Öz
Objective: Parental acceptance–rejection is linked to adolescent mental health, yet its distinct maternal versus paternal associations with suicidality in disadvantaged youth remain underexplored. This exploratory study aimed to delineate these specific relationships, examining perceived parental rejection as a predictor for suicidal ideation (SI) intensity, non-suicidal self-injury (NSSI), and psychopathology in a high-risk cohort.
Materials and Methods: Forty-six adolescents (82.6% girls; M age = 15.7±1.1 ) hospitalized in an ICU following a serious suicide attempt completed the Parental Acceptance-Rejection/Control Questionnaire and Youth Self-Report. A clinician assessed suicidality using the Columbia-Suicide Severity Rating Scale. Bivariate and multivariate regression analyses were performed to identify key predictors.
Results: A clear dissociation emerged between maternal and paternal roles. Greater perceived maternal rejection—particularly indifference and neglect—was significantly associated with higher SI intensity (B = 0.128, p < 0.001), and a perceived lack of maternal warmth correlated with depressive symptoms (r = 0.454, p = 0.002). In contrast, paternal acceptance was unrelated to SI or internalizing problems; however, paternal hostility was significantly associated with externalizing behaviors (r = 0.381, p = 0.013). Additionally, conduct problems were the only significant predictor of lifetime NSSI (OR = 1.125, p = 0.040), and SI intensity predicted a history of multiple suicide attempts (OR = 1.559, p = 0.016).
Conclusion: In this high-risk cohort, maternal rejection appeared to be more closely linked to suicidal ideation and internalizing distress, whereas paternal hostility showed a stronger association with externalizing behaviors. These exploratory findings point to the potential value of family-centered prevention approaches that enhance maternal responsiveness and address behavioral dysregulation to help mitigate suicide risk.
Anahtar Kelimeler: Adolescent, parent-child relations, suicidal ideation, socioeconomic disparities in health , self-injurious behavior
Kaynakça
- Ballesteros MF, Webb K, McClure RJ. A review of CDC’s web-based Injury Statistics Query and Reporting System (WISQARS™): planning for the future of injury surveillance. J Safety Res 2017; 61: 211-5. https://doi.org/10.1016/j.jsr.2017.01.001/journal.pmed.28454867
- Hua LL, Lee J, Rahmandar MH, et al. Suicide and suicide risk in adolescents. Pediatrics 2024; 153(1): e2023064800. https://doi.org/10.1542/peds.2023-064800/journal.pmed.38073403
- Gili M, Castellví P, Vives M, et al. Mental disorders as risk factors for suicidal behavior in young people: a meta-analysis and systematic review of longitudinal studies. J Affect Disord 2019; 245: 152-62. https://doi.org/10.1016/j.jad.2018.10.115/journal.pmed.30390504
- Wan Y, Chen R, Ma S, et al. Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents. Br J Psychiatry 2019; 214(3): 146-52. https://doi.org/10.1192/bjp.2018.263/journal.pmed.30477603
- ,Calati R, Ferrari C, Brittner M, et al. Suicidal thoughts and behaviors and social isolation: a narrative review of the literature. J Affect Disord 2019; 245: 653-67. https://doi.org/10.1016/j.jad.2018.11.022/journal.pmed.30445391
- Riabchych Y, Kapkan M. The social and psychological factors of youth’s suicidal behaviour. Psychol J 2021;7(1):9-19. https://doi.org/10.31108/1.2021.7.1.1
- Bowlby J. Attachment and loss. Random House; New York: Basic Books. Vol. 1: 1969.
- Diamond G, Russon J, Levy S. Attachment-based family therapy: a review of the empirical support. Fam Process 2016; 55(3): 595-610. https://doi.org/10.1111/famp.12241/journal.pmed. 27541199
- Spruit A, Goos L, Weenink N, et al. The relation between attachment and depression in children and adolescents: a multilevel meta-analysis. Clin Child Fam Psychol Rev 2020; 23(1): 54-69. https://doi.org/10.1007/s10567-019-00299-9/journal.pmed.31392452
- Verhees MWFT, Finet C, Vandesande S, et al. Attachment and the development of depressive symptoms in adolescence: the role of regulating positive and negative affect. J Youth Adolesc 2021;50(8):1649-62. https://doi.org/10.1007/s10964-021-01426-y/journal.pmed.33797009
- Consoli A, Peyre H, Speranza M, et al. Suicidal behaviors in depressed adolescents: role of perceived relationships in the family. Child Adolesc Psychiatry Ment Health 2013;7(1):8. https://doi.org/10.1186/1753-2000-7-8/journal.pmed.23497551
- Folker AE, Deater-Deckard K, Lansford JE, et al. Intraindividual variability in parental acceptance-rejection predicts externalizing and internalizing symptoms across childhood/adolescence in nine countries. J Fam Psychol 2024; 38(2): 333-44. https://doi.org/10.1037/fam0001133/journal.pmed.37732955
- Iemmi V, Bantjes J, Coast E, et al. Suicide and poverty in low-income and middle-income countries: a systematic review. Lancet Psychiatry 2016; 3(8): 774-83. https://doi.org/10.1016/S2215-0366(16)30066-9/journal.pmed.27475770
- Kim P, Neuendorf C, Bianco H, Evans GW. Exposure to childhood poverty and mental health symptomatology in adolescence: a role of coping strategies. Stress Health 2016; 32(5): 494-502. https://doi.org/10.1002/smi.2646/journal.pmed.26234956
- Dwairy M. Parental acceptance-rejection: a fourth cross-cultural research on parenting and psychological adjustment of children. J Child Fam Stud 2010; 19(1): 30-5. https://doi.org/10.1007/s10826-009-9338-y
- Hollingshead AB. Four factor index of social status. Yale University, Department of Sociology; 1975.
- Redlich FC. Social class and mental illness: a community study. By August B. Hollingshead and Fredrick C. Redlich. Am J Public Health Nations Health 1958; 48: 1563-4. https://doi.org/10.2105/ajph.48.11.1563/journal.pmed.17895405
- Achenbach TM. Manual for ASEBA school-age forms & profiles. University of Vermont, Research Center for Children, Youth & Families; 2001.
- Erol N, ŞimŞek ZT. Mental Health of Turkish Children: Behavioral and Emotional Problems Reported By Parents, Teachers, and Adolescents. Elsevier; 2000;1: 223–47. https://doi.org/10.1016/S1874-5911(00)80014-7
- Rohner RP. Parental acceptance-rejection questionnaire handbook. Rohner Research Publications; 2005.
- Varan A. Validity and reliability studies of the PARQ and PAQ child and parent measures in a Turkish sample. Unpublished manuscript. Hacettepe University, Ankara, Turkey; 2003.
- Posner K, Brown GK, Stanley B, et al. The Columbia–Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry 2011; 168(12): 1266-77. https://doi.org/10.1176/appi.ajp.2011.10111704/journal.pmed.22193671
- Kilincaslan A, Gunes A, Eskin M, Madan A. Linguistic adaptation and psychometric properties of the Columbia-Suicide Severity Rating Scale among a heterogeneous sample of adolescents in Turkey. Int J Psychiatry Med 2019; 54(2): 115-32. https://doi.org/10.1177/0091217418791454/journal.pmed.30058463
- Wang P, Yin L, Jia Q, et al. Mother phubbing and adolescent suicidal ideation: the roles of perceived acceptance from mother, perceived burdensomeness, and gender. Int J Ment Health Addict, 2023;23(1):850-69. https://doi.org/10.1007/s11469-023-01140-9
- Alegre A, Benson MJ, Pérez-Escoda N. Maternal warmth and early adolescents’ internalizing symptoms and externalizing behavior: mediation via emotional insecurity. J Early Adolesc 2014; 34(6): 712-35. https://doi.org/10.1177/0272431613501408
- Butterfield RD, Silk JS, Lee KH, et al. Parents still matter! Parental warmth predicts adolescent brain function and anxiety and depressive symptoms 2 years later. Dev Psychopathol 2021; 33(1): 226-39. https://doi.org/10.1017/S0954579419001718/journal.pmed.32096757
- Rothenberg WA, Ali S, Rohner RP, et al. Effects of parental acceptance-rejection on children’s internalizing and externalizing behaviors: a longitudinal, multicultural study. J Child Fam Stud 2022; 31(1): 29-47. https://doi.org/10.1007/s10826-021-02072-5/journal.pmed.35529327
- O’Brien M. Mothers’ emotional care work in education and its moral imperative. Gend Educ 2007; 19(2): 159-77. https://doi.org/10.1080/09540250601165938
- Vergara-Lopez C, Sokol NA, Bublitz MH, et al. Exploring the impact of maternal and paternal acceptance on adolescent girls’ emotion regulation. Child Psychiatry Hum Dev 2024; 55(2): 320-6. https://doi.org/10.1007/s10578-022-01405-9/journal.pmed.35916983
- Liu J, Cheng C, Edeleva K, et al. Association of parental rearing styles with suicidal ideation in Chinese adolescent patients with depression: a large-scale cross-sectional study. Front Psychiatry 2025; 15: 1414887. https://doi.org/10.3389/fpsyt.2024.1414887/journal.pmed.39850066
- Wu SL, Yaacob SN. Self-efficacy as the mediator of the relationship between paternal approval and suicidal ideation among Malaysian adolescents. In: 2nd International Conference on Intervention and Applied Psychology (ICIAP 2018). Atlantis Press; 2019;229: 522-8. https://doi.org/10.2991/iciap-18.2019.89
- Miranda MC, Affuso G, Esposito C, Bacchini D. Parental acceptance–rejection and adolescent maladjustment: mothers’ and fathers’ combined roles. J Child Fam Stud 2016; 25(4): 1352-62. https://doi.org/10.1007/s10826-015-0305-5
- Um J, Huh C. A meta-analysis of parenting attitudes on aggression in children and adolescents. J Learn Centered Curric Instr 2023; 23: 351-66. https://doi.org/10.22251/jlcci.2023.23.18.351
- Leatham C, Pillay J, Dunbar-Krige H. Patriarchal influences on the lives of African adolescent girls from child-headed households. J Psychol Afr 2015; 25(5): 470-2. https://doi.org/10.1080/14330237.2015.1101278
- Diggins E, Heuvelman H, Pujades-Rodriguez M, et al. Exploring gender differences in risk factors for self-harm in adolescents using data from the millennium cohort study. J Affect Disord 2024; 345: 131-40. https://doi.org/10.1016/j.jad.2023.10.106/journal.pmed.37863369
- Ali S, Khaleque A, Rohner RP. Pancultural gender differences in the relation between perceived parental acceptance and psychological adjustment of children and adult offspring: a meta-analytic review of worldwide research. J Cross Cult Psychol 2015; 46(8):1059-80. https://doi.org/10.1177/0022022115597754
- Lee WK. Psychological characteristics of self-harming behavior in Korean adolescents. Asian J Psychiatr 2016; 23: 119-24. https://doi.org/10.1016/j.ajp.2016.07.013/journal.pmed.27969068
- Rahman F, Webb RT, Wittkowski A. Risk factors for self-harm repetition in adolescents: a systematic review. Clin Psychol Rev 2021; 88: 102048. https://doi.org/10.1016/j.cpr.2021.102048/journal.pmed.34119893
- Baetens I, Greene D, Van Hove L, et al. Predictors and consequences of non-suicidal self-injury in relation to life, peer, and school factors. J Adolesc 2021; 90(1): 100-8. https://doi.org/10.1016/j.adolescence.2021.06.005/journal.pmed/journal.pmed.34182197
- Ribeiro JD, Franklin JC, Fox KR, et al. Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: a meta-analysis of longitudinal studies. Psychol Med 2016; 46(2): 225-36. https://doi.org/10.1017 S0033291715001804/journal.pmed.26370729
Telif hakkı ve lisans
Telif hakkı © 2026 Yazar(lar). Açık erişimli bu makale, orijinal çalışmaya uygun şekilde atıfta bulunulması koşuluyla, herhangi bir ortamda veya formatta sınırsız kullanım, dağıtım ve çoğaltmaya izin veren Creative Commons Atıf Lisansı (CC BY) altında dağıtılmıştır.