Observed Interactions in Families of Adolescent Suicide Attempters

Abstract

Family interactions of 71 adolescents hospitalized following a suicide attempt were compared with those of 29 psychiatric controls, using observational methods and a 2-year prospective, longitudinal design. Parent-adolescent dyadic interactions were coded for emotional validation and invalidation, and problem-solving constructiveness. There were no between-group differences for parents. However, adolescents who had attempted suicide displayed more emotional invalidation than controls. Within the suicide attempt group, maternal constructive problem solving predicted greater declines in youth suicide ideation, and a similar trend was observed for fathers. Adolescents who displayed more unconstructive problem solving with fathers were more likely to reattempt suicide during the follow up.

Psychotherapy and youth suicide prevention: An interpretative phenomenological analysis of specialist clinicians' experiences

“…Implicit in this was the importance of members of a client's support network also being able to regulate their own responses (Aakre, Lucksted, & Browning‐McNee, 2016; Hadlaczky, Hökby, Mkrtchian, Carli, & Wasserman, 2014; Hart, Cropper, Morgan, Kelly, & Jorm, 2019; Jorm, Kitchener, Sawyer, Scales, & Cvetkovski, 2010; Kelly et al, 2011). A family's ability to self‐ and coregulate was especially important to reduce suicidal behaviours, a view consistent with the literature (Aiken et al, 2017; Asarnow & Mehlum, 2019; Barzilay et al, 2019; Connell et al, 2019; Conner et al, 2016; Connor & Rueter, 2006; Crowell, Skidmore, Rau, & Williams, 2013; Hughes, Crowell, Uyeji, & Coan, 2012; Iyengar et al, 2018; Littlewood et al, 2019; Lougheed et al, 2016; Pineda & Dadds, 2013; Willemen, Schuengel, & Koot, 2009). The therapist played an important role in scaffolding effective self‐regulatory and mentalization capacities of the client and their network and needed to manage their own anxieties over the course of treatment.…”

“…Wraparound support from trusted adults (e.g., families, schools) resounds throughout current research (Asarnow & Mehlum, 2019; Brent, 2016; Caine, Reed, Hindman, & Quinlan, 2018; Iyengar et al, 2018; Wilcox & Wyman, 2016; Zalsman et al, 2016). Notably, parental emotional validation and flexible and constructive problem‐solving appear to be important processes relevant to reducing suicidality in adolescents (Aiken, Wagner, & Benjamin Hinnant, 2017; Conner et al, 2016; Connor & Rueter, 2006). Although therapists need to assess the family's capacity to provide support (Barzilay et al, 2019; Littlewood et al, 2019), family inclusive practices and broadening social supports were viewed as important in treatment of suicidality in young people.…”

Family processes: Risk, protective and treatment factors for youth at risk for suicide

“…A significant correlation was found between parent's dissatisfaction with academic performance and youth suicidal ideation and adolescent depression mediated this relationship (Lee, Wong, Chow & McBride-Chang, 2006). In a study with families of adolescents hospitalized following a suicide attempt, parents were found to be twice as emotionally invalidating compared to those in a psychiatric control group (Aiken, Wagner & Benjamin Hinnant, 2019).…”

Exploring Lived Experiences of Adolescents Presenting with Self-Harm and Their Views about Suicide Prevention Strategies: A Qualitative Approach

“…Similarly, interpersonal conflicts with family members were reported as a predisposing factor. There is already established evidence on a number of family and social factors which increase the likelihood of self-harm behaviour in adolescents such as maladaptive parenting, stress related to parenting, domestic violence, lack of support and child maltreatment [ 33 , 34 ]. Gender discrimination by the parents was reported as a potential triggering factor by the female adolescents (such as giving preference to son over daughter and supporting their acts), which is quite common within Pakistani culture, as Pakistan is a male dominant society, where males have more authority and power and females are treated as subordinates [ 35 ].…”