Suicidal ideation in an adolescent clinical sample: attachment patterns and clinical implications

This study investigated the relationship between attachment patterns and suicidal ideation in a clinical sample of adolescents. Participants (n=116) were assessed on level of current ideation through self-report questionnaires. Lethality of methods contemplated was also rated on a subset of the sample (n=16) who, in addition to endorsing current suicidal ideation, presented a plan on a diagnostic interview. Quality of attachment to care-givers based on a semi-structured clinical interview was assessed using Bartholomew's two-dimensional, four-category model of attachment. Categorical analyses indicated that youth with predominantly fearful or preoccupied attachment were more likely to endorse suicidal ideation than were predominantly secure or dismissing youth. Severity of suicidal ideation was positively correlated with ratings of fearfulness and negatively correlated with ratings on the secure and dismissing patterns. Greater lethality in methods of contemplated suicide was positively correlated with preoccupied tendencies. The importance of attachment theory for understanding the factors underlying suicidal ideation in troubled youth is discussed and implications for therapeutic intervention are presented. (C) 1998 The Association for Professionals in Services for Adolescents.