Impulsive Decision-Making, Affective Experiences, and Parental History of Self-Injurious Thoughts and Behaviors within Parent-Adolescent Dyads

Both individual-level and interpersonal processes may contribute to increased engagement in impulsive decision-making. In particular, dyadic relationships between adolescents and their parents represents a potential site of risk transmission (Brent & Mann, 2005; Ranning et al., 2022). Developmental models of emotions suggest that parents influence their children’s emotion regulation well into adolescence (Eisenberg et al., 1998). To this end, parents act as socialization agents for their children, where parental emotion dysregulation and inappropriate emotional expression, may contribute to poor emotion development outcomes for children (Bariola et al., 2011; Dix, 1991). Given that adolescence, more than other developmental stages, is marked by frequent and emotionally intense experiences, combined with the increased desire for autonomy, there are frequent opportunities for parent-child socialization processes to occur (Eisenberg & Morris, 2002; Miller-Slough & Dunsmore, 2016). Research by Maoz and colleagues (2014), for example, suggests that the offspring of parents with current mood disorders (e.g., depression) characterized by increases in negative affective states, were more likely to present with externalizing psychopathology, marked by increases in impulsivity. On the other hand, much less work has examined dyadic influences of parent positive affect on adolescent impulsivity. Greater parent positive affect has been associated with lower levels of externalizing and impulsive problems in young children (Wang et al., 2016). Furthermore, studies employing EMA to examine daily variation in parental affect found that parent variability in parent positive affect was associated with attention deficit hyperactivity disorder symptoms in youth, characterized by impulsive decision-making (Li & Lansford, 2018). Together, these findings highlight how parent affective states may be associated with impulsive action in their offspring; however, their interdependence remains poorly understood. Thus, the present study seeks to explore the interdependence of parent-adolescent affective states and impulsive decision-making processes within the transactional context of the family system.

To the extent that affect and impulsive decision-making are thought to be associated with the onset of SITBs (Auerbach et al., 2017; Lockwood et al., 2017), it would be important to evaluate how affective states and impulsive decision-making might be instantiated within the family context. Family, adoption, and twin studies have established familial transmission of self-injurious behaviors, such that rates of attempted suicide are elevated among the relatives of individuals who have died by suicide (Brent & Mann, 2005; Cheng et al., 2000; Gould et al., 1996). Moreover, it is known that family history of SITBs heightens risk for impulsive decision-making (Bridge et al., 2015), and past research has found elevated levels of impulsivity and aggression among decedents of individuals who have died by suicide (Brent et al., 2003). However, the extent to which a parent’s history of SITBs might influence bidirectional associations between parents and their adolescents' respective emotion-based impulsive decision-making has received virtually no empirical attention. Therefore, it would be important to determine first whether parents and adolescents influence each other’s affective states and impulsive decision-making, and further, whether these relationships differ based on family history of SITBs.

Prior research examining parent-child relationship mechanisms of risk transmission have tended to prioritize linear models, which fail to capture the bidirectional associations between parent and their adolescents. Thus, for the present study, we implemented an actor-partner model, an approach that considers the interdependence of the family member dyads (Cook & Kenny, 2005). A major advantage of this approach lies in its ability to model both the impact parent and adolescent affect has on their own impulsive decision-making (actor effects), and the impact parent and adolescent affective states may have on each other’s impulsive decision-making (partner effects).

Past studies have applied this approach to different dyadic relationships including couples, patient-caregiver, and parent-child relationships (Driscoll et al., 2012; Israel et al., 2014; Liu et al., 2013; Maroufizadeh et al., 2018; Thomson et al., 2012). However, application of this model to understanding psychosocial factors in parent-adolescent relationships at risk for SITBs remains limited. One study examined the relationship between impulsivity and depression symptoms in an acute sample of adolescents recruited from inpatient and partial hospitalization programs and found interdependence between parent impulsivity and adolescent depression (Wolff et al., 2020). While informative, these findings may not generalize to community samples, for whom parent-adolescent interactions remain pertinent as a site of potential risk and/or protection. In addition to understanding mechanisms including impulsive decision-making and affective instability that might be at play in the transmission of risk from parents to their adolescents, it is also important to better understand potential moderators of these relationships. The current study adds to the literature by examining the role of family history of SITBs as a potential moderator in the bidirectional influences of parent-adolescent affect on impulsive decision-making. Therefore, our proposed study seeks to extend past work to address some of the previously mentioned limitations.

The present study examines positive and negative affective states and impulsive decision-making on a delayed discounting task among a sample of parents and their adolescents recruited from the community. We used actor-partner interdependence models (APIM) to test the interdependence of parent-adolescent relationships and probe the extent to which an adolescent’s affective state might influence their own impulsive decision-making (i.e., the preference for immediate versus delayed rewards on a delay discounting task), along with that of their parent and vice versa. Furthermore, as an exploratory aim, we examined how parents’ own history of engagement in SITBs might moderate these actor or partner relationships. To this end, our study extends upon previous work by testing the interdependence of self-reported (affect) and behavioral measures (impulsive decision-making) within parent-adolescent dyads.

We hypothesized that there would be a significant positive relationship between an individual’s affect and their impulsive decision-making (actor effects). Furthermore, based on findings from previous literature supporting intergenerational transmission of risk for impulsive decision-making and emotion dysregulation from parents to adolescents (Li et al., 2019; Wolff et al., 2020), we hypothesized greater parent positive and negative affect would be associated with greater delay discounting among adolescents (partner effect). However, less remains known about adolescent’s impact on their caregivers' impulsive decision-making. Therefore, as an exploratory aim, we also hypothesized that greater adolescent positive and negative affect would be associated with greater delay discounting among parents. Although exploratory, we hypothesized that these relationships would be moderated by parent history of SITBs, such that actor and partner effects between affect and impulsive decision-making would be strongest among dyads with parents who have a history of SITBs, based on previous literature on the intergenerational transmission of risk.

A sample of 106 parent-adolescent dyads (N = 212) were recruited to participate in a study examining dyadic relationships between parents and their adolescents. To increase the diversity within our sample, we posted flyers online and across a wide range of communities, including neighborhoods in Wilmington, Delaware with elevated rates of socioeconomic disadvantage and adversity (https://​www.​neighborhoodscou​t.​com/​de/​wilmington/​crime; Wilmington, DE Crime Rates, 2021). Eligible dyads were fluent in English with adolescents between the ages of 13 and 17 years old. Dyads were asked to complete a set of self-report questionnaires and delay discounting task virtually via a secure, HIPAA compliant Zoom meeting. Parents and their children logged on using separate devices (e.g., smartphone, laptop) and were consented/assented before completing the surveys.

Parents in this sample were between the ages of 32 and 62 years old (M = 44.33, SD = 6.63) the majority of whom were mothers (84.9%). The majority of parents identified as White (65.7%), followed by Black (28.7%), Asian (3.7%), and American Indian or Alaska Native (2.8%), with 3.8% identifying as Hispanic. The socioeconomic status of this sample was diverse, as most participants reported a yearly income between $50,000 and $100,000 (33%), followed by $50,000 or less (28.3%). Adolescents in this sample were between the ages of 13 and 17 years old (M = 15.02, SD = 1.4). The majority of adolescents identified as female (54.7%), followed by male (41.5%), and 3.8% chose Other. Adolescents identified as primarily White (65.4%), followed by Black (31.8%), Hispanic (8.7%), Asian (2.8%), American Indian or Alaska Native (1.9%), and Native Hawaiian or Other Pacific Islander (0.9%).

The study procedures were approved by the Institutional Review Board of Human Studies Research at the University of Delaware. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975. Prior to data collection, informed consent and assent was obtained after reviewing the study description and procedures, and participants were compensated financially for their participation. Study data were collected, managed, and stored at the University of Delaware using REDCap electronic data capture tools (Research Electronic Data Capture; Harris et al., 2019).

In order to examine if parents and adolescents presented differing patterns of positive and negative affect in relation to delay discounting, we conducted a set of paired sample t-tests (Table 1). Our results suggest that adolescents reported significantly greater negative affect than parents. Conversely, parents endorsed significantly greater positive affect than adolescents. There were no significant differences between parent and adolescent delay discounting scores.

Bivariate correlations examining the associations between study variables are presented in Table 2. These results indicated that adolescent delay discounting was positively associated with parent negative affect and parent delay discounting, suggesting more adolescent delay discounting (greater preference for impulsive decision-making) was related to greater parent negative affect and delay discounting. Adolescent delayed discounting was also associated with both parent and adolescent SITB history. In addition, parent delay discounting was negatively associated with teen negative affect and parent positive affect, suggesting more parent delay discounting (greater preference for impulsive decision-making) is associated with reduced adolescent negative affect and reduced parent positive affect.

A set of two actor partner interdependence structural equation modeling (SEM) models were tested (Table 3) evaluating teen and parent negative affect (Fig. 1) and positive affect (Fig. 2) as predictor variables of teen and parent delay discounting while controlling for adolescent and parent gender and age respectively.

Next, to evaluate the impact of family history of SITBs on our models, we further tested the relationship between negative affect and delay discounting among parents with and without a history of SITBs (i.e., suicidal ideation, suicide attempt, non-suicidal self-injury, or suicidal plans). Within our sample, 28.30% of parents reported a history of SITBs. Among parents with a lifetime history of SITBs 96.67% endorsed suicidal ideation, 13.33% endorsed a history of NSSI, 16.66% endorsed a history of plans, and 33.33% endorsed a history of suicide attempts. This pattern was similar among the adolescent group, with 25.74% of the adolescents reporting a history of SITBs. Further, 57.69% of adolescents with a history of SITBs also had a parent who reported a history of SITBs.

Results from a moderated APIM model examining the relationship between delay discounting and negative affect revealed a moderating effect of parents’ history of SITBs. Specifically, our results revealed a significant partner effect with a large effect size only for the group with a family history of SITBs, where greater parent negative affect was associated with increased delay discounting values among teens (Estimate = 0.66, S.E. = 0.13, p < 0.001; Table 4). The APIM model among parents with a history of SITBs explained approximately 43.3% of the variance in adolescent delay discounting and 20.8% of the variance in parent delay discounting. In contrast, the APIM model among parents without a history of SITBs explained approximately 5.0% of the variance in adolescent delay discounting and 0.5% of the variance in parent delay discounting. Further, we used the model constraint function to test differences between the partner paths among groups with versus without a history of SITBs. A significant difference between the parent to adolescent partner paths was detected, wherein a stronger positive association between parent negative affect and adolescent delay discounting was observed for parents with a history of SITBs compared to the parent to adolescent partner path among parents without a history of SITBs (Estimate = -0.34, S.E = 0.09, p < 0.001). There was not a significant difference between adolescent to parent partner paths among parents with and without a history of SITBs (Estimate = -0.06, S.E = 0.05, p = 0.26).

In the second moderated APIM examining the relationship between delay discounting and positive affect, no significant actor or partner associations were found among families with or without a history of SITBs (Table 4). Further, when we used the model constraint function to test differences between the partner paths among groups with versus without a history of SITBs, no significant differences were detected between the parent to adolescent partner paths (Estimate = -0.09, S.E = 0.08, p = 0.22) or the adolescent to parent partner paths (Estimate = -0.05, S.E = 0.05, p = 0.33) among parents with versus without a history of SITBs.

Findings from our study must be interpreted within the context of several limitations. First, our findings represent a cross-sectional examination of affective states, impulsive decision-making, and lifetime parental history of SITBs. As such, our results do not capture the interdependence of these factors within the family dyad as they unfold over time and cannot shed light on causal pathways of risk transmission for future SITBs among adolescents. To test this possibility, future research should consider examining how these interdependent relationships might relate to the emergence of future SITBs using intensive longitudinal methods to capture thoughts and feelings preceding SITBs in the moment. In addition, our findings drew from a relatively small community sample, which may have partially contributed to the relatively smaller variance explained by our models and limit the generalizability of our findings to community samples. The sample size of the present study also prohibited examination of differences in parent-adolescent interdependence across different types of SITBs (e.g., parents with a history of attempts versus ideation). However, given that research examining parent-child dyads is relatively limited, our study provides preliminary evidence for the interdependence of parent-adolescent impulsive decision-making and negative affect. In addition, our study relied on the use of self-report questionnaires for our variables of interest with a relatively small number of items, which increases the possibility that response bias and poor reliability have influenced the findings. Future research should consider examining our variables of interest at multiple levels of analysis integrating behavioral tasks and psychophysiological data. Finally, our study enrollment was limited to one parent per adolescent, who predominantly identified as female mothers (84.9%). As a result, our findings may not be generalizable to male-identifying parents of adolescents, nor do these findings speak to how differences in family structures (e.g., single parent, stepparents) might influence our results. It would be important for future research to investigate the family system more comprehensively to better understand how dynamic processes unfold between adolescents and their caregivers.

Despite these limitations, there are several strengths of the present study that warrant mention. First, as previously stated, these findings offer preliminary support for the interdependence of well-established risk factors for SITBs within the parent-adolescent relationship. Given that relatively little research has applied APIM to model the interdependence within parent-adolescent relationships, our findings offer an important advancement toward understanding how risk might be instantiated within the family system. Finally, a unique advantage of the present study was the examination of the moderating role of family history of SITBs, which has not been applied to work using APIM approaches to the authors’ knowledge.

Importantly, this work advances prior work investigating the interdependence of affect and impulsive decision-making within parent-adolescent dyads and the extent to which these interactions may be particularly salient for families with known vulnerabilities for SITBs. Continued examination and exploration of dyadic relationships within the family system will be an important consideration for future research aiming to uncover potential mechanisms at stake in the intergenerational transmission of risk. Further replication and extension of the present work is imperative to identify specific targets of intervention within the family system (e.g., regulation of affect and impulsive decision-making) to potentially disrupt transmission of risk for SITBs among youth.