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Jeffrey G. Johnson, PhD; Patricia Cohen, PhD; Madelyn S. Gould, PhD; Stephanie Kasen, PhD; Jocelyn Brown, MD; Judith S. Brook, PhD

Arch Gen Psychiatry. 2002;59:741-749.

Background  Data from a community-based longitudinal study were used to investigate the association between childhood adversities, interpersonal difficulties during adolescence, and suicide attempts during late adolescence or early adulthood.

Methods  A community sample of 659 families from Upstate New York was interviewed in 1975, 1983, 1985 to 1986, and 1991 to 1993. During the 1991-1993 interview, the mean age of the offspring was 22 years.

Results  Maladaptive parenting and childhood maltreatment were associated with an elevated risk for interpersonal difficulties during middle adolescence and for suicide attempts during late adolescence or early adulthood after age, sex, psychiatric symptoms during childhood and early adolescence, and parental psychiatric symptoms were controlled statistically. A wide range of interpersonal difficulties during middle adolescence were associated with risk for suicidal behavior after the covariates were controlled. Profound interpersonal difficulties during middle adolescence mediated the association between maladaptive parenting or childhood maltreatment and suicide attempts during late adolescence or early adulthood.

Conclusions  Maladaptive parenting and childhood maltreatment may be associated with a risk for severe interpersonal difficulties during adolescence. These interpersonal difficulties may play a pivotal role in the development of suicidal behavior. Youths who are at an elevated risk for suicide may tend to be in need of mental health services that can help them to cope with an extensive history of profound interpersonal difficulties, beginning in childhood and continuing through adolescence.

From the Departments of Psychiatry (Drs Johnson, Cohen, Gould, and Kasen) and Pediatrics (Dr Brown), Columbia University, the New York State Psychiatric Institute (Drs Johnson, Cohen, Gould, and Kasen), and the Department of Community Medicine, The Mount Sinai Medical Center (Dr Brook), New York, NY.

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