Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents
Abstract Objective Effective suicide prevention for adolescents is urgently needed but difficult, as suicide models lack a focus on age-specific influencing factors such as emotional dysregulation. Moreover, examined predictors often do not specifically consider the contribution to the severity of s...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Child and Adolescent Psychiatry and Mental Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13034-023-00699-4 |
| _version_ | 1797350103141318656 |
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| author | Sabrina Mittermeier Alexandra Seidel Christin Scheiner Nikolaus Kleindienst Marcel Romanos Arne Buerger |
| author_facet | Sabrina Mittermeier Alexandra Seidel Christin Scheiner Nikolaus Kleindienst Marcel Romanos Arne Buerger |
| author_sort | Sabrina Mittermeier |
| collection | DOAJ |
| description | Abstract Objective Effective suicide prevention for adolescents is urgently needed but difficult, as suicide models lack a focus on age-specific influencing factors such as emotional dysregulation. Moreover, examined predictors often do not specifically consider the contribution to the severity of suicidality. To determine which adolescents are at high risk of more severe suicidality, we examined the association between emotional dysregulation and severity of suicidality directly as well as indirectly via depressiveness and nonsuicidal self-injury. Method Adolescents from 18 high schools in Bavaria were included in this cross-sectional and questionnaire-based study as part of a larger prevention study. Data were collected between November 2021 and March 2022 and were analyzed from January 2023 to April 2023. Students in the 6th or 7th grade of high school (11–14 years) were eligible to participate. A total of 2350 adolescents were surveyed and data from 2117 students were used for the analyses after excluding incomplete data sets. Our main outcome variable was severity of suicidality (Paykel Suicide Scale, PSS). Additionally, we assessed emotional dysregulation (Difficulties in Emotion Regulation Scale, DERS-SF), depressiveness (Patient Health Questionnaire, PHQ-9) and nonsuicidal self-injury (Deliberate Self-Harm Inventory, DSHI). Results In total, 2117 adolescents (51.6% female; mean age, 12.31 years [standard deviation: 0.67]) were included in the structural equation model (SEM). Due to a clear gender-specific influence, the model was calculated separately for male and female adolescents. For male adolescents, there was a significant indirect association between emotional dysregulation and severity of suicidality, mediated by depressiveness (β = 0.15, SE = .03, p = .008). For female adolescents, there was a significant direct path from emotional dysregulation to severity of suicidality and also indirect paths via depressiveness (β = 0.12, SE = .05, p = 0.02) and NSSI (β = 0.18, SE = .04, p < .001). Conclusions Our results suggest that gender-related risk markers in 11–14-year-olds need to be included in future suicide models to increase their predictive power. According to our findings, early detection and prevention interventions based on emotion regulation skills might be enhanced by including gender-specific adjustments for the co-occurrence of emotional dysregulation, depressiveness, and nonsuicidal self-injury in girls and the co-occurrence of emotional dysregulation and depressiveness in boys. |
| first_indexed | 2024-03-08T12:39:59Z |
| format | Article |
| id | doaj.art-0ad50e660141432d97efbfb81feb01db |
| institution | Directory Open Access Journal |
| issn | 1753-2000 |
| language | English |
| last_indexed | 2024-03-08T12:39:59Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Child and Adolescent Psychiatry and Mental Health |
| spelling | doaj.art-0ad50e660141432d97efbfb81feb01db2024-01-21T12:10:50ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002024-01-0118111010.1186/s13034-023-00699-4Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescentsSabrina Mittermeier0Alexandra Seidel1Christin Scheiner2Nikolaus Kleindienst3Marcel Romanos4Arne Buerger5Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of WuerzburgDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of WuerzburgDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of WuerzburgInstitute of Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health Mannheim, Heidelberg UniversityDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of WuerzburgDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of WuerzburgAbstract Objective Effective suicide prevention for adolescents is urgently needed but difficult, as suicide models lack a focus on age-specific influencing factors such as emotional dysregulation. Moreover, examined predictors often do not specifically consider the contribution to the severity of suicidality. To determine which adolescents are at high risk of more severe suicidality, we examined the association between emotional dysregulation and severity of suicidality directly as well as indirectly via depressiveness and nonsuicidal self-injury. Method Adolescents from 18 high schools in Bavaria were included in this cross-sectional and questionnaire-based study as part of a larger prevention study. Data were collected between November 2021 and March 2022 and were analyzed from January 2023 to April 2023. Students in the 6th or 7th grade of high school (11–14 years) were eligible to participate. A total of 2350 adolescents were surveyed and data from 2117 students were used for the analyses after excluding incomplete data sets. Our main outcome variable was severity of suicidality (Paykel Suicide Scale, PSS). Additionally, we assessed emotional dysregulation (Difficulties in Emotion Regulation Scale, DERS-SF), depressiveness (Patient Health Questionnaire, PHQ-9) and nonsuicidal self-injury (Deliberate Self-Harm Inventory, DSHI). Results In total, 2117 adolescents (51.6% female; mean age, 12.31 years [standard deviation: 0.67]) were included in the structural equation model (SEM). Due to a clear gender-specific influence, the model was calculated separately for male and female adolescents. For male adolescents, there was a significant indirect association between emotional dysregulation and severity of suicidality, mediated by depressiveness (β = 0.15, SE = .03, p = .008). For female adolescents, there was a significant direct path from emotional dysregulation to severity of suicidality and also indirect paths via depressiveness (β = 0.12, SE = .05, p = 0.02) and NSSI (β = 0.18, SE = .04, p < .001). Conclusions Our results suggest that gender-related risk markers in 11–14-year-olds need to be included in future suicide models to increase their predictive power. According to our findings, early detection and prevention interventions based on emotion regulation skills might be enhanced by including gender-specific adjustments for the co-occurrence of emotional dysregulation, depressiveness, and nonsuicidal self-injury in girls and the co-occurrence of emotional dysregulation and depressiveness in boys.https://doi.org/10.1186/s13034-023-00699-4SuicidalityEmotional dysregulationAdolescentsNonsuicidal self-injury (NSSI)Depressiveness |
| spellingShingle | Sabrina Mittermeier Alexandra Seidel Christin Scheiner Nikolaus Kleindienst Marcel Romanos Arne Buerger Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents Child and Adolescent Psychiatry and Mental Health Suicidality Emotional dysregulation Adolescents Nonsuicidal self-injury (NSSI) Depressiveness |
| title | Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents |
| title_full | Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents |
| title_fullStr | Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents |
| title_full_unstemmed | Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents |
| title_short | Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents |
| title_sort | emotional dysregulation and its pathways to suicidality in a community based sample of adolescents |
| topic | Suicidality Emotional dysregulation Adolescents Nonsuicidal self-injury (NSSI) Depressiveness |
| url | https://doi.org/10.1186/s13034-023-00699-4 |
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