title: Attachment organization in suicide prevention research: preliminary findings and future directions in a sample of inpatient adolescents.
abstract: BACKGROUND
  Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB.
  
  
  OBJECTIVE
  This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates.
  
  
  METHODS
  We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm.
  
  
  RESULTS
  Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm.
  
  
  CONCLUSIONS
  The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.
authors.affiliation: <location>Department of Psychology, University of Houston, Houston, TX, USA</location>
authors.forename: Amanda
authors.initials: A
authors.lastname: Venta
authors.affiliation: <location>Department of Psychology, University of Houston, Houston, TX, USA</location>
authors.forename: Carla
authors.initials: C
authors.lastname: Sharp
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D018570:Risk Assessment; D016728:Self-Injurious Behavior / Q000523:psychology; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology*; D000092864:Suicide Prevention
keywords: adolescent; attachment; security; self-harm; suicide