Requests for copies should be addressed to: S Rothmann, Programme in Industrial Psy- chology, PU for CHE, Private Bag X6001, Potchefstroom, 2520 SUICIDE IDEATION IN THE SOUTH AFRICAN POLICE SERVICES IN THE NORTH WEST PROVINCE S ROTHMANN G STRIJDOM Programme in Industrial Psychology PU for CHE, Potchefstroom ABSTRACT The South African Police Service (SAPS) shows relatively high numbers of suicide. However, little is known about the suicide ideation of members within the SAPS.The objective of this research was to determine the rela- tionship between sense of coherence, job satisfaction and suicide ideation among police personnel. The study population consisted of120 police personnel in the NorthWest Province.The results show that sense of coherence is related to suicide ideation in the case of white police members. Sense of coherence and satisfaction with inde- pendence, social status and supervision explained 55,30% of the variance in the suicide ideation scores of white police members. OPSOMMING ’n Relatiewe hoe« getal selfmoorde kom in die Suid-Afrikaanse Polisiediens (SAPD) voor. Min inligting oor die selfmoorddenkbeeldvorming van lede van die SAPD is egter bekend. Die doelstelling van hierdie navorsing was om te bepaal of daar ’n verband bestaan tussen koherensiesin en werkstevredenheid enersyds en selfmoord- denkbeeldvorming by polisiepersoneel andersyds. Die ondersoekgroep het bestaan 120 lede van die SAPD in die Noordwes-Provinsie. Die resultate toon aan dat koherensiesin by wit polisiebeamptes verband hou met self- moorddenkbeeldvorming. Koherensiesin en ontevredenheid met onafhanklikheid, sosiale status en toesighou- ding het 55,30% variansie in die selfmoorddenkbeeldvorming van wit polisiepersoneel verklaar. There is a growing emphasis on identifying police members at risk of suicidal behaviour. This emphasis is attributable to the increasing incidence of suicide among police members world- wide, but also in the South African Police Service (SAPS). Suicide rates in 1994 were higher in the SAPS (60 out of 100 000) than in the general population of South Africa (5 out of 100 000) (Nel,1994). Incidences of suicide in the SAPS increa- sed from 65 in 1991to 156 in 1997. In the NorthWest Province 13 police members committed suicide in 1996 (Van Rensburg, 1998). However, there had been a small decline in suicides from14 per10 000 police o⁄cials in1996 to11per10 000 police o⁄cials in 1998 (Van Rensburg & Van Rensburg, 2000). Suicidal behaviour may be considered a domain of psycholo- gical disturbance and is associated with potentially severe mental and/or physical health outcomes. According to Rey- nolds (1991a) suicidal behaviour may be categorised as inclu- ding suicide completion, overt intention, suicide attempt, and suicide ideation. Suicidal behaviour can be plotted on a continuum varying in severity from ideation, intent and at- tempt to completion. Suicide ideation therefore constitutes but one aspect of suicidal behaviour (Reynolds, 1991a). Re- search about suicide ideation may be viewed as an important and critical component in evaluating and promoting adult mental health. A strong association exists between suicide ide- ation and suicide (Jin & Zhang,1998). Suicide ideation, which refers to the thoughts and cognitions about suicidal behaviour and intent, may be considered an early marker of more serious suicidal behaviour (Bonner & Rich, 1987; Reynolds, 1991a; Shea, 1998). Suicide ideation can be characterised as ranging from relatively mild, general thoughts and wishes that one were dead to serious ideation about speci¢c plans and means of taking one’s life. Reynolds (1991a) de¢nes suicide ideation as the domain of thoughts and ideas about death, suicide and serious self-injurious behaviour, and includes thoughts related to the planning, conduct and outcome of suicidal behaviour, particularly as the last relates to thoughts about the response of others. The SAPS needs to intervene to decrease suicidal behaviour of police members. It is therefore necessary to study suicide ide- ation of police members and possible correlates thereof. Many factors may contribute to suicidal behaviour of police mem- bers, including the demands of the work situation (e.g. the high level of crime and dissatisfaction with aspects of the job) (Jacobs, 1998), factors outside the work situation (e.g. marital and ¢nancial problems) (Rossouw,1998) and personal charac- teristics. Previous research on suicide ideation focused on social factors (e.g. the e¡ects of family, religion, interpersonal relations and social support) and individual factors (e.g. stress and depres- sion) (Zhang & Lin,1998).The current research focuses on the possible relationshipbetween sense of coherence (Antonovsky, 1987), job satisfaction (Weiss, Dawis, England & Lofquist, 1967) and suicide ideation (Reynolds,1991a). The objective of this research was to determine the relation- ship between sense of coherence, job satisfaction and suicide ideation of police members in the NorthWest Province. Suicide ideation, sense of coherence and job satisfaction Suicide ideation as a psychological construct is more pheno- menological than theoretical in nature (Reynolds,1991a). Indi- viduals measuring high on suicide ideation wish they had never been born, feel life is not worth living, wish they were dead, and think that others would realise their worth when they are dead. They have thoughts of killing themselves, as well as thoughts on speci¢c methods they can use and times or places at which to kill themselves. A number of researchers have focused on suicide ideation as an important aspect of suicidal behaviour. Schotte and Clum (1982) found a relationship between the frequency of suicide ideation and the likelihood of attempts at suicide. Bonner and Rich (1987) formulated a stress-vulnerability model of suicidal behaviour in college students in which suicide ideation repre- sents a key variable in the development of more serious suici- dal behaviour. Suicide ideation is consistent with a cognitive- behavioural focus and may be viewed as a domain of self-state- ments. Suicide ideation has been associated with depression and anxiety disorders (Zhang,1996). Lester (1987) as well as Lester and Francis (1993) investigated the relationship between suicide ideation and personality variables and indicated that neuroticism is strongly (positively) related to suicidal thinking in non-clinical samples. Jin and Zhang (1998) found that psychologicalwell-being is amuch stronger predictor of suicide ideation than physical well-being, especially when an individual su¡ers from depression.Velting (1999) found apositive correlation between neuroticism and suicide ideation, and a SAJournal of Industrial Psychology, 2002, 28(1),44-48 SATydskrif vir Bedryfsielkunde, 2002, 28(1),44-48 44 negative correlation with self-discipline. It could be expected that psychological well-being (and psychological strengths) (Strˇmpfer, 1995), which is healthy, positive, and pro-social, should be a bu¡er against suicide ideation, which is unhealthy, negative and asocial. One of these psychological strengths, which correlates inversely with neurotiscism (see Mlonzi & Strˇmpfer,1998), is sense of coherence. Sense of coherence is a construct from a salutogenic paradigm (Antonovsky, 1987; Strˇmpfer, 1990) or fortigenic paradigm (Strˇmpfer, 1995). Sense of coherence can be described as the extent to which one has a pervasive, enduring though dyna- mic feeling of con¢dence that one’s internal and external envi- ronments are predictable and that there is a high probability that things will workout as well as can be reasonably expected. It thus in£uences an individual’s perception of stimuli.The de- ¢nition of sense of coherence includes three dimensions that represent the concept, namely comprehensibility, manageabi- lity and meaningfulness (Antonovsky, 1987, 1991). Compre- hensibility refers to the extent to which one perceives stimuli from the internal and external environment as information that is ordered, structured and consistent. Manageability refers to the extent to which individuals experience events in life as situations that are endurable or manageable and can even be seen as new challenges. Meaningfulness refers to the extent to which one feels that life is making sense on an emotional and not just a cognitive level. Petrie and Brook (1992) found that a low sense of coherence is related to suicidal behaviour.Various studies also showed negative correlations between sense of coherence and negative a¡ect (e.g. anxiety) (Carmel & Bernstein,1990; Flannery & Flannery,1990; Frenz, Carey & Jorgenson,1993; Gibson & Cook,1996; Kravetz, Drory & Florian,1993). Strˇmpfer (1995) found that sense of co- herence correlated signi¢cantly with health, psychological health and low feelings of helplessness. It was found that sense of coherence signi¢cantly correlates with a measure of general health, psychological well-being and social support, but it corre- lated negatively with feelings of helplessness. Sense of coherence is also related to job satisfaction and life satisfaction (Rothmann, 2000; Strˇmpfer, Danana, Gouws & Viviers, 1998). An indivi- dual with a strong sense of coherence will be more inclined to understand the nature and dimensions of an acute or chronic stressor and will de¢ne it as something that he or she can cope with. He or she will regard it as manageable by using resources within his or her own or others’control rather than becoming helpless. It is therefore hypothesised that a weak sense of cohe- rence could be related to suicide ideation. Few research studies were carried out concerning the rela- tionship between the work environment and suicide ideation. Samuelson, Gustavsson, Petterson, Arnetz and Asberg (1997) studied the relationship between suicidal feelings, attempted suicide and aspects of the work environment and well being in Swedish nursing personnel. They found that a negative work environment was associated with burnout and depres- sion, which in turn were related to suicide ideation. They found indirect evidence that a negative work environment may increase suicidal feelings. Goldney,Wine¢eld,Tiggeman andWine¢eld (1995) found an association between dissatisfac- tion with employment and suicide ideation. Police members work in circumstances of chronic stress (May- nard, Maynard, Mccubin & Shao, 1980). Irregular working hours, poor working conditions, constant fear and trauma make police members more susceptible to suicide. Research by Hageman (1978) has shown that stressors in the work envi- ronment may be related to suicide ideation. Shift work, the dan- gers involved in police work, poor working conditions and low salaries seem to be related to job dissatisfaction, stress and suicidal tendencies (Kruger, 1996; Lott, 1995). According to McCa¡erty (1992), suicide of police members could largely be ascribed to stressors at work. Factors that may cause distress include authoritarian structure, lack of participation in decision- making, lack of administrative support, unfair discipline, un- fair promotion and the nature of police work. According to Violanti (1996) police members’ experiences of organisational practices and the inherent nature of police work seem to be related to stress. Therefore it was decided to focus on satisfaction with job-related factors as a possible predictor of suicide ideation. Job satisfaction is an a¡ective (emotional) reaction to a job which stems from the incumbent’s compari- son of actual outcomes with the required outcomes (Cranny, Smith & Stone,1992). Employees seek to achieve and maintain correspondence with their environment (Weiss, Dawis, Eng- land & Lofquist,1967). Correspondence with the environment can be described in terms of the individual ful¢lling the re- quirements of the environment, and the environment ful¢l- ling the requirements of the individual (Cook, Hepworth, Wall & Warr, 1981). This means that employees would expe- rience job satisfaction if they feel that their individual capa- cities, experience and values can be utilised in their work environment and that the work environment o¡ers them op- portunities and rewards. Interpersonal relations in the workcontext may be related to sui- cide ideation. Interpersonal relations play a crucial role in deter- mining an individual’s well-being. Because good relations with people are associated with happiness, and because unhappiness (depression) predicts suicide ideation, a connection can be built between interpersonal relations and suicide ideation (Zhang & Jin, 1998). Zautra, Burleson, Matt, Roth and Burrows (1994) found that positive interpersonal events were inversely related to depression, whereas con£ictual interpersonal events cor- related directly with higher levels of depression. An important factor in the relationship between stress and de- pression is the amount of social support an individual has available when confronted with stressful events (Brown & Harris,1978).The more social support a person receives (in the work context or from the family and community), the less he or she experiences suicide ideation (Yang & Clum; 1994, Zhang & Jin,1998). Zhang and Jin (1998) found that interper- sonal con£ict had the greatest and total e¡ect on suicide ide- ation, and social isolation was the weakest predictor among three measures of interpersonal relations. RESEARCH METHOD Research design A surveydesignwas used to reach the research objective.The spe- ci¢c design is the cross-sectional design, whereby a sample is drawn from apopulation at one time (Shaughnessy & Zechmeis- ter,1997). Informationcollected is used to describe the population at that time. This design can be used also to assess interrelation- ships among variables within a population. According to Shaughnessy and Zechmeister (1997) this design is ideally suited to the descriptive and predictive functions associated with corre- lational research. Sample A non-probability sample was taken from the six largest police stations in the Marico area of the North West Province. The sample consisted of constables (n = 6), sergeants (n = 77) and inspectors (n = 37) and included 92 males and 28 females. Most participants (93%) were between the ages of 26 and 45, mar- ried (67%), had a quali¢cation of Standard 10 or higher (87%) and had between three and15 years’ (85%) service in the SAPS. Measuring instruments Three questionnaires were used in the study, namely the Orien- tation to Life Questionnaire (OLQ) (Antonovsky, 1987), the Minnesota Job Satisfaction Index (Weiss et al., 1967), and the Adult Suicide Ideation Questionnaire (ASIQ) (Reynolds,1991a). The Orientation to Life Questionnaire (OLQ) was used to mea- sure participants’sense of coherence. Antonovsky (1993) repor- ted alpha coe⁄cients of the OLQ in 29 research studies varying between 0,85 and 0,91. Test-retest reliability studies found coe⁄cients between 0,41 and 0,97 (Antonovsky, 1993). The alpha coe⁄cient of the OLQ in this study was 0,89, which may be regarded as acceptable (Nunnally & Bernstein, 1994). 45SUICIDE IDEATION Regarding the construct validity of the OLQ, it was found that there is a negative relationship between the OLQ and ex- perienced stress and that the OLQ correlates negatively with the ‘‘State-Trait Anxiety Inventory-Trait’’and the ‘‘Beck De- pression Inventory’’ (Frenz et al.,1993). The MinnesotaJob Satisfaction Index was used to measure partici- pants’ job satisfaction (Weiss et al., 1967). The latter researcher argues that the interaction between the work personality (in- dividual needs and characteristics of the worker) and the work environment is responsible for satisfaction. The long form of the Minnesota Job Satisfaction Index, which consists of 100 items, was used in this study (Weiss et al.,1967).The question- naire provides avalid and reliable measure speci¢callyof gene- ral job satisfaction (Cook et al., 1981). The alpha coe⁄cient of the general satisfaction score of the Minnesota Job Satisfaction Index in this study was 0,87. The Adult Suicide Ideation Questionnaire (ASIQ) (Reynolds, 1991a) was used to measure participants’current level of suicide ideation. Each of the items measures a speci¢c suicidal beha- viour or thought. The maximum possible score is 150, with higher scores indicating more numerous and/or frequent suici- dal thoughts. Reynolds (1991a) reported that the internal con- sistency (coe⁄cient alpha) of the ASIQ is 0,96, while Osman et al. (1999) found a coe⁄cient alpha of 0,98.The test-retest relia- bility of the ASIQ varies between 0,86 and 0,95 (Reynolds, 1991b). Reynolds (1991a) provided evidence for the content, construct and criterion-related validity of the ASIQ. Osman et al. (1999) found that the ASIQ di¡erentiated signi¢cantly between suicide attempt and psychiatric control groups. Statistical analysis The statistical analysis was carried out with the help of the SAS- program (SAS Institute,1996). Because a non-probability sample was used in the present study, descriptive statistics were used.The Cronbach alpha coe⁄cient was determined to indicate the inter- nal consistency of the measuring instruments. Pearson’s correla- tions were used to determine the relationship between variables. For the purposes of the present study, r = 0,30 (medium e¡ect) (Cohen,1988) is regarded as practically signi¢cant. A stepwise multiple regression analysis was conducted to de- termine the proportion of variance in the dependent variable (suicide ideation) that is explained by the independent varia- bles (sense of coherence and job satisfaction). The e¡ect size (which indicates practical signi¢cance) in the case of multiple regression is given by the following formula: f 2 = R2 / 1 �R2 For the purposes of this research f 2 = 0,10 (medium e¡ect) is regarded as practically signi¢cant (Steyn,1999). RESULTS The descriptive statistics of the MSQ, the OLQ and the ASIQ for the di¡erent race groups are reported inTable 1. TABLE 1 DESCRIPTIVE STATISTICS OF THE CONSTRUCTS FOR DIFFERENT RACE GROUPS Item White (n = 43) Black (n = 77) Mean SD � Mean SD � Job satisfaction: Total 414,81 50,16 0,87 425,36 49,99 0,87 Ability 22,79 5,41 0,51 21,54 4,29 0,09 Performance 21,09 4,95 0,43 23,45 5,53 0,56 Activity 21,48 3,57 0,32 21,63 4,13 0,19 Promotion 18,88 6,17 0,59 20,67 4,47 0,25 Authority 23,65 3,90 0,14 23,01 4,75 0,39 Company policy 16,74 5,76 0,56 19,23 4,97 0,35 Reward 17,56 5,42 0,36 16,50 5,12 0,37 Co-workers 21,63 5,34 0,49 21,56 4,64 0,25 Creativity 22,44 4,68 0,37 21,31 5,17 0,42 Independence 23,51 5,40 0,59 22,32 4,82 0,29 Item White (n = 43) Black (n = 77) Mean SD � Mean SD � Moral values 21,06 4,93 0,38 22,32 4,59 0,17 Recognition 18,95 5,77 0,60 20,84 5,91 0,55 Security 20,07 5,29 0,48 21,16 5,33 0,38 Social service 21,63 4,87 0,42 20,83 4,38 0,15 Social status 21,65 4,64 0,32 22,54 4,66 0,23 Supervision human 17,93 5,50 0,47 19,74 4,41 0,08 Supervision technical 19,35 5,29 0,47 20,41 4,06 0,10 Responsibility 23,16 5,56 0,69 24,21 6,02 0,65 Variety 21,60 4,45 0,27 21,96 4,25 0,15 Work conditions 19,60 6,22 0,64 20,06 4,41 0,16 SOC (Total) 122,61 18,56 0,77 127,75 17,14 0,67 ASIQ (Total) 13,51 25,30 0,98 16,52 25,71 0,95 Table 2 shows that the mean of the ASIQ for whites was 13,51, while the mean for blacks was 16,51. Table 2 shows that the mean of Total Job Satisfaction for black police personnel is 425,36, while the mean for white police personnel is 414,81. The Cronbach coe⁄cient alpha of the MSQ is 0,87 for whites as well as for blacks, although the coe⁄cient alphas of the sub- scales for Blacks are questionable. The Cronbach coe⁄cient alphas of the OLQ are 0,77 for whites and 0,67 forblacks, while the internal consistencies of the ASIQ are 0,98 and 0,95 for whites and blacks respectively. These internal consistencies could be regarded as acceptable (Nunnally & Bernstein,1994). The product-moment correlations between the OLQ, the MSQ and the ASIQ are reported inTable 2. TABLE 2 PRODUCT MOMENT CORRELATIONS BETWEEN SUICIDE IDEATION, SENSE OF COHERENCE AND JOB SATISFACTION Item MSQ ASIQ White Black Total White Black Total OLQ 0,31* 0,23 0,28 -0,51** 0,24 -0,33* MSQ ^ Total ^ ^ ^ -0,29 -0,24 0,20 * Correlation is practically signi¢cant r = 0,30 (medium e¡ect) ** Correlation is practically signi¢cant r = 0,50 (large e¡ect) Table 2 shows that a practically signi¢cant correlation of large e¡ect (r = -0,51) exists between suicide ideation and sense of coherence in the sample of white police personnel, while a practical signi¢cant correlation of medium e¡ect (r = -0,33) exists in the total sample. No practically signi¢cant correla- tions were found between sense of coherence and job satisfac- tion or suicide ideation and job satisfaction for the total sample. A practically signi¢cant correlation of medium e¡ect (r = 0,31) was found between the job satisfaction and sense of coherence of white police personnel. Next, a stepwise regression analysis was done on the results of the white group. A signi¢cance level of p < 0,15 was set. The variables included in the regression analysis for white police personnel are reported inTable 3. TABLE 3 REGRESSION ANALYSIS OF SENSE OF COHERENCE, JOB SATISFACTION AND SUICIDE IDEATION IN THE WHITE GROUP ANALYSIS OF VARIANCE Multiple correlation: Source of Degrees of Sum of Average 0,744 variance freedom squares squares R2 : 0,596 Regression 4 16005, 288 4001,321 Adapted R2 : 0,553 Residual 38 10855,457 285,670 F = 14,01 f 2 = 1,475 ROTHMANN, STRIJDOM46 VARIABLES Independent B Standard error f value p variables of B Constant -114,00 20,766 30,14 0,0001 SOC -0,664 0,150 19,67 0,0001 Independence -1,936 0,527 13,51 0,0007 Social status -1,398 0,607 5,30 0,0269 Supervision Human -1,913 0,481 15,80 0,0003 An inspection of Table 3 shows that a total of 55,30% of the variance in suicide ideation of white police personnel (as mea- sured by the ASIQ) is predicted by a combination of four va- riables, namely sense of coherence and satisfaction with independence, social status and supervision (human). The re- sulting multiple correlation of 0,77 is practically signi¢cant (large e¡ect) (f 2 = 1,475). Because of the low Cronbach coe⁄cient alphas of the scales of the measuring instruments for black police personnel, the re- gression analysis was not carried out for them. DISCUSSION The mean of the ASIQ for whites was 13,51, while the mean for blacks was 16,51. Compared with the mean of 8 that was found for adults and 11 for students, it seems that the scores of white and black police members are higher.The average scores of both whites and blacks are well below the cut-o¡ point of 31, which is regarded as severe suicide ideation (Reynolds, 1991a). Reynolds (1991a) designated six items of the ASIQ on the basis of their signi¢cant potency for more serious self- destructive behaviour (regardless of scores). Based on their responses to these six items, 12 police members in this study could be regarded as at risk in terms of suicidal behaviour. The results show that black police personnel obtained higher mean scores on suicide ideation and sense of coherence than white police personnel. Suicide ideation of the total sample of police personnel is related to their sense of coherence.This result con¢rms the ¢ndings of Petrie en Brook (1992). Suicide ideation of white police personnel is related to a low sense of coherence and dissatisfaction with company policy, supervision and working conditions. The means of the OLQ for the white and black police person- nel are 122,61and127,75 respectively, which is substantially lo- wer than means obtained in other samples (Rothmann, 2000). Police personnel in this study were especially dissatis¢ed with the rewards, company policies, supervision (especially that re- lated to human aspects) and physical working conditions (which can be described as uncomfortable and even dange- rous).They experienced a higher degree of job satisfaction re- garding responsibility (to use own discretion), authority (to tell others what to do) and independence (the opportunity to work independently). White police personnel are relatively dissatis¢ed with supervision (human and technical aspects), re- wards (salaries and fringe bene¢ts), company policy, working conditions, recognition and promotion. Black police person- nel are more dissatis¢ed with company policy, rewards and supervision (human aspects). The job satisfaction of police personnel is related to their sense of coherence.This ¢nding con¢rms the ¢ndings of McCa¡er- ty (1992) andViolante (1995).White police personnel who have a high sense of coherence are also more satis¢ed with their work (which con¢rms the ¢ndings of Rothmann, 2000 and Strˇmpfer et al.,1998) and less inclined to suicide ideation. A low sense of coherence, satisfaction with independence and dissatisfaction with social status and supervision (human) ex- plain 55,30% of the variance in the suicide ideation scores of white police members. White police personnel with a low sense of coherence who are satis¢ed with their independence (probably because they prefer to isolate themselves from others’support) and who are dissatis¢ed with their social status as well as their supervisors, obtained higher scores on suicide ideation. Satisfaction with the human aspects of supervision (including the understanding between the police member and his or her supervisor, the way he or she is treated by the supervisor and the way his or her grievances are handled) pre- dicts suicide ideation of police members.White police mem- bers’dissatisfaction with their social position in and the regard of the community are related to suicide ideation, which may be related to a low self-regard. In interpreting these results it should be remembered that the sample consisted only of police members in the Marico area of the NorthWest Province.The results could not be generalised to other areas and provinces. Another shortcoming of the re- search was that the causality of the relationships between the various constructs could not be determined. RECOMMENDATIONS The SAPS should attend to the suicide ideation of police per- sonnel and correlates thereof, such as dissatisfactionwith social status and supervision.The sense of coherence of police mem- bers should be assessed and developed in order to decrease sui- cide ideation. The SAPS can select individuals who have a strong sense of coherence, depending on the job. However, more research is needed, especially because the relationship between sense of coherence and suicide ideation were not studied in a selection context. By equipping police personnel with the necessary knowledge, skills, material, instruments and other resources, and by ensu- ring a balance in the load of tasks to be handled, they will in- creasingly feel that the work expectations are manageable and within their or important other’s power. Senior police person- nel should be treated in identifying individuals who tend to- wards suicide ideation. They should also be sensitised to the e¡ect of their behaviour on members who have ideas about suicide. Support groups for uniformed police personnel should be used and lay counsellors should be trained to pro- vide social support to individuals who are stressed. Participation in decision-making will enhance the police members’ feeling of membership and contribute to the mea- ningfulness component of sense of coherence. Police person- nel should have the freedom to disagree with their supervisors and to discuss what to do with them (rather than to be told what to do).The role of station commanders is cru- cial in this regard. Research should be undertaken into other factors in the work environment that could be related to suicide ideation of white and black police personnel.The role of social and interpersonal factors in suicide ideation should also be researched. 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