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University Microfilms International 300 North Zeeb Road Ann Arbor INFORMATION TO USERS This material was produced from a microfilm copy of the original document. While the moat advanced technological means to photograph and reproduce this document have been used, the quality is heavily dependent upon the quality of the original submitted. The following explanation of techniques is provided to help you understand markings or patterns which may appear on this reproduction. 1. The sign or "target" for pages apparently lacking from the document photographed is "Missing Page(s)". If it was possible to obtain the missing page(s) or section, they are spliced into the film along with adjacent pages. This may have necessitated cutting thru an image and duplicating adjacent pages to insure you complete continuity. 2. When an image on the film is obliterated with a large round black mark, it is an indication that the photographer suspected that the copy may have moved during exposure and thus cause a blurred image. You will find a good image of the pege in the adjacent frame. 3. When a map, drawing or chart, etc., was part of the material being photographed the photographer followed a definite method in "sectioning" the material. It is customary to begin photoing at the upper left hand corner of a large sheet and to continue photoing from left to right in equal sections with a small overlap. If necessary, sectioning is continued again — beginning below the first row and continuing on until complete. 4. The majority of users indicate that the textual content is of greatest value, however, a somewhat higher quality reproduction could be made from "photographs" if essential to the understanding of the dissertation. Silvar prints of "photographs" may be ordered at additional charge by writing the Order Department, giving the catalog number, title, author and specific pages you wish reproduced. 5. PLEASE NOTE: Some pages may have indistinct print. Filmed as received. University Microfilms International 300 North Zeeb Road Ann Arbor. Michigan 48t06 USA St. John's Road. Tylar's Groan High Wycombe. Bucks. England HP 10 8HR I I 77-31,810 ABRAHAM, Yair, 1946- PATTERNS OF COMMUNICATION AND REJECTION IN FAMILIES OF SUICIDAL ADOLESCENTS. The Ohio State University, Ph.D., 1977 Education, psychology University Microfilms InternationalAnn ,Arbor, Michigan 48106 PATTERNS OF COMMUNICATION AND REJECTION IN FAMILIES OF SUICIDAL ADOLESCENTS DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Yair Abraham, B.A., M.A. The Ohio State University 1977 Reading Committee: Approved By Herbert E. Rie Henry R Angelino Malcolm M. Helper Adviser Department of Psychology ACKNOWLEDGMENTS It gives me much pleasure to acknowledge my indebtedness to the many persons whose assistance and cooperation made the completion of this re­ search project possible. Dr. Herbert Rie, ray academic adviser, was involved in every phase of the study. The constructive remarks and invaluable ideas he offered made my work a genuine educational experience. Dr. Henry Angelino and Dr. Malcolm Helper served as members of the dissertation committee and contributed much of their time. Dr. Charles Wenar provided important en­ couragement and support during the initial stage of this undertaking. Much gratitude is extended to Dr. Ferdinand van der Veen for his permission to use The Family Concept Test, and to Dr. Antonio Ferreira for his permission to use The Unrevealed Differences Technique. Special thanks are deserved by all the hospitals and mental health agencies, too numerous to be listed here, for allowing access to their patients, offering the use of their facilities, and bearing with my fre­ quent intrusions. Many thanks must go to those families which volunteered their time and patiently accepted my intrusions into their privacy. My greatest thanks are due to ray wife, Ety. She always found the time and energy to assist, support and encourage me. By contributing much more than her fair share to our family's life she allowed me all the time needed for the completion of this work. All these while working on her own dissertation. -ii- VITA December IS, 1946 ................ B o m - Ramatayim, Israel 1970 ............................. B.A., The Hebrew University, Jerusalem, Israel 1971-1972 ........................ Research Assistant, Department of Educational Development, The Ohio State University, Columbus, Ohio 1972-1974 ......................... Teaching Associate, Department of Psychology, The Ohio State Univer­ sity, Columbus, Ohio 1973 ............................. M.A., The Ohio State University, Columbus, Ohio 1974-1975 ......................... Clinical-Child Internship, Philadelphia Child Guidance Clinic, Philadelphia, Pennsylvania FIELDS OF STUDY Major Field: Clinical-Child Psychology Minor Field: Developmental Psychology -iii- TABLE OF CONTENTS Page ACKNOWLEDGMENTS.................... ii VITA ............................................................ iii LIST OF TABLES ................................................. vi INTRODUCTION ................................................... 1 Chapter I. REVIEW OF THE L I T E R A T U R E ................................. 3 The Incidence and Severity of Adolescent Suicidal Behavior ................................... 3 Theories of Suicide ................................... 6 General Empirical Studies of Adolescent Suicidal Behavior ................................... 19 Family Studies ....................................... 24 Family Interaction Theory ............................. 35 Statement of the Problem ............................. 36 II. METHODOLOGY .............................................. 39 S u b j e c t s ............................................... 39 Instruments ........................................... 47 Procedure ............................................. 55 III. RESULTS .................................................. SB Hypothesis 1--Intra-Familial Closeness, Com­ munication, Sensitivity, and Responsiveness .......... 58 Hypothesis 2--Family Efficiency ....................... 65 Hypothesis 3--Perceived Family Effectiveness .......... 65 Hypothesis 4--Family Satisfaction ..................... 66 Hypothesis 5--IP's Position Within His Own F a m i l y ............................................... 69 Hypothesis 6— Perception of One's Own Status .......... 75 IV. DISCUSSION ................................................ 77 Evaluation and Implications ........................... 84 Suggestions for Further Studies ....................... 86 -iv- APPENDIX A. The Unrevealed Differences Technique ..................... 87 B. The Family Concept Test: Real and I d e a l ................. 97 C. The Statement Game: Negative and Positive .............. 106 D. The Guessing Game ........................... 109 LIST OF REFERENCES ............................................. Ill -v- LIST OF TABLES Page 1. Age, Sex and Sibling Position of the Identified Patient in Three Groups ................................... 46 2. Formal and General Characteristics of All Families, by Group . 48 3. Means and Standard Deviations of Dyadic SA Scores and FSA Scores for Each Group ........................................60 4. Means and Standard Deviations of CF and FCF Scores by Role and Group .................................................... 62 5. Group Means and Standard Deviations for Four Measures of Accuracy of Identification of Statements Made by Family Members ...................................................... 64 6. Means and Standard Deviations of FE Scores by Role and Group . 67 7. Means and Standard Deviations of FS Scores by Role and Group . 68 8. IP*s Relative Position Within His Family in Terms of His SA Scores, for Each Gr o u p .........................................70 9. Means and Standard Deviations of NSR and PSR Scores by Group and Role .................................................... 72 10. Means and Standard Deviations of NPBO and PPBO Scores by Group and R o l e ................................................ 74 11. Means and Standard Deviations of NSP and PSP Scores by Group and Role .................................................... 76 -vi- INTRODUCTION Suicidal behavior among adolescents has been increasing at a steady rate in recent years. It now ranks as the third leading cause of death of teenagers and there are no signs that the trend may subside in the near future. Historically, suicide had been perceived as a sinful and immoral act. It was Freud's thinking that marked the beginning of a more human­ istic approach, one which treats suicide as an understandable human reaction to stress. However, psychoanalytic' explanations emphasized the unconscious, irrational and maladaptive nature of suicide and focused on inner stresses and conflicts. Traditional psychological theories em­ ployed intrapsychic constructs such as self-punishment, rebirth and reunion fantasies, object loss, and hopelessness and despair to account for a person’s attempt to voluntarily end his own life. Only few con­ cerned themselves with developmental considerations or attempted to ac­ count for adolescent suicide rather than suicide in general. Sociological theories, on the other hand, placed the emphasis on external stresses and social disintegration as the major or even exclu­ sive causes of suicidal behavior. More recently a few attempts were made to integrate empirical data with learning theories, most notably, the drive reduction theory, avoid­ ance learning, modeling, and
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