Cited by 183Suicide and Self-Harm StudiesChild and Adolescent Psychosocial and Emotional DevelopmentGrief, Bereavement, and Mental Health

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Emotion regulation difficulties, youth-adult relationships, and suicide attempts among high school students in underserved communities

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Pisani, Anthony R., Wyman, Peter A., Petrova, Mariya, Schmeelk-Cone, Karen, Goldston, David B., Xia, Yinglin, Gould, Madelyn S.·2013·Journal of Youth and Adolescence

DOI 10.1007/s10964-012-9884-2PMC PMC3654393

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Abstract

To develop and refine interventions to prevent youth suicide, knowledge is needed about specific processes that reduce risk at a population level. Using a cross-sectional design, the present study tested hypotheses regarding associations between self-reported suicide attempts, emotion regulation difficulties, and positive youth-adult relationships among 7,978 high-school students (48.6% male, 49.9% female) in 30 high schools from predominantly rural, low-income communities. 683 students (8.6%) reported a past-year suicide attempt. Emotion regulation difficulties and a lack of trusted adults at home and school were associated with increased risk for making a past-year suicide attempt, above and beyond the effects of depressive symptoms and demographic factors. The association between emotion regulation difficulties and suicide attempts was modestly lower among students who perceived themselves as having higher levels of trusted adults in the family, consistent with a protective effect. Having a trusted adult in the community (outside of school and family) was associated with fewer suicide attempts in models that controlled only for demographic covariates, but not when taking symptoms of depression into account. These findings point to adolescent emotion regulation and relationships with trusted adults as complementary targets for suicide prevention that merit further intervention studies. Reaching these targets in a broad population of adolescents will require new delivery systems and "option rich" (OR) intervention designs.

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“…than normal controls , based both on self-report questionnaires (e.g., Khazem & Anestis, 2016; Miranda, Tsypes, Gallagher, & Rajappa, 2013; Pisani et al., 2013; Rajappa, Gallagher, & Miranda, 2012; Saffer, Glenn, & Klonsky, 2015) and laboratory performance (e.g., Keilp et al., 2013;…”
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“These coping patterns can contribute to increased suicidality [American Psychiatric Association, 2013; Pisani et al., 2013].”
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“Studies have also found that having better ER was associated with lower odds of suicidal behavior among youths (Barr et al., 2017; Pisani et al., 2013), while impairment in regulating emotions was identified as a risk factor for drug abuse (Nawi et al., 2021) and associated with positive smoking…”
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“A larger community sample of 683 adolescents also found ER deficits to be significantly associated with a past-year suicide attempt (29).”
Background
Atypical Cortical Activation During Risky Decision Making in Disruptive Behavior Disordered Youths With Histories of Suicidal Ideation
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“Nevertheless, as the PSS is widely used in studies with adolescents [30, 45, 46], we retained this scale for the sake of comparability with previous research.”
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“For youth with acute distress and with numerous risk factors for suicide, social modeling of emotional regulation strategies could slow or reverse a negative trajectory or prevent impulsive attempts to escape painful emotions [11,12].”
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Associations of interpersonal and intrapersonal emotion regulation strategies to suicidal ideation and suicide attempts
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“Additionally, there is a significant association between suicide attempts and emotion regulation in high school students which is mediated by having trusted adults in the family (Pisani et al. 2013).”
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“A baseline fMRI scan was completed a mean [SD] of 4.6 [6.86] months after the baseline clinical assessment.”
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“Problems with emotion reactivity and regulation have been linked to severe psychiatric symptoms including suicide-related risk in adolescents across community, school, and inpatient settings (Hatkevich et al., 2019; Nock et al., 2008; Pisani et al., 2013).”
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“…to compare three leading perspectives on suicidal ideation: The Interpersonal Theory of Suicide (IPTS; Joiner, 2005; Van Orden et al., 2010), Hopelessness Theory (Beck, 1986; Beck, Brown, Berchick, Stewart, & Steer, 1990), and a perspective emphasizing emotion dysregulation (Pisani et al., 2013).”
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“The difficulty in determining the emotions and limitations of effective regulatory strategies is predicted by suicide attempts to control the initial depressive symptoms [62].”
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“…correlated with all nine dimensions, aligns with previous research, which shows that whether students have a trusted adult at school who cares about them is one of the most meaningful predictors of adolescent health and well-being (Murphey et al., 2013; Pisani et al., 2013; Sieving et al., 2017).”
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“Difficulties have been found to be associated with suicide ideation in adolescents (Weinberg and Klonsky, 2009) and, for high school students from underserved rural schools for mental health services, ineffective ER was the most potent correlate of suicide attempts (Pisani et al., 2013).”
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“Pisani et al. (2013) also reported that the presence of a trusted adult in the family Health, Inc.”
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“, 2012); adult connectedness and stability such as availability of trusted adults at home or school (Pisani et al., 2012); cognitive/neurological factors such as academic performance and adequate sleep (Fitzgerald et al.”
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Background
Emotion Regulation in Elementary School-Aged Children with a Maternal History of Suicidal Behavior: A Pilot Study
Sheftall, A. H., Bergdoll, E. E., James, M., Bauer, C., Spector, E., Vakil, F., Armstrong, E., Allen, J. D., & Bridge, J. A. (2020) · Child Psychiatry & Human Development · doi:10.1007/s10578-020-01010-8 · Cited by 9

Authors: Pisani, A. R., Wyman, P. A., Petrova, M., Schmeelk-Cone, K., Goldston, D. B., Xia, Y., & Gould, M. S.
Affiliations: University of Rochester Medicine (US)
Duke University (US)
University of Rochester (US)
New York State Psychiatric Institute (US)
Corresponding author: Pisani, Anthony R.
ORCID: Pisani, Anthony R.
Wyman, Peter A.
Petrova, Mariya
Goldston, David B.
Xia, Yinglin
Gould, Madelyn S.
Venue: Journal of Youth and Adolescence
Publisher: Springer Science and Business Media LLC
Published: 2012-12-18
Volume: 42
Issue: 6
Pages: 807-820
ISSN: 0047-2891 (ISSN-L)
1573-6601
DOI: 10.1007/s10964-012-9884-2
PMC: PMC3654393
OpenAlex: W2029472717
Cited by: 183
References: 111
Citations by year: 2026: 8 · 2025: 8 · 2024: 17 · 2023: 10 · 2022: 17 · 2021: 17 · 2020: 19 · 2019: 24 · 2018: 15 · 2017: 11 · 2016: 7 · 2015: 11 · 2014: 15 · 2013: 4
FWCI: 10.88
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.springer.com/tdm (tdm)
Locations: Journal of Youth and Adolescence (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: University of Rochester
Georgia Clinical and Translational Science Alliance
National Institute of Mental Health (R01MH091452, K24MH066252)
National Center for Research Resources (KL2RR024136)
National Center for Advancing Translational Sciences
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
Keywords: suicide attempts, emotional dysregulation, adult-youth relationships, trusted adults, suicide prevention, adolescents, depressive symptoms, underserved populations, high school students, protective factors
MeSH terms: Suicide Prevention, Adolescent, Adult, Affective Symptoms, Child, Cross-Sectional Studies, Female, Humans, Male, Students, Suicide, Attempted, Intergenerational Relations, Young Adult

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Emotion regulation difficulties, youth-adult relationships, and suicide attempts among high school students in underserved communities

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