Attachment organization and history of suicidal behavior in clinical adolescents.

Abstract

One hundred thirty-three adolescents in psychiatric treatment participated in a case-comparison study investigating the association of attachment patterns with a history of suicidal behaviors. The comparison group comprised 64 adolescents who had never experienced suicidal ideation or behaviors; the case group included 69 adolescents with histories of suicidal behavior (n = 53) and severe suicidal ideation (n =16). Attachment patterns were assessed using the Adult Attachment Interview. In accordance with definitions provided in the scoring system, 86% of case and 78% of comparison adolescents in psychiatric treatment had experienced attachment-related trauma. Lapses in the monitoring of reasoning or discourse occurred during the attempted discussion of these events in 73% of adolescents in the case group but in only 44% of adolescents in the clinical comparison group (p = .002), suggesting that cognitive disorganization may be an important variable mediating between traumatic experience and suicidal behavior. Female adolescents and older adolescents were significantly more likely than other adolescents to be in the case group. Preoccupied attachment, in interaction with unresolved-disorganized attachment, was associated with the case group, whereas dismissing attachment was associated with the comparison group.

Suicidal ideation in an adolescent clinical sample: attachment patterns and clinical implications

“…However, as has been found in other adolescent samples (e.g. Adam et al, 1996;Rosenstein and Horowitz, 1996), males on average received significantly lower ratings on the preoccupied pattern t(114)=Ϫ3·60, p<0·001, and significantly higher ratings of dismissingness, t(114)=3·51, p<0·002 in comparison to their female counterparts.…”

Family environment, expressed emotion and adolescent self-harm: A review of conceptual, empirical, cross-cultural and clinical perspectives

“…In addition, suicidal adolescents are more likely to live in nonintact families compared with non-suicidal peers (De Wilde et al, 1992;Kienhorst et al, 1990;Paluszny et al, 1991). When young people do live with their parents, there may be poor attachment (Adam, 1994;Adam et al, 1996;Lessard & Moretti, 1998;Martin & Waite, 1994), parent -child confl ict (Asarnow, 1992;Brent et al, 1990;Meneese & Yutrzenka, 1990;Rubenstein et al, 1989), hostility (Kosky et al, 1986) and rejection (Fotti et al, 2006). Moreover, family confl icts are among the most commonly identifi ed precipitants to self-harm, based on adolescent self-report (Lowenstein, 2005).…”

Self/other Perception Mediates Between Personality and Suicidal Ideation in Young Adults

“…One possible reason for such greater vulnerability may be a predisposition for these conditions in the face of stress, negative affect, and interpersonal difficulties, as evidenced elsewhere [49][50][51] . Yet, the overlap between suicidal behavior and insecure attachment could be interpreted as result of failure to resolve attachment-related distress, leading to the emergence of depressive symptoms, negative models of the self and the others, and lack of future expectations 17 .…”

“…Respondents choose statements that reflect how they have felt over the past 2 weeks. BDI-II scores range between 0 and 63; categorical depression ratings are "minimal" (0-13), "mild" (14)(15)(16)(17)(18)(19), "moderate" (20)(21)(22)(23)(24)(25)(26)(27)(28), and "severe" . The authors found, in their assessed clinical sample, a cut-off of 17 or greater with a 93% true-positive rate and a 18% false-positive rate.…”

“…However, to date, research has mainly focused on the role of attachment in adolescents' psychopathology and suicidality 17,18 . Few studies have investigated the role of attachment styles in SI in adults.…”