Parent and peer disapproval can lead to teen suicide

NEW YORK (Reuters Health) - Teens who’ve attempted suicide, or tried to harm themselves, are more likely to try again to kill or hurt themselves if they think their parents or peers “invalidate” their feelings, a new study suggests.

People can feel invalidated when they feel someone’s not listening to them, or when someone negates their feelings, for example.

Adolescent boys with serious psychiatric problems who felt invalidated by their families were more likely to try to kill themselves, and teen girls with psychiatric problems who felt invalidated by their peers were more likely to mutilate themselves, researchers found.

Researchers interviewed 99 teenagers and their parents when the children were admitted to psychiatric facilities because of a suicide attempt or elevated suicide risk and then again six months later.

To measure the youngsters’ “perception of invalidation,” investigators asked questions like, “Were there times when you did not feel accepted by your family?” or “Were there times when you did not feel accepted by your classmates?”

Within half a year, 35 of the teens had attempted suicide or displayed signs of heightened risk, the study found. Boys who felt their parents didn’t validate their feelings were more likely to have a suicidal event, and girls who felt invalidated by their peers were more likely to self-mutilate, according to the article in the Journal of Child and Adolescent Psychopharmacology.

Lead researcher Shirley Yen differentiates between validation and support.

“Validating a child’s sense of identity, what they are, is important,” she told Reuters Health. “You can have social support and still feel invalidated.”

Yen is a clinical psychologist and a professor at the Warren Alpert Medical School of Brown University in Providence, Rhode Island.

A boy who feels depressed or anxious and hears from a parent that he has no reason to be depressed or anxious may feel invalidated by an otherwise supportive family, Yen said.

“It’s really just invalidation when you negate someone’s feelings about something,” she said.

“You hear these cases of teen suicide of people who seem to have everything,” she said. “We need to ask more questions in evaluating a teen’s supportive system. Do you feel like you can really talk to your friends and family? Do you feel like you’re listened to?”

Suicide is the second leading cause of death among 13 to 17 year olds, according to the Centers for Disease Control and Prevention.

Nearly 16 percent of high school students in a 2011 nationwide study reported seriously considering killing themselves in the previous year, and almost 8 percent reported a suicide attempt during the prior year.

A 2009 publication from the American Psychological Association estimated that 14 to 21 percent of teens and young adults inflict self-harm by cutting and burning.

Researchers believe people self-mutilate for a range of reasons, including as self-punishment and simply as a way to feel something.

Of the 99 participants in the current study, 64 were girls and 23 boys. Within six months, 21 girls and 14 boys attempted suicide or showed elevated suicidal risk, and 25 girls and 15 boys mutilated themselves. Twenty-one kids had experienced both problems.

Girls were significantly more likely to have high perceived family invalidation when first questioned in the hospital, the study found. But perceived family invalidation was more likely to trigger suicide in boys. Two-thirds of the boys who initially reported high family invalidation attempted suicide or were at elevated risk within six months, Yen said.

Of the 25 girls who engaged in self-mutilation within six months, 72 percent reported high family invalidation at baseline. Of the 15 boys who engaged in self-mutilation at six months, two-thirds reported high perceived peer invalidation at baseline, the study found.

Clinical child psychologist Mitch Prinstein told Reuters Health the study underscores the need for parents to take adolescents’ worries seriously. Prinstein, a professor at the University of North Carolina at Chapel Hill, does similar research but was not involved in the current study.

“Sometimes I imagine it can feel to parents that their child can be having an overblown reaction, and they might want to tell their child it’s no big deal and to calm down,” he said. “And that can feel very invalidating to kids.”

He also stressed the need for parents to take any talk of suicide seriously every time.

“Some people say they may be trying to get attention,” he said. “It’s very important that adults who hear a child talking about suicide at all have that child evaluated by a trained mental health professional. It is literally a matter of life and death.”

SOURCE: Journal of Child and Adolescent Psychopharmacology, online September 29, 2014.