Family Support and Mental Health Service Use Among Suicidal Adolescents

Despite the fact that multiple evidence-based treatments exist for suicidal adolescents, these youth are unlikely to engage in mental health treatment. While family members can be influential in connecting adolescents to mental health care, suicidal youth are more likely to be exposed to family environments characterized by abuse, neglect, and to have poorer parent–child attachment quality than non-suicidal youth. This study analyzed data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine the relationships between perceived levels of parental support, symptom severity, and mental health service use in a nationally representative sample of suicidal adolescents in the U.S. (n = 1804). Higher levels of parental support were associated with a lower likelihood of mental health service use, lower levels of depression, and lower likelihood of an actual suicide attempt. Additionally, the presence of a suicide attempt and higher levels of depression were associated with a higher likelihood of mental health service use. When mediation effects were tested, the presence of a suicide attempt partially mediated the relationship between parental support and mental health service use. Implications discussed include the protective nature of parental support the need for more family-based interventions for this population.     

Parenting Styles and Suicidal Ideation in Adolescents: Mediating Effect of Attachment

The present study aims to analyze the role of parenting styles in the development of suicidal ideation in adolescents, as well as test the mediating role of attachment to parents in the association between authoritative, authoritarian and permissive parenting style and suicidal ideation. The sample was made up of 604 individuals, aged between 15 and 18. In order to gather data, the Styles & Dimensions Questionnaire: Short Version, the Father/Mother Attachment Questionnaire and the Suicidal Ideation Questionnaire were used. The results suggest that the relations with parents, which are characterized by inhibition of exploration and of individuality, contribute to an emotional maladjustment being positively associated with suicidal ideation (r?=?.26 to r?=?.28). This confirmed the mediating role of parental attachment in the association between authoritative and permissive parenting styles from father and mother to suicidal ideation. It was also verified also a partial mediation, through the attachment to parents, in the association between the parent’s authoritarian style and the mother’s permissive styles and suicidal ideation. Furthermore, it was found the presence of total mediation, by throughout to attachment to the father, in the association between the father’s permissive style and suicidal ideation. The results suggest the importance of adopting authoritative parenting styles, since they seem to facilitate the development of the quality of attachment with parents. The results were analyzed in light of the attachment theory, taking into consideration the importance of parenting styles in understanding the processes inherent to suicidal ideation in adolescence.     

When the West Meets the East: Cultural Clash and Its Impacts on Anomie in a Sample of Chinese Adolescents

ABSTRACT

Criminological studies conducted in China have highlighted the important role of Chinese culture and anomie theory in explaining crime patterns and delinquency among adolescents. None of the studies, however, have empirically tested the relationship between cultural attachment and anomie. The purpose of this study is to examine the influence of ethnic identity associated with cultural attachment on anomie in the Chinese social setting. Specifically, the effects of both attachment to conventional Chinese culture and attachment to Western popular culture (WPC) were examined; the interaction between the two may shed some important light on how culture and cultural conflict can lead to anomie among Chinese adolescents. The data analyzed were collected from a sample of more than 6,500 middle school students. Structural equation modeling was employed to test the hypothesized relationships. The study found that attachment to traditional Chinese cultural values, especially showing respect to conventional figures/values, reduces anomie among adolescents. In contrast, attraction to WPC and being socially labeled as a big fan of WPC elevate the levels of anomie reported by the students. Reflections on cultural conflict and relevant policy implications are provided in the “Discussions and conclusions” section.     

Attachment, Behavioral Inhibition, and Anxiety Disorders Symptoms in Normal Adolescents

The current study examined relationships between attachment style, behavioral inhibition, and anxiety disorders symptoms not only relying on youths' self-report but also including the parents' point of view. A large group of young adolescents aged 11–15 years and their parents (N = 280) completed measures of attachment style and behavioral inhibition and the Revised Children's Anxiety and Depression Scale, a questionnaire designed to measure symptoms of anxiety disorders in terms of the Diagnostic and Statistical Manual of Mental Disorders. Highly similar results were found for child and parent report. That is, attachment style and behavioral inhibition were found to be interrelated with insecure attachment being associated with higher levels of behavioral inhibition. Furthermore, adolescents who were classified as insecurely attached and/or high on behavioral inhibition displayed higher levels of anxiety disorders symptoms. Finally, attachment status and behavioral inhibition both accounted for a unique proportion of the variance of anxiety disorders symptomatology.     

Exposure to Violence in Young Inner-City Adolescents: Relationships With Suicidal Ideation, Depression, and PTSD Symptomatology

This study examined the relationship of exposure to violence to suicidal ideation, depression, and post-traumatic stress disorder (PTSD) symptomatology in 94 young adolescents from an inner-city school. Participants completed self-report measures of the Reynolds Adolescent Depression Scale, the Suicidal Ideation Questionnaire—Junior, Adolescent Psychopathology Scale—Posttraumatic Stress Disorder Subscale, and the Exposure to Violence Questionnaire. Using a hierarchical multiple regression design, exposure to violence demonstrated a unique relationship with PTSD symptomatology. Specifically, the relationship between violence exposure and PTSD symptomatology remained significant after controlling for depression and suicidal ideation severity. Controlling for PTSD symptomatology resulted in nonsignificant relationships between violence exposure and depression and suicidal ideation in adolescents. Additional analyses suggest that PTSD functions as a mediating variable between exposure to violence and depression and suicidal ideation. The implication of these results and suggestions for future research are discussed.     

儿童心理虐待与忽视和自杀意念的关系：有调节的中介模型

采用问卷法对988名初中生进行调查,探究儿童心理虐待与忽视和自杀意念的关系,应对方式的中介作用以及友谊质量的调节作用。结果表明：（1）儿童心理虐待与忽视正向预测自杀意念;（2）应对方式是儿童心理虐待与忽视和自杀意念之间的中介变量;（3）儿童心理虐待与忽视对自杀意念的直接效应受到友谊质量的调节,直接效应对于友谊质量低的青少年更显著;（4）儿童心理虐待与忽视通过应对方式对自杀意念的间接效应的后半段受到友谊质量的调节,友谊质量高的青少年的自杀意念水平相对更低。因此,儿童心理虐待与忽视和自杀意念之间是有调节的中介关系,儿童心理虐待与忽视通过应对方式影响自杀意念,友谊质量在直接路径和间接路径中起调节作用。     

Building social support for adolescents with suicidal ideation: implications for school guidance and counselling

This study involved interviews with 13 adolescents with high levels of suicidal ideation. It aimed to understand how these adolescents perceived their family, school and peer relationships, and how they perceived these systems as their support. Comparison between adolescents with severe and mild suicidal ideation showed that the family, school and peers could act as effective support systems in times of stress. A close interpersonal relationship was the key factor in unlocking these support systems. The school as a support system was highlighted. Implications for school guidance and counselling to strengthen the social support of adolescents and adolescents' resiliency were discussed.     

Externalizing problems,internalizing problems,and suicidal ideation in Singaporean adolescents: Sex differences

Adolescent suicide is considered a worldwide problem and an increasing source of concern in Singapore. This study explores the relationships among four factors of maladjustment (that is, emotional distress, negative self, antisocial behavior, and anger control problems) and suicidal ideation in two hundred and seventy-one adolescents from Singapore. Findings from the study indicated that emotional distress, negative self-concept, and antisocial behavior significantly predicted suicidal ideation for the whole sample. Beta weight is largest for emotional distress, followed by negative self, and then antisocial behavior. For females, only emotional distress significantly predicted suicidal ideation. Implications of these findings with regard to working with adolescents with suicidal ideations are discussed. Funding for this research is facilitated by grant RP 1/01 APH.     

Stress, self-esteem, and suicidal ideation in late adolescents

The relationships among stress, self-esteem, and suicidal ideation in late adolescents were examined in a group of college students. Multiple regression analysis indicated that both stress and self-esteem were significantly related to suicidal ideation; low self-esteem and stressful life events significantly predicted suicidal ideation. The hypothesis that self-esteem would moderate the effects of life stressors on suicidal ideation was supported at the .06 level. A significant minority of the sample indicated having thoughts severe enough to be classified as clinical suicidal ideation. In general, participants who had experienced negative life events in the 6 to 12 months prior to participating in the study had lower self-esteem than those who had similar stresses within the prior six months. However, the opposite was true for clinical suicidal ideators; those who experienced negative life stressors recently had lower self-esteem than those who experienced negative life events six months to a year in the past.     

Parent and peer attachment in early adolescent depression

Insecure attachment relations have been theorized to play a significant role in the development of depressogenic modes of adaptation and to thus form a vulnerability factor for the emergence of depressive disorder in children. This study examined security of parent and peer attachment among four groups of early adolescents: clinically depressed, nondepressed psychiatric controls, nonpsychiatric controls, and adolescents with resolved depression. Depressed adolescents reported significantly less secure parent attachment than either of the control groups, and less secure peer attachment than the nonpsychiatric control group. Attachment security of adolescents with resolved depression was on a par with the nonpsychiatric control group. Among all psychiatric patients, security of attachment to parents was negatively correlated with severity of depression according to interview and self-report ratings. Less secure attachment to parents, but generally not to peers, was also related to more maladaptive attributional styles, presence of separation anxiety disorder, and history of suicidal ideation.     

Parent–Adolescent Attachment and Academic Adjustment: The Mediating Role of Self-Worth

Within the theoretical framework of attachment theory, this study examined associations between adolescents’ attachment relationships with both mother and father and their academic adjustment, and explored the potential mediation role of self-worth in the associations. Participants were 384 Chinese adolescents (49.6% male, average age?=?15.13 years) from public schools in Shanghai, China. They completed self-report measures of mother–adolescent attachment, father–adolescent attachment, general self-worth, academic engagement and school grades. The results indicated that adolescents’ attachments to both parents were associated with higher levels of academic engagement. There was partial support of the mediating role of self-worth, as adolescents who had high levels of parent–adolescent attachment were more likely to have high levels of self-worth, which in turn enhanced their academic engagement and then improved high school grades. The findings highlighted the importance of parental attachment-based intervention strategies to promote and maintain academic adjustment among adolescents.     

青少年同伴依恋与问题性手机使用的关系:自我建构对孤独感中介作用的调节

采用同伴依恋问卷、问题性手机使用量表、孤独感问卷以及自我建构量表对624名青少年进行调查,以探讨青少年同伴依恋对问题性手机使用的作用过程及其机制。结果显示,青少年同伴依恋通过孤独感的完全中介作用对问题性手机使用产生影响;依存型建构在孤独感与问题性手机使用之间起调节作用,独立型建构的调节作用不显著。这说明同伴依恋通过孤独感影响青少年的问题性手机使用,依存型建构可促进感到孤独的青少年使用手机。     

Psychosocial vulnerability from adolescence to adulthood: a prospective study of attachment style differences in relationship functioning and partner choice

Using a prospective research design, this study explored whether attachment style during adolescence forecasts the nature and quality of romantic relationships in early adulthood and investigated two general pathways for explaining these effects. Black and White community residents were first interviewed in adolescence at which time they completed a self-report measure of attachment style. Approximately 6 years later, they participated in a follow-up interview along with their current romantic partners (N = 224 couples). Results revealed that insecure attachment in adolescence was a risk factor for adverse relationship outcomes in adulthood, although the effects were most consistent for avoidant attachment. Avoidant adolescents were involved in relationships that they (and their partners) rated as less satisfying overall; they also engaged in fewer pro-relationship behaviors, and perceived that their partners engaged in fewer pro-relationship behaviors. In addition, avoidant adolescents were involved with partners who had less healthy personality profiles. Results for anxious-ambivalent and secure attachment were weaker, more complex, and moderated by gender. This study provides the first prospective evidence that avoidant attachment places individuals at risk for adverse relationship outcomes and highlights potential pathways through which this occurs.     

Risk and Resiliency Factors Influencing Suicidality Among Urban African American and Latino Youth

For decades, suicide rates among minority African American and Latino young people have been stable and, when compared with Whites, relatively low. This is no longer the case, underscoring the need for documenting and understanding the problem of suicidality in this population. We report on the prevalence and predictors of suicidality among 879 urban adolescents in the Reach for Health study. All youth resided in economically disadvantaged neighborhoods; 69% were African American, 16% Latino, and 15% reported mixed or other ethnicity. In the past year, 15% had seriously considered suicide; 13% had made a suicide plan, 11% had attempted suicide at least once, and 4% reported multiple attempts. Risk factors significantly related to suicidal ideation are being female, having basic needs unmet, engaging in same-gender sex, and depression. Resiliency factors include family closeness and, marginally, religiosity. Risk factors related to reports of suicide attempts are being female, being Hispanic, and depression; family closeness is strong resiliency factor. Family composition, ethnic identity, coping style, peer support, and school attachment are not significant correlates of suicidal ideation or attempts.     

Differentiating Adolescent Suicide Attempters from Ideators: Examining the Interaction between Depression Severity and Alcohol Use

Depressed mood, frequency of alcohol use, and their combination were examined to see if they differentiated nonsuicidal adolescents from those with suicidal ideation and adolescents with suicidal ideation from those who have made a suicide attempt. Hierarchical logistic regressions indicated that frequency of alcohol use did not differentiate nonsuicidal adolescents from those with current suicidal ideation, but severity of depressed mood did so. In contrast, alcohol use was a significant differentiating factor between adolescents who had attempted suicide compared to those with suicidal ideation only, with severity of depressed mood not being significant. However, there was also a significant interaction effect such that for adolescents with suicidal ideation and low levels of depression, increased frequency of alcohol use was associated with increased odds of a suicide attempt. These findings suggest that alcohol use may hasten the transition from suicidal ideation to suicide attempt in adolescents with low levels of depressed mood.     

Adolescent attachment insecurity and parasympathetic functioning predict future loss adjustment

Losing a close relationship is highly stressful and a robust predictor of major depression in adolescents. The current study examined relationships between attachment insecurity, parasympathetic nervous system activity, indexed by respiratory sinus arrhythmia (RSA), and adolescent adjustment to the loss of a close social partner. Adolescents with more attachment anxiety to their mother at age 14 were more likely to report poorer adjustment to a subsequent loss than adolescents with less attachment anxiety. Attachment avoidance interacted with stress-induced changes in RSA to predict loss adjustment. Among adolescents with higher RSA in response to the stressor, those with more attachment avoidance reported better loss adjustment, whereas among adolescents with lower RSA in response to the stressor, those with more attachment avoidance reported poorer loss adjustment. In sum, the combination of attachment insecurity and stress-induced changes in RSA predicted how well adolescents adjusted to a loss.     

Attachment relationships and physical activity in adolescents: The mediation role of physical self-concept

ObjectivesBased on the integration of attachment and physical self-perception perspectives, the present study examined links between adolescents' engagement in physical activity and their attachment relationships with mothers, fathers, and friends, respectively, and assessed the potential mediation role of physical self-perception in this link.Design and methodsUsing a cross-sectional design, questionnaire data was obtained from 767 adolescents (49% boys, M_age = 12.92, SD = .86) and structural equation modeling was used to examine relationships among variables.ResultsAttachment security with parents and friend was associated with higher levels of physical activity. There was partial support of the mediation role of physical self-perception, as adolescents who were securely attached to mother and friend perceived themselves as having better physical condition, which in turn predicted greater engagement in physical activity. The mediation role of physical self-perception between mother attachment and PA was stronger for female adolescents. Secure attachment to father had a direct positive effect on physical activity. The direct effect was strongest for male adolescents.ConclusionsOur findings highlight the importance of relationship-based intervention strategies to enhance and maintain healthy regular physical activity among adolescents.     

Affect Regulation and Attachment Strategies of Adjudicated and Non-Adjudicated Adolescents and Their Parents

This exploratory qualitative study used semi-structured interviews with adjudicated and non-adjudicated adolescents and their parents to identify: (1) different behavioral manifestations of affect regulation and attachment interactions as described by respondents; and (2) interactional patterns that we might wish to target in a therapeutic intervention. Parents used more functional internal affect regulation strategies, while adolescents relied on less functional ones. Most respondents used functional external affect regulation strategies, such as direct communication. Approximately half of them used more dysfunctional strategies, such as yelling and aggression. Most of the adolescents used at least one secure attachment strategy in their relationships with their parents, but the majority also used avoidant or ambivalent strategies. Almost half of the parents described secure strategies in their relationships with their adolescents, while the remainder indicated using insecure.     

Internalizing and Externalizing Problems as Correlates of Self-Reported Attachment Style and Perceived Parental Rearing in Normal Adolescents

The current study examined relationships between attachment style, parental rearing behaviors, and symptoms of internalizing and externalizing in a large sample of nonreferred adolescents (N = 742). Adolescents completed (a) a single-item measure of attachment style, (b) the child version of the EMBU, a questionnaire measuring perceptions of parental rearing behaviors, and (c) the Youth Self-Report, an index of severity of internalizing and externalizing symptoms. Results showed that attachment style was related to internalizing as well as externalizing symptoms. More specifically, adolescents who classified themselves as avoidantly or ambivalently attached displayed higher levels of internalizing and externalizing symptoms than adolescents who classified themselves as securely attached. Furthermore, perceived parental rearing behaviors were also associated with internalizing and externalizing symptoms. That is, low levels of emotional warmth and high levels of rejection and overprotection were accompanied by high levels of psychopathological symptoms. Finally, both attachment and parental rearing behaviors accounted for a unique proportion of the variance in internalizing symptoms. Yet, when predicting externalizing symptoms, only parental rearing behaviors declared a significant proportion of the variance.     

Suicidality as a function of impulsivity, callous-unemotional traits, and depressive symptoms in youth

Suicidality represents one of the most important areas of risk for adolescents, with both internalizing (e.g., depression, anxiety) and externalizing-antisocial (e.g., substance use, conduct) disorders conferring risk for suicidal ideation and attempts (e.g., Bridge, Goldstein, & Brent, 2006). However, no study has attended to gender differences in relationships between suicidality and different facets of psychopathic tendencies in youth. Further, very little research has focused on disentangling the multiple manifestations of suicide risk in the same study, including behaviors (suicide attempts with intent to die, self-injurious behavior) and general suicide risk marked by suicidal ideation and plans. To better understand these relationships, we recruited 184 adolescents from the community and in treatment. As predicted, psychopathic traits and depressive symptoms in youth showed differential associations with components of suicidality. Specifically, impulsive traits uniquely contributed to suicide attempts and self-injurious behaviors, above the influence of depression. Indeed, once psychopathic tendencies were entered in the model, depressive symptoms only explained general suicide risk marked by ideation or plans but not behaviors. Further, callous-unemotional traits conferred protection from suicide attempts selectively in girls. These findings have important implications for developing integrative models that incorporate differential relationships between (a) depressed mood and (b) personality risk factors (i.e., impulsivity and callous-unemotional traits) for suicidality in youth.