title: Depressed parents' attachment: effects on offspring suicidal behavior in a longitudinal family study.
abstract: OBJECTIVE
  To investigate relationships of depressed parents' attachment style to offspring suicidal behavior.
  
  
  METHODS
  244 parents diagnosed with a DSM-IV depressive episode completed the Adult Attachment Questionnaire at study entry. Baseline and yearly follow-up interviews of their 488 offspring tracked suicidal behavior and psychopathology. Survival analysis and marginal regression models with correlated errors for siblings investigated the relationship between parent insecure attachment traits and offspring characteristics. Data analyzed were collected 1992-2008 during a longitudinal family study completed January 31, 2014.
  
  
  RESULTS
  Parental avoidant attachment predicted offspring suicide attempts at a trend level (P = .083). Parental anxious attachment did not predict offspring attempts (P = .961). In secondary analyses, anxious attachment in parents was associated with offspring impulsivity (P = .034) and, in offspring suicide attempters, was associated with greater intent (P = .045) and lethality of attempts (P = .003). Avoidant attachment in parents was associated with offspring impulsivity (P = .025) and major depressive disorder (P = .012). Parental avoidant attachment predicted a greater number of suicide attempts (P = .048) and greater intent in offspring attempters (P = .003). Results were comparable after adjusting for parent diagnosis of borderline personality disorder.
  
  
  CONCLUSIONS
  Insecure avoidant, but not anxious, attachment in depressed parents may predict offspring suicide attempt. Insecure parental attachment traits were associated with impulsivity and major depressive disorder in all offspring and with more severe suicidal behavior in offspring attempters. Insecure parental attachment merits further study as a potential target to reduce risk of offspring psychopathology and more severe suicidal behavior.
authors.affiliation: Columbia University and New York State Psychiatric Institute, New York.
authors.forename: Erica K
authors.initials: EK
authors.lastname: MacGregor
authors.forename: Michael F
authors.initials: MF
authors.lastname: Grunebaum
authors.forename: Hanga C
authors.initials: HC
authors.lastname: Galfalvy
authors.forename: Nadine
authors.initials: N
authors.lastname: Melhem
authors.forename: Ainsley K
authors.initials: AK
authors.lastname: Burke
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
authors.forename: J John
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D016241:Child of Impaired Parents / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D009769:Object Attachment; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D013406:Suicide, Attempted / Q000523:psychology*; D055815:Young Adult
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