3 - (SYM 19) Examining Associations Between Multiple Facets of Parental Expressed Emotion and Youth Suicidal Thoughts and Behaviors Using a Performance-based Measure

Interpersonal factors are frequently associated with suicidal thoughts and behaviors (STBs). For youth, interpersonal interactions frequently occur in the context of the family unit, and research supports links between family factors and STBs in youth (Gould et al., 2003). A recent finding from a large representative dataset (ABCD Study) revealed that family conflict is particularly associated with STBs in preadolescence (DeVille et al., 2020). However, prior research is mostly restricted to cross-sectional, self-report data. Further, it is not well understood which characteristics of adverse family functioning may be most deleterious. High expressed emotion (EE) is linked to related psychopathological symptoms (e.g., depression) and may highlight mechanisms of STB risk in adverse family contexts (Wedig & Nock, 2007). This study utilized a performance-based measure of parental EE to test associations of three objectively-assessed components of EE with STBs to understand family-related interpersonal mechanisms underlying STB risk in youth.

Method: A mixed clinical-community sample of 178 girls, ages 9-15 (M = 11.76), attended a lab visit with a caregiver and completed interview-based and self-report measures of STBs and other clinical symptoms. Caregivers completed a Five Minute Speech Sample (FMSS; Magaña et al., 1986) in which they described their child and their relationship with their child. FMSS recordings were independently coded for two indices of parental EE: parental criticism (PC) and emotional overinvolvement (EOI), as well as a third index of overall relationship quality (RQ). Youths’ STBs were assessed again 4 months later.

Results: Higher levels of PC were associated with youth suicide attempt history (OR = 1.78, 95% CI = 1.06-3.00, p = .03), above and beyond other youth psychopathology (i.e., depressive and aggressive symptoms). While PC was not concurrently associated with suicidal ideation, prospective analyses revealed that high levels of PC predicted greater likelihood of youth suicidal ideation 4 months later (OR = 2.08, 95% CI = 1.06-4.08, p = .03), controlling for baseline ideation and other psychopathology. EOI and RQ were not associated with STBs, suggesting that PC may be particularly deleterious.

Conclusion: Parental criticism may increase girls’ risk for STBs, including future risk. Findings support the clinical utility of interpersonal effectiveness and validation skills in parent-child relationships—skills that are central to evidence-based treatments, like DBT, for individuals experiencing STBs.