A study conducted tackled, "Birth order: Self-injurious and suicidal behaviour among adolescents".

(Kircaldy B., Veljgaard R., and Siefen G. 2008) used a sample of 2553 children and adolescents in a
psychiatry clinic in Germany were assessed using a structured interview inventory that included history
of self-injurious behaviour, suicidal intent and socially disruptive and threatening behaviour, and diverse
socio-demographic variables (the basis documentation or ‘Ba-Do’). Birth order was associated with both
suicidal and self-injurious behaviour, middle children being most likely to exhibit such behaviour. Females
were more than twice as likely to have self-injured than males. Comparisons of birth order groups within
gender found no significant differences in suicidal behaviour between birth positions for males, however
among females, middle children were much more likely to have attempted suicide. Conversely, there was
no difference in self-injurious behaviour among birth positions in females, but among males, middle
children were significantly more likely to have self-injured than firstborns, only children or lastborns. The
number of siblings in the family was significantly correlated with both suicidal history (r = 0.12, p <
0.001) and self-injurious behaviour (r = 0.10, p < 0.001). The risk of suicidal behaviour was highest for
those with four or more siblings.

Kircaldy B., Veljgaard R., and Siefen G. 2008. Birth order: Self-injurious and suicidal behaviour among
adolescents. Retrieved on October 24, 2017 from
www.tandfonline.com/doi/full/10.1080/13548500801983058?scroll=top&needAccess=true

According to the article (Blumenthal, S. 2010), suicide appears to occur when multiple overlapping
factors are present in the absence of protective factors. Such protective factors include strong social
support, hopefulness, obtaining treatment for mental illness, not experiencing losses and
disappointments as humiliating, and having a safer environment with restricted access to highly lethal
methods of suicide, such as guns. Women are more likely than men to have stronger social supports, to
feel that their relationships are deterrents to committing suicide, and to seek psychiatric and medical
intervention -- these protective factors may contribute to their lower rate of completed suicide. For
example, being married and having children is a protective factor against completed suicide for women --
but not for men. Similarly, women's suicide attempts can be efforts to modify the human environment to
protect themselves from completing suicide through gaining support and intervention from family
members and medical professionals.

Blumenthal, S. 2010. Suicide and Gender. Retrieved on October 25, 2017 from http://susan-
blumenthal.org/wp-content/uploads/2010/04/Susan-Blumenthal-Suicide_and_Gender.pdf