Integration of the 5A's Framework in Research on Obesity and Weight Counseling: Systematic Review of Literature.

Adolescence is a critical period marked by significant physical, cognitive, and emotional changes []. These transitions can make individuals vulnerable to mental health issues, including depression, anxiety, and suicidal ideation []. Suicide is one of the leading causes of death among adolescents, highlighting the urgency of this public health concern []. The key risk factors for adolescent suicide encompass a range of mental health disorders, previous suicidal behaviors, adverse experiences, social isolation, access to lethal means, and other factors. Mental health issues like depression, anxiety, bipolar disorder, and substance abuse disorders significantly increase the risk of suicidal behavior []. Adverse experiences such as abuse, neglect, bullying, family conflicts, and exposure to intimate partner violence or sexual abuse are associated with increased suicidal thoughts and attempts []. Social isolation, lack of supportive relationships, and barriers to accessing mental health care contribute to suicidal behavior []. Understanding the factors that contribute to suicidal thoughts and attempts during adolescence is crucial for developing effective prevention and intervention strategies. Thailand is grappling with alarmingly high suicide rates, which have been steadily increasing in recent years, particularly since the COVID-19 pandemic []. In 2022, Thailand's suicide rate reached 7.97 per 100,000 people, a concerning rise from 6.64 in 2019 []. The World Health Organization (WHO) estimates Thailand's suicide rate to be even higher at 8.8 per 100,000 people in 2019, potentially due to underreporting or misclassification []. Men in Thailand have a significantly higher suicide rate of 12.27 per 100,000 compared to 2.68 for women []. Adolescents and school-age children are among the most vulnerable groups for suicide attempts in Thailand []. According to the 2021 Global School-based Student Health Survey, 11% of males and 23% of females aged 13–17 considered suicide, with 12% of males and 18% of females attempting it. These concerning rates highlight the urgent need for further investigation into the underlying risk factors. Several unique cultural, social, and economic factors make Thailand particularly vulnerable to these trends. Strong collectivist values and the emphasis on family reputation can place intense pressure on adolescents to conform to societal expectations, leading to feelings of shame and hopelessness when these expectations are not met [, ]. Additionally, mental health stigma and traditional family structures often limit open communication about personal struggles, making it difficult for adolescents to seek help []. Economic pressures, heightened by the COVID-19 pandemic, have exacerbated stress and anxiety, further contributing to mental health issues []. Moreover, the rise of cyberbullying and exposure to violence in Thailand's rapidly digitalizing society presents unique challenges []. These factors, combined with limited access to mental health resources, particularly in rural areas [], underscore the urgent need for targeted prevention and intervention strategies to address the growing issue of adolescent suicidality in Thailand. Recent research highlights the importance of distinguishing between suicide ideators and attempters to better understand and prevent suicidal behavior. The ideation-to-action framework posits that the development of suicidal thoughts and the progression to attempts are distinct processes with different predictors, each influenced by different predictors [, ]. Suicidal thoughts, or ideation, refer to the contemplation of suicide, while suicide attempts involve actual efforts to end one's life. Previous studies have shown that mental health disorders, experiences of bullying, and substance use can be significant predictors of suicidal ideation and attempts. However, the distinction and nature of these relationships can vary based on factors such as gender and other demographic characteristics [, ], highlighting the need for a nuanced approach to research and intervention.