Psychological dimensions associated with suicidal ideation and attempts in the National Comorbidity Survey

Three important psychological dimensions in the suicide literature (neuroticism, self-criticism, and hopelessness) were examined in relation to suicidal ideation and attempts in the U.S. National Comorbidity Survey (Kessler et al., 1994; n = 5,877), after first controlling for the effects of previously identified sociodemographic and psychiatric variables related to suicidality in this nationally representative sample (Kessler, Borges, & Walters, 1999). Analyses were conducted separately for lifetime, current (12-month), and past history of suicidal ideation and attempts. Brief indices of self-criticism and hopelessness were robustly associated with suicide attempts across all three time frames. The results support the value of examining psychological individual differences over sociodemographic and psychiatric diagnoses alone in the comprehensive assessment of factors associated with suicidality in the general population.     

中国青少年父母教养方式与自杀意念的元分析

如何降低自杀意念是研究者共同面临的问题,其中家庭因素近些年得到了越来越多的关注。本研究采用元分析的方法考察中国青少年父母教养方式与自杀意念的关系及其影响因素,纳入了符合标准的文献22篇,包括158个效应量,总样本量为16980人。结果发现,父母积极教养方式与自杀意念呈显著负相关,父母消极教养方式与自杀意念呈显著正相关。年龄阶段、自杀意念测量工具能够显著调节父母教养方式与自杀意念的关系,独生子女比例能够调节父母消极教养方式与自杀意念的关系。上述结果表明,父母教养方式能够显著影响自杀意念,家长应采用情感温暖、理解等积极教养方式,而非拒绝、过度干涉等消极教养方式。     

Hopelessness Predicts Suicide Ideation But Not Attempts: A 10‐Year Longitudinal Study

Hopelessness is one of the most commonly cited risk factors for suicidal behaviors. However, several retrospective studies suggest that hopelessness, while strongly correlated with suicide ideation, does not distinguish attempters from ideators without attempts. This study is the first to utilize a prospective design to disambiguate the relationship of hopelessness to ideation versus attempts. Participants were 142 depressed patients followed up over 10 years. Hopelessness and suicidality (ideation and attempts) were assessed using validated questionnaires and structured interviews. Both retrospective and prospective analyses revealed that hopelessness was higher among those reporting any suicidality (ideation or attempts) compared with nonsuicidal individuals. However, hopelessness failed to meaningfully distinguish attempters from ideators in both retrospective and prospective analyses. Taken together with results from previous studies, our findings suggest hopelessness is best conceptualized as a risk factor for suicide ideation but not progression from ideation to attempts.     

Suicidal ideation,parenting style,and family climate among Hong Kong adolescents

The prevalence of suicidal ideation and its relations with perceived parenting treatment and family climate was examined in 120 Hong Kong students aged 15–19 years. Fifty‐two per cent of the participants reported suicide ideation. Suicide ideation was found to be significantly associated with perceived authoritarian parenting, low parental warmth, high maternal over‐control, negative child‐rearing practices, and a negative family climate. A positive family climate may act as a buffer against developing suicide ideation in adolescents.     

Perfectionism,Stress, Daily Hassles,Hopelessness, and Suicide Potential in Depressed Psychiatric Adolescents

The current study examined dimensions of perfectionism, stress, hopelessness, and suicidality in a sample of adolescent psychiatric patients diagnosed with depression. This study evaluated the unique contribution of perfectionism in predicting suicidality after considering other predictors (i.e., hopelessness, depression) and it also examined the diathesis-stress model of perfectionism and suicide. A sample of 55 adolescents (41 females, mean age = 15.53, 25.5 % ethnic/racial minorities) who were psychiatric patients completed measures including the Child-Adolescent Perfectionism Scale, subjective and objective indices of life stress, daily hassles, depression, hopelessness, suicide ideation, prior attempts and suicide potential. In addition, other informants (i.e., adolescents’ parents) completed a diagnostic interview and an interview assessing major stressful experiences. Socially prescribed perfectionism (i.e., the perception that others require perfection of oneself) predicted concurrent levels of suicide potential and this association with suicide potential held even after controlling for the variances accounted for by depression and hopelessness. Hierarchical regression analyses provided partial support for the diathesis-stress model, that is, socially prescribed perfectionism interacted with daily hassles to predict concurrent suicide potential even after controlling for depression, hopelessness, and prior suicide attempt. Together, these findings suggest that socially prescribed perfectionism acts as a vulnerability factor that is predictive of suicide potential or risk among clinically depressed adolescents.     

The Moderating Effects of Gratitude on the Association Between Perceived Parenting Styles and Suicidal Ideation

Suicidal ideation is defined as the thoughts about engaging in suicidal-related behaviors. Very few studies have been conducted on children’s suicidal ideation as there is a biased perception that suicidal behavior under the age of 12 is scarce. However, suicide is the leading cause of death among young children. Child suicidal ideation is predictive of suicidal ideation and suicide attempts in adulthood. Association between certain parenting styles and suicidal ideation have been found in empirical studies. However, little is known about the role of parenting and suicidal ideation in Chinese young children. We examined whether gratitude can reduce the risk of suicide by moderating the association between parenting styles and child suicidal ideation. We recruited 447 Chinese children (53.3% female; mean age?=?10.06, SD?=?1.76) to participate in a survey. Perceived parenting style (warmth/accepting, dominating, and autonomy granting), gratitude, and suicidal ideation were assessed using self-reported measures. We found that all three perceived parental styles were significantly associated with child suicidal ideation. Further, gratitude was found to have a significant moderating effect on suicidal ideation, across the analysis of the three perceived parenting styles. This suggests that gratitude may be adopted in preventive and clinical interventions so that children at risk can benefit from reducing the negative effects of ineffective parenting styles and suicidal ideation.     

Clarifying the Relationship of Parental Bonding to Suicide Ideation and Attempts

Suicide and suicidal behavior are major public health problems, especially among adolescents and young adults. Previous research has established links between parental bonding and suicidality; however, it remains unclear whether parental bonding is associated with suicide ideation, the progression from suicide ideation to suicide attempts, or both. This study examined the relation of parental bonding to suicide ideation and suicide attempts in adolescents from two settings: (1) acute psychiatric care (n = 172) and (2) high school (n = 426). All participants were administered validated measures of parental bonding, suicide ideation, and suicide attempts, as well as emotion dysregulation, loneliness, and self‐worth. In the psychiatric sample, lower parental care significantly differentiated adolescents with a history of suicide attempts from those with suicide ideation only or without histories of suicidality. This pattern remained even after controlling for other known correlates of suicidality (i.e., emotional dysregulation, loneliness, and low self‐worth). Similar effects were found in the community sample, although these findings failed to reach statistical significance. In both samples, parental overprotection was not associated with suicide ideation or suicide attempts. Results suggest that parental care may be an important risk factor for youth suicidal behavior and may help differentiate suicide attempters from suicide ideators.     

Suicidality in adolescence: review and legal considerations

Adolescence is a unique developmental stage in which suicidality first emerges as a public health problem. The increasing trend of teenage suicide since the 1950s has only relented in the past ten years. The risk factors for adolescent suicide, suicidal ideation, and suicide attempts and an approach to assessing the suicidal adolescent for risk of future self-harm are reviewed. Treatment consists of ensuring safety and then treating the underlying psychiatric, psychological, and interpersonal disturbances. Issues of consent, confidentiality, and malpractice actions are addressed.     

Effects of a Military Parenting Program on Parental Distress and Suicidal Ideation: After Deployment Adaptive Parenting Tools

Few studies have examined whether parenting prevention programs might mitigate risk for suicidality in parents, yet parent suicidality is a strong risk factor for offspring suicidality. We report results from a randomized controlled trial of a parenting program for deployed National Guard and Reserve families with a school‐aged child. Intent‐to‐treat analyses showed that random assignment to the parenting program (ADAPT) was associated with improved parenting locus of control (LOC). Improved parenting LOC was concurrently associated with strengthened emotion regulation which predicted reductions in psychological distress and suicidal ideation at 12 months postbaseline. Results are discussed in the context of ongoing efforts to reduce suicide rates in military populations.     

Hopelessness,Parent‐Adolescent Communication,and Suicidal Ideation among Chinese Adolescents in Hong Kong

Based on the responses of 5,557 Chinese secondary students in Hong Kong, the relationships among perceived hopelessness, family functioning, and suicidal ideation were examined. Results showed that suicidal ideation was positively related to hopelessness, but negatively related to parent‐adolescent communication. Compared with father‐adolescent communication, mother‐adolescent communication generally had a stronger association with adolescent suicidal ideation. It was further found that the linkage between hopelessness and adolescent suicidal ideation was stronger under a low parent‐adolescent communication condition, thus suggesting the moderating effect of parent‐adolescent communication on the effect of hopelessness on suicidal ideation. The theoretical and practical implications of the findings are discussed.     

Suicidal Ideation of Psychiatrically Hospitalized Adolescents has One-Year Predictive Validity for Suicide Attempts in Girls Only

Clinicians commonly incorporate adolescents’ self-reported suicidal ideation into formulations regarding adolescents’ risk for suicide. Data are limited, however, regarding the extent to which adolescent boys’ and girls’ reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys’ and girls’ self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13–17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children’s Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization.     

校园氛围与青少年的自杀意念/企图：自尊的中介作用

尽管相当一部分青少年自杀发生于学校背景中,但目前较少有研究考察校园氛围是否会影响以及怎样影响青少年的自杀意念/企图。本研究旨在检验校园氛围的不同方面(教师支持、同学支持、自主机会)与青少年自杀意念/企图的关系,以及自尊在其中的中介作用。采用分层整群抽样的方法,选取广东省10所学校2758名初中生作为被试,匿名填写家庭功能问卷、社区问题问卷、校园氛围问卷、Rosenberg自尊量表、自杀意念与企图问卷。回归分析表明:(1)在控制了性别、年龄、社会经济地位、家庭功能和社区问题后,教师支持和同学支持均能显著负向预测自杀意念/企图,自主机会对自杀意念/企图的预测作用不显著;(2)自尊在教师支持和同学支持与自杀意念/企图之间起着中介作用。因此,实践工作中应重视教师支持和同学支持对青少年自尊的塑造作用,进而减少自杀意念/企图。     

Adolescent–parent attachment as a mediator of relations between parenting and adolescent social behavior and wellbeing in China

The purpose of this study was to examine links between parenting dimensions (authoritative parenting, psychological control, and parental authority) and adolescent wellbeing (self‐esteem, autonomy, and peer attachments) as mediated by parent–teen attachment, among Chinese families. The sample included 298 Chinese adolescents, ages 15–18 years (M age = 16.36, SD = .68; 60% female). The mediation model was examined using path analyses (one model with parental authority as overprotection, and one with it as perceived behavioral control). To improve model fit a direct path was added from authoritative parenting to autonomy. Authoritative parenting was positively predictive of attachment, while psychological control and overprotection (but not behavioral control) were negative predictors. In turn, adolescent–parent attachment was positively related to the three outcomes. Lastly, the model paths did not differ by adolescent gender. These findings suggest that parenting behaviors may play a crucial role in adolescent social behaviors and wellbeing via adolescent–parent attachment.     

Relationship Between Religious Coping and Suicidal Behaviors Among African American Adolescents

This study investigated whether hopelessness and depression were risk factors for suicidal thoughts and behaviors in African American adolescents and looked at whether religious participation and religious coping protected these students from suicidality. Participants were 212 African American high school students (133 females, 79 males). The results of multiple and logistic regression analyses found that hopelessness and depression were risk factors for suicidal ideation and attempts. Religious coping style was significantly related to suicidal behaviors: Self-directed coping was related to increased hopelessness, depression, and suicide attempts, and collaborative coping was related to increased reasons for living. Gender differences were found in symptoms of depression, religious coping style and religious participation. Results provide additional support for suicide interventions to target hopelessness and depressive symptoms and highlight the importance of examining the role of culturally salient variables, such as religious participation and religious coping style, when developing intervention programs for suicide.     

Parenting Narcissus: What Are the Links Between Parenting and Narcissism?

Previous theorizing by clinical psychologists suggests that adolescent narcissism may be related to parenting practices (Kernberg, 1975; Kohut, 1977). Two studies investigated the relations between parenting dimensions (i.e., warmth, monitoring, and psychological control) and narcissism both with and without removing from narcissism variance associated with trait self-esteem. Two hundred and twenty-two college students (Study 1) and 212 high school students (Study 2) completed the Narcissistic Personality Inventory, a trait self-esteem scale, and standard measures of the three parenting dimensions. Parental warmth was associated positively and monitoring was associated negatively with both types of narcissism. Psychological control was positively associated with narcissism scores from which trait self-esteem variance had been removed. Clinical implications of the findings are discussed, limitations are addressed, and future research directions are suggested.     

Peer Victimization and Suicidal Thoughts and Behaviors in Depressed Adolescents

Suicide is a leading cause of death among youth worldwide, and depressed adolescents are at a significantly elevated risk to report suicidal ideation, planning, and attempts. Peer victimization is a robust predictor of adolescent suicidal thoughts and behaviors (STBs), but little research has focused on why bullying leads to suicidal thoughts and behaviors. To address this empirical gap, we recruited 340 (246 female) depressed adolescents ages 13–19 (M = 15.59, SD = 1.41) within 48 h of admission for acute psychiatric treatment. At the initial assessment, participants were administered clinical interviews characterizing psychopathology, nonsuicidal self-injury, and STBs (ideation, plans, and attempts). Further, they completed questionnaires assessing 3 forms of victimization (overt, relational, and reputational), recent risky behavior engagement, and psychiatric symptom severity. Controlling for internalizing symptoms and age, overt and reputational bullying were associated with more frequent past month suicide attempts, but not suicide ideation. Past month risky behavior engagement, but not NSSI, mediated the relation between victimization and attempts. However, sex differences revealed that this effect only held for males whereas bullying was directly associated with suicide attempts among females. In contrast, overt and relational bullying were non-linearly associated with suicide plans, and these relations were not mediated by risky behaviors or NSSI. Results highlight the complex network of factors that lead victimized adolescents to engage in STBs and may inform targeted suicide prevention and intervention programs.     

Naturalistic evaluation of suicidal ideation: variability and relation to attempt status

Suicidal ideation has been thought to have a relatively stable course across weeks and months. However, daily changes in levels of ideation have not been adequately examined despite the importance of potential variability clinically and conceptually. For example, it has been suggested that variability in suicidal ideation may become less closely tied to variability in other mood symptoms (e.g., depression, hopelessness) among individuals with multiple suicide attempts. The present report had two related goals: (1) to prospectively evaluate suicidal ideation and related mood symptoms, and (2) to determine whether suicide attempt status predicted a decreased association between ideation and other mood symptoms. Non-clinical participants (N=108) with varying levels of suicidal ideation and number of previous suicide attempts completed the beck hopelessness scale (BHS), beck depression inventory (BDI), and suicide probability scale (SPS) every day for 4 weeks. Findings suggested considerable variability in suicidal ideation, especially for multiple attempters. Multiple attempt status predicted a decreased association between suicidal ideation and depression, although the results were only marginally significant. These findings have implications for conceptual models of suicide risk as well as assessment and treatment of suicidal individuals.     

A multisystems analysis of adolescent suicide attempters

The present study tested an ecologically based model, which predicted that hopelessness (individual level) mediates the effects of family dysfunction (interpersonal level) and socioeconomic status (sociocultural level) on both suicidal intent and suicidal ideation, within a sample of attempters. Subjects included adolescent males and females presenting at a general hospital emergency room following suicide attempts. Baron and Kenny's (1986) criteria for testing mediation models through multiple-regression analyses were employed. Little evidence of mediation was found. Hopelessness proved to be the best predictor of suicidal intent and ideation within a sample of attempters.     

Reevaluating Suicidal Behaviors: Comparing Assessment Methods to Improve Risk Evaluations

This study examined suicide assessment validity by comparing methods of measuring current risk associated with past suicidal behaviors. Three independent samples (Ns = 359, 1007, and 713; aged 18–76 years) all included participants covering a broad spectrum of suicidality. Information theory, item response theory, general linear modeling, and linear regression modeling tested seven competing methods/models of assessing past suicidal behaviors in relation to current suicidality. In contrast to contemporary theories, ANOVA results showed suicide plans can indicate higher risk than suicide attempts when intent to die is higher. Contrary to popular practice, evidence demonstrated that defining risk by suicide ideation (yes/no), attempts or serious attempts (yes/no), are false dichotomies, were the least valid models tested, and failed to explain substantial explainable variance in suicidality/risk. A newly proposed model, differentiating behaviors with or without intent to die, was the most efficacious dichotomous method. However, as predicted, continuous variables were superior to dichotomous. The proposed suicidal barometer model (SBM) exhibited robust evidence as the best available model for evaluating suicidal behaviors in all samples (100 % probability), explaining 47–61 % of suicidality variance and provided incremental improvement in risk evaluations. Findings were consistent by sample, sex, age-group, ethnicity, and psychiatric history. This study, and related evidence, demonstrate that there is a clear and present need for updating measures, clinical training and core competencies, for valid assessment and risk formulation.     

Adolescent sibling differences in suicidal symptoms: The role of parent-child relationships

This study examined concordance for symptoms of suicide among 178 pairs of adolescent siblings, and the association of youth and maternal reports of parenting with variation in suicide ideation both across families and between siblings. Crosstabulation analyses indicated a significant risk of suicide ideation among siblings of adolescents who had made suicide attempts, as well as a significant degree of concordance for suicide ideation among pairs of siblings. Regression analyses indicated that reported levels of maternal warmth and harsh discipline, especially youth reports, were associated with suicide ideation, and that sibling differences on these parenting indices were associated with differences in suicide ideation both across families as well as between siblings. However, sibling differences in reported parenting did not contribute to prediction of suicide ideation above the variance accounted for by the simple levels of parenting reported by adolescents.