Family Relationships and Suicide Ideation: The Mediating Roles of Anxiety, Hopelessness, and Depression in Adolescents

Abstract

Background: Several studies have shown that the suicide trend in Iran is rising. Although there is a growing number of studies that identify a number of the risk and protective factors associated with suicidal behaviors in adolescents, only a few studies have integrated this knowledge for the purpose of validating more complex models of adolescent suicidal behaviors in the Middle East. Objectives: The purpose of this study was to explore a theoretically derived model positing that anxiety, depression, and hopelessness mediate between family relationships as indicators of burdensomeness and belongingness in interpersonal-psychological theory and suicide ideation among adolescent suicidal attempters. Patients and Methods: This study develops and tests a model of suicide ideation with family relationships as antecedents, and latent variables as depression, hopelessness, and anxiety. In particular, we investigated 120 consecutive adolescent suicidal attempters who were assessed in terms of their Family Environment Scale (FES) and Beck Depression Inventory (BDI-II), Beck Hopelessness Scale (BHS), Beck Anxiety Inventory (BAI), and Beck Suicide Ideation Scale (BSSI). The final structural models have shown to be fitted to the considered data. Results: The results showed that family cohesion and expressiveness were stronger predictors of suicide ideation than family conflict. Indeed, family cohesion exerted direct and indirect effects through depression, hopelessness, and anxiety on suicide ideation, and family expressiveness was also directly related to suicide ideation. It was shown that latent variables (depression, hopelessness, and anxiety) were positively correlated with suicide ideation. Conclusions: The results of the study imply that family cohesion and family expressiveness act as predictive factors against depression, hopelessness, anxiety, and suicide ideation.