Friday, February 7, 2020

Family Conflict, Low Parental Supervision Risk Factors for Suicidality in Children, Study Finds

Family conflict and low parental supervision are associated with suicidality in children, according to a study published today in JAMA Network Open.

“Although many factors that influence a child’s risk for suicide may not necessarily be directly modifiable, family conflict and parental monitoring present targets for intervention,” wrote Danielle C. DeVille, M.A., of the Laureate Institute for Brain Research and colleagues.

DeVille and colleagues analyzed baseline data from the Adolescent Brain Cognitive Development (ABCD) study, a longitudinal study supported by the National Institute of Mental Health that is tracking children from across the United States over a period of 10 years. As part of the ABCD study, 11,814 children (aged 9 and 10) and their caregivers were asked whether the children had current or past suicidal thoughts and/or had ever tried to hurt themselves. Suicidality categories included passive suicide ideation (a wish to be dead), nonspecific active suicidal ideation (wanting to end one’s own life without considering a method or plan to do so), active suicidal ideation, or past suicide attempts. Nonsuicidal self-injury (NSSI) was defined as intentional self-inflected damage to the body without suicidal intent. Children were placed in a given suicidality category if either they or their caregiver reported the behavior.

The researchers gathered information on family and home environments, including parental surveys that detailed the extent to which the parents supervised and/or tracked their children. They also collected the children’s reports of family conflict, including fighting, anger, criticism, competitiveness, yelling, and/or temper within the family.

Overall, 6.4% of the children had a lifetime history of passive suicidal ideation; 4.4% had nonspecific active suicidal ideation; 2.4% had active ideation with a method, intent, or plan; 1.3% had a past suicide attempts; and 9.1% had a NSSI. Additional findings include the following:

  • High family conflict was significantly associated with suicidal ideation and NSSI.
  • Low parental monitoring was significantly associated with ideation, attempts, and NSSI.
  • Most children’s reports of suicidality and NSSI were either unknown or not reported by their caregivers; for 77% of the children who reported suicidal ideation, their caregivers denied all forms of suicidal ideation or attempts. (Families with a history of depression were less likely to have suicidality reports in which the child and parent didn’t agree.)
  • Rates of suicidal ideation and NSSI were higher in boys, though there was no significant difference between boys and girls in the prevalence of suicide attempts.
  • Greater financial problems were found among children who reported suicidal ideation, suicide attempts, and NSSI.
  • No significant differences were found on the basis of race or ethnicity.

“The high levels of parent-child discordance in the reporting of ideation, suicide attempts, and NSSI observed in the current study may have important clinical implications,” the authors wrote. “Our findings highlight the need to ensure that suicide assessments are conducted with children directly rather than solely with the child’s caregivers.”

For related information, see the Psychiatric News article “Preteen Suicides: Rare, Mysterious, and Devastating.”

(Image: iStock/fizkes)

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