Association of Perceived Gender Conflict with Depression and Attempted Suicide in Adolescent Girls

Background and Goals: Suicide attempts occur mostly during adolescence and are much more frequent in females than in males, although males tend to commit suicide more often than females. This study aims to examine the association between female gender, gender conflict, depression, stress and suicide attempts in adolescent girls. Methods: Participants included 86 adolescent girls aged 12-21 (μ=15.7, SD=3.07) with depression (n=29), attempted suicide (n=15) or both (n=42), admitted consecutively to a tertiary medical center and 93 healthy controls from the community. Depression, suicidal ideation and behavior, gender identity and conflict, personality factors, and stress were compared between the study group and controls and each of the three study-subgroups and controls. Results: A difference was found in the perception gap of own femininity versus others' expectations of the subject’s femininity, between the suicide attempters both with and without depression and the controls. Personality factors were also found to be related to depression and suicide attempts. Suicide attempters with depression showed more harm avoidance than those without depression. Novelty seeking was significantly higher in non-depressed suicide attempters than in controls but not when compared to suicide attempters with depression. Conclusion: It seems that suicide attempts and depression may not only be related to female gender identity. Conflicting gender expectations may result in increased stress, raising the risk for suicide attempts, particularly in girls with high harm avoidance.