Skip to main content

Restrictive Emotionality, Depressive Symptoms, and Suicidal Thoughts and Behaviors Among High School Students

Abstract

Depression and suicidal thoughts and behaviors are prevalent among youth today. The current study sought to further our understanding of the correlates of depression and suicidality by assessing the relationship between restrictive emotionality (difficulty understanding and expressing emotions) and depressive symptoms and suicidal ideation and attempts among adolescents. A large group of high school students (n = 2189, 58.3% male; 13–18 years of age) completed a self-report survey as part of a 2-stage suicide screening project. Logistic regression analyses were used to assess the association between restrictive emotionality and depressive symptoms, suicidal ideation, and suicide attempts. Those reporting high restrictive emotionality were 11 times more likely to have elevated depressive symptom scores, 3 times more likely to report serious suicidal ideation (after controlling for depressive symptoms), and more than twice as likely to report a suicide attempt (after controlling for depressive symptoms) than those reporting low restrictive emotionality. Restrictive emotionality partially mediated the relationship between depressive symptoms and suicidal ideation and behavior. The pattern of association between restrictive emotionality and the outcome variables was similar for boys and girls. Restrictive emotionality is highly associated with elevated depressive symptoms and suicidal thoughts and behaviors among high school students, and may be a useful specific target in prevention and treatment efforts.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. Andover, M. A., Pepper, C. M., & Gibb, B. E. (2007). Self-mutilation and coping strategies in a college sample. Suicide and Life Threatening Behavior, 37, 238–243.

    PubMed  Article  Google Scholar 

  2. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    PubMed  Article  Google Scholar 

  3. Beautrais, A. L. (2001). Child and young adolescent suicide in New Zealand. Australian and New Zealand Journal of Psychiatry, 35, 647–653.

    PubMed  Article  Google Scholar 

  4. Beautrais, A. L., Joyce, P. R., & Mulder, R. T. (1996). Risk factors for serious suicide attempts among youths aged 13 through 24 years. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1174–1182.

    PubMed  Article  Google Scholar 

  5. Beck, A. T., & Steer, R. A. (1993). Manual for the Beck depression inventory. San Antonio: The Psychological Corporation.

    Google Scholar 

  6. Bennett, D. S., Ambrosini, P. J., Bianchi, M., Barnett, D., Metz, C., & Rabinovich, H. (1997). Relationship of Beck depression inventory factors to depression among adolescents. Journal of Affective Disorders, 45, 127–134.

    PubMed  Article  Google Scholar 

  7. Blazina, C., Pisecco, S., & O’Neil, J. M. (2005). An adaptation of the gender role conflict scale for adolescents: Psychometric issues and correlates with psychological distress. Psychology of Men and Masculinity, 6, 39–45.

    Article  Google Scholar 

  8. Boergers, J., Spirito, A., & Donaldson, D. (1998). Reasons for adolescents suicide attempts: Associations with psychological functioning. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 1287–1293.

    Article  Google Scholar 

  9. Brent, D. A., Baugher, M., Bridge, J. A., Chen, H., & Chiappetta, L. (1999). Age- and sex- related risk factors for adolescent suicide. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 1497–1505.

    Article  Google Scholar 

  10. Centers for Disease Control and Prevention. (2008). Youth Risk Behavior Surveillance—United States, 2007. Surveillance Summaries, June 6. Morbidity and Mortality Weekly Report, 57 (No.SS-4).

  11. Eaton, D. K., Kann, L., Kinchen, S., Shanklin, S., Ross, J., Hawkins, J., et al. (2008). Youth risk behavior surveillance- United States, 2005. Morbidity and Mortality Weekly Reports, 57, 1–131.

    Google Scholar 

  12. Foley, D. L., Goldston, D. B., Costello, E., & Angold, A. (2006). Proximal psychiatric risk factors for suicidal thoughts and behaviors in youth: The Great Smoky Mountains Study. Archives of General Psychiatry, 63, 1017–1024.

    PubMed  Article  Google Scholar 

  13. Gould, M. S., King, R., Greenwald, S., Fisher, P., Schwab-Stone, M., Kramer, R., et al. (1998). Psychopathology assoiciated with suicidal ideation and attempts among children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 915–923.

    Article  Google Scholar 

  14. Gould, M., Marrocco, F., Kleinman, M., Thomas, J. G., Mostkoff, K., Cote, J., et al. (2005). Evaluating iatrogenic risk of youth suicide screening programs: A randomized controlled trial. Journal of the American Medical Association, 293, 1635–1643.

    PubMed  Article  Google Scholar 

  15. Gould, M. S., Velting, D. M., Kleinman, M., Lucas, C. P., Thomas, J. G., & Chung, M. (2004). Teenagers’ attitudes about coping strategies and help-seeking behavior for suicidality. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 1124–1133.

    Article  Google Scholar 

  16. Gratz, K. L. (2006). Risk factors for deliberate self-harm among female college students: The role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. American Journal of Orthopsychiatry, 76, 238–250.

    PubMed  Article  Google Scholar 

  17. Hawton, K., Cole, D., O’Grady, J., & Osborn, M. (1982). Motivational aspects of deliberate self-poisoning in adolescents. British Journal of Psychiatry, 141, 286–291.

    PubMed  Article  Google Scholar 

  18. Holmbeck, G. N. (1997). Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from child-clinical and pediatric psychology literature. Journal of Consulting and Clinical Psychology, 65, 599–619.

    PubMed  Article  Google Scholar 

  19. Jacobson, C. M., & Gould, M. (2008). Suicide and non-suicidal self-injurious behaviors among youth: Risk and protective factors. In S. Nolen-Hoeksema & E. M. Hill (Eds.), Handbook of depression in adolescents (pp. 207–236). New York: Taylor & Francis, Inc.

    Google Scholar 

  20. Keane, E. M., Dick, R. W., Bechtold, D. W., & Manson, S. M. (1996). Predictive and concurrent validity of the Suicidal Ideation Questionnaire among American Indian adolescents. Journal of Abnormal Child Psychology, 24, 735–747.

    PubMed  Article  Google Scholar 

  21. Kienhorst, I. C., Wilde, E. J., Diekstra, R. F. W., & Wolters, W. H. G. (1995). Adolescents’ image of their suicide attempt. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 623–628.

    Article  Google Scholar 

  22. King, C. A., Hill, E. M., Naylor, M., Evans, T., & Shain, B. (1993). Alcohol consumption in relation to other predictors of suicidal thoughts and behaviors among adolescent inpatient girls. Journal of the American Academy of Child & Adolescent Psychiatry, 32, 82–88.

    Article  Google Scholar 

  23. Lloyd-Richardson, E., Perrine, N., Dierker, L., & Kelley, M. L. (2007). Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychological Medicine, 37, 1183–1192.

    PubMed  Article  Google Scholar 

  24. MacLane, J. (1996). The voice on the skin: Self-mutilation and Merleau-Ponty’s theory of language. Hypatia, 11, 107–121.

    Article  Google Scholar 

  25. Mufson, L., Dorta, K. P., Moreau, D., & Weissman, M. M. (2004). Interpersonal psychotherapy for depressed adolescents (2nd ed.). New York: The Guildford Press.

    Google Scholar 

  26. O’Neil, J. M., Good, G. E., & Holmes, S. (1995). Fifteen years of theory and research on men’s gender role conflict: New paradigms for empirical research. In R. Levant & W. Pollack (Eds.), The new psychology of men (pp. 164–206). New York: Basic Books.

    Google Scholar 

  27. Reynolds, W. M. (1988). SIQ professional manual. Odessa, FL: Psychological Assessment Resources, Inc.

    Google Scholar 

  28. Reynolds, W. M., & Mazza, J. J. (1999). Assessment of suicidal ideation in inner-city children and young adolescents: Reliability and validity of the Suicidal Ideation Questionnaire-Jr. The School Psychology Review, 28, 17–30.

    Google Scholar 

  29. Roberts, R. E., Lewinsohn, P. M., & Seeley, J. R. (1991). Screening for adolescent depression: A comparison of depression scales. Journal of the American Academy of Child & Adolescent Psychiatry, 30, 58–66.

    Article  Google Scholar 

  30. Rodham, K., Hawton, K., & Evans, E. (2004). Reasons for deliberate self-harm: Comparison of self-poisoners and self-cutters in a community sample of adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 80–87.

    Article  Google Scholar 

  31. Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 28–38.

    Article  Google Scholar 

  32. Shaffer, D., Gould, M. S., Fisher, P., Trautman, P., Moreau, D., Kleinman, M., et al. (1996). Psychiatric diagnosis in child and adolescent suicide. Archives of General Psychiatry, 53, 339–348.

    PubMed  Google Scholar 

  33. Shaffer, D., Scott, M., Wilcox, H., Maslow, C., Hicks, R., Lucas, C. P., et al. (2004). The Columbia suicide screen: Validity and reliability of a screen for youth suicide and depression. Journal of the American Academy of Child & Adolescent Psychiatry, 43(1), 71–79.

    Article  Google Scholar 

  34. Sobel, M. E. (1982). Asymptomatic intervals for indirect effects in structural equation models. In S. Leinhart (Ed.), Sociological methodology (pp. 290–312). San Francisco: Jossey-Bass.

    Google Scholar 

  35. Steer, R. A., Kumar, G., Ranieri, W. F., & Beck, A. T. (1998). Use of the Beck Depression Inventory-II with adolescent psychiatric outpatients. Journal of Psychopathology and Behavioral Assessment, 20, 127–137.

    Article  Google Scholar 

  36. Wichstrom, L. (2000). Predictors of adolescent suicide attempts: A nationally representative longitudinal study of Norwegian adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 603–610.

    Article  Google Scholar 

  37. Zlotnick, C., Shea, M. T., Pearlstein, T. S., Costello, E., & Begin, A. (1996). The relationship between dissociative symptoms, alexithymia, impulsivity, sexual abuse, and self- mutilation. Comprehensive Psychiatry, 37(1), 12–16.

    PubMed  Article  Google Scholar 

  38. Zlotnick, C., Woldsdorf, B. A., Johnson, B., & Spirito, A. (2003). Impaired self-regulation and suicidal behavior among adolescent and young adult psychiatric inpatients. Archives of Suicide Research, 7, 149–157.

    Article  Google Scholar 

Download references

Acknowledgments

The authors report no conflict of interest related to the work. The project was supported by NIMH grant, R01-MH64632 and NIMH grant, T32 MH16434-26.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Colleen M. Jacobson.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Jacobson, C.M., Marrocco, F., Kleinman, M. et al. Restrictive Emotionality, Depressive Symptoms, and Suicidal Thoughts and Behaviors Among High School Students. J Youth Adolescence 40, 656–665 (2011). https://doi.org/10.1007/s10964-010-9573-y

Download citation

Keywords

  • Suicide
  • Adolescents
  • Depression
  • Restrictive emotionality