings From an International Web-Based Sample

Alyssa Clare Milton  1 , Tracey A Davenport  1 , Frank Iorfino  1 , Anna Flego  2 , Jane M Burns  3 , Ian B Hickie  1
Affiliations

Suicidal Thoughts and Behaviors and Their Associations With Transitional Life Events in Men and Women: Findings From an International Web-Based Sample

Alyssa Clare Milton et al. JMIR Ment Health. .

Abstract

Background: Although numerous studies have demonstrated sex differences in the prevalence of suicidal thoughts and behaviors (STB), there is a clear lack of research examining the similarities and differences between men and women in terms of the relationship between STB, transitional life events, and the coping strategies employed after experiencing such events when they are perceived as stressful.

Objective: This study aims to examine the differences between men's and women's experiences of STB, sociodemographic predictors of STB, and how coping responses after experiencing a stressful transitional life event predict STB.

Methods: A web-based self-report survey was used to assess the health and well-being of a voluntary community-based sample of men and women aged 16 years and older, living in Australia, Canada, New Zealand, the United Kingdom, and the United States, who were recruited using web-based social media promotion and snowballing.

Results: In total, 10,765 eligible web-based respondents participated. Compared with men, a significantly greater proportion of women reported STB (P<.001) and endorsed experiencing a transitional life event as stressful (P<.001). However, there were no gender differences in reporting that the transitional life event or events was stressful for those who also reported STB. Significant sociodemographic adjusted risk factors of STB included younger age; identifying as a sexual minority; lower subjective social connectedness; lower subjective intimate bonds; experiencing a stressful transitional life event in the past 12 months; living alone (women only); not being in employment, education, or training (women only); suddenly or unexpectedly losing a job (men only); and experiencing a relationship breakdown (men only). Protective factors included starting a new job, retiring, having a language background other than English, and becoming a parent for the first time (men only). The results relating to coping after experiencing a self-reported stressful transitional life event in the past 12 months found that regardless of sex, respondents who reported STB compared with those who did not were less likely to engage in activities that promote social connections, such as talking about their feelings (P<.001). Coping strategies significantly explained 19.0% of the STB variance for men (F16,1027=14.64; P<.001) and 22.0% for women (F16,1977=36.45; P<.001).

Conclusions: This research highlights multiple risk factors for STB, one of which includes experiencing at least one stressful transitional life event in the past 12 months. When individuals are experiencing such events, support from services and the community alike should consider using sex-specific or targeted strategies, as this research indicates that compared with women, more men do nothing when experiencing stress after a transitional life event and may be waiting until they experience STB to engage with their social networks for support.

Keywords: adaptation, psychological; health surveys; life change events; men; sex differences; suicidal ideation; suicide; suicide, attempted; women.

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Conflict of interest statement

Conflicts of Interest: IH was an inaugural commissioner on Australia’s National Mental Health Commission (2012-2018). He is the Co-Director, Health and Policy, at the Brain and Mind Centre (BMC), University of Sydney. The BMC operates early intervention youth services at Camperdown under contract to headspace. IH has previously supported community-based and pharmaceutical industry–supported (Wyeth, Eli Lily, Servier, Pfizer, and AstraZeneca) projects focused on the identification and better management of anxiety and depression. He was a member of the Medical Advisory Panel for Medibank Private until October 2017, a Board Member of Psychosis Australia Trust, and a member of the Veterans Mental Health Clinical Reference Group. He is the Chief Scientific Advisor to and an equity shareholder in InnoWell. InnoWell has been formed by the University of Sydney and PricewaterhouseCoopers to deliver the Aus $30 (US $22.20) million Australian Government-funded Project Synergy. Project Synergy is a 3-year program for the transformation of mental health services through the use of innovative technologies. JB is the Chair of the National Advisory Council for Open Arms, Veterans, and Families Counselling Service. She is a well-being and digital health consultant to Bupa, a member of the Veterans Mental Health Clinical Reference Group, and a Chief Investigator and author of the Defense and Veterans Transition and Wellbeing Study. She is the founder of and an equity shareholder in InnoWell. She is a Professor at the Social Innovation and Chair of the Centre for Mental Health at Swinburne University and Adjunct Professor of Social Impact and Entrepreneurship at Royal Melbourne Institute of Technology. The other authors have no conflicts of interest to declare.

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