The Influence of Insecure Attachment to Parents on Adolescents’ Suicidality

Insecure attachment has been identified as a risk factor for adolescent psychopathology and, consequently, for suicidal behavior. We aimed to highlight the relationship between the attachment styles of adolescents and their suicidal behavior and to investigate the role of each parent in the suicidality pathway of adolescents. The sample consisted of 217 adolescent inpatients who were at the highest risk for suicidal behavior and who were hospitalized in the Unit for Intensive Child and Adolescent Psychiatry. Self-report questionnaires assessing their attachment to their parents, their acquired capability for attempting suicide, their suicidality, and a number of traumatic life events were administered. The results showed a higher level of attachment avoidance rather than attachment anxiety among the most at-risk adolescents. An acquired capability for suicide (ACS) mediated the positive correlation between adolescents’ attachment avoidance in relation to the mother or father and their suicidality. The suppressive mediating effect of an ACS on the association between attachment anxiety in relation to the father and suicidality was detected. The odds ratio for attempted suicide was more than two times higher for adolescents who were insecurely attached to their father compared to adolescents who were insecurely attached to their mother. Our results confirmed the importance of attachment, especially paternal attachment, in developing suicidality during adolescence. Preventive and clinical interventions should target these important domains with the aim of decreasing suicidality among adolescents.

[1]  H. Christensen,et al.  Personality factors associated with suicidal ideation, plans and attempts in adolescents. , 2022, Journal of affective disorders.

[2]  G. Diamond,et al.  Attachment-based family therapy: Theory, clinical model, outcomes, and process research. , 2021, Journal of affective disorders.

[3]  N. Bratina,et al.  Validation of the Lifetime Incidence of Traumatic Events (LITE-S/P) Questionnaires in Children and Adolescents in Slovenia , 2021, Frontiers in Psychiatry.

[4]  S. McMahon,et al.  Assessment of Somatosensory Function and Self-harm in Adolescents , 2021, JAMA network open.

[5]  N. Bratina,et al.  Carer's Attachment Anxiety, Stressful Life-Events and the Risk of Childhood-Onset Type 1 Diabetes , 2021, Frontiers in Psychiatry.

[6]  S. Stewart,et al.  Validation of Fearlessness about Death Scale in adolescents. , 2021, Psychological assessment.

[7]  D. Pratt,et al.  Attachment Security and Suicide Ideation and Behaviour: The Mediating Role of Reflective Functioning , 2021, International journal of environmental research and public health.

[8]  R. Tremblay,et al.  Machine Learning Assessment of Early Life Factors Predicting Suicide Attempt in Adolescence or Young Adulthood , 2021, JAMA network open.

[9]  L. Mehlum,et al.  Associations between insecure attachment styles to parents and suicidal ideation in adolescents with depression , 2021, Scandinavian journal of child and adolescent psychiatry and psychology.

[10]  Thenral Mangadu,et al.  Psychological and neurobiological aspects of suicide in adolescents: Current outlooks , 2020, Brain, Behavior, & Immunity - Health.

[11]  K. R. Gomes,et al.  Suicidal ideation and associated factors among high school adolescents , 2020, Revista de saude publica.

[12]  G. Martinotti,et al.  Attachment in Patients with Bipolar and Unipolar Depression: A Comparison with Clinical and Non-clinical Controls , 2019, Clinical practice and epidemiology in mental health : CP & EMH.

[13]  Cindy M. Gray,et al.  The Relationship Between Adult Attachment and Suicidal Thoughts and Behaviors: A Systematic Review , 2019, Archives of suicide research : official journal of the International Academy for Suicide Research.

[14]  E. Fonseca-Pedrero,et al.  Validation of the Prodromal Questionnaire–Brief in a representative sample of adolescents: Internal structure, norms, reliability, and links with psychopathology , 2018, International journal of methods in psychiatric research.

[15]  Raúl Quevedo-Blasco,et al.  Sociodemographic Variables Most Associated with Suicidal Behaviour and Suicide Methods in Europe and America. A Systematic Review , 2018 .

[16]  Andy P. Field,et al.  Discovering Statistics Using Ibm Spss Statistics , 2017 .

[17]  I. Galynker,et al.  Attachment style and suicide behaviors in high risk psychiatric inpatients following hospital discharge: The mediating role of entrapment , 2017, Psychiatry Research.

[18]  Nicholas J. Rockwood,et al.  Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation. , 2017, Behaviour research and therapy.

[19]  M. Kaess,et al.  Ecological Momentary Assessment of Affective and Interpersonal Instability in Adolescent Non-Suicidal Self-Injury , 2017, Journal of abnormal child psychology.

[20]  R. Kobak,et al.  The Suicide Narrative Interview: adolescents’ attachment expectancies and symptom severity in a clinical sample , 2017, Attachment & human development.

[21]  M. Miniati,et al.  Adult Attachment Style and Suicidality. , 2017, Psychiatria Danubina.

[22]  Wei Liu,et al.  Personality traits and suicide attempts with and without psychiatric disorders: analysis of impulsivity and neuroticism , 2017, BMC Psychiatry.

[23]  G. Falgares,et al.  Attachment Styles and Suicide-Related Behaviors in Adolescence: The Mediating Role of Self-Criticism and Dependency , 2017, Front. Psychiatry.

[24]  C. Mota,et al.  Parenting Styles and Suicidal Ideation in Adolescents: Mediating Effect of Attachment , 2017 .

[25]  O. Kirtley,et al.  Pain and self-harm: A systematic review. , 2016, Journal of affective disorders.

[26]  A. Zaborskis,et al.  Prevalence and familial predictors of suicidal behaviour among adolescents in Lithuania: a cross-sectional survey 2014 , 2016, BMC Public Health.

[27]  J. Russon Attachment-based family therapy for depressed and suicidal adolescents , 2016 .

[28]  Alaa M Althubaiti,et al.  Information bias in health research: definition, pitfalls, and adjustment methods , 2016, Journal of multidisciplinary healthcare.

[29]  Ü. Özer,et al.  Relationship of Suicidal Ideation and Behavior to Attachment Style in Patients with Major Depression. , 2015, Noro psikiyatri arsivi.

[30]  G. Diamond,et al.  Attachment-based family therapy for depressed and suicidal adolescents: theory, clinical model and empirical support , 2015, Attachment & human development.

[31]  R. Kobak,et al.  Attachment based treatments for adolescents: the secure cycle as a framework for assessment, treatment and evaluation , 2015, Attachment & human development.

[32]  Jeffrey J. Glenn,et al.  Pain analgesia among adolescent self-injurers , 2014, Psychiatry Research.

[33]  C. Sharp,et al.  Assessing attachment in adolescence: a psychometric study of the child attachment interview. , 2014, Psychological assessment.

[34]  A. Elklit,et al.  A validation of the Experiences in Close Relationships-Relationship Structures scale (ECR-RS) in adolescents , 2014, Attachment & human development.

[35]  Y. Levi-Belz,et al.  Attachment patterns in medically serious suicide attempts: the mediating role of self-disclosure and loneliness. , 2013, Suicide & life-threatening behavior.

[36]  J. Mann,et al.  The effect of social adjustment and attachment style on suicidal behaviour , 2011, Acta psychiatrica Scandinavica.

[37]  R. C. Fraley,et al.  The Experiences in Close Relationships-Relationship Structures questionnaire: a method for assessing attachment orientations across relationships. , 2011, Psychological assessment.

[38]  Kelly C. Cukrowicz,et al.  Capable of suicide: a functional model of the acquired capability component of the Interpersonal-Psychological Theory of Suicide. , 2010, Suicide & life-threatening behavior.

[39]  M. Oquendo,et al.  Attachment and social adjustment: relationships to suicide attempt and major depressive episode in a prospective study. , 2010, Journal of affective disorders.

[40]  Kelly C. Cukrowicz,et al.  The interpersonal theory of suicide. , 2010, Psychological review.

[41]  R. Gallop,et al.  Attachment-based family therapy for adolescents with suicidal ideation: a randomized controlled trial. , 2010, Journal of the American Academy of Child and Adolescent Psychiatry.

[42]  P. Fonagy,et al.  Mentalization based treatment for borderline personality disorder , 2010, World psychiatry : official journal of the World Psychiatric Association.

[43]  K. Kerns,et al.  Parent–child attachment and internalizing symptoms in childhood and adolescence: A review of empirical findings and future directions , 2010, Development and Psychopathology.

[44]  I. Bretherton Fathers in attachment theory and research: a review , 2010 .

[45]  C. Essau Treatments for adolescent depression : theory and practice , 2009 .

[46]  L. I. Reed,et al.  The role of attachment styles and interpersonal problems in suicide-related behaviors. , 2008, Suicide & life-threatening behavior.

[47]  Thomas E Joiner,et al.  Suicidal desire and the capability for suicide: tests of the interpersonal-psychological theory of suicidal behavior among adults. , 2008, Journal of consulting and clinical psychology.

[48]  D. Ng-Mak,et al.  Adolescent suicidal behavior: associations with preadolescent physical abuse and selected risk and protective factors. , 2007, Journal of the American Academy of Child and Adolescent Psychiatry.

[49]  Robin D. Everall,et al.  In My Mind I Was Alone: Suicidal Adolescents' Perceptions of Attachment Relationships , 2006 .

[50]  G. Fitzmaurice,et al.  Adolescent suicidal ideation as predictive of psychopathology, suicidal behavior, and compromised functioning at age 30. , 2006, The American journal of psychiatry.

[51]  John C. Wright,et al.  Attachment and the Body in Suicidal Adolescents: A Pilot Study , 2005 .

[52]  M. Moretti,et al.  Adolescent-parent attachment: Bonds that support healthy development. , 2004, Paediatrics & child health.

[53]  M. Tomori,et al.  Suicidal behaviour and family factors among Dutch and Slovenian high school students:
a comparison , 2001, Acta psychiatrica Scandinavica.

[54]  J. Overholser,et al.  Suicidal Ideation in Adolescent Psychiatric Inpatients as Associated With Depression and Attachment Relationships , 2000, Journal of clinical child psychology.

[55]  A. Rubin,et al.  Assessment of Posttraumatic Symptoms in Children: Development and Preliminary Validation of Parent and Child Scales , 1999 .

[56]  M. Moretti,et al.  Suicidal ideation in an adolescent clinical sample: attachment patterns and clinical implications. , 1998, Journal of adolescence.

[57]  E. Paykel,et al.  Suicidal Feelings in the General Population: A Prevalence Study , 1974, British Journal of Psychiatry.

[58]  Michelle E. Roley‐Roberts Predictors of the acquired capability for suicide among childhood trauma survivors , 2017 .

[59]  P. Trairatvorakul,et al.  Patterns of Attachment: A Psychological Study of the Strange Situation , 2016 .

[60]  Jason A. Kacmarski Attachment Styles and the Interpersonal Psychological Theory of Suicide: An Examination of Interrelationships , 2016 .

[61]  S. Schoppe‐Sullivan,et al.  Insecure attachment and suicidal behavior in adolescents. , 2014, Crisis.

[62]  A. Sheftall Attachment and Suicidality in Adolescents: An Exploration of Mediators and Moderators , 2010 .

[63]  L. Hankoff Why People Die by Suicide , 2006 .

[64]  M. Main,et al.  Discovery of an insecure-disorganized/disoriented attachment pattern. , 1986 .