Depression and Suicidal Ideation among College Students with and without Learning Disabilities in Nigeria
Abstract
This study investigated depression and suicidal ideation in students with and without learning disabilities in two Colleges of Education in Nigeria. The students in this study were between 18 and 24 years old, numbering 391 in total. The number of male students was 165, while female students were 226. Five valid and reliable instruments were used to carry out the study. The study adopted a descriptive research design, and purposive sampling technique was used to select the population. Data was analyzed using mean, standard deviation and Pearson product moment correlation. In this study, students with learning disabilities experienced more depression and were more prone to suicidal ideation when compared to their mates without learning disabilities. One of the recommendations in the study is that mental health experts need to address mental health issues and suicidality affecting students in tertiary institutions.
Keywords: Depression, suicidal ideation, learning disabilities, students
Introduction
Depression is a serious mental health problem that may lead to different ripple effects in students. One of such ripple effects is suicidal ideation or suicidal thoughts which may lead to suicide attempts or suicide. Suicidality or suicidal behaviour exists along a continuum that extends from suicidal ideation or thoughts, suicide related communications, suicide attempts and finally suicide (CDCP, 2008). While a review of theoretical and empirical works show that researches on depression and its effects on Nigerian students are common, investigations on depression and its effect on suicidality in Nigerian students are, however, not that common. Schlebusch, Burrows and Wada (2009), Palmier (2011), Fine, Alison, Vanderwesthuizen and Kruger (2012), and Norhayati and Suen (2014) reported that researches on suicidality in the developing world are sparse for a number of reasons such as socio-cultural taboos, political and economic instability, cultural and religious diversity and beliefs. In relation to taboo, committing suicide is seen as disgraceful and families of people who commit suicide do not openly come out to verify that a family member has committed suicide. As such, depression and suicidal ideation in Nigerian students with and without learning disabilities need to be diagnosed and treated so that these students do not go on to commit suicide.
Literature Review
A sizable population of students with and without learning disabilities are not immune to depression and suicidal ideation; an observation that has been buttressed by many scholars. Wilson et al. (2009) found high levels of depression and suicidal thoughts among participants with learning disabilities aged 15 – 44 in their study. Other participants in the study who were of the same age range, without learning disabilities were not as depressed and prone to suicidal ideations as the participants with learning disabilities. Interestingly, female participants with learning disabilities in the work of Wilson et al. (2009) were shown to have higher mental health problems and suicidal ideation. Research by Renee, James and Ashley (2011) has affirmed that students identified as having learning disabilities experience more symptoms of depression and suicidal ideation compared to students without learning disabilities. Medoff's study (2007) showed that depression had a strong link with suicidal behaviours in students with and without learning disabilities. Females with and without learning disabilities in this study had higher levels of depression and suicidal behaviours. Saghatoleslami (2005) opined that there is a link between depression and suicidal ideation in students with learning disabilities. Moon (2006), Oh, Park and Choi (2008) averred that poor academic performance could aggravate depression and suicidal ideation among students. It should be noted that while poor academic performance can occur generally in students, it is one of the major factors that denominate an individual as having learning disabilities as reported by Steenken (2000) in her work.
Sullivan's work (2007) indicates a link between depression and suicidal ideation in the population of students with disabilities. A significant number of scholars reported in their studies that depression could result in suicidal ideation in students without learning disabilities (Norhayati & Suen, 2014; Cheung & Dewa, 2006); Shaffer & Waslick, 2002; Garlow et al. 2007; Galaif et al., 2007; Arria et al., 2009; Wild, Flisher, & Lombard, 2004; Cannetto, 2008; King et al., 2001; Dunlay, Aquah & Wilson, 2015).
A systematic review of literature by Evans, Hawton and Rodham (2004) also linked depression as one of the factors causing suicidality in students. Depression and suicidality in the work of Cheung and Dewa (2006) were found to be higher in female students when compared to their male participants. Shaffer and Waslick (2002) also reported that adolescent females are at higher risk for developing depression and suicidality compared to their male counterparts. Researches and theoretical postulations have posited many factors responsible for depression which leads to suicidal ideation in students with and without learning disabilities. Poor self concept and low self esteem as observed by Shaghatoleslami (2005) have a link to depression and suicidal ideation in students with learning disabilities. Students with learning disabilities and those with mathematical disabilities in Alesi, Rappo and Pepi (2014)’s study experienced low self esteem and depression. Rosetti and Henderson (2013) averred that individuals with learning disabilities reported lower levels of self esteem. The researches of Orth, Robins and Roberts (2008), and Jayanthi and Rajkumar (2014) revealed a correlation between low self esteem and depression among students without learning disabilities. Sowislo and Orth (2013) also stated that it is widely believed that low self esteem results in depression. Depression according to Katz, Chapman and Chun (2010) is higher in those who have school problems. Katz et al. (2010) confirmed that the population of those who have school problems include those with learning disabilities. Academic problems according to Bansal and Yamuna (2012), Bandura et al. (1999), Oh et al. (2008), Park (2009) and Moon (2006) predict depression in students. Academic stress, academic failure and academic problems were discovered in the studies of Flatt (2013), Furr et al. (2001), and Mojs et al. (2012) as correlating with depression in students and young adults in higher institutions.
Mojs et al. (2012) also linked poor financial status to depression in students and young adults in their study. Increased sensitivity to rejection in romantic relationships and feelings of worthlessness among other factors were also discovered in the work of Bansal and Yamuna (2012) as predicting depression in students. Romantic relationship problems were linked to depression in students by Andrews (2010). Grupp-Phelan and Delgado (2008) similarly described relationship difficulty such as a breakup with a significant other as correlating with depression in students. Family factors were reported by Consoli et al. (2013) as having links to depression in students. Despite all this evidence on depression and suicidality, researches linking psycho-social problems, for example depression, to suicidality and specifically suicidal ideation in Nigerian students with and without learning disabilities are sparse. Omigbodun et al. (2008) according to Palmier (2011) were the first set of researchers to investigate the relationship between suicidal ideation and suicide attempt and associated psycho-social factors in youths aged 10 – 17 in South-west Nigeria.
Information on links between mental health problems, suicidality or suicidal behaviours is limited in Nigeria due to certain reasons. Attempting or committing suicide is regarded as taboo and these acts are discussed in hushed tones. When information is sought about an individual who has committed suicide in a family, family members will often deny that the reason for death is suicide. Cultural or traditional beliefs in some families such as the need to perform certain rituals before a person that has committed suicide is buried also hampers information on suicide. Some families keep silent about family members who have committed suicide because they may sometimes not want to partake in such rituals that expose their family member as having committed suicide. From the religious point of view, it is believed in some quarters that anybody who commits suicide will go to hell. Hence, a person who wants to commit suicide may give no hint about committing suicide so as not to be dissuaded by religious authorities. In some instances in the African setting, it is strongly believed that a person who commits suicide is under a spell or a curse. Families whose members commit suicide are also sometimes stigmatised. Children and young adults in the African setting are to be seen and not heard by adults. As such, they are, most of the time, not free to discuss their feelings or problems with adults. This lack of freedom may also hinder them from discussing their thoughts with their family or peers. Due to this, it is obvious then that little information is available on suicidal ideation, suicide plans and attempts in Nigeria.
Nigerian students have one of the highest rates of suicidal ideation and attempts. These rates and attempts are comparable to those of other developing countries and higher than developed countries. (Omigbodun et al 2008). It is therefore imperative to conduct researches on suicidal behaviours and factors that may trigger them, of which depression is one such factor. If depression and suicidal ideation are not nipped in the bud in students, the rate of suicide in this population may become alarmingly high, which would be detrimental to national well-being.
Statement of the Problem
Depression and suicidal ideation are serious mental conditions that put those affected at risk for attempted suicide or suicide. The developed world, unlike developing countries has carried out a number of researches that have linked depression and suicidality in students. Such researches have provided the developed world with statistical data that can be used to provide assistance to those who are prone to depression and suicidality. Nigeria is not known to have a data bank where information on depression and suicidality among students with and without learning disabilities can be accessed. Lack of information on depression and suicidality in Nigerian students is due to religious, cultural and traditional beliefs. Researches on depression and suicidality in Nigeria will provide statistics that can guide mental health experts and related professionals on how to overcome these problems. Students, with or without learning disabilities, need to be assisted to overcome factors that predispose them to depression and suicidal ideation so that they will not go on to attempt or commit suicide.
Research Questions
The following research questions were formulated to guide the direction of the study:
1.Is there a relationship between depression and suicidal ideation in students with and without learning disabilities sampled in this study?
2.Do students with learning disabilities experience more depression and suicidal ideation compared to students without learning disabilities?
3.Are female participants in this study more prone to depression and suicidal ideation compared to their male counterparts?
4.Do female students with learning disabilities experience higher depression and suicidal ideation compared with female students without learning disabilities?
5.Do male students with learning disabilities experience higher depression and suicidal ideation compared with male students without learning disabilities?
6.What are the factors responsible for depression and suicidal ideation in students with and without learning disabilities?
Purpose of the Study
1.To investigate whether depression leads to suicidal ideation in students with and without learning disabilities in two selected Colleges of Education in Oyo State Nigeria.
2.To investigate whether gender determines depression and suicidal ideation in the students sampled.
3.To identify the factors that lead to depression which in turn leads to suicidal ideation in these students.
Significance of the Study
Based on an extensive literature search, it can be established that this study is one of the few studies that has been able to establish a link between depression and suicidal ideation in some students with and without learning disabilities in two tertiary institutions in Nigeria. Findings in this study are also significant because they are in line with what has been established in a number of researches in this area in the developed world.
This work may also sensitise Nigerian researchers to carry out more studies of this nature. Carrying out more of these studies in the Nigerian setting would create a database for world bodies such as the World Health Organisation and mental health experts. Information from such databases can be used to intervene in the mental health problems and suicidal behaviours in students with and without learning disabilities in Nigeria.
Scope of the Study
This study was carried out on 391 students in two Colleges of Education in Oyo town located in Oyo State Nigeria. The names of the higher education institutions are Federal College of Education (Special) and Emmanuel Alayande College of Education.
Research Design
A descriptive survey research design was adopted for the study. The implication of this is that no variables were manipulated. The study is therefore the ex-post facto type where data is usually collected after the events have already taken place. In this study, the events as mentioned relate to depression and suicidal ideation.
Population of the Study
The population of the study were all parts two and three students of the Federal College of Education (Special), Oyo and Emmanuel Alayande College of Education Oyo, Nigeria.
Sample and Sampling Technique
391 students ranging between 18 and 24 years participated in this study. 165 were males and 226 were females. Of this number, 252 manifested learning disabilities manifestations. This group comprised 108 males and 144 females. Participants without learning disabilities numbered 139 comprising 57 males and 82 females. Convenience sampling was used in this study, because all the students who expressed willingness participated in the study.
Instrumentation
Five instruments were used to obtain the data for the study; these are presented in Table 1 below.
All the instruments were revalidated in November/December of 2014 through pilot/trial testing. The Checklist of Factors responsible for Depression in students developed by the researchers itemised five factors (see Table 8 below) causing depression in participants. Standardised instruments and the developed checklist were subjected to trial testing and therefore revalidated using item total correlation. The new reliability coefficients using Cronbach’s Alpha and range of Item Total Correlation (ITC) are reported in Table 1. Table 2 below presents the details of the instruments and the constructs being tested.
Procedure for Administration of Instruments
391 students from two colleges of education who indicated interest in the research were the sample for the study. Participants for the study were screened for Attention Deficit Hyperactivity Disorder (ADHD) using the Six Item Adult Self Report Scale. This scale was used to screen for ADHD to ensure that it was not an additional problem that could lead to depression and suicidal ideations in the sample as reported in the literature. The Beck Depression Inventory II was used to screen participants for symptoms of depression while the Checklist of Factors Responsible for Depression in College Students was used to screen for factors causing depression in the sample. The Modified Scale for Suicidal Ideation was used to screen for suicidal ideation in participants. Participants with and without learning disabilities did not manifest symptoms of ADHD, but were found to exhibit symptoms of depression. The Checklist of Factors Responsible for Depression was used to elicit factors responsible for symptoms of depression in participants.
Findings
Research Question 1
Is there any relationship between depression and suicidal ideation in students with and without learning disabilities?
Table 3 reveals that a significant relationship exists between depression and suicidal ideation in students with learning disabilities (r = .619; p<0.05) while a less significant relationship exists between depression and suicidal ideation in students without learning disabilities (r = .423; p< 0.05).
Research question 2
Do students with learning disabilities experience more depression and suicidal ideation compared to students without learning disabilities (LD)?
Table 4 below shows that the mean of the scores for students with LD was 77.51 (n=252) while that for students without LD was 31.62 (n=139). This shows that there is a clear difference in the experience of the two groups. The mean of students with LD is higher; this means they experience more depression and suicidal ideation.
Research question 3
Are female participants in this study more prone to depression and suicidal ideation compared to their male counterparts?
Table 5 below shows that the mean of the score for male students was 36.87 (n=165) while the mean of the score for female students was 79.63 (n=226). This indicates that there is clear difference in the tendency of male and female students to depression and suicidal ideation. The mean of the score for female students is higher, showing that they are more prone to depression and suicidal ideation.
Research question 4
Do female students with learning disabilities experience higher depression and suicidal ideation compared with female students without learning disabilities?
Table 6 below shows that the mean of female students with LD + D + SI was 78.23 (n=144) and the mean of female students without LD + D + SI was 32.54 (n=82). The mean of female students with LD+D+SI is higher showing that they experience higher depression and suicidal ideation.
Research question 5
Do male students with LD+D+SI experience higher depression and suicidal ideation compared with male students without LD+D+SI?
Table 7 below shows that the mean of male students with LD + D + SI was 76.25 (n=108) while the mean of male students without LD + D + SI was 30.35 (n=57). The mean of male students with LD+D+SI is higher; it implies that male students with LD+D+SI experience higher depression and suicidal ideation compared to those without.
Research question 6
What are the factors responsible for depression and suicidal ideation in students with and without learning disabilities?
From Table 8 below the majority of students with and without LD+D+SI agreed that academic stress, problems with romantic relationships, poor economic background and trouble at home, are responsible for depression and suicidal ideation. The number of students with LD+D+SI who agreed on low self esteem as a factor for D+SI is higher than the number of students without LD+D+SI.
Discussion
This research shows that there is indeed a relationship between depression and suicidal ideation in students with and without learning disabilities. Students with learning disabilities however experienced more depression and suicidal ideation when compared to their peers without learning disabilities. These findings are in line with the studies of Wilson et al. (2009), Renee et al. (2011) Garlow et al. (2008) and Dunlay et al. (2015). Overall as expected, the female participants in this study experienced more depression and suicidal thoughts compared to males, and females with learning disabilities experienced more depression and suicidal ideation than females without learning disabilities. Male students with learning disabilities also recorded higher depression and suicidal ideation when compared to their male participants without learning disabilities. This concurs with Wilson et al (2009) who found higher depression and suicidal ideation in female students with learning disabilities in their study. An interesting finding revealed that depression and suicidal thoughts in males with learning disabilities were not as high as those found in their female counterparts.
Medoff (2006) discovered “higher levels of depression and suicidal behaviours in female students with and without learning disabilities in his study on Native American Adolescents. Depression and suicidality were also found to be higher in female students without learning disabilities in Cheung and Dewa (2006) and Shaffer and Waslick (2002) when compared to the male participants. Low self esteem, trouble at home and academic stress were selected by the majority of students with learning disabilities in this study as causing depression. The majority of these participants also selected problems with romantic relationships and poor economic background as factors leading to depression. Academic stress, poor economic background, trouble at home and problems with romantic relationships were selected by participants without learning disabilities as factors responsible for their depression.
Saghatoleslami (2005), Rappo and Pepi (2014) Rosetti and Henderson (2013) all observed that low self esteem correlates with depression in students with learning disabilities which concurs with the findings of this study. As confirmed in this study, Mojs et al. (2012) reported a relationship between poor financial status, rejection in romantic relationships and depression in students. Academic stress, academic failure and academic problems were reported by Flatt (2013), Furr et al. (2001), Mojs et al. (2012), Bansal and Yamana (2012), Bandura et al. (1999), Oh et al. (2008), Park (2009) and Moon (2006) as correlating with depression in young adults and students in higher institutions.
Conclusions and Recommendations
Students in any nation are potential nation builders. As such, they are the bedrock of the nation and their mental and physical health need to be monitored and take care of. Those who experience mental health problems and suicidal ideation need swift intervention so that they do not commit suicide. A sad incident that occurred during this study confirms the dire need for young people's health to be monitored and looked after. A participant identified as manifesting learning disabilities and depression did not complete the suicidal ideation instrument used in this study. This student later committed suicide by taking poison because of poor grades when results were released. This tragic incident underpins the importance of undertaking more studies in this area which may help to prevent such an unnecessary loss of young lives.
A multidisciplinary approach should be employed to support students with depression and suicidal ideation. Students could also be attached to staff who can act as advisers on academic and personal matters. Academic workload of students in Colleges of Education where possible should be reduced. A cross section of these students, during personal interaction while conducting this study complained bitterly of too much workload. Students with learning disabilities should be identified and referred for comprehensive diagnostic assessment which would enable them to access academic and behavioural interventions. Parents should be good listeners and not dismiss their children's problems as unimportant or as a problem that will sort itself out with time. Mental health experts, for example, school psychologists, behaviour analysts, and professional counsellors should be available in tertiary institutions to assist students to manage or overcome distress that may interfere with their overall mental health development.
Literature reviewed and the results of this study showed that participants with learning disabilities experience more depression and suicidal ideation. It is therefore recommended that the academic problems of these young people be seriously addressed at the tertiary institution level. Females in this study also experience more depression and suicidal ideation than their male counterparts. The inference here is that more studies need to be conducted on why this is so and what can be done to overcome this.
Studies of this nature should be carried out in different populations and different states in Nigeria. Data collected from such studies will give mental health professionals and the Nigerian government an insight into causes of mental health problems and how such problems can be tackled in students and other populations.
The study cannot be generalised to all students with and without learning disabilities in Nigeria because of the limited sample and the narrow geographical spread.
Researches on mental health problems and suicidality need to be conducted in tertiary institutions in Nigeria. Follow up programmes should be planned and implemented for those at risk for mental health problems and suicidality. Programmes on how to develop positive mental health attitudes should also be planned and promoted in order to ensure the balanced and holistic development of the younger generation.
Acknowledgements
The authors declare that they have no conflict of interest.
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