The Associations between Peer and Parental Relationships and Suicidal Behaviours in Early Adolescents
Fotti, Sarah A., Katz, Laurence Y., Afifi, Tracie O., Cox, Brian J., Canadian Journal of Psychiatry
Objective: To investigate associations between suicidal behaviours, including suicidal ideation and attempts, and poor peer and parental relationships in a nationally representative sample of Canadian adolescents aged 12 to 13 years.
Methods: We used Statistics Canada's National Longitudinal Survey of Children and Youth as the dataset. This cross-sectional sample included 1049 girls and 1041 boys aged 12 to 13 years. We obtained answers to self-report questionnaires that included measures of peer relationships, parental nurturance, and parental rejection, as well as information regarding suicidal ideation and attempts. Unadjusted and adjusted logistic regression models were used for the analysis. We included depression in the multiple logistic regression analysis. Analyses were run separately for boys and girls.
Results: The unadjusted logistic regression models found that, among early adolescent boys and girls, depression, poor peer relationships, decreased parental nurturance, and increased parental rejection were all significantly associated with suicidal ideation and attempts. However, after adjusting for all other variables in the multiple logistic regression models, poor peer relationships were no longer significantly associated with suicidal ideation among early adolescent boys and were only weakly associated among early adolescent girls.
Conclusions: Poor parental relationships and depression were more powerfully associated with suicidal ideation and attempts than were peer relationships in a nationally representative sample of boys and girls aged 12 to 13 years, and these factors may be important early intervention targets.
(Can J Psychiatry 2006;51:698-703)
Information on funding and support and author affiliations appears at the end of the article.
* It is important to target early interventions toward identifying and treating depression in early adolescents.
* For early adolescents, parental relationships may also be an important treatment target to prevent suicidal behaviours.
* Differences between early adolescent boys and girls require further research to determine whether they translate into differing interventions.
* Data were collected entirely by self-report.
* The cross-sectional study design limits any interpretation in regard to possible causality among any of the variables examined.
* Demographic information, such as socioeconomic status and ethnicity, was not controlled.
Key Words: child, adolescent, peers, parents, suicidal behaviours
Adolescent suicidal behaviours, including ideation and attempts, are a relatively common psychiatric emergency (1), and such adolescents are at significant risk of completed suicide (2). Worldwide, suicide is the second-leading cause of death for individuals between the ages of 10 and 34 years (3). As a result of the high risk for suicide among adolescents, substantial research has been dedicated to investigating risk factors for completed suicide in this age group. Much of this research has been dedicated to the role of psychiatric disorders, prior suicide attempts, and familial psychiatric history (4-10). In addition, most of the research has focused on older adolescents, likely because the suicide rate increases dramatically after age 15 years (1,2,5,9-19). However, younger adolescents do attempt and complete suicide. In Canada, 51 children aged 14 years or younger completed suicide in 1997 (20).
To allow for intervention prior to completed suicide, it is important to understand risk factors for suicidal behaviours, including ideation and attempts. It is estimated that the rate of suicide attempts is at least 20 times greater than that of completed suicides (3). However, this may be underestimated because many attempts are unknown and undocumented. With regard to sex, the distribution of suicidal ideation and attempts has been previously reported to be about equal among youth aged 12 to 13 years, but rates for girls are 2 to 3 times higher than rates for boys by mid-to-late adolescence (8). …