A conditional process analysis of suicidal thoughts and behaviors in outpatient parents: Examining the Narrative Crisis Model by parenthood status.
Suicide Crisis Syndrome
interpersonal distress
parenthood
suicidal thoughts and behaviors
suicide
Journal
Family process
ISSN: 1545-5300
Titre abrégé: Fam Process
Pays: United States
ID NLM: 0400666
Informations de publication
Date de publication:
07 Aug 2023
07 Aug 2023
Historique:
revised:
26
07
2023
received:
24
06
2022
accepted:
27
07
2023
medline:
8
8
2023
pubmed:
8
8
2023
entrez:
8
8
2023
Statut:
aheadofprint
Résumé
No study to date has examined the moderating effect of parenthood on suicidal states and outcomes using a conditional process model. The Narrative Crisis Model, a multi-stage model from interpersonal distress to suicidal outcomes mediated by Suicide Crisis Syndrome severity, was assessed (H1). The present study tested whether (H2) parenthood moderates the indirect association between interpersonal distress and suicidality to reduce suicide risk. Psychiatric outpatients (N = 466) completed measures assessing the severity of interpersonal distress and Suicide Crisis Syndrome, as well as a clinical interview of suicidal thoughts and behaviors. The sample was predominantly female (65.7%), with ages ranging from 18 to 84 years. Mediation was conducted on the total sample (H1) and a conditional process analysis compared parents (n = 170) and non-parents (H2). Suicide Crisis Syndrome severity mediated the relationship between interpersonal distress and suicidal outcomes. Parenthood moderated the indirect relationship between interpersonal distress and suicidal outcomes through Suicide Crisis Syndrome such that parents had a significantly higher suicide risk than non-parents (index = 0.058; 95% CI [0.005, 0.139]). In the context of an outpatient population, parents appear to be more at risk for developing a suicidal crisis and engaging in suicidal thoughts and behaviors than non-parents. Parenthood may act as a pile-up stressor for this population, outweighing the protective effects of having children. In this way, the Narrative Crisis Model is a theoretical model suitable for the examination of complex factors impacting risk for near-term suicidal thoughts and behaviors.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : American Foundation for Suicide Prevention
ID : Focus Grant #RFA-1-015-14
Informations de copyright
© 2023 Family Process Institute.
Références
Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. Journal of the American Medical Association, 325(18), 1829-1830.
American Foundation for Suicide Prevention. (2020). Our nationwide initiative to reduce the annual rate of suicide in the U.S. by 20% by 2025. https://annual2020.afsp.org/project2025.htm
Beck, A. T., & Steer, R. A. (1991). Manual for the Beck scale for suicide ideation. Psychological Corporation.
BeLue, R., Halgunseth, L. C., Abiero, B., & Bediako, P. (2015). Maternal health status and parenting stress in low-income, ethnic-minority mothers of children with conduct disorder problems: The role of daily parenting hassles. Journal of Racial and Ethnic Health Disparities, 2, 501-509.
Bergen, H., Hawton, K., Kapur, N., Cooper, J., Steeg, S., Ness, J., & Waters, K. (2012). Shared characteristics of suicides and other unnatural deaths following non-fatal self-harm? A multicenter study of risk factors. Psychological Medicine, 42(4), 727-741.
Bloch-Elkouby, S., Gorman, B., Schuck, A., Barzilay, S., Calati, R., Cohen, L. J., Begum, F., & Galynker, I. (2020). The suicide crisis syndrome: A network analysis. Journal of Counseling Psychology, 67(5), 595-607.
Borges, G., Angst, J., Nock, M. K., Ruscio, A. M., & Kessler, R. C. (2008). Risk factors for the incidence and persistence of suicide-related outcomes: A 10-year follow-up study using the National Comorbidity Surveys. Journal of Affective Disorders, 105(1-3), 25-33.
Chan, L. F., Shamsul, A. S., & Maniam, T. (2014). Are predictors of future suicide attempts and the transition from suicidal ideation to suicide attempts shared or distinct: A 12-month prospective study among patients with depressive disorders. Journal of Psychiatric Research, 220(3), 867-873.
Cohen, L. J., Ardalan, F., Yaseen, Z., & Galynker, I. (2018). Suicide crisis syndrome mediates the relationship between long-term risk factors and lifetime suicidal phenomena. Suicide and Life-threatening Behavior, 48(5), 613-623.
Cohen, L. J., Gorman, B., Briggs, J., Jeon, M. E., Ginsburg, T., & Galynker, I. (2019). The suicidal narrative and its relationship to the suicide crisis syndrome and recent suicidal behavior. Suicide & Life-Threatening Behavior, 49(2), 413-422.
Cohen, L. J., Mokhar, R., Richards, J. A., Hernandez, M., Bloch-Elkouby, S., & Galynker, I. (2022). The narrative crisis model and its prediction of near-term suicide risk. Suicide and Life-threatening Behavior, 52(2), 231-243.
Conner, K. R., McCarthy, M. D., Bajorska, A., Caine, E. D., Tu, X. M., & Knox, K. L. (2012). Mood, anxiety, and substance-use disorders and suicide risk in a military population cohort. Suicide and Life-threatening Behavior, 42(6), 699-708.
de Boer, A. G., van Lanschot, J. J., Stalmeier, P. F., van Sandick, J. W., Hulscher, J. B., de Haes, J. C., & Sprangers, M. A. (2004). Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life? Quality of Life Research, 13(2), 311-320.
DeCou, C. R., Comtois, K. A., & Landes, S. J. (2019). Dialectical behavior therapy is effective for the treatment of suicidal behavior: A meta-analysis. Behavior Therapy, 50(1), 60-72.
Dehara, M., Wells, M. B., Sjöqvist, H., Kosidou, K., Dalman, C., & Sörberg Wallin, A. (2020). Parenthood is associated with lower suicide risk: A register-based cohort study of 1.5 million swedes. Acta Psychiatrica Scandinavica, 143(3), 206-215.
Denney, J. T., Rogers, R. G., Krueger, P. M., & Wadsworth, T. (2009). Adult suicide mortality in the United States: Marital status, family size, socioeconomic status, and differences by sex. Social Science Quarterly, 90(5), 1167-1185.
Derogatis, L. R., & Melisaratos, N. (1983). The brief symptom inventory: An introductory report. Psychological Medicine, 13(3), 595-605.
Ehlman, D. C., Yard, E., Stone, D. M., Jones, C. M., & Mack, K. A. (2022). Changes in suicide rates - United States, 2019 and 2020. Morbidity and Mortality Weekly Report, 71(8), 306-312.
Evenson, R. J., & Simon, R. W. (2005). Clarifying the relationship between parenthood and depression. Journal of Health and Social Behavior, 46(4), 341-358.
Farkas, C., & Valdés, N. (2010). Maternal stress and perceptions of self-efficacy in socioeconomically disadvantaged mothers: An explicative model. Infant Behavior and Development, 33(4), 654-662.
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., Musacchio, K. M., Jaroszewski, A. C., Chang, B. P., & Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187-232.
Frey, L. M., & Cerel, J. (2015). Risk for suicide and the role of family: A narrative review. Journal of Family Issues, 36(6), 716-736.
Galynker, I. (2017). The suicidal crisis: Clinical guide to the assessment of imminent suicide risk. Oxford University Press.
Galynker, I., Yaseen, Z. S., Cohen, A., Benhamou, O., Hawes, M., & Briggs, J. (2017). Prediction of suicidal behavior in high-risk psychiatric patients using an assessment of acute suicidal state: The suicide crisis inventory. Depression and Anxiety, 34(2), 147-158.
Gibb, S. J., Beautrais, A. L., & Fergusson, D. M. (2005). Mortality and further suicidal behaviour after an index suicide attempt: A 10-year study. The Australian and New Zealand Journal of Psychiatry, 39(1-2), 95-100.
Glass, J., Simon, R. W., & Andersson, M. A. (2016). Parenthood and happiness: Effects of work-family reconciliation policies in 22 OECD countries. American Journal of Sociology, 122(3), 886-929.
Hansen, T. (2012). Parenthood and happiness: A review of folk theories versus empirical evidence. Social Indicators Research, 108, 29-64.
Hayes, A. F., & Little, T. D. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford.
Hayes, A. F., & Rockwood, N. J. (2020). Conditional process analysis: Concepts, computation, and advances in the modeling of the contingencies of mechanisms. American Behavioral Scientist, 64(1), 19-54.
Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43, 629-642.
Hedegaard, H., Curtin, S. C., & Warner, M. (2020). Increase in suicide mortality in the United States, 1999-2018. NCHS Data Brief, 362, 1-8.
Hughes, M. E., & Waite, L. J. (2002). Health in household context: Living arrangements and health in late middle age. Journal of Health and Social Behavior, 43(1), 1-21.
Ilgen, M. A., Zivin, K., McCammon, R. J., & Valenstein, M. (2008). Pain and suicidal thoughts, plans and attempts in the United States. General Hospital Psychiatry, 30(6), 521-527.
Kessler, R. C., Borges, G., Sampson, N., Miller, M., & Nock, M. K. (2009). The association between smoking and subsequent suicide-related outcomes in the National Comorbidity Survey panel sample. Molecular Psychiatry, 14(12), 1132-1142.
Knoester, C., & Eggebeen, D. J. (2006). The effects of the transition to parenthood and subsequent children on men's well-being and social participation. Journal of Family Issues, 27(11), 1532-1560.
Lindström, C., Åman, J., & Norberg, A. (2010). Increased prevalence of burnout symptoms in parents of chronically ill children. Acta Paediatrica, 99, 427-432.
Lobo, S., Molinari, V., Bowers, T., & Lomax, J. (2010). Role of the family in suicide prevention: An attachment and family systems perspective. Bulletin of the Menninger Clinic, 74(4), 301-327.
Nelson, S. K., Kushlev, K., & Lyubomirsky, S. (2014). The pains and pleasures of parenting: When, why, and how is parenthood associated with more or less well-being? Psychological Bulletin, 140(3), 846-895.
Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008). Suicide and suicidal behavior. Epidemiologic Reviews, 30(1), 133-154.
Oquendo, M. A., Perez-Rodriguez, M. M., Poh, E., Sullivan, G., Burke, A. K., Sublette, M. E., Mann, J. J., & Galfalvy, H. (2014). Life events: A complex role in the timing of suicidal behavior among depressed patients. Molecular Psychiatry, 19(8), 902-909.
Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., & Mann, J. J. (2011). The Columbia-suicide severity rating scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168(12), 1266-1277.
Preacher, K. J., Rucker, D. D., & Hayes, A. F. (2007). Addressing moderated mediation hypotheses: Theory, methods, and prescriptions. Multivariate Behavioral Research, 42(1), 185-227.
Rutherford, H. J., Wallace, N. S., Laurent, H. K., & Mayes, L. C. (2015). Emotion regulation in parenthood. Developmental Review, 36, 1-14.
Sanders, M. R., & Mazzucchelli, T. G. (2013). The promotion of self-regulation through parenting interventions. Clinical Child and Family Psychology Review, 16(1), 1-17.
Simon, R. W., & Caputo, J. (2019). The costs and benefits of parenthood for mental and physical health in the United States: The importance of parenting stage. Society and Mental Health, 9(3), 296-315.
Umberson, D., Pudrovska, T., & Reczek, C. (2010). Parenthood, childlessness, and wellbeing: A life course perspective. Journal of Marriage and the Family, 72(3), 612-629.
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E., Jr. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575-600.
Woods, A. D., Davis-Kean, P., Halvorson, M. A., King, K. M., Logan, J. A. R., Xu, M., Bainter, S., Brown, D., Clay, J. M., Cruz, R. A., Elsherif, M. M., Gerasimova, D., Joyal-Desmarais, K., Moreau, D., Nissen, J., Schmidt, K., Uzdavines, A., Van Dusen, B., & Vasilev, M. R. (2021). Missing data and multiple imputation decision tree. Https://doi.org/10.31234/osf.io/mdw5r
Yaseen, Z. S., Hawes, M., Barzilay, S., & Galynker, I. (2019). Predictive validity of proposed diagnostic criteria for the suicide crisis syndrome: An acute presuicidal state. Suicide & Life-Threatening Behavior, 49(4), 1124-1135.
Ying, G., Cohen, L. J., Lloveras, L., Barzilay, S., & Galynker, I. (2020). Multi-informant prediction of near-term suicidal behavior independent of suicidal ideation. Journal of Psychiatry Research, 291, 113-169.