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Short Report

Insecure Attachment and Suicidal Behavior in Adolescents

Published Online:https://doi.org/10.1027/0227-5910/a000273

Background: Suicide among adolescents is an important public health problem. One risk factor for youth suicidal behavior that has been underexplored is insecure attachment. Aims: To investigate the association between attachment avoidance/anxiety and suicidal behavior in an adolescent sample. Method: This study examined attachment insecurity in 40 adolescents who had attempted suicide and 40 never-suicidal demographically matched youths. Adolescents completed self-report measures of attachment style, family alliance, and depressive symptoms. Results: Suicide attempters reported significantly higher attachment avoidance and anxiety. Attachment avoidance, but not anxiety, predicted suicide attempt status in a conditional logistic regression analysis that controlled for depressive symptoms and family alliance. Conclusion: Future research should determine the relative utility of attachment insecurity in prospectively predicting suicide attempts and investigate potential mediators and moderators of this association. Implications for clinicians working with suicidal youth with insecure attachment styles are discussed.

References

  • Adam, K. S. , Sheldon-Keller, A. E. , & West, M. (1996). Attachment organization and history of suicidal behavior in clinical adolescents. Journal of Consulting and Clinical Psychology, 64(2), 264–272. First citation in articleCrossref MedlineGoogle Scholar

  • Allen, J. P. , & Land, D. (1999). Attachment in adolescence. In J. Cassidy, P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 319–335). New York, NY: The Guilford Press. First citation in articleGoogle Scholar

  • Ammaniti, M. , van Ijzendoorn, M. H. , Speranza, A. M. , & Tambelli, R. (2000). Internal working models of attachment during late childhood and early adolescence: An exploration of stability and change. Attachment and Human Development, 2(3), 328–346. First citation in articleCrossref MedlineGoogle Scholar

  • Armsden, G. C. , & Greenberg, M. T. (1987). The Inventory of Parent and Peer Attachment: Individual differences and their relationship to psychological well-being in adolescence. Journal of Youth and Adolescence, 16(5), 427–454. First citation in articleCrossref MedlineGoogle Scholar

  • Beck, A. T. , Steer, R. A. , & Brown, G. K. (1996). Beck Depression Inventory-II manual. San Antonio, TX: Psychological Corporation. First citation in articleGoogle Scholar

  • Beck, A. T. , Steer, R. A. , & Brown, G. K. (2000). BDI-FastScreen for medical patients: Manual. San Antonio, TX: Psychological Corporation. First citation in articleGoogle Scholar

  • Bowlby, J. (1969). Attachment and loss: Volume I. Attachment. New York, NY: Basic Books. First citation in articleGoogle Scholar

  • Bowlby, J. (1980). Attachment and loss: Volume III. Loss. New York, NY: Basic Books. First citation in articleGoogle Scholar

  • Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York, NY: Basic Books. First citation in articleGoogle Scholar

  • Brennan, K. A. , Clark, C. L. , & Shaver, P. R. (1998). Self-report measurement of adult attachment: An integrative overview. In J. A. Simpson, W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York, NY: The Guilford Press. First citation in articleGoogle Scholar

  • Brent, D. A. (1995). Risk factors for adolescent suicide and suicidal behavior: Mental and substance abuse disorders, family environmental factors, and life stress. Suicide and Life-Threatening Behavior, 25, 52–63. First citation in articleCrossref MedlineGoogle Scholar

  • Brent, D. A. , Baugher, M. , Bridge, J. , Chen, T. , & Chiappetta, L. (1999). Age- and sex-related risk factors for adolescent suicide. Journal of American Academy of Child and Adolescent Psychiatry, 38(12), 1497–1505. First citation in articleCrossref MedlineGoogle Scholar

  • Bridge, J. A. , McBee-Strayer, S. M. , Cannon, E. A. , Sheftall, A. H. , Reynolds, B. , Campo, J. V. , … Brent, D. A. (2012). Impaired decision making in adolescent suicide attempters. Journal of the American Academy of Child and Adolescent Psychiatry, 51(4), 394–403. First citation in articleCrossref MedlineGoogle Scholar

  • Brumariu, L. E. , & Kerns, K. A. (2010). Parent-child attachment and internalizing symptoms in childhood and adolescence: A review of empirical findings and future directions. Development and Psychopathology, 22, 177–203. First citation in articleCrossref MedlineGoogle Scholar

  • Diamond, G. S. , Reis, B. , Diamond, G. M. , Siqueland, L. , & Isaacs, L. (2002). Attachment-based family therapy for depressed adolescents: A treatment development study. Journal of the American Academy of Child and Adolescent Psychiatry, 41(10), 1190–1196. First citation in articleCrossref MedlineGoogle Scholar

  • Diamond, G. S. , Wintersteen, M. B. , Brown, G. K. , Diamond, G. M. , Gallop, R. , Shelef, K. , & Levy, S. (2010). Attachment-based family therapy for adolescents with suicidal ideation: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 49(2), 122–131. First citation in articleMedlineGoogle Scholar

  • Eaton, D. K. , Kann, L. , Kinchen, S. , Shanklin, S. , Flint, K. H. , Hawkins, J. , … Wechsler, H. (2012). Youth risk behavior surveillance–United States, 2011. Morbidity and Mortality Weekly Report, 61(4), 1–166. First citation in articleGoogle Scholar

  • Fergusson, D. M. , Beautrais, A. L. , & Horwood, L. J. (2003). Vulnerability and resiliency to suicidal behaviours in young people. Psychological Medicine, 33, 61–73. First citation in articleCrossref MedlineGoogle Scholar

  • Grunebaum, M. F. , Galfalvy, H. C. , Mortenson, L. Y. , Burke, A. K. , Oquendo, M. A. , & Mann, J. J. (2010). Attachment and social adjustment: Relationships to suicide attempt and major depressive episode in a prospective study. Journal of Affective Disorders, 123, 123–130. First citation in articleCrossref MedlineGoogle Scholar

  • Gutierrez, P. M. , Osman, A. , Kopper, B. A. , & Barrios, F. X. (2000). Why young people do not kill themselves: The Reasons for Living Inventory for adolescents. Journal of Clinical Child Psychology, 29(2), 177–187. First citation in articleCrossref MedlineGoogle Scholar

  • Johnson, J. G. , Cohen, P. , Gould, M. S. , Kasen, S. , Brown, J. , & Brook, J. S. (2002). Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Archives of General Psychiatry, 59, 741–749. First citation in articleCrossref MedlineGoogle Scholar

  • Kerns, K. A. , & Stevens, A. C. (1996). Parent-child attachment in late adolescence: Links to social relations and personality. Journal of Youth and Adolescence, 25(3), 323–342. First citation in articleCrossrefGoogle Scholar

  • Lee, S. (2011). Reasons for living and their moderating effects on Korean adolescents’ suicidal ideation. Death Studies, 35, 711–728. First citation in articleCrossref MedlineGoogle Scholar

  • Lizardi, D. , Grunebaum, M. F. , Burke, A. , Stanley, B. , Mann, J. J. , Harkavy-Friedman, J. , & Oquendo, M. (2011). The effect of social adjustment and attachment style on suicidal behaviour. Acta Psychiatrica Scandinavica, 124, 295–300. First citation in articleCrossref MedlineGoogle Scholar

  • Mann, J. J. , McBride, A. , Brown, R. P. , Linnoila, M. , Leon, A. C. , DeMeo, M. , … Stanley, M. (1992). Relationship between central and peripheral serotonin indexes in depressed and suicidal psychiatric inpatients. Archives of General Psychiatry, 49, 442–446. First citation in articleCrossref MedlineGoogle Scholar

  • Osman, A. , Downs, W. R. , Kopper, B. A. , Barrios, F. X. , Baker, M. T. , Osman, J. R. , … Linehan, M. M. (1998). The reasons for living inventory for adolescents (RFL-A): Development and psychometric properties. Journal of Clinical Psychology, 54(8), 1063–1078. First citation in articleCrossref MedlineGoogle Scholar

  • Palitsky, D. , Mota, N. , Afifi, T. O. , Downs, A. C. , & Sareen, J. (2013). The association between adult attachment style, mental disorders, and suicidality. The Journal of Nervous and Mental Disease, 201(7), 579–586. First citation in articleCrossref MedlineGoogle Scholar

  • Shaver, P. R. , Schachner, D. A. , & Mikulincer, M. (2005). Attachment style, excessive reassurance seeking, relationship processes, and depression. Personality and Social Psychology Bulletin, 31, 343–359. First citation in articleCrossref MedlineGoogle Scholar

  • Sheftall, A. H. , Mathias, C. W. , Furr, R. M. , & Dougherty, D. M. (2013). Adolescent attachment security, family functioning, and suicide attempts. Attachment and Human Development, 15(4), 368–383. First citation in articleCrossref MedlineGoogle Scholar

  • Shpigel, M. S. , Diamond, G. M. , & Diamond, G. S. (2012). Changes in parenting behaviors, attachment, depressive symptoms, and suicidal ideation in attachment-based family therapy for depressive and suicidal adolescents. Journal of Marital and Family Therapy, 38(s1), 271–283. First citation in articleCrossref MedlineGoogle Scholar

  • Stanley, B. , & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19, 256–264. First citation in articleCrossrefGoogle Scholar