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This longitudinal study of recently hospitalized suicidal youth examined parental mental health history in addition to several indices of adolescent functioning as risk factors for time-to-suicide attempt over a 1-year period. Participants were 352 adolescents (253 girls, 99 boys; ages 13-17 years) who participated in self-report and interview assessments within 1 week of hospitalization and 6 weeks, 3, 6, and 12 months post-hospitalization. Multivariable proportional hazards regression modeled time-to-suicide attempt. Results indicate that adolescents were almost twice as likely to make a suicide attempt if they had at least one biological parent with mental health problems. Risk was also increased for adolescents with baseline histories of multiple previous suicide attempts, more severe suicidal ideation and more severe functional impairment. Findings suggest the need to consider the family system when intervening with suicidal youth.

Number of lifetime episodes, duration of current episode, and severity of maternal depression were investigated in relation to family functioning and child adjustment. Participants were the 151 mother-child pairs in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) child multi-site study. Mothers were diagnosed with Major Depressive Disorder; children (80 males and 71 females) ranged in age from 7 to 17 years. Measures of child adjustment included psychiatric diagnoses, internalizing and externalizing symptoms, and functional impairment. Measures of family functioning included family cohesion, expressiveness, conflict, organization, and household control; parenting measures assessed maternal acceptance and psychological control. Children of mothers with longer current depressive episodes were more likely to have internalizing and externalizing symptoms, with this association being moderated by child gender. Mothers with more lifetime depressive episodes were less likely to use appropriate control in their homes.