Dynamic Impact of Parental Closeness on Suicidal Trajectories: The Moderating Role of Future Orientation

Background/Purpose
Suicide is the second leading cause of death for people aged 10-34. Previous studies showed that greater parental closeness reduced adolescent suicidal behaviors. Few examined whether changes in parental closeness (i.e., parental closeness trajectories) affect changing patterns of suicidal behaviors over time (i.e., suicidal trajectories). Less is known about protective factors, future orientation (FO) in particular, of suicidal trajectories.

This study aims to determine: 1) if parental closeness trajectories predict longitudinal trajectories of suicidal ideation (SI) and suicide attempts (SA) among adolescents transitioning to adulthood; 2) whether FO moderates the associations; and, 3) whether there are racial/ethnic differences in the moderating effect of FO.

Methods
Data and samples: Data were derived from the National Longitudinal Study of Adolescent to Adult Health conducted from 1994 to 2008 (Wave I-IV). Study sample included 9,421 high school students in grades 9–12 (53.2% female, Mage= 14.99±1.61).

Measures: At each wave, self-reported SI, SA, closeness to mother and father were assessed. FO was measured by 6 items depicting one’s beliefs of future events and hopefulness. Sociodemographic characteristics were captured by race/ethnicity, sex, sexual orientation, age, socioeconomic status. Depression assessed by CES-D was controlled.

Analysis: Latent class growth analyses were conducted to examine the trajectories of SI and SA. Latent growth curve modeling was employed to characterize the growth trajectories of mother-child and father-child closeness. Path analyses were used to test associations between trajectories of parental closeness and suicidal behaviors, and the moderating effect of FO. Three-way interactions were introduced to explore racial/ethnic differences.

Results
Three suicidal ideation trajectories and two suicide attempt trajectories were identified. SI Trajectory 1 showed consistently low SI risk, Trajectory 2 showed high risk of SI in early adolescence, which gradually decreased, and Trajectory 3 had a moderate risk of SI initially, followed by an increased SI. SA Trajectory 1 reported low suicide attempts, whereas Trajectory 2 showed moderate risk in early adolescence, which decreased over time. Maternal and paternal closeness trajectories showed decreasing trends over time. Individuals with low perceived parental closeness during early adolescence continued to experience low parental closeness over time, and that group was more likely to be in SI Trajectory 3 and SA Trajectory 2. FO moderated the association between paternal closeness trajectories and the probability of being in SI Trajectory 3. The moderating effect of FO was only significant in reducing the likelihood of being in SA Trajectory 2 for Black and Hispanic populations with a steeper decline in maternal closeness.

Conclusion/Implications
Closer relationships with parents are protective against higher risks of SI and SA over time. Individuals with high levels of FO were less likely to report severe SI and SA overtime when paternal closeness decreased. FO can be an especially valuable source of protecting racial/ethnic minorities from SA when maternal closeness is low and decreasing over time. Findings highlight the dynamic relationships among parental closeness, suicidal trajectories, and FO. For public health professionals and policymakers, network-based interventions improving parent-adolescent closeness may be effective in preventing SI and SA across the lifespan.