Ambivalent attitudes toward loved ones as a predictor of self-harming and suicidal behavior in adolescents and young adults with mood, behavioral, and emotional disorders

Abstract

Introduction. Using the example of adolescents and young adults with mood, behavioral, and emotional disorders, this article highlights the role of destructive family relationships as predictors of intra- and interpersonal conflicts that contribute to self-harming behavior. It also addresses disruptions in parental attachment resulting from exposure to various forms of parental violence. Aims. This article aims to identify and validate a structural model of family relationships in which an ambivalent attitude toward family members serves as a predictor of self-harming and suicidal behavior in adolescents and young adults diagnosed with “Mood Disorders” or “Mixed Disorders of Conduct and Emotions”. Materials and methods. The study involved 100 respondents from 2 age groups (12–15 years: n = 56; 16–18 years: n = 44) undergoing inpatient treatment at the Children’s department of the Usoltsev Central Clinical Psychiatric Hospital (Moscow). All respondents were diagnosed with “Mood Disorders” (F30-F39) or “Mixed Disorders of Conduct and Emotions” (F92) from ICD-10 and had a documented history of self-harming behavior and suicidal attempts, confirmed by clinical records. The following psychodiagnostic methods were used to establish the nature of family relationships: the Buss-Durkee Hostility Inventory for evaluating hostility and guilt levels; the Sacks Sentence Completion Test (J. Sacks, S. Levy) for assessing personal attitudes and the nature of family relationships; the Anti-Vitality and Resilience Questionnaire (O. Sagalakova, D. Truevtsev); the Volkova Sentence Completion Test for identifying violence against children. The study methods also included the collection of medical history data and a semi-structured interview aimed at establishing respondents’ individual perceptions, emotions, and subjective experiences with respect to family members. Confirmatory factor analysis was employed for data processing and statistical analysis (Jamovi 2.6; R: psych, lavaan). Results. The analysis of empirical data demonstrates a strong correlation between the nature of family relationships and self-harming and suicidal behavior in the subjects. In the context of destructive parenting styles, emotional deprivation, and an unsafe home environment, ambivalent attitudes were identified in 46 % of respondents toward their mothers and in 60 % toward their fathers. Jealousy of siblings and competition for maternal attention were reported by 45 % of the respondents. The level of resentment was characterized as high in 91 % of the participants, while the level of guilt was elevated in 81 % of participants. Conclusion. According to the study results, family therapy aimed at restoring child-parent relationships has been identified as a highly significant factor in resolving the problem of self-harming behavior and suicidal tendencies in adolescents and young adults with mood, behavioral, and emotional disorders.