Parent’s Depression and Its Relation to Adolescent Suicide Attempts

Christina Solomon
University of Michigan, Ann Arbor

Abstract

There is current research that shows the relation between parent psychopathology along with mental health outcomes in adolescents. This study examined the relationship between parents’ depression and adolescent suicide attempts. The hypothesis was that adolescents with multiple suicide attempts would have parents who are more depressed than adolescents with none or one suicide attempt. There were a total of 448 adolescents who were in a psychiatric hospital at a university or private facility. Age, race/ethnicity, and income of the sample are given. The results showed that there was not a strong relationship between parent depression and youth suicide attempts. Further research must be conducted to show the significance of parent depression on adolescent suicide attempts.

Introduction

Parent’s psychopathology such as depression has been shown to relate to child psychopathology. According to the STAR*D Ancillary Study, having a depressed mother increases the likelihood of having a comorbid disorder among adolescents (Pilowsky et al., 2006). The mothers who were severely depressed had a 3-fold increase in the chance of having a child with depressive disorder. Among those adolescents, forty percent of children with a depressive disorder also had a concurrent diagnosis of anxiety disorder. Additionally 58 percent with a current anxiety disorder also had concurrence of disruptive behavior disorder (Pilowsky et al., 2006). Furthermore, parents’ depression, symptoms experienced directly such as withdrawal, hopelessness, and helplessness decreased the effectiveness of identifying adolescents’ depression. The lack of identifying evidential clues of adolescent depression can further lead to lower service use among those adolescents (Logan & King, 2001). Ultimately, this study showed that parents diagnosed with major depressive disorder were more likely to have children diagnosed with disruptive behavior, anxiety, panic, and depressive disorder.

The adolescent view of families as less cohesive and adaptable is one way that disengagement of a family environment can affect their mental health outcomes. The inflexible family system without any direction leads to painful isolation and strong feelings of hopelessness. The quality of communication with parents is an important component when differentiating psychopathology from the psychiatric group and the control group. Lack of warmth and empathy from parents is also known to affect the mental health outcomes of an adolescent (Miller, King, Shain, & Naylor, 1992). The Miller et al. study emphasizes how a dysfunctional family system can create higher risks of developing a psychiatric disorder.

These studies identified that parents’ depression is significantly related to adolescent psychopathology. Other studies show the relation between adolescent psychopathology and suicidal thoughts and behaviors. According to Lewinsohn, Rohde, and Seeley (1996), suicide ideation is much higher in groups with pure depression (prevalence of 40.7 percent) compared to other groups with anxiety and disruptive behavior disorder. Almost half of depressed adolescents have a preoccupation with suicide and death. Suicide ideation has a high predictability for future suicide attempts. The current depression levels of the adolescent can emphasize the severity of suicide attempts. In a three-month period after the initial study evaluation, approximately 27 percent of male attempters and 21 percent of female attempters had reattempted after first attempt. The risk of suicide attempts increases with more than one psychiatric disorder. For males and females diagnosed with major depression, those with comorbid alcohol and drug abuse/dependence, and disruptive behavior disorders were more likely to have suicide attempts (Lewinsohn et al., 1996). Given this information, it is clear that suicidal ideation leads to single or multiple suicide attempts.

Suicide is the fourth leading cause of death in young adults between the age of 10 and 24 years with an 11 percent rate (Eaton et al., 2006). According to the 2005 Youth Risk Behavior Survey, 16.9 percent of students had seriously thought of attempting suicide 12 months after the survey was given. The prevalence of having made a suicide plan was much higher among females. Nationwide, 8.4 percent have actually attempted suicide one or more times 12 months after the survey was given. The prevalence was much higher in females again (Eaton et al., 2006).

From the current research, there is a strong association between parent’s depression and child psychopathology. Lack of cohesiveness and dysfunctional family system are potential predictors of possible mental health complications in adolescents. A present history of ideation and attempts in youth could be caused by a poor family environment without support and communication (King & Merchant, 2008). The parents that fail to identify depression in their adolescent may not seek services until an actual suicide attempt or hospitalization has occurred. Therefore, it would seem that adolescents who are hospitalized for multiple attempts are more likely to have depressed parents. The aim of this study is to determine if parent’s depression is related to multiple suicide attempts among psychiatrically hospitalized youth. It is hypothesized that adolescents with multiple suicide attempts will have parents who are more depressed than adolescents with none or one suicide attempt.

Methods

The sample consisted of 448 adolescents (319 girls, 129 boys), 13 to 17 years (mean=15.59, SD=1.31), psychiatrically hospitalized at either a university (n=132) or private hospital (n=316). They were participants in the NIMH-funded Youth Support Team intervention trial for suicidal adolescents (King et al., 2009), which examined a supplemental social support intervention for adolescents following a psychiatric hospitalization. Data were collected between November 2002 and December 2005. The study’s inclusion criteria were either parent or adolescent report of (a) recent suicidal ideation that was either unrelenting or accompanied by a specific plan or (b) suicide attempt within the last four weeks.

Results

The participants were divided up into 3 separate groups based on suicide attempts. The first group consisted of 117 non-attempters (NA, n = 117). The second group consisted of adolescents with a single attempt (SA, n = 153). The last group was adolescents with multiple attempts of 2 or more (MA, n = 178). Table 1 gives the demographic characteristics of the overall sample and the individual attempt status groups. There were no significant differences between the groups on age, gender, income, or distribution of race/ethnicities.

Table 1: Demographic characteristics of sample (overall and by attempt group)

	Overall (N = 448)	No attempts (n = 117)	1 attempt (n = 153)	2 or more attempts (n = 178)
Gender (% female)	71.2	65.8	69.3	76.4
Age (Mean(SD))	15.59 (1.31)	15.45 (1.36)	15.49(1.29)	15.75 (1.28)
Race/Ethnicity (%)
Non-Hispanic White	83.3	86.3	85.6	79.2
Non-Hispanic Black	6.9	5.1	6.5	8.4
Non-Hispanic American Indian	0.4	.9	2.0	1.1
Non-Hispanic Asian American	0.7	.9	.7	1.1
Non-Hispanic other	5.3	.9	4.6	6.7
Hispanic	3.3	3.4	2.7	3.4
Income (%) ����
Under $14,999	6.0	6.1	5.4	6.5
$15-$39,999	22.8	21.2	19.2	26.8
$40-$79,999	37.7	39.4	36.1	37.9
$80,000 and higher	33.5	33.3	39.3	28.7

Table 2 contains the means and standard deviations for parent depression as well as anxiety, hostility, and interpersonal problems. In order to test for differences between suicide attempt groups, a one-way ANOVA was conducted with parent depression as the independent variable. The test was non-significant [F (2,409) = .56, p = .574], indicating no difference between the attempt status groups in terms of level of parent reported depression symptoms.

Table 2: Means and standard deviations for parent psychopathology variables by attempt group

	No attempts (n = 117)	1 attempt (n = 153)	2 or more attempts (n = 178)
Parent depression	0.79 (0.88)	0.74 (0.87)	0.84 (0.93)
Parent anxiety	0.77 (0.72)	0.80 (0.79)	0.89 (0.85)
Parent interpersonal problems	0.70 (0.77)	0.54 (0.76)	0.64 (0.86)
Parent hostility	0.56 (0.61)	0.52 (0.58)	0.57 (0.62)

*Note: All means and standard deviations are based on scores from the Brief Symptom Inventory

Discussion

Current research shows the relation between parents’ depression to adolescent psychopathology. The purpose of this study was to determine if parents’ depression was related to multiple suicide attempts in hospitalized adolescents. It was hypothesized that adolescents with multiple suicide attempts would have parents who were more depressed than adolescents with none or one suicide attempt. From our results, the statistics were non-significant and did not show the relation between depressed parents and suicide attempts. Within each attempt status group the level of depressive symptoms was not a clear determinate of suicide attempts in psychiatrically hospitalized adolescents.

There are multiple reasons why the hypothesis was not proven correct. This sample was taken from a particularly acute suicidal group of adolescents in mental health facilities. It is possible that very depressed parents under-utilize services (as suggested by Logan and King (2002)) and thus these youth would not appear to be suicidal with particularly depressed parents. Another major limitation of the study is the lack of variability in parent depression scores. Perhaps with a comparison group of more depressed mothers, we would have been able to uncover an effect. Additionally, certain other effects such as gender, ethnicity, and income were not tested, and these might relate to how parent psychopathology affects adolescent suicidality. These demographic variables were also fairly skewed. The sample was mostly middle and upper class and Caucasian adolescents.

Future research should acknowledge the increased use of mental health services among the wealthy. Looking at the lower income groups may show that fewer resources increase likelihoods of associations between parent psychopathology and adolescent suicide. Lower income families may not have financial resources to seek proper mental health care. The stress of financial worries may lead to dysfunctional family behavior when the adolescent develops interpersonal problems. These possible problems with financial or family effects are not visible from this study and it may be one reason the hypothesis was proven incorrect.

Conclusion

Although this study did not show the association expected of the relation between parent depression and adolescent suicide attempts, there are numerous other avenues of research that might yield the predicted results. New variables need to be tested to show the relation. More research needs to be conducted in order to fully determine the impact of parent depression on youth suicidality.

References

Eaton, D. K., Kann, L., Kinchen, S., Ross, J., Hawkins, J., Harris, W.A., et al. (2006). Youth Risk Behavior Surveillance — United States, 2005. Surveillance Summaries, 55(SS-5), 1-109.

King, C.A., Merchant, C.M., Kerr, D.C.R., Ewell Foster, C.., Hanna, B., Gillespie, B., & Venkataraman, S.(2009)  Acutely Suicidal Adolescents: Differentiation by Lethality of Most Recent Attempt and History of Multiple Attempts.  Manuscript in preparation.

King C. A, & Merchant C. R. (2008). Social and Interpersonal Factors Relating to Adolescent Suicidality: A Review of the Literature. Archives of Suicide Research, 12, 181-196.

Lewinsohn P. M., Rohde P., & Seeley J. R. (1996). Adolescent Sicudal Ideation and Attempts: Prevalence Risk Factors, and Clinical Implications. American Psychological Association, D12, 25-46.

Logan D. E. & King C. A. (2002). Parental Identification of Depression and Mental Health Service Use Among Depreessed Adolescents. Child Adolescent Psychiatry, 41(3) 296-304.

Miller K. E., King C. A., Shain B. N., & Naylor M. W. (1992). Suicidal Adolescent’s Perception of Their Family Environment. Suicide and Life-Threatening Behavior, 22(2), 226-239.

Pilowsky D. J., Wickramaratne P. J., Rush J. A., Hughes C. W., Garber J., Malloy E. et al. (2006). Children of Currently Depressed Mothers: A STAR*D Ancillary Study. Clinical Psychology , 67(1) 126-136.

Weissman M. M., Pilowsky D. J, Wickramaratne P. J., Talati A., Wisnieski S. R., Fava M., et al. (2006). Remission in Maternal Depression and Child Psychopathology. American Medical Association , 295(12), 1389-1397.