Waraan Luxsiya, Mehlum Lars, Rognli Erling W, Czajkowski Nikolai O, Aalberg Marianne
Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.
National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
Scand J Child Adolesc Psychiatr Psychol. 2021 Apr 9;9:41-51. doi: 10.21307/sjcapp-2021-006. eCollection 2021.
Suicidal ideation and depressive symptoms are often interrelated in clinical settings. Insecure attachment may be a risk factor for suicidal ideation in depressed adolescents. To our knowledge, this study is the first to examine the association between self-reported insecure attachment styles to both parents and suicidal ideation in a clinical sample of adolescents with depression.
Fifty clinically depressed adolescents (13-17 years, 84% girls) completed self-reported measures of suicidal ideation, depressive symptoms, and attachment style to parents.
There was a statistically significant bivariate association between higher levels of attachment anxiety in relation to mothers and fathers and higher levels of suicidal ideation. When attachments to both parents were included in the same multivariate model, only attachment anxiety to the mother was significantly associated with the level of suicidal ideation. Self-reported depressive symptoms remained significantly associated with the level of suicidal ideation in all analyses. Younger adolescents with attachment anxiety reported higher levels of suicidal ideation than older adolescents.
Conclusions about directionality and causality of associations between insecure attachment and suicidal ideation are limited due to the cross-sectional design. Our findings suggest that attachment anxiety in relation to the mother and father is associated with increased levels of suicidal ideation. Implication of these findings for treatment selection is discussed.
在临床环境中，自杀意念和抑郁症状常常相互关联。不安全依恋可能是抑郁青少年自杀意念的一个风险因素。据我们所知，本研究首次在患有抑郁症的青少年临床样本中，考察自我报告的对父母双方的不安全依恋模式与自杀意念之间的关联。
五十名临床诊断为抑郁症的青少年（年龄在13 - 17岁之间，84%为女孩）完成了关于自杀意念、抑郁症状以及对父母依恋模式的自我报告测量。
与母亲和父亲相关的较高水平的依恋焦虑与较高水平的自杀意念之间存在统计学上显著的双变量关联。当将对父母双方的依恋纳入同一多变量模型时，只有对母亲的依恋焦虑与自杀意念水平显著相关。在所有分析中，自我报告的抑郁症状与自杀意念水平仍显著相关。有依恋焦虑的较年轻青少年报告的自杀意念水平高于年龄较大的青少年。
由于采用横断面设计，关于不安全依恋与自杀意念之间关联的方向性和因果关系的结论有限。我们的研究结果表明，与母亲和父亲相关的依恋焦虑与自杀意念水平的升高有关。讨论了这些研究结果对治疗选择的启示。
