Attachment Security and Suicide Ideation and Behaviour: The Mediating Role of Reflective Functioning.


Journal

International journal of environmental research and public health
ISSN: 1660-4601
Titre abrégé: Int J Environ Res Public Health
Pays: Switzerland
ID NLM: 101238455

Informations de publication

Date de publication:
17 03 2021
Historique:
received: 01 02 2021
revised: 12 03 2021
accepted: 13 03 2021
entrez: 3 4 2021
pubmed: 4 4 2021
medline: 27 4 2021
Statut: epublish

Résumé

To understand why attachment difficulties predispose individuals to suicidal thinking (suicide ideation) and behaviour, a leading cause of death, we need to explore the role of pertinent psychological mechanisms. Attachment processes are closely linked to the development of mentalisation capabilities, or reflective functioning; the ability to understand and interpret self and other behaviour as an expression of mental states. Interventions designed to improve mentalisation have been associated with a reduction in suicidal behaviour, yet reflective functioning has not been directly investigated in relation to suicidal ideation and behaviour. We aim to further verify the link between adult attachment security and suicidal ideation and examine whether deficits in reflective functioning mediate this relationship. Sixty-seven participants who experienced suicidal ideation within the past 12 months completed self-report measures of adult attachment, current suicidal ideation, reflective functioning, depressive symptomology and hopelessness. Partial correlations, mediation analyses and group comparisons were conducted to explore relationships between these factors. Findings did not support a mediational role for reflective functioning in the relationship between attachment security and suicidal ideation. A direct relationship was established between attachment avoidance and suicidal ideation, after controlling for age, gender and depressive symptoms. However, participants with a history of attempted suicide were higher in anxious attachment compared to participants with no such history. This study shows that the attachment dimensions of attachment anxiety and avoidance may play differential roles in increasing risk for suicidal attempts versus ideation. This has important implications for tailoring interventions. Those aimed at reducing suicide attempts should focus on reducing attachment anxiety by helping people develop skills in emotional regulation. Interventions aimed at reducing suicidal ideation should focus on reducing attachment avoidance by helping people develop closer relationships with significant others. However, longitudinal and experimental designs are required to verify causality.

Sections du résumé

BACKGROUND
To understand why attachment difficulties predispose individuals to suicidal thinking (suicide ideation) and behaviour, a leading cause of death, we need to explore the role of pertinent psychological mechanisms. Attachment processes are closely linked to the development of mentalisation capabilities, or reflective functioning; the ability to understand and interpret self and other behaviour as an expression of mental states. Interventions designed to improve mentalisation have been associated with a reduction in suicidal behaviour, yet reflective functioning has not been directly investigated in relation to suicidal ideation and behaviour.
AIM
We aim to further verify the link between adult attachment security and suicidal ideation and examine whether deficits in reflective functioning mediate this relationship.
METHODS
Sixty-seven participants who experienced suicidal ideation within the past 12 months completed self-report measures of adult attachment, current suicidal ideation, reflective functioning, depressive symptomology and hopelessness. Partial correlations, mediation analyses and group comparisons were conducted to explore relationships between these factors.
RESULTS
Findings did not support a mediational role for reflective functioning in the relationship between attachment security and suicidal ideation. A direct relationship was established between attachment avoidance and suicidal ideation, after controlling for age, gender and depressive symptoms. However, participants with a history of attempted suicide were higher in anxious attachment compared to participants with no such history.
CONCLUSIONS
This study shows that the attachment dimensions of attachment anxiety and avoidance may play differential roles in increasing risk for suicidal attempts versus ideation. This has important implications for tailoring interventions. Those aimed at reducing suicide attempts should focus on reducing attachment anxiety by helping people develop skills in emotional regulation. Interventions aimed at reducing suicidal ideation should focus on reducing attachment avoidance by helping people develop closer relationships with significant others. However, longitudinal and experimental designs are required to verify causality.

Identifiants

pubmed: 33802833
pii: ijerph18063090
doi: 10.3390/ijerph18063090
pmc: PMC8002725
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Références

Ann N Y Acad Sci. 2009 Jun;1167:207-11
pubmed: 19580567
Suicide Life Threat Behav. 2014 Feb;44(1):1-5
pubmed: 24313594
Psychol Rev. 1990 Jan;97(1):90-113
pubmed: 2408091
Psychol Psychother. 2008 Mar;81(Pt 1):55-77
pubmed: 17919360
J Consult Clin Psychol. 1987 Feb;55(1):49-54
pubmed: 3571658
J Consult Clin Psychol. 1979 Apr;47(2):343-52
pubmed: 469082
Crisis. 2011;32(6):295-8
pubmed: 21945841
PLoS One. 2016 Jul 08;11(7):e0158678
pubmed: 27392018
Neuropsychobiology. 1993;28(1-2):76-81
pubmed: 8255414
Acta Psychiatr Scand. 2011 Oct;124(4):295-300
pubmed: 21644941
J Pers Soc Psychol. 1997 Nov;73(5):1092-106
pubmed: 9364763
J Affect Disord. 2010 Jun;123(1-3):123-30
pubmed: 19819021
Front Psychiatry. 2017 Mar 10;8:36
pubmed: 28344562
Psychol Rev. 2010 Apr;117(2):575-600
pubmed: 20438238
Compr Psychiatry. 2016 Jan;64:59-66
pubmed: 26654293
Behav Res Ther. 2017 Nov;98:39-57
pubmed: 27865431
J Consult Clin Psychol. 1974 Dec;42(6):861-5
pubmed: 4436473
Br J Psychiatry. 2008 Feb;192(2):98-105
pubmed: 18245022
Clin Psychol Psychother. 2020 Jul;27(4):463-488
pubmed: 32167194
J Youth Adolesc. 1992 Jun;21(3):357-73
pubmed: 24263848
Clin Psychol Rev. 2014 Mar;34(2):107-17
pubmed: 24486522
Suicide Life Threat Behav. 2013 Oct;43(5):511-22
pubmed: 23662907
Child Dev. 2002 Nov-Dec;73(6):1715-26
pubmed: 12487489
Psychol Med. 2007 Jun;37(6):769-78
pubmed: 17202001
Lancet Psychiatry. 2014 Jun;1(1):73-85
pubmed: 26360404
J Adolesc. 1998 Aug;21(4):383-95
pubmed: 9757403
J Clin Psychol. 2012 Sep;68(9):1019-27
pubmed: 22644790
Dev Psychopathol. 1997 Fall;9(4):679-700
pubmed: 9449001
Suicide Life Threat Behav. 2010 Dec;40(6):612-9
pubmed: 21198330
Dev Psychopathol. 2009 Fall;21(4):1355-81
pubmed: 19825272
J Pers Disord. 2008 Feb;22(1):4-21
pubmed: 18312120
J Consult Clin Psychol. 2002 Feb;70(1):195-204
pubmed: 11860045
Attach Hum Dev. 2013;15(4):368-83
pubmed: 23560608
J Psychiatr Res. 2019 Oct;117:100-107
pubmed: 31376620
J Pers Soc Psychol. 1987 Mar;52(3):511-24
pubmed: 3572722
Am J Psychiatry. 2008 May;165(5):631-8
pubmed: 18347003
J Pers Soc Psychol. 1986 Dec;51(6):1173-82
pubmed: 3806354
Suicide Life Threat Behav. 2018 Oct;48(5):613-623
pubmed: 28833408
Acta Psychiatr Scand. 2004 Dec;110(6):438-45
pubmed: 15521828
Suicide Life Threat Behav. 2008 Oct;38(5):592-607
pubmed: 19014310
J Consult Clin Psychol. 2000 Jun;68(3):371-7
pubmed: 10883553
J Consult Clin Psychol. 1996 Apr;64(2):264-72
pubmed: 8871410
Psychiatr Danub. 2017 Sep;29(3):250-259
pubmed: 28949306
J Pers Soc Psychol. 2000 Feb;78(2):350-65
pubmed: 10707340
Psychol Assess. 2009 Dec;21(4):616-21
pubmed: 19947794
J Psychosom Res. 2010 Oct;69(4):419-32
pubmed: 20846544
Pers Soc Psychol Bull. 2005 Nov;31(11):1524-36
pubmed: 16207771
J Youth Adolesc. 2010 May;39(5):474-83
pubmed: 19885722
Death Stud. 2020;44(3):168-178
pubmed: 30696383
J Pers Soc Psychol. 1991 Aug;61(2):226-44
pubmed: 1920064
Clin Psychol Rev. 2016 Jun;46:34-45
pubmed: 27155061
Psychiatry Res. 2017 Nov;257:309-314
pubmed: 28797954
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
J Nerv Ment Dis. 2013 Jul;201(7):579-86
pubmed: 23817155
Crisis. 2014;35(6):426-30
pubmed: 25231855
Annu Rev Clin Psychol. 2008;4:1-32
pubmed: 18509902
J Clin Psychol. 1988 Jul;44(4):499-505
pubmed: 3170753
Psychol Bull. 2017 Dec;143(12):1313-1345
pubmed: 29072480

Auteurs

Jessica Green (J)

Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK.

Katherine Berry (K)

Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK.
Greater Manchester Mental Health NHS Foundation Trust, Manchester M25 3BL, UK.

Adam Danquah (A)

Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK.
Greater Manchester Mental Health NHS Foundation Trust, Manchester M25 3BL, UK.

Daniel Pratt (D)

Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK.
Greater Manchester Mental Health NHS Foundation Trust, Manchester M25 3BL, UK.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH