Parasuicide: interaction between inadequate parenting and recent interpersonal stress.

Abstract

We report a controlled study in which we searched for links between early family adversity and recent interpersonal stress in parasuicidal patients. Our subjects reported fewer adverse experiences in childhood than did the younger, predominantly female, patients investigated in previous studies. Nevertheless, 47% of our parasuicidal group, as compared to 19% of control subjects, reported a sequential pattern of relationship difficulties starting in childhood. The pattern of early exposure to neglectful and overprotective parenting followed by recent conflict or separations in adulthood was found to discriminate most clearly between the parasuicidal and control groups. We suggest that factors such as low self-esteem, a sense of helplessness in the face of adversity and an abiding insecurity in intimate relationships may variously account for this heightened vulnerability. We conclude that a history of adverse relationships beginning in childhood should alert primary care-givers to the risk of suicidal behaviour in patients who are exposed to distressing separations or interpersonal conflict.