The Role of Family Functioning and Perceived Parental Support in Suicidal and Non-suicidal Self-injurious Ethnic Minority Adolescents

Deliberate self-harm (DSH), which includes nonsuicidal self-injury (NSSI) and suicide attempt (SA), is of serious psychiatric and public health concern for adolescents in the United States. Despite increasing rates of DSH behaviors in ethnic minority adolescents, there is limited understanding of factors that discriminate NSSI from SA, two behaviors that frequently co-occur. The current study examined group differences between adolescents with No DSH, NSSI Only, and those with NSSI and SA amongst a sample of primarily ethnic minority adolescents receiving services at an outpatient psychiatric clinic. Differences between the three DSH groups were compared on family dysfunction, parental acceptance and rejection, externalizing and internalizing behaviors, and parent-adolescent discordance on family and behavioral functioning. It was hypothesized that higher levels of family dysfunction, behavioral symptoms, and parent-adolescent discordance would be evidenced for adolescents with NSSI and SA followed by NSSI Only and No DSH. Results indicated the NSSI Only group perceived more family dysfunction and significantly less parental acceptance compared to the No DSH group. Externalizing and internalizing behaviors and parent-adolescent discordance were not significant predictors of DSH group. However, adolescent suicidal ideation was a significant predictor of parent-adolescent discordance, such that as suicidal ideation increased discordance between parent and adolescent reports decreased. Contrary to hypotheses, the current study variables were not robust predictors of DSH group and results suggested that these DSH groups may not represent an escalating continuum of severity. More research is needed to identify predictors that distinguish which adolescents are at risk for NSSI and SA.