Funcionamiento familiar en adolescentes en riesgo de suicidio con rasgos de personalidad límite:un estudio exploratorio

  1. Sara Marco-Sánchez 1
  2. María Mayoral-Aragón 2
  3. Fátima Valencia-Agudo 3
  4. Laura Roldán-Díaz 2
  5. Ana Espliego Felipe 2
  6. Carlos Delgado-Lacosta 2
  7. Gonzalo Hervás-Torres 3
  1. 1 Hospital Sant Joan de Déu Terres de Lleida, España
  2. 2 Hospital General Universitario Gregorio Marañón, España
  3. 3 Universidad Complutense de Madrid, España.
Show affiliations +
Journal:
Revista de Psicología Clínica con Niños y Adolescentes

ISSN: 2340-8340

Year of publication: 2020

Volume: 7

Issue: 2

Pages: 50-55

Type: Article

DOI: 10.21134/RPCNA.2020.07.2.6 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: Revista de Psicología Clínica con Niños y Adolescentes

Sustainable development goals

Abstract

Family functioning in suicidal adolescents with borderline personality traits. High prevalence of suicide in adolescent population all over the world is considered a world challenge in mental health. Family environment has been pointed as an important factor involved in adolescents’ suicide risk, playing a role not only as a risk factor but also as protective. This study has its goal on understanding which factors of the family functioning, measured by the Social Environment in the Family Scale, are related to the total score of the Beck Suicide Ideation Scale in a sample of 37 adolescents with ages between 14 and 17 years old (M = 15.76; SD = 1.06) borderline personality traits. It was hypothesized that worse levels of family functioning will increase suicide risk in adolescents. Results showed that the risk of suicide was higher when the Relationships Scale total score (quality of communication and interaction in the family) was lower. After analyzing each subscale separately, it was demonstrated the specific relevance of Expressivity Subscale, referred to the level of free expression of feelings in the family, suggesting that the lower expressivity in the family, the higher suicide ideation showed by the adolescents, and Social-Recreative, referred to the social participation and leisure of the family, what means the more social participation, the less suicide ideation. These results are supported by other studies that show the relevance of modifying the family environment for reducing the suicidal risk among adolescents. The value of this data involves taking into account the families in the treatment programs for suicidal adolescents

Bibliographic References

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC: American Psychiatric Association.
  • Barksdale, C. L., Walrath, C. M., Compton, J. S., & Goldston, D. B. (2009). Caregiver strain and youth suicide attempt: Are they related? Suicide & Life-threatening Behavior, 39(2), 152–160. doi:10.1521/suli.2009.39.2.152
  • Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47(2), 343-352. doi: 10.1037/0022-006X.47.2.343
  • Brent, D. A., McMakin, D. L., Kennard, B. D., Goldstein, T. R., Mayes, T. L., & Douaihy, A. B. (2013). Protecting Adolescents from Self-Harm: A Critical Review of Intervention Studies. Journal of the American Academy of Child and Adolescent Psychiatry, 52(12), 1260-1271. doi: 10.1016/j. jaac.2013.09.009
  • Chambers, W., Puig-Antich, J., Hirsch, M., Paez, P., Ambrosini, P. J., Tabrizi, M. A., & Davies, M. (1985). The assessment of affective disorders in children and adolescents by semi-structured interview. Test-retest reliability of the schedule for affective disorders and schizophrenia for school-age children, present episode version. Archives of General Psychiatry, 42(7), 696-702. doi:10.1001/archpsyc.1985.01790300064008
  • Compton, M. T., Thompson, N. J., & Kaslow, N. J. (2005). Social environment factors associated with suicide attempt among low-income African Americans: The protective role of family relationships and social support. Social Psychiatry and Psychiatric Epidemiology, 40(3), 175-185. doi: 10.1007/s00127-005-0865-6
  • Consoli, A., Cohen, D., Bodeau, N., Guilé, J. M., Mirkovic, B., Knafo, A., … Gérardin, P. (2015). Risk and protective factors for suicidality at 6-month follow-up in adolescent inpatients who attempted suicide: An exploratory model. Canadian Journal of Psychiatry, 60(2 Suppl1), S27–S36.
  • Conway, C. C., Hammen, C., & Brennan, P. A. (2015). Adolescent precursors of adult Borderline Personality Pathology in a high-risk community sample. Journal of Personality Disorders, 29(3), 316-333. doi:  10.1521/ pedi_2014_28_158
  • Diamond, G., Wintersteen, M., Brown, G., Diamond, G., Gallop, R., Shelef, K., & Levy S. (2010). Attachment-based family therapy for adolescents with suicidal ideation: a randomized controlled trial. Journal of American Academy Child and Adolescent Psychiatry, 49(2), 122-131. doi: 10.1037/2329- 0382.1.S.91
  • Dixon, L., McFarlane, W., Lefley, H., Lucksted, A., Cohen, M., Falloon, I., …. Sondheimer, D. (2001). Evidence-based practices for services to families of people with psychiatric disabilities. Psychiatry Services, 52(7), 903-910. doi: 10.1176/appi.ps.52.7.903
  • First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B.W., & Benjamin, L. S. (1997). Entrevista Clínica Estructurada para los Trastornos de Personalidad del Eje II del DSM-IV. Barcelona: Masson.
  • Flouri, E., Buchanan, A., & Bream, V. (2002). Adolescents’ perceptions of their fathers’ involvement: Significance to school attitudes. Psychology in Schools, 3, 575-582. doi: 10.1002/pits.10055
  • Fulginiti, A., Rice, E., Hsu, H., Rhoades, H., & Winetrobe, H. (2016). Risky Integration. Crisis, the Journal of Crisis Intervention and Suicide Prevention, 37(3), 184-193. doi: 10.1027/0227-5910/a000374
  • Gould, M. Greenberg, T., Velting, D. M., & Shaffer, D. (2003). Youth suicide risk and preventive intervention: a review of the past 10 years. Journal of the American Academy of Child and Adolescence Psychiatry, 42(4), 386- 405. doi: 10.1097/01.CHI.0000046821.95464.CF
  • Groholt, B., Ekeberg, O., Wichstrom, L., & Haldorsen, T. (2000). Young suicide attempters: a comparison between a clinical and an epidemiological sample. Journal of the American Academy of Child and Adolescence Psychiatry, 39, 868-875. doi: 10.1097/00004583-200007000-00015
  • Gutierrez, P. M. (2006). Integratively assessing risk and protective factors for adolescent suicide. Suicide and Life-Threatening Behavior, 36, 129-135. doi: 10.1521/suli.2006.36.2.129
  • Harris, T., & Molock, S. (2000). Cultural orientation, family cohesion, and family support in suicide ideation and depression among African American college students. Suicide and Life-Threatening Behavior, 30, 341-353. doi: 10.1111/j.1939-0025.2010.01078.x
  • Insel, P. M., & Moos, R. H. (1974). Psychological environments: Expanding the scope of human ecology. American Psychologist, 29(3), 179-188. doi: 10.1037/h0035994
  • Kaess, M., Brunner, R., & Chanen, A. (2014). Borderline personality disorder in adolescence. Pediatrics.134(4), 782-793. doi: 10.1542/peds.2013-3677
  • King, C., Segal, H., Kaminski, K., Naylor, M., Ghaziuddin N., & Radpour, L. (1995). A prospective study of adolescent suicidal behavior following hospitalization. Suicide and Life-Threatening Behavior, 25, 327-338. doi: 10.1080/15374416.2013.836454
  • Lenzenweger, M. F., Lane, M. C., Loranger, A. W., & Kessler, R. C. (2007). DSM-IV Personality Disorders in the National Comorbidity Survey Replication (NCS-R). Biological Psychiatry, 62, 553-564. doi: 10.1016/j. biopsych.2006.09.019
  • Linehan, M. (1993). Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press.
  • Lipschitz, J., Yen, S., Weinstock, L., & Spirito, A. (2012). Adolescent and caregiver perception of family functioning: relation to suicide ideation and attempts. Psychiatry Research, 200(2-3), 400-403. doi: 10.1016/j. psychres.2012.07.051
  • Lucksted, A., Stewart, B., & Forbes, C. (2008). Benefits and changes for family to family graduates. American Journal of Community Psychology, (1-2), 154-166. doi: 10.1007/s10464-008-9195-7
  • Machell, K., Rallis, B., & Esposito-Smythers, C. (2016). Family environment as a moderator of the association between anxiety and suicidal ideation. Journal of Anxiety Disorders, 40, 1-7. doi: 10.1016/j.janxdis.2016.03.002.
  • McDonell, M., Short, R., Berry, C., & Dyck, D. G. (2003). Burden in schizophrenia caregivers: impact of family psychoeducation and awareness of patient suicidality. Family Process, 42(1), 91-103. doi: 10.1111/j.1545- 5300.2003.00091.x
  • Meadows, L., Kaslow, N., Thompson, M., & Jurkovic G. (2005). Protective factors against suicide attempt risk among African American women experiencing intimate partner violence. American Journal of Community Psychology, 36(1-2), 109-121. doi: 10.1007/s10464-005-6236-3
  • Miller, A. L., Muehlenkamp, J. J., & Jacobson, C. M. (2008). Fact or fiction: diagnosing borderline personality disorder in adolescents. Clinical Psychology Review, 28(6), 969-981. doi: 10.1016/j.cpr.2008.02.004
  • Miller, A. L., Rathus, J. H., & Linehan, M. M. (2007) Dialectical Behavior Therapy with Suicidal Adolescents. New York, NY: The Guilford Press.
  • Moos, R. H. (1974). The social climate scales: an overview. Palo Alto: Consulting Psychologists Press.
  • Organización Mundial de la Salud & Organización Panamericana de la Salud (‎2014)‎. Prevención del suicidio: un imperativo global. Organización Panamericana de la Salud.
  • Pineda, J., Mark, R., & Dadds, M. (2013). Family intervention for adolescents with suicidal behaviour: A randomized controlled trial and mediation analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 52(8), 851-862. doi: 10.1016/j.jaac.2013.05.015
  • Raphael, H., Clarke, G., & Kumar, S. (2006). Exploring parents’ responses to their child’s deliberate self-harm. Health Education, 106(1), 9-20. doi: 10.1108/09654280610637166
  • Seisdedos, N., Victoria de la Cruz, M., & Cordero, A. (1989). Escalas de Clima Social (FES). Madrid: TEA Ediciones.
  • Skegg, K. (2005). Self-harm. The Lancet, 366(9495), 1471-1483. doi: 10.1016/ S0140-6736(05)67600-3
  • Tyrer, P., Crawford, M., & Mulder, R. (2011). Reclassifying personality disorders. The Lancet, 377(9780):1814–1815. doi: 10.1016/S0140- 6736(10)61926-5
  • Xing, X., Tao, F., Wan, Y., Xing, C., Qi, X., Hao, J., Su, P., Pan, H., & Huang, L. (2010). Family factors associated with suicide attempts among Chinese adolescent students: A national cross-sectional survey. Journal of Adolescent Health, 46, 592–599. doi: 10.1016/j.jadohealth.2009.12.006
  • Yen, S., Gagnon, K., & Spirito, A. (2013). Borderline personality disorder in suicidal adolescents. Personality & Mental Health, (2): 89–101. doi: 10.1002/pmh.1216
  • Zimmerman, M., Rothschild, L., & Chelminski, I. (2005). The prevalence of DSM-IV personality disorders in psychiatric outpatients. American Journal of Psychiatry, 162(10), 1911-1918. doi: 10.1176/appi.ajp.162.10.1911
Data source: Dialnet