Parental bonding and suicidality in pregnant teenagers: a population-based study in southern Brazil

Abstract

Purpose

To assess the associations of the perceived quality of parental bonding with suicidality in a sample of pregnant adolescents.

Methods

A cross-sectional study with a sample size of 828 pregnant teenagers receiving prenatal medical assistance in the national public health system in the urban area of Pelotas, southern Brazil. Suicidality and psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview (MINI), and the Parental Bonding Instrument (PBI) was employed to measure the perceived quality of parental bonding. A self-report questionnaire was used to collect sociodemographic, obstetric and other psychosocial data.

Results

Forty-three (4.94 %) teenagers from a consecutive sample of 871 refused to participate, resulting in 828 participants. Prevalence of suicidality was 13.3 %, lifetime suicide attempts were 7.4 % with 1.3 % reporting attempting suicide within the last month. Significant associations of suicidality with the 18–19-year-old subgroup, low education, prior abortion, physical abuse within the last 12 months were present, and most psychiatric disorders were associated with a higher suicidality prevalence. Additionally, after adjustment in the multivariate analysis, the style of parental bonding was independently associated with suicidality in the pregnant adolescent, with a PR of 2.53 (95 % CI 1.14–5.59) for the maternal ‘affectionless control’ and a PR of 2.91 (95 % CI 1.10–7.70) for the paternal ‘neglectful parenting.’

Conclusions

We found that maternal ‘affectionless control’ and paternal ‘neglectful parenting’ were independent predictors of suicidality in this sample of pregnant teenagers.

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References

  1. 1.

    Center for Diseases Control and Prevention (CDC) (2011) Vital signs: teen pregnancy—United States, 1991–2009. MMWR Morb Mortal Wkly Rep 60(13):414–420

    Google Scholar 

  2. 2.

    Chalem E, Mitsuhiro SS, Ferri CP, Barros MC, Guinsburg R, Laranjeira R (2007) Teenage pregnancy: behavioral and socio-demographic profile of an urban Brazilian population. Cad Saude Publica 23:177–186

    PubMed  Article  Google Scholar 

  3. 3.

    Chen XK, Wen SW, Fleming N et al (2007) Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol 36(2):368–373

    CAS  PubMed  Article  Google Scholar 

  4. 4.

    Gilbert W, Jandial D, Field N, Bigelow P, Danielsen B (2004) Birth outcomes in teenage pregnancies. J Matern Fetal Neonatal Med 16:265–270

    PubMed  Article  Google Scholar 

  5. 5.

    Bradley T, Cupples ME, Irvine H (2002) A case control study of a deprivation triagle: teenage motherhood, poor educational achievement and unemployment. Int J Adolesc Med Health 12:117–123

    Google Scholar 

  6. 6.

    Mitsuhiro SS, Chalem E, Barros MM, Guinsburg R, Laranjeira R (2006) Teenage pregnancy: use of drugs in the third trimester and prevalence of psychiatric disorders. Rev Bras Psiquiatr 28(2):122–125

    PubMed  Article  Google Scholar 

  7. 7.

    Olausson PO, Haglund B, Weitoft GR, Cnattingius S (2001) Teenage childbearing and long-term socio-economic consequences: a case study in Sweden. Fam Plann Perspect 33:70–74

    CAS  PubMed  Article  Google Scholar 

  8. 8.

    Olausson PO, Haglund B, Weitoft GR, Cnattingius S (2004) Premature death among teenage mothers. BJOG 111:793–799

    Article  Google Scholar 

  9. 9.

    Freitas GVS, Cais CFS, Stefanello S et al (2008) Psychosocial conditions and suicidal behavior in pregnant teenagers: a case–control study in Brazil. Eur Child Adolesc Psychiatry 17:336–342

    PubMed  Article  Google Scholar 

  10. 10.

    Asad N, Karmaliani R, Sullaiman N, Bann CM, McClure EM, Pasha O, Wright LL, Goldenberg RL (2010) Prevalence of suicidal thoughts and attempts among pregnant Pakistani women. Acta Obstet Gynecol Scand 89:1545–1551

    PubMed Central  PubMed  Article  Google Scholar 

  11. 11.

    Bayatpour M, Wells RD, Holford S (1992) Physical and sexual abuse as predictors of substance use and suicide among pregnant teenagers. J Adolesc Health 13:128–132

    CAS  PubMed  Article  Google Scholar 

  12. 12.

    Freitas GVS, Botega NJ (2002) Prevalence of depression, anxiety and suicidal ideation in pregnant adolescents. Rev Assoc Med Bras 48(3):245–249

    PubMed  Article  Google Scholar 

  13. 13.

    Gausia K, Fisher C, Ali M, Oosthuizen J (2009) Antenatal depression and suicidal ideation among rural Bangladeshi women: a community-based study. Arch Womens Ment Health 12(5):351–358

    PubMed  Article  Google Scholar 

  14. 14.

    Gavin AR, Tabb KM, Melville JL, Guo Y, Katon W (2011) Prevalence and correlates of suicidal ideation during pregnancy. Arch Womens Ment Health 14(3):239–246

    PubMed Central  PubMed  Article  Google Scholar 

  15. 15.

    Gentile S (2011) Suicidal mothers. J Inj Violence Res 3:90–97

    PubMed Central  PubMed  Article  Google Scholar 

  16. 16.

    Mota NP, Burnett M, Sareen J (2010) Associations between abortion, mental disorders, and suicidal behavior in nationally representative sample. Can J Psychiatry 55:239–247

    PubMed  Google Scholar 

  17. 17.

    Newport DJ, Levey LC, Pennell PB, Ragan K, Stowe ZN (2007) Suicidal ideation in pregnancy: assessment and clinical implications. Arch Womens Ment Health 10(5):181–187

    CAS  PubMed  Article  Google Scholar 

  18. 18.

    Murphy E, Wickramaratne P, Weissman M (2010) The stability of parental bonding reports: a 20-year follow-up. J Affect Disord 125(1–3):307–315

    PubMed Central  PubMed  Article  Google Scholar 

  19. 19.

    Patton GC, Coffey C, Posterino M, Carlin JB, Wolfe R (2001) Parental ‘affectionless control’ in adolescent depressive disorder. Soc Psychiatry Psychiatr Epidemiol 36(10):475–480

    CAS  PubMed  Article  Google Scholar 

  20. 20.

    Heider D, Matschinger H, Bernert S et al (2008) Adverse parenting as a risk factor in the occurrence of anxiety disorders : a study in six European countries. Soc Psychiatry Psychiatr Epidemiol 43(4):266–272

    PubMed  Article  Google Scholar 

  21. 21.

    Kovess-Masfety V, Boyd A, Haro JM et al (2011) High and low suicidality in Europe: a fine-grained comparison of France and Spain within the ESEMeD surveys. J Affect Disord 133(1–2):247–256

    CAS  PubMed  Article  Google Scholar 

  22. 22.

    Overbeek G, ten Have M, Vollebergh W, de Graaf R (2007) Parental lack of care and overprotection. Longitudinal associations with DSM-III-R disorders. Soc Psychiatry Psychiatr Epidemiol 42(2):87–93

    PubMed  Article  Google Scholar 

  23. 23.

    Enns MW, Cox BJ, Clara I (2002) Parental bonding and adult psychopathology: results from the US National Comorbidity Survey. Psychol Med 32(6):997–1008

    CAS  PubMed  Article  Google Scholar 

  24. 24.

    Behringer J, Reiner I, Spangler G (2011) Maternal representations of past and current attachment relationships, and emotional experience across the transition to motherhood: a longitudinal study. J Fam Psychol 25(2):210–219

    PubMed  Article  Google Scholar 

  25. 25.

    Amorim P (2000) Mini Internacional Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais. Rev Bras Psiquiatr 22:106–115

    Article  Google Scholar 

  26. 26.

    Hauck S, Schestatsky S, Terra L et al (2006) Adaptação transcultural para o português brasileiro do Parental Bonding Instrument (PBI). Rev Psiquiatr RS 28(2):162–168

    Article  Google Scholar 

  27. 27.

    Parker G (1984) The measurement of pathogenic parental style and its relevance to psychiatric disorder. Soc Psychiatry 19(2):75–81

    CAS  PubMed  Article  Google Scholar 

  28. 28.

    Associação Brasileira de Empresas em Pesquisa (ABEP). [Critério de Classificação econômica no Brasil.] http://www.abep.org/codigosguias/ABEP_CCEB.pdf. Acessed in October 2009

  29. 29.

    Savoia MG (1999) Life events and coping scales. Rev Psiquiatr Clin 26(2):57–67

    Google Scholar 

  30. 30.

    Griep RH, Chor D, Faerstein E et al (2005) Construct validity of the Medical Outcomes Study’s social support scale adapted to Portuguese in the Pró-Saúde Study. Cad Saude Publica 21(3):703–714

    PubMed  Article  Google Scholar 

  31. 31.

    Reichenheim ME, Moraes CL, Hasselmann MH (2000) Equivalência semântica da versão em português do instrumento Abuse Assessment Screen para rastrear a violência contra a mulher grávida. Rev Saude Publica 34(6):610–616

    CAS  PubMed  Article  Google Scholar 

  32. 32.

    Pinheiro RT, da Silva RA, Magalhães PV, Horta BL, Pinheiro KA (2008) Two studies on suicidality in the postpartum. Acta Psychiatr Scand 118(2):160–163

    CAS  PubMed  Article  Google Scholar 

  33. 33.

    Hodgkinson SC, Colantuoni E, Roberts D, Berg-Cross L, Belcher HM (2010) Depressive symptoms and birth outcomes among pregnant teenagers. J Pediatr Adolesc Gynecol 23(1):16–22

    PubMed Central  PubMed  Article  Google Scholar 

  34. 34.

    Adam KS, Keller A, West M, Larose S, Goszer LB (1994) Parental representation in suicidal adolescents: a controlled study. Aust N Z J Psychiatry 28(3):418–425

    CAS  PubMed  Article  Google Scholar 

  35. 35.

    Goldney RD (1985) Parental representation in young women who attempt suicide. Acta Psychiatr Scand 72:230–232

    CAS  PubMed  Article  Google Scholar 

  36. 36.

    Martin G, Waite S (1994) Parental bonding and vulnerability to adolescent suicide. Acta Psychiatr Scand 89(4):246–254

    CAS  PubMed  Article  Google Scholar 

  37. 37.

    Canetti L, Bachar E, Galili-Weisstub E, De-Nour AK, Shalev AY (1997) Parental bonding and mental health in adolescence. Adolescence 32(126):381–394

    CAS  PubMed  Google Scholar 

  38. 38.

    Heider D, Bernert S, Matschinger H, Haro JM, Alonso J, Angermeyer MC (2007) Parental bonding and suicidality in adulthood. Aust N Z J Psychiatry 41(1):66–73

    PubMed  Article  Google Scholar 

  39. 39.

    Ferri CP, Mitsuhiro SS, Barros MCM et al (2007) The impact of maternal experience of violence and common mental disorders on neonatal outcomes: a survey of adolescent mothers in Sao Paulo, Brazil. BMC Public Health 7:209

    PubMed Central  PubMed  Article  Google Scholar 

  40. 40.

    Coleman PK (2011) Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009. Br J Psychiatry 199:180–186

    PubMed  Article  Google Scholar 

  41. 41.

    Cash SJ, Bridge JA (2009) Epidemiology of youth suicide and suicidal behavior. Curr Opin Pediatr 21:613–619

    PubMed Central  PubMed  Article  Google Scholar 

  42. 42.

    Sareen J, Cox BJ, Afifi TO et al (2005) Anxiety disorders and risk for suicidal ideation and suicide attempts: a population-based longitudinal study of adults. Arch Gen Psychiatry 62(11):1249–1257

    PubMed  Article  Google Scholar 

  43. 43.

    Goldstein BI, Strober MA, Birmaher B et al (2008) Substance use disorders among adolescents with bipolar spectrum disorders. Bipolar Disord 10(4):469–478

    PubMed Central  PubMed  Article  Google Scholar 

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Correspondence to Fábio Monteiro da Cunha Coelho.

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Coelho, F.M.C., Pinheiro, R.T., Silva, R.A. et al. Parental bonding and suicidality in pregnant teenagers: a population-based study in southern Brazil. Soc Psychiatry Psychiatr Epidemiol 49, 1241–1248 (2014). https://doi.org/10.1007/s00127-014-0832-1

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Keywords

  • Suicidal behavior
  • Suicidality
  • Parental bonding
  • Teenage pregnancy