The Journal of Primary Prevention, Vol. 13, No. 4, 1993
The Relationship of Bystander Intervention Variables to Adolescents' Responses to Suicidal Peers John Kalafat, 1,4 Maurice Elias, 2 and Michael A. Gara 3
This study sought to understand factors that might enhance su&ide prevention programs by investigating the responses of adolescents to potentially suicidal peers in analogue situations embodying variables from the social psychological research on bystander intervention. 314 high school students were randomly assigned one of four vignettes about a troubled peer under conditions of high or low diffusion of responsibility (respondent was alone or one of a group) and high or low ambiguity (confronted by a troubled peer or heard an essay written by a peer). Students' statements concerning the likelihood of suicide and their level of concern in the situation provided evidence for the internal validity of the vignettes. Results included significant main effects of ambiguity (more likely to tell an adult than simply talk to the peer in low vs high ambiguous conditions) for males and females, and of diffusion (more likely to ignore or do nothing than talk or tell in high vs low diffuse situations) for males. Students' estimates of how other students would respond corresponded with findings from social comparison research and suggested the operation of an erroneously perceived social norm of no response to a troubled peer by those who indicated that they would ignore the peer. The results have implications for the application of social psychological models to social influence-based prevention efforts to enhance adolescents' roles in the prevention of youth suicidal behavior. KEY WORDS: adolescents; suicidal; peers. 1Spalding University, Department of Psychology, Louisville, KY. 2Rutgers University, Psychology Dept., Piscataway, NJ. 3University of Medicine and Dentistry of New Jersey Community Mental Health Center at
Piscataway. 4Address reprint requests to John Kalafat, Spalding University, Department of Psychology, 851 South 4th Ave., Louisville, KY 40203. 231 @ 1993 HumanSciencesPress, Inc.
232
Kalafat et al.
Current estimates of the incidence of suicide attempts among adolescents in this country place the figure at one out of ten youths (Boggs, 1986; Ritter, 1990; Shaffer, Garland & Whittle, 1988; Smith & Crawford, 1986). The majority of those youthful attempters do not come to the attention of adult caregivers, but are in fact most likely to be known to their peers (Boggs, 1986; Ross, 1985; Shaffer, et al., 1988; Shafii, Whittinghill, Dolen, Pearson, Derrick & Carrington, 1984; Spirito, Brown, Overholser & Fritz, 1988). In surveys of adolescents across the country, roughly one quarter of all males and nearly one half of the females report having known a peer who had talked about or tried to kill themselves (Bowers & Gilbert, 1987; Harkavy-Friedman, Asnis, Boeck, & DiFiore, 1987; Overholser, Hemsteet, Spirito & Vyse, 1989). Such peer confidantes have the potential to play an important role in preventing adolescents from progressing to completed suicide. Ross (1985) called for prevention programs that educate adolescents both as potential victims and rescuers. Shafii and his colleagues concluded their report on psychological autopsies by stating: "The role of friends and peers in the early recognition of suicidal behavior and prevention of suicide cannot be overemphasized." (1984, pg. 293). The most effective preventive response for a youth who is confronted with a suicidal peer would be to tell a responsible adult. When surveys ask youths to endorse their choices from a list of non-mutually exclusive options in response to the hypothetical situation of a friend telling them that s(he) was thinking of killing (him) herself, the majority of respondents indicate that they would tell an adult----(71% in a survey of 2104 students by Boggs (1986); 64% in a survey of 2233 students by Shaffer et al. (1988). However, these surveys do not agree with psychological autopsy studies (Robinson, 1979; Shafii et al., 1984) that indicated that peers knew of, but did not report the victims' suicidal intent. In a recent study that investigated adolescents' reported responses in actual encounters with peers whom they considered to be definitely suicidal, only twenty-four percent reported having told an adult (Kalafat & Elias, in press). NEW APPLICATION FOR AN ESTABLISHED PARADIGM: BYSTANDER INTERVENTION RESEARCH Telling an adult about a suicidal peer may be difficult for adolescents because of their preference for peer confidantes and the importance of keeping confidences among friends at this age (Cauce & Srebnik, 1989; Parker & Asher, 1987; Youniss, 1980), as well as negative feelings about the helpfulness of adults (Meeks, 1986; Trautman, 1989). The behavior of youths with these attitudes and values may in turn be influenced by the
Bystander intervention and Adolescents' Responses
233
characteristics of the contexts in which they encounter a possibly suicidal peer. A prevention program that takes these variables into account has been classified by Felner and Felner (1989) as a transactional program. Such programs identify a set of characteristics of the person as well as the environment that in combination increase the probability of risk behaviors. Felner and Felner further cite specific cases of transactional programs that see the source of risk as the interaction between youths and their peers in which the problematic behavior arises from the situational context. In this case, the design of prevention programs aimed at increasing the rate of adolescents who tell an adult about a suicidal peer requires a better understanding of the vicissitudes of these encounters. The presence of a potentially life-threatening situation in which a responsible intervention has both perceived benefits (in this case, obtaining help for a troubled peer) and costs (breaking a confidence, turning to adults rather than peer helpers, making a fool out of oneself) has been extensively studied and reported in a body of literature known as bystander intervention research. This research may provide some u n d e r s t a n d i n g of adolescents' behavior in this situation that can guide preventive educational efforts. The bystander intervention research---which consisted largely of subjecting individuals to emergency situations staged by confederates---yielded information as to the particular variables that appear to affect the cost of taking or failing to take action. Two of the major variables that were identified are: • number of bystanders (Latan6 & Darley, 1969; Latan6 & Rodin, 1969): the more bystanders, the less likely each is to take action. Two explanations for this phenomenon have been offered. Pluralistic ignorance implies that if the emergency is ambiguous, each bystander is likely to appear unconcerned (and is in fact undecided). This provides a source of normative influence (it is okay to not respond) and information influence (it must not be an emergency). Diffusion of responsibility operates such that as the number of bystanders increases, there is less responsibility for each to take action, as each assumes another can act. • ambiguity (Clark & Word, 1972): if there is some ambiguity as to whether harm is occurring, there is significantly less intervention; intervention is additionally reduced in ambiguous situations by additional bystanders. Another source of normative influence that may affect an adolescent's response to a suicidal peer is his/her belief as to how other adolescents would respond. Findings from the substance abuse prevention literature indicate that perceptions of social norms (use by similar others)
234
Kalafat et al.
are strong predictors of drug use onset. (Johnson, Pentz, Dwyer, Weber, MacKinnon & Hansen, 1990). It was also found that experimentally induced changes in perception of prevalence of drug use by peers and probability of sanctions from friends following one's own use better predicted decreased drug use than other common educational program components, including resistance skills (MacKinnon, Johnson, Pentz, Dwyer, Hansen, Flay & Wang, in press). Similarly, refusal to take responsible action in response to a suicidal peer may be associated with an incorrect belief that most peers would respond in the same way. Clearly, the bystander intervention paradigm suggests several points which may be essential to the success of suicide prevention efforts intended to mobilize responsible youth action when faced with a suicidal peer. The purpose of the present study was to assess the effects of variables derived from the bystander research, including ambiguity of the situation, diffusion of responsibility and beliefs about peers' responses to suicidal peers, on the responses of adolescents to potentially suicidal peers in an analogue situation. Diffusion was defined as whether the adolescent was alone or with a group when confronted by the suicide situation. The responses under investigation were whether the adolescent would take no action (ignore or do nothing), take some action (talk to the troubled peer) or take the action with the highest cost in terms of typical adolescents' preferred ways of dealing with problems (tell an adult). Previous research (Kalafat & Elias, in press) indicated that adolescents' reports of their responses to suicidal peers could be reliably assigned to one of these three categories. It was hypothesized that the high diffusion and high ambiguity conditions would each be associated with a lower frequency of the "tell an adult" response, and a higher frequency of the no action response. It was hypothesized that the no action response would be associated with a belief that the average student would take no action when faced with a potentially suicidal peer. Previous research suggested that females are less opposed to seeking adult help for possibly suicidal peers than males (Kalafat & Elias, in press; Overholser et al., 1989; Spirito et al., 1988); and that negative attitudes toward suicidal individuals and intervening with them are more prevalent among males (Overholser et al., 1989; Wellman & Wellman, 1986). Thus, talking to a troubled peer or telling an adult may be a higher cost option for males than for females, and diffusion and ambiguity were therefore hypothesized to be more likely to suppress these behaviors and/or increase the "no action" response for males than for females.
Bystander intervention and Adolescents' Responses
235
METHOD Conditions Four analogue conditions, consisting of vignettes representing the factors of ambiguity and diffusion were developed for this study. (See Table 1) The vignettes were developed by the authors and three teachers who teach the health curriculum in the secondary school in which the study was conducted. They were pilot tested, along with questions as to how the subject would respond, with a group of peer counselors from another, demographically similar, high school in the same community. Discussion with the teachers and the students indicated that the situations were realistic. Review and discussion of the responses of the peer counselors revealed a variance of responses across situations as well as reported rationales for responses that coincided with the concepts of diffusion and ambiguity (e.g., students responding to the high diffusion situation reported such reactions as "there was less pressure on me"). 1 Each condition was provided by placing one of the vignettes on the front page of a questionnaire. The second page contained the question, "What do you think will happen next in this situation?" The purpose of this question was to compare across conditions (particularly the ambiguous and unambiguous conditions) as to the extent to which (a) suicide was mentioned as an outcome (might or will attempt or complete); (b) suicide was implied by responses involving telling an adult or friends, or confronting the peer; or (c) suicide was neither mentioned or implied, or was not seriously considered. This was intended to provide a manipulation check to assess the internal validity of the vignettes as presenting conditions of greater or lesser ambiguity or likelihood of suicidal behavior, rather than suicidal versus nonsuicidal situations. The third page of the questionnaire contained the following questions: "How would you respond to this situation?"; "How do you think the average student would respond to this situation?"; "How concerned would you be in this situation?" (1 = very, 2 = somewhat, 3 = not very, 4= not at all). This last question was included to provide a further manipulation check as it was hypothesized that students would express greater concern in low versus high diffusion (less responsibility) conditions. Responses to the "How would you respond . . .?" and "How would the average s t u d e n t . . . ? " questions were scored by two raters (an assistant blind to the hypotheses and an author blind to the condition) into one of three categories: 1Note that this study did not provide a test for the "pluralistic ignorance" hypothesis as there was no opportunity to observe cues from other bystanders.
236
Kalafat et al. Table 1. Conditions
Situation 1: Low ambiguity, low diffusion A good friend of yours has seemed troubled lately and has begun to keep more and more to himself. One day you go to see him and he tells you he would like to talk about something, but you must promise to keep it a secret. He seems pretty serious and you value your friendship with him a lot so you agree not to tell anyone what he has to say. H e tells you that he and everyone else would be better off if he were not around. Then he says "Sometimes I think I might as well kill myself." He smiles and shrugs his shoulders when he says it. H e then reminds you of your promise not to tell anyone. You are the only person he trusts, he says, and if you tell, he will never forgive you. Situation 2: Low ambiguity, high diffusion One Friday afternoon at lunchtime, you are sitting around with a small group of friends talking. One person in the group, who is a friend of yours although (s)he is a closer friend to a couple of others in the group, says he wants to explain why he has been keeping to himself lately, but everyone must promise to keep a secret. He seems pretty serious so everyone agrees not to tell anyone what he has to say. He says he thinks that he and everyone else would be better off if he were not around. Then he says "Sometimes I think I might as well kill myself." H e smiles and shrugs his shoulders when he says it. H e then reminds everyone of your promises not to tell anyone or he will never forgive you. The bell rings and everyone hurries for their next class. You know you won't see any of these friends over the weekend. Situation 3: High ambiguity, low diffusion You have a friend at school who has been keeping to himself lately. You know he has trouble at home----his parents are getting divorced and he's now not sure who he will be living with or if there will be enough money for him to go to college. It is Friday and you ask him to go to a party with you but he declines to go. Later that day in English, the teacher is reading sample student's short essays that she had assigned. She doesn't identify the writer but one of them is entitled "(Final) Family Decisions" and describes a very important decision that is about to be made by the writer's parents that will involve whether he will change schools and whether he will be able to go to college. The writer says that he may not go along with his parents' decisions and may make one of his own that will resolve things. You believe that your friend wrote this essay and that you are the only one who knows what he is writing about. Situation 4: High ambiguity, high diffusion You have a friend at school who has been keeping to himself lately. You know he has trouble at home---his parents are getting divorced and he's now not sure who he will be living with or if there will be enough money for him to go to college. It is Friday and you ask him to go to a party with you but he declines to go. Later that day in English, the teacher is reading sample student's short essays that she had assigned. She doesn't identify the writer but one of them is entitled "(Final) Family Decisions" and describes a very important decision that is about to be made by the writer's parents that will involve whether he will change schools and whether he will be able to go to college. The writer says that be may not go along with his parents' decisions and may make one of his own that will resolve things. You believe that your friend wrote this essay and that you and the group of mutual friends, who are also in this class, know what he is writing about. You are going to work right after school and know you won't have a chance to talk to him over the weekend or to your friends until the party late Saturday night.
Bystander intervention and Adolescents' Responses
237
• talk: the student wrote that s(he) would talk to the peer in an attempt to provide support or dissuade him/her from an attempt; or, would talk about the situation with peers. No other action was reported. • tell: the student explicitly wrote that s(he) would tell an adult about this situation. • nothing: the student wrote that s(he) would ignore, or not take seriously, or would do nothing further in response to the situation. It should be noted that the "tell" category is completely dichotomous with the "talk" category. Some students simply wrote that they would tell an adult, while others wrote that they would talk with their peer and then tell an adult. Both were scored "tell." The raters agreed on 91% of their ratings on the first question, and 95% of their ratings on the second question. Differences were resolved prior to analyses.
Procedure The questionnaires were randomly distributed to students during regular health class periods with the instructions that responses were to be anonymous (only students' gender was to be indicated), and they were to proceed through the questions in order as quickly as they could. Students completed the questionnaires in 10-15 minutes and to the authors' knowledge no student failed to complete the questionnaire.
Participants A total of 158 males and 156 females in grades nine and eleven of a predominantly white, middle class suburban high school responded to the questionnaire. Males and females, respectively, were distributed across the conditions as follows: low ambiguity, low diffusion: 42, 39; low ambiguity, high diffusion: 42, 37; high ambiguity, low diffusion: 37, 42; high ambiguity, high diffusion: 37, 38. There were no known completed suicides among the students in this school at any time prior to this study, nor were there any in the other high school in that community. RESULTS Responses to the first question, "What do you think will happen next in this situation?", were analyzed by comparing the responses in the low ambiguity conditions (1&2) to responses in the high ambiguity conditions (3&4). Students were significantly more likely to mention or imply suicide
238
Kalafat et al.
Table 2. Respondent's Estimates as to What Will Happen Next in the Situation Happen Condition Low Ambiguity High Ambiguity
Suicide Mentioned
Suicide Implied
Suicide not Mentioned or implied
33% 40%
51% 28%
15% 31%
x2 = 19.0, p < .001.
Table 3. Response Percentages for Each Condition Response Talk to Peer
Tell an Adult
Ignore/do Nothing
Low Diffusion Low Ambiguity
33%
63%
4%
High Diffusion Low Ambiguity
24%
52%
24%
Low Diffusion High Ambiguity
58%
33%
8%
High Diffusion High Ambiguity
51%
26%
23%
Condition
in the low ambiguity conditions compared to the high ambiguity conditions (84% vs. 68%); students were more likely to mention suicide in the high ambiguity conditions and imply it in the low ambiguity conditions. (See Table 2) A log linear analysis was carried out to assess the effects of diffusion and ambiguity on students' responses to the vignettes (question 2, "How would you respond to this situation?"). Significant overall effects were found for ambiguity (x2 = 30.09, p < .001) and diffusion (x2 = 16.15, p < .001), while no interaction effects were found. Table 3 depicts the percent of students responding in each of the three categories for each of the conditions. Log linear analyses of the effects of the conditions for the sexes separately revealed significant effects for ambiguity (x2 = 24.06, p < .001) and diffusion (x2 = 14.1, p < .009) for males, with no interaction effects; and a significant effect for ambiguity only (x2 = 8.83, p < .01) for females. (See Table 4) In the high diffusion conditions as compared to the low diffusion
Bystander intervention and Adolescents' Responses
239
Table 4. Males and Females Response Percentages for Each Condition Males
Response Condition
Talk to Peer
Tell an Adult
Ignore/do Nothing
Low Diffusion High Diffusion
47% 34%
45% 31%
8% 35%
Low Ambiguity High Ambiguity
24% 60%
54% 19%
22% 21%
Females
Response Condition
Talk to Peer
Tell an Adult
Ignore/do Nothing
Low Diffusion High Diffusion
43% 43%
53% 49%
4% 9%
Low Ambiguity High Ambiguity
34% 52%
62% 39%
4% 9%
conditions, males were more likely to report that they would ignore than talk to their peer or tell an adult. In the low ambiguity conditions as compared to the high ambiguity conditions, both males and females were more likely to report that they would tell an adult than simply talk to their peer. When these data were collapsed across all conditions, females were more likely to report that they would tell an adult (51% vs 38%) than to ignore a troubled peer (6% vs 22%), as compared to males. The relationship between how students responded to the vignettes and their estimates of how the average student would respond is presented in Table 5. The majority of students who indicated that they would talk to the troubled peer estimated that other students would also talk, but one third of them estimated that other students would do nothing. Of those students who indicated that they would tell an adult, nearly as many estimated that other students would do nothing (40%) as estimated that others would tell (45%). A clear majority (71%) of students who indicated that they would do nothing estimated that other students would respond in a similar manner. Students were significantly more concerned in the low diffusion (alone) than the high diffusion (in a group) conditions (x2 = 10.72, p < .01). Overall, females expressed greater concern than males (x2 = 8.69, p < .02).
240
Kalafat et al.
Table 5. Students' Estimates of Average Students' Responses Compared to their Own
Responses Estimates of Average Students' Response Students' own responses Talk to peer Tell an adult Ignore/do nothing
Talk to Peer
Tell an Adult
Ignore/do Nothing
60% 15% 17%
7% 45% 12%
33% 40% 71%
DISCUSSION The findings confirm the hypothesis that conditions of ambiguity and diffusion of responsibility would be associated with differences in adolescents' reported responses to troubled peers in a manner consistent with the bystander intervention research. The hypothesis concerning gender differences was also confirmed. That is, the central findings of this study are that adolescents of both genders may talk with a troubled peer, but only in the relatively unambiguous conditions were the majority compelled to indicate that they would take the more "costly" option of telling an adult. For males, some of whom appear to hold more negative views toward help seeking and less empathic views toward troubled peers, diffusion of responsibility may also lower the cost of the "no response" option. The finding that those who said that they would ignore the troubled peer estimated that others would also ignore or take no action indicates that this response may be supported by an erroneous perceived social norm similar to the perception about peer drug use that was cited earlier. The fact that most of those students who indicated that they would talk or tell estimated that other students would behave in a similar fashion, but with a sizable minority assuming that others would behave less responsibly, is consistent with literature on social comparison which indicates that individuals see themselves as well above average on a variety of dimensions (Brown, 1986; Svenson, 1981; Wylie, 1979). The present study assessed students' responses in analogue situations, and thus may not indicate with complete accuracy how they will respond in actual encounters with troubled peers. While previous bystander interv e n t i o n r e s e a r c h may have b e e n m o r e ecologically valid, t h o s e methodologies are outside of current ethical guidelines. Through pilot testing and discussion with teachers and peer counselors, the effort was made to present students with realistic situations. The written responses of the students were overwhelmingly thorough, serious and thoughtful. "Wise" re-
Bystander intervention and Adolescents' Responses
241
sponses were found to at most two questions on only seven questionnaires of ninth graders. The more typical responses can be illustrated by that of one eleventh grade male in situation 3 who wrote in response to the question, "what do you think will happen next in this situation?": "He will choose one parent to live with and give up a place in his heart." In addition, responses to questions included as manipulation checks provide evidence for the internal validity of vignettes. The responses to the question, "What do you think will happen next in this situation?", provided support for the relative ambiguity of the first and second conditions compared to the third and fourth conditions in that twice as many students failed to mention or imply suicidal behavior in the high ambiguity conditions (32% to 16%). However, the fact that 68% of the students mentioned or implied suicidal behavior indicates that the vignettes produced the desired result of presenting conditions of greater or lesser clarity or likelihood of suicidal behavior, rather than comparing suicidal to non-suicidal conditions. The fact that suicide was more frequently mentioned rather than implied in the high ambiguity compared to the low ambiguity conditions may be due to the demand characteristics of the vignettes. That is, when the vignette consisted of a peer stating "sometimes I think I might as well kill myself" it may be somewhat redundant to state that s(he) might or will kill him/herself. It would be more natural to state some action that indicates that the possibility of suicide is understood, such as confronting the student or telling an adult; and such a response was scored in the "imply" category. When the vignettes implied suicide, as in the high ambiguity conditions, this would pull for a statement that the student is contemplating or might attempt or complete suicide. The fact that students expressed a greater concern when responding to the vignettes when they were alone in the analogue (low diffusion), as compared to being in a group (high diffusion), also might be expected when responsibility for a decision is borne by oneself rather than potentially shared, as is implied in the bystander intervention literature. The finding that females expressed greater concern overall is not only consistent with previous findings that stressful events affecting peers tend to cause more distress for females than males (Compas & Wagner, 1991), but also with the finding in the present study that they were more likely to indicate that they would tell an adult than ignore a troubled peer, as compared to males. Further evidence for the validity of these analogue situations is provided by the findings that responses in this study were not only internally consistent but were also consistent in predicted directions with previous research in the areas of adolescent suicide, bystander intervention, gender differences, social comparison and substance abuse prevention. Therefore,
242
Kalafat et al.
these results may inform adolescent suicide prevention efforts in several ways. National surveys have identified over 200 suicide education prevention programs that directly address students. These programs generally range from one to four hours and have a variety of objectives concerning students' knowledge about and attitudes toward suicide and helping resources (Garland, Whittle & Shaffer, 1989; Smith, Eyman, Dick & Ryerson, 1987). The few evaluations carried out to date provide some evidence for the achievement of knowledge gains and none for attitude change (Kalafat & Elias, 1991). It is suggested that the limited time available in schools to address the topic of youth suicide might best be applied to focused, research based behavioral objectives. Given that peers are most likely to know of a potentially suicidal youth, getting them to take responsible action (i.e., tell an adult) may be the most important behavioral objective of suicide prevention programs for students. If bystander intervention variables are operative in encounters with potentially suicidal peers, then a transactional (Felner & Felner, 1989) prevention program must find a way to encourage students to tell an adult even in those situations in which there is some ambiguity as to the risk, or when other students may also be aware of their troubled peer. The findings of Cauce and Srebnik (1989) concerning the prominence of peer groups in teens' lives suggest that peer networks affect youth behavior both in terms of the support they provide and the values they promote, and these values may serve to support or undermine the goals of prevention programs. Thus, they call for better ways to channel students' energies into activities that promote mutual help. The results of the present study suggest that this may entail addressing those perceived social norms that may lower the cost of ignoring a troubled peer, such as that held by some teens that most of their peers would behave in this manner. The gender differences found in this and other studies also suggest that prevention programs must address the negative attitudes toward possibly suicidal peers and toward seeking adult help that are found more often among males than females. This is particularly important in light of the fact that, among adolescents, male suicide rates are four times that of females (National Center for Health Statistics, 1988). Adopting aspects of other paradigms, such as bystander intervention, is a strategy that can be of assistance to prevention researchers and program developers, particularly in the area of youth suicide. Further studies should be carried out to extend the ways in which social psychology models can be used for social influence based prevention efforts. Through such
Bystander intervention and Adolescents' Responses
243
efforts, w e m a y b e a b l e to i n c r e a s e t h e l i k e l i h o o d t h a t t e e n s will effectively c a r r y o u t t h e i r critical r o l e in t h e p r e v e n t i o n o f y o u t h s u i c i d a l b e h a v i o r .
REFERENCES
Boggs, C. (1986). Project Lifesaver: Child and adolescent suicide prevention in two school systems. Dayton, OH: Suicide Prevention Center, Inc. Bowers, C. & Gilbert, J. (1987). Survey of effectiveness of suicide education program in Richmond schools. Richmond, VA: Crisis Center. Brown, J. D. (1986). Evaluations of self and others: Self-enhancement biases in social judgments. Social Cognition, 4, 353-376. Cauce, A. M. & Srebnik, D. S. (1989). Peer networks and social support: A focus for preventive efforts with youths. In L. A. Bond & B. E. Compas (Eds.) Primary prevention and promotion in the schools. (pp. 235-254). Newbury Park, CA: Sage Publications, Inc. Clark, R. D., I I I & Word, L. E. (1972). Why don't bystanders help? Because of ambiguity? Journal of Personality and Social Psychology, 24, 392-400. Compas, B. E. & Wagner, B. M. (1991). Psychosocial stress during adolescence: Intrapersonal and interpersonal processes. In M. E. Colten & S. Gore (Eds.)Adolescent stress: Causes and consequences. (pp. 67-86). New York: Aldine De Gruyter. Felner, R. D. & Felner, T. Y. (1989). Primary prevention programs in the educational context: A transactional-ecological framework and analysis. In L. A. Bond & B. E. Compas (Eds.) Primary prevention and promotion in the schools. (pp. 13-49) Newbury Park, CA: Sage Publications, Inc. Garland, A., Whittle, B., Shaffer, D. (1989). A national survey of school-based adolescent suicide prevention programs. Journal of the American Academy of Child & Adolescent Psychiatry, 28, 931-934. Harkavy-Friedman, J. M., Asnis, G. M., Boeck, M. & DiFiore, J. (1987). Prevalence of specific suicidal behaviors in a high school sample. American Journal of Psychiatry, 144 1203-1206. Johnson, C. A., Pentz, M. A., Weber, M. D., Dwyer, J. H., Baer, N., MacKinnon, D. P. & Hansen, W. B. (1990). Relative effectiveness of comprehensive community programming for drug abuse prevention with high-risk and low-risk adolescents. Journal of Consulting and Clinical Psychology, 58, 447-456. Kalafat, J. & Elias, M. (In Press). Adolescents' experience with and response to suicidal peers. Suicide and Life-Threatening Behavior. Kalafat, J. & Elias, M. (1991). Evaluation of school-based interventions. In A. A. Leenaars & S. Wenckstern (Eds.) Suicide prevention in schools. (pp. 231-241). New York: Hemisphere Publishing Corp. Latan6, B. & Darley, J. M. (1969). Bystander apathy. American Scientist, 57, 224-268. Latan6, B. & Rodin, J. (1969). A lady in distress: Inhibiting effects of friends and strangers on bystander intervention. Journal of Experimental Social Psychology, 5, 189-202. MacKinnon, D. P., Johnson, C. A., Pentz, M. A., Dwyer, J. H., Hansen, W. B., Flay, B. R. & Wang, E. Y. I. (In Press). Mediating mechanisms in a school-based drug prevention program: First year effects of the Mid-Western Prevention Project. Health Psychology. Meeks, J. (1986). The fragile alliance. Malverne, FLA: Kruger. National Center for Health Statistics (1988). Mortality Statistics Branch, Division of Vital Statistics. Overholser, J. C., Hemstreet, A. H., Spirito, A. & Vyse, S. (1989). Suicide awareness programs in the schools: Effects of gender and personal experience. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 925-930. Parker, J. G. & Asher, S. R. (1987). Peer relationships and later personal adjustment: Are low-accepted children at risk? Psychological Bulletin, 102, 357-389. Ritter, D. (1990). Adolescent suicide: Social competence and problem behavior of youth at high risk and low risk for suicide. School Psychology Review, 19, 83-95.
244
Kalafat et ai.
Robinson, S. M. (1979). Identification of suicidal persons at a suicide prevention center based on their initial contact data. Unpublished Masters thesis, California School of Professional
Psychology. Ross, C. P. (1985). Teaching children the facts of life and death: Suicide prevention in the schools. In M. L. Peck, N. L. Farberow & R. E. Litman (Eds.) Youth Suicide. (pp. 147-169). New York: Springer Publishing Co. Shaffer, D., Garland, A. & Whittle, B. (1988). An evaluation of youth suicide prevention programs. New Jersey adolescent suicide prevention project: Final project report. Trenton, N.J. New Jersey Division of Mental Health and Hospitals. Shafii, M., Whittinghill, J. R., Dolen, D. C., Pearson, V. D., Derrick, A. & Carrington, S. (1984). Psychological reconstruction of completed suicide in childhood and adolescence. In H. S. Sudak, A. B. Ford & N. B. Rushforth (Eds.) Suicide in the young. (pp. 271-294). Boston: John Wright-PSG, Inc. Smith, K. & Crawford, S. (1986) Suicidal behavior among "normal" high school students. Suicide and life threatening behavior, 3, 313-325. Smith, K., Eyman, J. J., Dick, R. & Ryerson, D. (1987, October), Report of the school suicide programs questionnaire. Albuquerque, NM: The Menninger Clinic. Spirito, A., Brown, L., Overholser, J. & Fritz, G. (1989). Attempted suicide in adolescence: A review and critique of the literature. Clinical Psychology Review, 9, 335-363. Svenson, O. (1981). Are we less risky and more skilled than our fellow drivers? Acta Psychologica, 47, 143-148. Trautman, P. D. (1989). Specific treatment modalities for adolescent suicide attempters. Report of the secretary's task force on youth su&ide Volume 3: DHHS Pub. No. (ADM)89-1623 Washington, D.C. Supt. of Docs., U.S. Govt. Print Off. Wellman, M. M. & Wellman, R. J. (1986). Sex differences in peer responsiveness to suicide ideation. Suicide & Life-Threatening Behavior, 3, 360-378. Wylie, R. C. (1979). The self-concept (Vol. 2): Theory and research on selected topics. Lincoln, Neb.: University of Nebraska Press. Youniss, J. (1980). Parents andpeers in socialdevelopment. Chicago: The University of Chicago Press.
The Relationship of Bystander Intervention Variables to Adolescents' Responses to Suicidal Peers John Kalafat, 1,4 Maurice Elias, 2 and Michael A. Gara 3
This study sought to understand factors that might enhance su&ide prevention programs by investigating the responses of adolescents to potentially suicidal peers in analogue situations embodying variables from the social psychological research on bystander intervention. 314 high school students were randomly assigned one of four vignettes about a troubled peer under conditions of high or low diffusion of responsibility (respondent was alone or one of a group) and high or low ambiguity (confronted by a troubled peer or heard an essay written by a peer). Students' statements concerning the likelihood of suicide and their level of concern in the situation provided evidence for the internal validity of the vignettes. Results included significant main effects of ambiguity (more likely to tell an adult than simply talk to the peer in low vs high ambiguous conditions) for males and females, and of diffusion (more likely to ignore or do nothing than talk or tell in high vs low diffuse situations) for males. Students' estimates of how other students would respond corresponded with findings from social comparison research and suggested the operation of an erroneously perceived social norm of no response to a troubled peer by those who indicated that they would ignore the peer. The results have implications for the application of social psychological models to social influence-based prevention efforts to enhance adolescents' roles in the prevention of youth suicidal behavior. KEY WORDS: adolescents; suicidal; peers. 1Spalding University, Department of Psychology, Louisville, KY. 2Rutgers University, Psychology Dept., Piscataway, NJ. 3University of Medicine and Dentistry of New Jersey Community Mental Health Center at
Piscataway. 4Address reprint requests to John Kalafat, Spalding University, Department of Psychology, 851 South 4th Ave., Louisville, KY 40203. 231 @ 1993 HumanSciencesPress, Inc.
232
Kalafat et al.
Current estimates of the incidence of suicide attempts among adolescents in this country place the figure at one out of ten youths (Boggs, 1986; Ritter, 1990; Shaffer, Garland & Whittle, 1988; Smith & Crawford, 1986). The majority of those youthful attempters do not come to the attention of adult caregivers, but are in fact most likely to be known to their peers (Boggs, 1986; Ross, 1985; Shaffer, et al., 1988; Shafii, Whittinghill, Dolen, Pearson, Derrick & Carrington, 1984; Spirito, Brown, Overholser & Fritz, 1988). In surveys of adolescents across the country, roughly one quarter of all males and nearly one half of the females report having known a peer who had talked about or tried to kill themselves (Bowers & Gilbert, 1987; Harkavy-Friedman, Asnis, Boeck, & DiFiore, 1987; Overholser, Hemsteet, Spirito & Vyse, 1989). Such peer confidantes have the potential to play an important role in preventing adolescents from progressing to completed suicide. Ross (1985) called for prevention programs that educate adolescents both as potential victims and rescuers. Shafii and his colleagues concluded their report on psychological autopsies by stating: "The role of friends and peers in the early recognition of suicidal behavior and prevention of suicide cannot be overemphasized." (1984, pg. 293). The most effective preventive response for a youth who is confronted with a suicidal peer would be to tell a responsible adult. When surveys ask youths to endorse their choices from a list of non-mutually exclusive options in response to the hypothetical situation of a friend telling them that s(he) was thinking of killing (him) herself, the majority of respondents indicate that they would tell an adult----(71% in a survey of 2104 students by Boggs (1986); 64% in a survey of 2233 students by Shaffer et al. (1988). However, these surveys do not agree with psychological autopsy studies (Robinson, 1979; Shafii et al., 1984) that indicated that peers knew of, but did not report the victims' suicidal intent. In a recent study that investigated adolescents' reported responses in actual encounters with peers whom they considered to be definitely suicidal, only twenty-four percent reported having told an adult (Kalafat & Elias, in press). NEW APPLICATION FOR AN ESTABLISHED PARADIGM: BYSTANDER INTERVENTION RESEARCH Telling an adult about a suicidal peer may be difficult for adolescents because of their preference for peer confidantes and the importance of keeping confidences among friends at this age (Cauce & Srebnik, 1989; Parker & Asher, 1987; Youniss, 1980), as well as negative feelings about the helpfulness of adults (Meeks, 1986; Trautman, 1989). The behavior of youths with these attitudes and values may in turn be influenced by the
Bystander intervention and Adolescents' Responses
233
characteristics of the contexts in which they encounter a possibly suicidal peer. A prevention program that takes these variables into account has been classified by Felner and Felner (1989) as a transactional program. Such programs identify a set of characteristics of the person as well as the environment that in combination increase the probability of risk behaviors. Felner and Felner further cite specific cases of transactional programs that see the source of risk as the interaction between youths and their peers in which the problematic behavior arises from the situational context. In this case, the design of prevention programs aimed at increasing the rate of adolescents who tell an adult about a suicidal peer requires a better understanding of the vicissitudes of these encounters. The presence of a potentially life-threatening situation in which a responsible intervention has both perceived benefits (in this case, obtaining help for a troubled peer) and costs (breaking a confidence, turning to adults rather than peer helpers, making a fool out of oneself) has been extensively studied and reported in a body of literature known as bystander intervention research. This research may provide some u n d e r s t a n d i n g of adolescents' behavior in this situation that can guide preventive educational efforts. The bystander intervention research---which consisted largely of subjecting individuals to emergency situations staged by confederates---yielded information as to the particular variables that appear to affect the cost of taking or failing to take action. Two of the major variables that were identified are: • number of bystanders (Latan6 & Darley, 1969; Latan6 & Rodin, 1969): the more bystanders, the less likely each is to take action. Two explanations for this phenomenon have been offered. Pluralistic ignorance implies that if the emergency is ambiguous, each bystander is likely to appear unconcerned (and is in fact undecided). This provides a source of normative influence (it is okay to not respond) and information influence (it must not be an emergency). Diffusion of responsibility operates such that as the number of bystanders increases, there is less responsibility for each to take action, as each assumes another can act. • ambiguity (Clark & Word, 1972): if there is some ambiguity as to whether harm is occurring, there is significantly less intervention; intervention is additionally reduced in ambiguous situations by additional bystanders. Another source of normative influence that may affect an adolescent's response to a suicidal peer is his/her belief as to how other adolescents would respond. Findings from the substance abuse prevention literature indicate that perceptions of social norms (use by similar others)
234
Kalafat et al.
are strong predictors of drug use onset. (Johnson, Pentz, Dwyer, Weber, MacKinnon & Hansen, 1990). It was also found that experimentally induced changes in perception of prevalence of drug use by peers and probability of sanctions from friends following one's own use better predicted decreased drug use than other common educational program components, including resistance skills (MacKinnon, Johnson, Pentz, Dwyer, Hansen, Flay & Wang, in press). Similarly, refusal to take responsible action in response to a suicidal peer may be associated with an incorrect belief that most peers would respond in the same way. Clearly, the bystander intervention paradigm suggests several points which may be essential to the success of suicide prevention efforts intended to mobilize responsible youth action when faced with a suicidal peer. The purpose of the present study was to assess the effects of variables derived from the bystander research, including ambiguity of the situation, diffusion of responsibility and beliefs about peers' responses to suicidal peers, on the responses of adolescents to potentially suicidal peers in an analogue situation. Diffusion was defined as whether the adolescent was alone or with a group when confronted by the suicide situation. The responses under investigation were whether the adolescent would take no action (ignore or do nothing), take some action (talk to the troubled peer) or take the action with the highest cost in terms of typical adolescents' preferred ways of dealing with problems (tell an adult). Previous research (Kalafat & Elias, in press) indicated that adolescents' reports of their responses to suicidal peers could be reliably assigned to one of these three categories. It was hypothesized that the high diffusion and high ambiguity conditions would each be associated with a lower frequency of the "tell an adult" response, and a higher frequency of the no action response. It was hypothesized that the no action response would be associated with a belief that the average student would take no action when faced with a potentially suicidal peer. Previous research suggested that females are less opposed to seeking adult help for possibly suicidal peers than males (Kalafat & Elias, in press; Overholser et al., 1989; Spirito et al., 1988); and that negative attitudes toward suicidal individuals and intervening with them are more prevalent among males (Overholser et al., 1989; Wellman & Wellman, 1986). Thus, talking to a troubled peer or telling an adult may be a higher cost option for males than for females, and diffusion and ambiguity were therefore hypothesized to be more likely to suppress these behaviors and/or increase the "no action" response for males than for females.
Bystander intervention and Adolescents' Responses
235
METHOD Conditions Four analogue conditions, consisting of vignettes representing the factors of ambiguity and diffusion were developed for this study. (See Table 1) The vignettes were developed by the authors and three teachers who teach the health curriculum in the secondary school in which the study was conducted. They were pilot tested, along with questions as to how the subject would respond, with a group of peer counselors from another, demographically similar, high school in the same community. Discussion with the teachers and the students indicated that the situations were realistic. Review and discussion of the responses of the peer counselors revealed a variance of responses across situations as well as reported rationales for responses that coincided with the concepts of diffusion and ambiguity (e.g., students responding to the high diffusion situation reported such reactions as "there was less pressure on me"). 1 Each condition was provided by placing one of the vignettes on the front page of a questionnaire. The second page contained the question, "What do you think will happen next in this situation?" The purpose of this question was to compare across conditions (particularly the ambiguous and unambiguous conditions) as to the extent to which (a) suicide was mentioned as an outcome (might or will attempt or complete); (b) suicide was implied by responses involving telling an adult or friends, or confronting the peer; or (c) suicide was neither mentioned or implied, or was not seriously considered. This was intended to provide a manipulation check to assess the internal validity of the vignettes as presenting conditions of greater or lesser ambiguity or likelihood of suicidal behavior, rather than suicidal versus nonsuicidal situations. The third page of the questionnaire contained the following questions: "How would you respond to this situation?"; "How do you think the average student would respond to this situation?"; "How concerned would you be in this situation?" (1 = very, 2 = somewhat, 3 = not very, 4= not at all). This last question was included to provide a further manipulation check as it was hypothesized that students would express greater concern in low versus high diffusion (less responsibility) conditions. Responses to the "How would you respond . . .?" and "How would the average s t u d e n t . . . ? " questions were scored by two raters (an assistant blind to the hypotheses and an author blind to the condition) into one of three categories: 1Note that this study did not provide a test for the "pluralistic ignorance" hypothesis as there was no opportunity to observe cues from other bystanders.
236
Kalafat et al. Table 1. Conditions
Situation 1: Low ambiguity, low diffusion A good friend of yours has seemed troubled lately and has begun to keep more and more to himself. One day you go to see him and he tells you he would like to talk about something, but you must promise to keep it a secret. He seems pretty serious and you value your friendship with him a lot so you agree not to tell anyone what he has to say. H e tells you that he and everyone else would be better off if he were not around. Then he says "Sometimes I think I might as well kill myself." He smiles and shrugs his shoulders when he says it. H e then reminds you of your promise not to tell anyone. You are the only person he trusts, he says, and if you tell, he will never forgive you. Situation 2: Low ambiguity, high diffusion One Friday afternoon at lunchtime, you are sitting around with a small group of friends talking. One person in the group, who is a friend of yours although (s)he is a closer friend to a couple of others in the group, says he wants to explain why he has been keeping to himself lately, but everyone must promise to keep a secret. He seems pretty serious so everyone agrees not to tell anyone what he has to say. He says he thinks that he and everyone else would be better off if he were not around. Then he says "Sometimes I think I might as well kill myself." H e smiles and shrugs his shoulders when he says it. H e then reminds everyone of your promises not to tell anyone or he will never forgive you. The bell rings and everyone hurries for their next class. You know you won't see any of these friends over the weekend. Situation 3: High ambiguity, low diffusion You have a friend at school who has been keeping to himself lately. You know he has trouble at home----his parents are getting divorced and he's now not sure who he will be living with or if there will be enough money for him to go to college. It is Friday and you ask him to go to a party with you but he declines to go. Later that day in English, the teacher is reading sample student's short essays that she had assigned. She doesn't identify the writer but one of them is entitled "(Final) Family Decisions" and describes a very important decision that is about to be made by the writer's parents that will involve whether he will change schools and whether he will be able to go to college. The writer says that he may not go along with his parents' decisions and may make one of his own that will resolve things. You believe that your friend wrote this essay and that you are the only one who knows what he is writing about. Situation 4: High ambiguity, high diffusion You have a friend at school who has been keeping to himself lately. You know he has trouble at home---his parents are getting divorced and he's now not sure who he will be living with or if there will be enough money for him to go to college. It is Friday and you ask him to go to a party with you but he declines to go. Later that day in English, the teacher is reading sample student's short essays that she had assigned. She doesn't identify the writer but one of them is entitled "(Final) Family Decisions" and describes a very important decision that is about to be made by the writer's parents that will involve whether he will change schools and whether he will be able to go to college. The writer says that be may not go along with his parents' decisions and may make one of his own that will resolve things. You believe that your friend wrote this essay and that you and the group of mutual friends, who are also in this class, know what he is writing about. You are going to work right after school and know you won't have a chance to talk to him over the weekend or to your friends until the party late Saturday night.
Bystander intervention and Adolescents' Responses
237
• talk: the student wrote that s(he) would talk to the peer in an attempt to provide support or dissuade him/her from an attempt; or, would talk about the situation with peers. No other action was reported. • tell: the student explicitly wrote that s(he) would tell an adult about this situation. • nothing: the student wrote that s(he) would ignore, or not take seriously, or would do nothing further in response to the situation. It should be noted that the "tell" category is completely dichotomous with the "talk" category. Some students simply wrote that they would tell an adult, while others wrote that they would talk with their peer and then tell an adult. Both were scored "tell." The raters agreed on 91% of their ratings on the first question, and 95% of their ratings on the second question. Differences were resolved prior to analyses.
Procedure The questionnaires were randomly distributed to students during regular health class periods with the instructions that responses were to be anonymous (only students' gender was to be indicated), and they were to proceed through the questions in order as quickly as they could. Students completed the questionnaires in 10-15 minutes and to the authors' knowledge no student failed to complete the questionnaire.
Participants A total of 158 males and 156 females in grades nine and eleven of a predominantly white, middle class suburban high school responded to the questionnaire. Males and females, respectively, were distributed across the conditions as follows: low ambiguity, low diffusion: 42, 39; low ambiguity, high diffusion: 42, 37; high ambiguity, low diffusion: 37, 42; high ambiguity, high diffusion: 37, 38. There were no known completed suicides among the students in this school at any time prior to this study, nor were there any in the other high school in that community. RESULTS Responses to the first question, "What do you think will happen next in this situation?", were analyzed by comparing the responses in the low ambiguity conditions (1&2) to responses in the high ambiguity conditions (3&4). Students were significantly more likely to mention or imply suicide
238
Kalafat et al.
Table 2. Respondent's Estimates as to What Will Happen Next in the Situation Happen Condition Low Ambiguity High Ambiguity
Suicide Mentioned
Suicide Implied
Suicide not Mentioned or implied
33% 40%
51% 28%
15% 31%
x2 = 19.0, p < .001.
Table 3. Response Percentages for Each Condition Response Talk to Peer
Tell an Adult
Ignore/do Nothing
Low Diffusion Low Ambiguity
33%
63%
4%
High Diffusion Low Ambiguity
24%
52%
24%
Low Diffusion High Ambiguity
58%
33%
8%
High Diffusion High Ambiguity
51%
26%
23%
Condition
in the low ambiguity conditions compared to the high ambiguity conditions (84% vs. 68%); students were more likely to mention suicide in the high ambiguity conditions and imply it in the low ambiguity conditions. (See Table 2) A log linear analysis was carried out to assess the effects of diffusion and ambiguity on students' responses to the vignettes (question 2, "How would you respond to this situation?"). Significant overall effects were found for ambiguity (x2 = 30.09, p < .001) and diffusion (x2 = 16.15, p < .001), while no interaction effects were found. Table 3 depicts the percent of students responding in each of the three categories for each of the conditions. Log linear analyses of the effects of the conditions for the sexes separately revealed significant effects for ambiguity (x2 = 24.06, p < .001) and diffusion (x2 = 14.1, p < .009) for males, with no interaction effects; and a significant effect for ambiguity only (x2 = 8.83, p < .01) for females. (See Table 4) In the high diffusion conditions as compared to the low diffusion
Bystander intervention and Adolescents' Responses
239
Table 4. Males and Females Response Percentages for Each Condition Males
Response Condition
Talk to Peer
Tell an Adult
Ignore/do Nothing
Low Diffusion High Diffusion
47% 34%
45% 31%
8% 35%
Low Ambiguity High Ambiguity
24% 60%
54% 19%
22% 21%
Females
Response Condition
Talk to Peer
Tell an Adult
Ignore/do Nothing
Low Diffusion High Diffusion
43% 43%
53% 49%
4% 9%
Low Ambiguity High Ambiguity
34% 52%
62% 39%
4% 9%
conditions, males were more likely to report that they would ignore than talk to their peer or tell an adult. In the low ambiguity conditions as compared to the high ambiguity conditions, both males and females were more likely to report that they would tell an adult than simply talk to their peer. When these data were collapsed across all conditions, females were more likely to report that they would tell an adult (51% vs 38%) than to ignore a troubled peer (6% vs 22%), as compared to males. The relationship between how students responded to the vignettes and their estimates of how the average student would respond is presented in Table 5. The majority of students who indicated that they would talk to the troubled peer estimated that other students would also talk, but one third of them estimated that other students would do nothing. Of those students who indicated that they would tell an adult, nearly as many estimated that other students would do nothing (40%) as estimated that others would tell (45%). A clear majority (71%) of students who indicated that they would do nothing estimated that other students would respond in a similar manner. Students were significantly more concerned in the low diffusion (alone) than the high diffusion (in a group) conditions (x2 = 10.72, p < .01). Overall, females expressed greater concern than males (x2 = 8.69, p < .02).
240
Kalafat et al.
Table 5. Students' Estimates of Average Students' Responses Compared to their Own
Responses Estimates of Average Students' Response Students' own responses Talk to peer Tell an adult Ignore/do nothing
Talk to Peer
Tell an Adult
Ignore/do Nothing
60% 15% 17%
7% 45% 12%
33% 40% 71%
DISCUSSION The findings confirm the hypothesis that conditions of ambiguity and diffusion of responsibility would be associated with differences in adolescents' reported responses to troubled peers in a manner consistent with the bystander intervention research. The hypothesis concerning gender differences was also confirmed. That is, the central findings of this study are that adolescents of both genders may talk with a troubled peer, but only in the relatively unambiguous conditions were the majority compelled to indicate that they would take the more "costly" option of telling an adult. For males, some of whom appear to hold more negative views toward help seeking and less empathic views toward troubled peers, diffusion of responsibility may also lower the cost of the "no response" option. The finding that those who said that they would ignore the troubled peer estimated that others would also ignore or take no action indicates that this response may be supported by an erroneous perceived social norm similar to the perception about peer drug use that was cited earlier. The fact that most of those students who indicated that they would talk or tell estimated that other students would behave in a similar fashion, but with a sizable minority assuming that others would behave less responsibly, is consistent with literature on social comparison which indicates that individuals see themselves as well above average on a variety of dimensions (Brown, 1986; Svenson, 1981; Wylie, 1979). The present study assessed students' responses in analogue situations, and thus may not indicate with complete accuracy how they will respond in actual encounters with troubled peers. While previous bystander interv e n t i o n r e s e a r c h may have b e e n m o r e ecologically valid, t h o s e methodologies are outside of current ethical guidelines. Through pilot testing and discussion with teachers and peer counselors, the effort was made to present students with realistic situations. The written responses of the students were overwhelmingly thorough, serious and thoughtful. "Wise" re-
Bystander intervention and Adolescents' Responses
241
sponses were found to at most two questions on only seven questionnaires of ninth graders. The more typical responses can be illustrated by that of one eleventh grade male in situation 3 who wrote in response to the question, "what do you think will happen next in this situation?": "He will choose one parent to live with and give up a place in his heart." In addition, responses to questions included as manipulation checks provide evidence for the internal validity of vignettes. The responses to the question, "What do you think will happen next in this situation?", provided support for the relative ambiguity of the first and second conditions compared to the third and fourth conditions in that twice as many students failed to mention or imply suicidal behavior in the high ambiguity conditions (32% to 16%). However, the fact that 68% of the students mentioned or implied suicidal behavior indicates that the vignettes produced the desired result of presenting conditions of greater or lesser clarity or likelihood of suicidal behavior, rather than comparing suicidal to non-suicidal conditions. The fact that suicide was more frequently mentioned rather than implied in the high ambiguity compared to the low ambiguity conditions may be due to the demand characteristics of the vignettes. That is, when the vignette consisted of a peer stating "sometimes I think I might as well kill myself" it may be somewhat redundant to state that s(he) might or will kill him/herself. It would be more natural to state some action that indicates that the possibility of suicide is understood, such as confronting the student or telling an adult; and such a response was scored in the "imply" category. When the vignettes implied suicide, as in the high ambiguity conditions, this would pull for a statement that the student is contemplating or might attempt or complete suicide. The fact that students expressed a greater concern when responding to the vignettes when they were alone in the analogue (low diffusion), as compared to being in a group (high diffusion), also might be expected when responsibility for a decision is borne by oneself rather than potentially shared, as is implied in the bystander intervention literature. The finding that females expressed greater concern overall is not only consistent with previous findings that stressful events affecting peers tend to cause more distress for females than males (Compas & Wagner, 1991), but also with the finding in the present study that they were more likely to indicate that they would tell an adult than ignore a troubled peer, as compared to males. Further evidence for the validity of these analogue situations is provided by the findings that responses in this study were not only internally consistent but were also consistent in predicted directions with previous research in the areas of adolescent suicide, bystander intervention, gender differences, social comparison and substance abuse prevention. Therefore,
242
Kalafat et al.
these results may inform adolescent suicide prevention efforts in several ways. National surveys have identified over 200 suicide education prevention programs that directly address students. These programs generally range from one to four hours and have a variety of objectives concerning students' knowledge about and attitudes toward suicide and helping resources (Garland, Whittle & Shaffer, 1989; Smith, Eyman, Dick & Ryerson, 1987). The few evaluations carried out to date provide some evidence for the achievement of knowledge gains and none for attitude change (Kalafat & Elias, 1991). It is suggested that the limited time available in schools to address the topic of youth suicide might best be applied to focused, research based behavioral objectives. Given that peers are most likely to know of a potentially suicidal youth, getting them to take responsible action (i.e., tell an adult) may be the most important behavioral objective of suicide prevention programs for students. If bystander intervention variables are operative in encounters with potentially suicidal peers, then a transactional (Felner & Felner, 1989) prevention program must find a way to encourage students to tell an adult even in those situations in which there is some ambiguity as to the risk, or when other students may also be aware of their troubled peer. The findings of Cauce and Srebnik (1989) concerning the prominence of peer groups in teens' lives suggest that peer networks affect youth behavior both in terms of the support they provide and the values they promote, and these values may serve to support or undermine the goals of prevention programs. Thus, they call for better ways to channel students' energies into activities that promote mutual help. The results of the present study suggest that this may entail addressing those perceived social norms that may lower the cost of ignoring a troubled peer, such as that held by some teens that most of their peers would behave in this manner. The gender differences found in this and other studies also suggest that prevention programs must address the negative attitudes toward possibly suicidal peers and toward seeking adult help that are found more often among males than females. This is particularly important in light of the fact that, among adolescents, male suicide rates are four times that of females (National Center for Health Statistics, 1988). Adopting aspects of other paradigms, such as bystander intervention, is a strategy that can be of assistance to prevention researchers and program developers, particularly in the area of youth suicide. Further studies should be carried out to extend the ways in which social psychology models can be used for social influence based prevention efforts. Through such
Bystander intervention and Adolescents' Responses
243
efforts, w e m a y b e a b l e to i n c r e a s e t h e l i k e l i h o o d t h a t t e e n s will effectively c a r r y o u t t h e i r critical r o l e in t h e p r e v e n t i o n o f y o u t h s u i c i d a l b e h a v i o r .
REFERENCES
Boggs, C. (1986). Project Lifesaver: Child and adolescent suicide prevention in two school systems. Dayton, OH: Suicide Prevention Center, Inc. Bowers, C. & Gilbert, J. (1987). Survey of effectiveness of suicide education program in Richmond schools. Richmond, VA: Crisis Center. Brown, J. D. (1986). Evaluations of self and others: Self-enhancement biases in social judgments. Social Cognition, 4, 353-376. Cauce, A. M. & Srebnik, D. S. (1989). Peer networks and social support: A focus for preventive efforts with youths. In L. A. Bond & B. E. Compas (Eds.) Primary prevention and promotion in the schools. (pp. 235-254). Newbury Park, CA: Sage Publications, Inc. Clark, R. D., I I I & Word, L. E. (1972). Why don't bystanders help? Because of ambiguity? Journal of Personality and Social Psychology, 24, 392-400. Compas, B. E. & Wagner, B. M. (1991). Psychosocial stress during adolescence: Intrapersonal and interpersonal processes. In M. E. Colten & S. Gore (Eds.)Adolescent stress: Causes and consequences. (pp. 67-86). New York: Aldine De Gruyter. Felner, R. D. & Felner, T. Y. (1989). Primary prevention programs in the educational context: A transactional-ecological framework and analysis. In L. A. Bond & B. E. Compas (Eds.) Primary prevention and promotion in the schools. (pp. 13-49) Newbury Park, CA: Sage Publications, Inc. Garland, A., Whittle, B., Shaffer, D. (1989). A national survey of school-based adolescent suicide prevention programs. Journal of the American Academy of Child & Adolescent Psychiatry, 28, 931-934. Harkavy-Friedman, J. M., Asnis, G. M., Boeck, M. & DiFiore, J. (1987). Prevalence of specific suicidal behaviors in a high school sample. American Journal of Psychiatry, 144 1203-1206. Johnson, C. A., Pentz, M. A., Weber, M. D., Dwyer, J. H., Baer, N., MacKinnon, D. P. & Hansen, W. B. (1990). Relative effectiveness of comprehensive community programming for drug abuse prevention with high-risk and low-risk adolescents. Journal of Consulting and Clinical Psychology, 58, 447-456. Kalafat, J. & Elias, M. (In Press). Adolescents' experience with and response to suicidal peers. Suicide and Life-Threatening Behavior. Kalafat, J. & Elias, M. (1991). Evaluation of school-based interventions. In A. A. Leenaars & S. Wenckstern (Eds.) Suicide prevention in schools. (pp. 231-241). New York: Hemisphere Publishing Corp. Latan6, B. & Darley, J. M. (1969). Bystander apathy. American Scientist, 57, 224-268. Latan6, B. & Rodin, J. (1969). A lady in distress: Inhibiting effects of friends and strangers on bystander intervention. Journal of Experimental Social Psychology, 5, 189-202. MacKinnon, D. P., Johnson, C. A., Pentz, M. A., Dwyer, J. H., Hansen, W. B., Flay, B. R. & Wang, E. Y. I. (In Press). Mediating mechanisms in a school-based drug prevention program: First year effects of the Mid-Western Prevention Project. Health Psychology. Meeks, J. (1986). The fragile alliance. Malverne, FLA: Kruger. National Center for Health Statistics (1988). Mortality Statistics Branch, Division of Vital Statistics. Overholser, J. C., Hemstreet, A. H., Spirito, A. & Vyse, S. (1989). Suicide awareness programs in the schools: Effects of gender and personal experience. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 925-930. Parker, J. G. & Asher, S. R. (1987). Peer relationships and later personal adjustment: Are low-accepted children at risk? Psychological Bulletin, 102, 357-389. Ritter, D. (1990). Adolescent suicide: Social competence and problem behavior of youth at high risk and low risk for suicide. School Psychology Review, 19, 83-95.
244
Kalafat et ai.
Robinson, S. M. (1979). Identification of suicidal persons at a suicide prevention center based on their initial contact data. Unpublished Masters thesis, California School of Professional
Psychology. Ross, C. P. (1985). Teaching children the facts of life and death: Suicide prevention in the schools. In M. L. Peck, N. L. Farberow & R. E. Litman (Eds.) Youth Suicide. (pp. 147-169). New York: Springer Publishing Co. Shaffer, D., Garland, A. & Whittle, B. (1988). An evaluation of youth suicide prevention programs. New Jersey adolescent suicide prevention project: Final project report. Trenton, N.J. New Jersey Division of Mental Health and Hospitals. Shafii, M., Whittinghill, J. R., Dolen, D. C., Pearson, V. D., Derrick, A. & Carrington, S. (1984). Psychological reconstruction of completed suicide in childhood and adolescence. In H. S. Sudak, A. B. Ford & N. B. Rushforth (Eds.) Suicide in the young. (pp. 271-294). Boston: John Wright-PSG, Inc. Smith, K. & Crawford, S. (1986) Suicidal behavior among "normal" high school students. Suicide and life threatening behavior, 3, 313-325. Smith, K., Eyman, J. J., Dick, R. & Ryerson, D. (1987, October), Report of the school suicide programs questionnaire. Albuquerque, NM: The Menninger Clinic. Spirito, A., Brown, L., Overholser, J. & Fritz, G. (1989). Attempted suicide in adolescence: A review and critique of the literature. Clinical Psychology Review, 9, 335-363. Svenson, O. (1981). Are we less risky and more skilled than our fellow drivers? Acta Psychologica, 47, 143-148. Trautman, P. D. (1989). Specific treatment modalities for adolescent suicide attempters. Report of the secretary's task force on youth su&ide Volume 3: DHHS Pub. No. (ADM)89-1623 Washington, D.C. Supt. of Docs., U.S. Govt. Print Off. Wellman, M. M. & Wellman, R. J. (1986). Sex differences in peer responsiveness to suicide ideation. Suicide & Life-Threatening Behavior, 3, 360-378. Wylie, R. C. (1979). The self-concept (Vol. 2): Theory and research on selected topics. Lincoln, Neb.: University of Nebraska Press. Youniss, J. (1980). Parents andpeers in socialdevelopment. Chicago: The University of Chicago Press.
