Publication year
2013
Citation Title
Emotion regulation difficulties, youth–adult relationships, and suicide attempts among high school students in underserved communities.
Journal Name
Journal of Youth and Adolescence
Journal Volume
42
Issue Number
6
Page Numbers
807-820
DOI
10.1007/s10964-012-9884-2
Summary
Adolescence can be a particularly risky developmental period, especially for mental health problems and suicidal ideation. The impact of emotion regulation difficulties and trusting youth-adult relationships on past year suicide attempts was examined in a sample of high school students. Trusted adult relationships protected adolescents against suicide attempts, while emotion regulation difficulties and the absence of trusting adult relationships were predictive of past-year suicide attempts.
Key Findings
During the previous year, 8.6% of students reported at least one suicide attempt, with higher rates among females and Asian-American or Native American students.
Emotion regulation difficulties and a lack of trusted adults at home or school were associated with past-year suicide attempts, even after controlling for depressive symptoms and demographic variables.
Having trusted adult relationships, particularly with family members, was a protective factor, reducing the association between emotion regulation difficulties and suicide attempts.
Implications for Military Professionals
Help develop online modules to teach emotion regulation skills to youth struggling with suicidal ideation
Facilitate support groups for children of Service members experiencing depression or suicidal ideation to prevent suicide attempts
Implications for Program Leaders
Offer classes on emotion regulation strategies to help young people effectively manage emotional reactions
Develop structured social opportunities to enhance youth-adult relationships, particularly with family members and trusted adults at school
Implications for Policy Makers
Encourage the development of programs that teach children healthy emotion regulation strategies
Continue to support parent education program for military parents to foster positive youth-adult relationships
Methods
Data were drawn from baseline measures of a larger study of students from 30 high schools, and there was an 80% response rate.
High school students completed online surveys during the 2010-2011 or 2011-2012 academic years evaluating past year suicide attempts, emotion regulation difficulties, depressive symptoms, and the perception of having trusted adults in several domains (i.e., family, school, community).
The associations between emotion regulation difficulties, trusted relationships, and past year suicide attempts were examined, controlling for depression and other demographic variables.
Participants
The sample consisted of 7,978 students from 30 high schools (21 in New York, 9 in North Dakota), located primarily in non-metropolitan, low-income areas.
The sample was primarily White (77%), with similar numbers of males and females.
Most participants (93%) were 17 years of age and under.
Limitations
Participants were primarily White high school students from non-metropolitan, low income areas, limiting generalizability to individuals with other demographic characteristics.
The cross-sectional design prohibits drawing causal conclusions about the beneficial effects of enhanced emotion regulation and youth-adult relationships on suicide attempts.
All outcome measures were based on retrospective self-report, which may threaten the validity of the conclusions.
Avenues for Future Research
Evaluate with a prospective, longitudinal study whether enhanced emotion regulation skills and youth-adult relationship confer protective effects on suicide attempts
Seek to replicate these findings in a more diverse sample including demographically diverse adolescents, families with varying incomes, and metropolitan communities
Examine the role of trusting friendships on adolescent emotion regulation, depression, and suicide attempts
Focus
Civilian
Target Population
Population Focus
Abstract
To develop and refine interventions to prevent youth suicide, knowledge is needed about specific processes that reduce risk at a population level. Using a crosssectional design, the present study tested hypotheses regarding associations between self-reported suicide attempts, emotion regulation difficulties, and positive youth–adult relationships among 7,978 high-school students (48.6 % male, 49.9 % female) in 30 high schools from predominantly rural, low-income communities. 683 students (8.6 %) reported a past-year suicide attempt. Emotion regulation difficulties and a lack of trusted adults at home and school were associated with increased risk for making a past-year suicide attempt, above and beyond the effects of depressive symptoms and demographic factors. The association between emotion regulation difficulties and suicide attempts was modestly lower among students who perceived themselves as having higher levels of trusted adults in the family, consistent with a protective effect. Having a trusted adult in the community (outside of school and family) was associated with fewer suicide attempts in models that controlled only for demographic covariates, but not when taking symptoms of depression into account. These findings point to adolescent emotion regulation and relationships with trusted adults as complementary targets for suicide prevention that merit further intervention studies. Reaching these targets in a broad population of adolescents will require new delivery systems and ‘‘option rich’’ (OR) intervention designs.
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