In this study, three groups of adolescents were administered Offer Self-Image Questionnaire, Beck Depression Inventory, Symptom Check List-90-R, and a “sociodemographic questionnaire.” The groups of adolescents were suicide attempters, non-suicidal psychiatric outpatients, and normal controls. The adolescents who attempted suicide had significantly higher number of siblings and family members and were mostly the older children. Being the older child in a large family may play a negative role in the development of psychic structures, causing the adolescent to be more vulnerable. The results also showed that the self-image was affected negatively by family relations and this negativity led to suicide attempts. Because of the tension with family members, the adolescent lacked family support, an important protective factor for mental health, which may add to the frustrations leading to the suicide attempt. Results showed that the self-image factor was specific for suicidal girls but not for boys. Disturbance in the development of the self-image, especially in its relationship with other family members was an important risk factor in attempted suicides by female adolescents. This reinforced the importance of involving family members in the treatment of suicidal adolescents. None of the factors evaluated in this study were significant in attempted suicides by males. Depression was found to be a predictive factor for identity confusion of male adolescents. The investigation of depression and identity problems in further studies may help determine the specific factors important in suicide attempts of male adolescents. 2 notes, 3 tables, 38 references