Year: 2010
Type: article
Study design: Observational Study
Abstract: Suicide among adolescents is an important public health problem in the United States and the world.Adolescents who have attempted or completed suicide experience a number of risk factors including parental psychopathology, depression, and anxiety.One potential critical risk factor, however -insecure attachment -has been surprisingly underexplored in the literature despite the fact that attachment is central to understanding close relationships and relationship difficulties often precipitate suicidality.Attachment security is formed in infancy and is dependent upon the quality of parent/caregiver-child relationship.The quality of these relationships influence the individual's development of internal working models of relationships.These models serve to regulate, interpret, and predict behaviors, thoughts, and feelings about the self and others across multiple relationships.Individuals with secure attachments demonstrate better functioning in a number of domains, particularly in close relationships.This research explored the association between adolescent attachment security and suicidality and possible mediators and moderators using data from a case-control study of 80 adolescents, half of whom had attempted suicide in the past year.The mediators that were examined included affective lability (emotional instability) and locus of control (sense of control) while the moderators explored included religiosity and family alliance (familial closeness).It was expected that controls would be lower on attachment anxiety and avoidance, higher on religiosity and family alliance, lower on affective lability, and report a greater internal locus of control.Furthermore, it was hypothesized that affective lability and locus of control would mediate the association between attachment security and suicidality, such that adolescents with insecure attachment would report greater affective lability and external locus of control, which in turn would predict suicidality.Finally, it was expected that the association between insecurity and suicidality would be moderated (weakened) by high religiosity and high family alliance.Compared to controls, adolescent suicide attempters were higher on depressive symptoms, t(78) = 2.28, p < .05,higher on attachment avoidance, t(78) = 3.21, p < .05,and attachment anxiety, t(78) = 2.61, p < .05,lower on family alliance, t(78) = -3.20,p < .05,and had lower levels of religiosity, t(78) = -2.41,p < .05.For the mediation analysis, no significant indirect effects for either of the proposed mediators were found.For the moderation analysis, an interaction between attachment avoidance and religiosity approached significance (p < .10).It was found that adolescents with moderate to higher levels of religiosity and high attachment avoidance were more like to be in the attempter group.The mediation and moderation analyses did not confirm the hypotheses proposed, but attachment avoidance and religiosity did show a trend toward significance and attachment avoidance continued to predict group even after controlling for depressive symptoms.It may be important to explore the concepts of cognitive dissonance and identity formation to gain a better understanding of this interaction.In conclusion, it may v be wise to include depression, attachment security, and religiosity questions on screeners to be used in pediatric and/or family doctor settings in order to prevent suicidality in the adolescent population.vi Dedication This document is dedicated to my husband, grandmother, and dear friends who have stuck with me throughout all of my 9 years of schooling.Without your prayers and love, I know achieving this goal would not have been possible.In addition, I would like to dedicate this dissertation to my mother.Thank you for teaching me that with hard work and dedication, you can reach your goals!I will always love and remember you dearly.You will always be present in my heart.
Author: Arielle H. Sheftall
Institution: The Ohio State University
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2260221036