Int. J. Environ. Res. Public Health 2012, 9 988 increase in suicide among ethnic minority boys accompanied by stable suicide mortality rates among girls of all ethnic groups. A key issue in adolescent suicidal behavior is the different impact of certain risk factors by gender. Some risk factors lead to different suicidal behaviors (fatal/nonfatal) in boys and girls, and others are associated with suicidal behavior specifically in girls but not boys or vice versa. For example, depression appears to be a better predictor of suicidal behavior in European American girls than boys, whereas alcohol abuse, substance abuse, and conduct disorders appear to be stronger correlates of suicidal behavior in European American boys than girls. In the United States, sexual abuse is increasingly being recognized as a factor in girls’ DSH. Conflict with parents seems to create a unique vulnerability of girls to DSH [23]. Others found that social isolation from peers and intransitive friendships significantly increase the odds of suicidal ideation in girls, and being part of a tightly networked school community (high relative density of friendship ties) is protective against suicide attempts in boys. Thus, social network variables are relevant to suicidality in different ways in boys and girls [24]. Accordingly, there may be preventive methods that are more suitable for one gender than the other. As mentioned, in Western cultures, adolescent males often find it difficult to seek help owing to social norms [25]. Therefore, encouraging adolescent boys to communicate distress before it is too late should be a cornerstone of school and youth suicide preventive programs. This could be especially useful for young military conscripts. By contrast, girls should be encouraged to adopt more constructive coping mechanisms rather than self-injury as a means of solving interpersonal problems. Recent developments in feminist psychology, such as the practices introduced by Carol Gilligan, may be very helpful in this regard [26]. Gilligan offers gender-based strategies for preventing psychological distress and youth violence. According to Gilligan, girls tend to suicidal behavior as a language that commands attention and respect and as an expression of a desire for relationship, while boys turn to violence as an alternative to feeling helpless and powerless. Thus, shifting the interpretation of the suicidal behavior to the relational communication of the violent intention might enable adolescent girls to verbally express their psychological distress. Moreover, strengthening healthy resistance and courage in young children (boys and girls) will prevent violence and enable these young adolescents to say what they feel and to know how to stay in a relationship with others instead of turning to suicidal behaviors. 4.2. Family Factors Research has pointed to the importance of the family environment as a predictor of suicidal behavior among adolescents. The relevant family-related risk factors are parental psychopathology, family history of suicidal behavior, family discord, loss of a parent to death or divorce, poor quality of the parent-child relationship, and maltreatment [16]. There is strong and convergent evidence that suicidal behavior is familial and, perhaps, genetic, and that the liability to suicidal behavior is transmitted in families independently of psychiatric disorder [27]. Nevertheless, there may also be environmental routes of transmission, such as imitation and intergenerational family adversity [28]. Therefore, prevention programs should be designed for early identification and treatment of potentially suicidal adolescents from dysfunctional families. Mental health professionals should be encouraged to try to improve functioning within the family of suicidal youth.