Is parenting style a predictor of suicide attempts in a representative sample of adolescents?
BACKGROUND
Suicidal ideation and suicide attempts are serious but not rare conditions in adolescents. However, there are several research and practical suicide-prevention initiatives that discuss the possibility of preventing serious self-harm. Profound knowledge about risk and protective factors is therefore necessary. The aim of this study is a) to clarify the role of parenting behavior and parenting styles in adolescents' suicide attempts and b) to identify other statistically significant and clinically relevant risk and protective factors for suicide attempts in a representative sample of German adolescents.


METHODS
In the years 2007/2008, a representative written survey of N = 44,610 students in the 9th grade of different school types in Germany was conducted. In this survey, the lifetime prevalence of suicide attempts was investigated as well as potential predictors including parenting behavior. A three-step statistical analysis was carried out: I) As basic model, the association between parenting and suicide attempts was explored via binary logistic regression controlled for age and sex. II) The predictive values of 13 additional potential risk/protective factors were analyzed with single binary logistic regression analyses for each predictor alone. Non-significant predictors were excluded in Step III. III) In a multivariate binary logistic regression analysis, all significant predictor variables from Step II and the parenting styles were included after testing for multicollinearity.


RESULTS
Three parental variables showed a relevant association with suicide attempts in adolescents - (all protective): mother's warmth and father's warmth in childhood and mother's control in adolescence (Step I). In the full model (Step III), Authoritative parenting (protective: OR: .79) and Rejecting-Neglecting parenting (risk: OR: 1.63) were identified as significant predictors (p < .001) for suicidal attempts. Seven further variables were interpreted to be statistically significant and clinically relevant: ADHD, female sex, smoking, Binge Drinking, absenteeism/truancy, migration background, and parental separation events.


CONCLUSIONS
Parenting style does matter. While children of Authoritative parents profit, children of Rejecting-Neglecting parents are put at risk - as we were able to show for suicide attempts in adolescence. Some of the identified risk factors contribute new knowledge and potential areas of intervention for special groups such as migrants or children diagnosed with ADHD.
Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany. carolin.donath@uk-erlangen.de.
Carolin
C
Donath
Elmar
E
Graessel
Dirk
D
Baier
Stefan
S
Bleich
Thomas
T
Hillemacher
D000041:Absenteeism; D000124:Achievement; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D063425:Binge Drinking / Q000453:epidemiology; D004243:Divorce / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000706:statistics & numerical data; D014838:Volunteers / Q000706:statistics & numerical data