A prospective investigation of the relation between dysfunctional family communication and suicidal ideation severity in a clinical adolescent sample: A serial mediation model

Abstract

BackgroundExtant research has documented a relation between the quality of family communication and adolescent suicidal ideation. However, few studies have examined this relation longitudinally or explored potential mechanisms of this effect. In the present study, unhealthy family communication was hypothesized to be associated with suicidal ideation severity over 18 months via a serial mediation pathway through emotion regulation difficulties and depressive symptom severity. MethodsThe sample consisted of 147 adolescents (Mage = 14.91, SD = 1.51, range = 12–18 years; 76.2% female, 85.5% White) enrolled in a randomized clinical trial. Family communication quality was assessed at baseline using the Family Assessment Device. Emotion regulation difficulties and depressive symptoms were assessed using the Difficulties in Emotion Regulation Scale and Children's Depression Inventory-2, respectively, at baseline, 6-, and 12-months. Suicidal ideation was assessed using the Suicidal Ideation Questionnaire-JR at baseline and 18-months. Path analysis was used to analyze temporal relations between constructs. ResultsAfter accounting for participant's age, sex, treatment condition, and baseline levels of variables of interest, analyses supported the indirect relation between baseline family communication and 18-month suicidal ideation severity through 6-month emotion regulation difficulties and 12-month depressive symptom severity. LimitationsData were exclusively collected via self-report, and the sample was racially homogenous. ConclusionsTreatment aimed at improving family communication may help bolster emotion regulation abilities, lower depressive symptoms, and subsequently, suicide risk.