title: Self-reported suicide attempts and associated risk and protective factors among secondary school students in New Zealand.
abstract: OBJECTIVE
  To examine associations between individual, family, school and community characteristics and rates of suicide attempts in a national population sample of New Zealand secondary school students.
  
  
  METHODS
  A total of 9570 randomly selected 9- to 13-year-old students from 114 schools were surveyed, using the New Zealand Adolescent Health Survey. This is a 523-item anonymous self-report comprehensive questionnaire delivered by Multi-Media Computer-Assisted Self-Interviewing. Multivariate analyses were used to examine correlates of self-reported suicide attempts within the last 12 months.
  
  
  RESULTS
  In total, 739 participants (4.7% of males and 10.5% of females) reported having made a suicide attempt within the last 12 months. Depressive symptoms, alcohol abuse, -having a friend or family member attempt suicide, family violence and non-heterosexual attractions were independently associated with increased rates of suicide attempts while parents caring, other family members caring, teachers being fair and feeling safe at school were independently associated with decreased rates of suicide attempts. Caring friendships, attending worship frequently, possible sexual abuse and anxiety symptoms were not independently associated with suicide attempts. Risk and protective factors operated in the same way for male and female students and for those with and without other suicide predictors.
  
  
  CONCLUSIONS
  New Zealand secondary school students, particularly female students, report high rates of suicide attempts. Risk of suicide attempts is lower in students reporting caring home and fair, safe school environments and this effect remains once depression is taken into account. This study confirms the importance of depression, substance use, problem behaviour, negative life events, exposure to suicide behaviour by others and the significance of sexual orientation in suicidal behaviour among school students and provides evidence of the importance of the family and school environments in reducing risk among this group.
authors.affiliation: Department of Paediatrics, University of Auckland, Auckland, New Zealand. adevidence@ihug.co.nz
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Fleming
authors.forename: Sally N
authors.initials: SN
authors.lastname: Merry
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Robinson
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Denny
authors.forename: Peter D
authors.initials: PD
authors.lastname: Watson
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005195:Family Relations; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D009520:New Zealand; D012307:Risk Factors; D012931:Social Environment; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires