Suicide and Self-Injury
Longitudinal Relations Between Parenting Practices and Adolescent Suicidal Ideation in a High-Risk Clinical Sample: A Moderated Mediation Model
Katherine Maultsby, M.A.
Clinical Psychology Graduate Student
George Mason University
Arlington, Virginia
Roberto Lopez, Jr., M.A.
Graduate Student
George Mason University
Fairfax, Virginia
Lauren Seibel, B.A.
Graduate Student
George Mason University
Fairfax, Virginia
Jennifer C. Wolff, Ph.D.
Associate Professor
Warren Alpert Medical School of Brown University
Providence, Rhode Island
Anthony Spirito, Ph.D.
Professor
Alpert Medical School of Brown University
Providence, Rhode Island
Christianne Esposito-Smythers, Ph.D.
Professor
George Mason University
Fairfax, Virginia
In 2019, approximately 1 in 5 high school students reported seriously considering suicide (Ivey-Stephenson et al., 2020), and research suggests that this number is increasing with the COVID-19 pandemic (Yard et al., 2021). Parenting behaviors are a potentially modifiable variable associated with adolescent suicidal ideation (SI) (for a review, see Diamond et al., 2021), but few studies have examined this association longitudinally or investigated underlying mechanisms of this relationship. In the present study, we investigated a conditional process model to explain the longitudinal relationship between two parenting behaviors (warmth and verbal hostility) and adolescent SI. We hypothesized that perceived burdensomeness (PB) mediates the relation between these parenting behaviors and adolescent SI. As past research suggests that the relationship between parenting and PB may depend on adolescent level of impairment (Buitron et al., 2020), we further hypothesized that this association would be particularly strong among adolescents with more significant mental health related functional impairment. The sample included 147 adolescents (Mage = 14.91, 76.2% female, 85.5% White) and a primary caregiver (Mage = 43.45, 81.4% female, 87.1% White) enrolled in a randomized clinical trial. Caregivers completed self-report measures of warmth and verbal hostility (PCPR) and adolescents completed self-report measures of functional impairment (CDI-2), perceived burdensomeness (INQ), and suicidal ideation severity (SIQ-JR) at baseline, 12 and 18 months. Two path models, one for each parenting behavior examined, were conducted to examine the relations between these constructs. Age, sex, treatment condition assignment, and baseline SI severity and PB were included as covariates. Neither model found a significant direct effect between baseline parental verbal hostility or warmth and 18-month SI severity. However, both forms of maladaptive parenting (lower warmth and higher verbal hostility) were found to be positively associated with 18-month SI indirectly through greater PB among youth with relatively higher levels of functional impairment. Thus, findings suggest that youth perceptions of burdensomeness are a mechanism by which low parental warmth and high parental verbal hostility contribute to suicidal ideation risk among those with more significant functional impairment. Interventions to address youth perceptions of burdensomeness in the family may be beneficial, particularly for the most highly impaired youth.