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The Relations of Temperament and Emotion Self-regulation with Suicidal Behaviors in a Clinical Sample of Depressed Children in Hungary

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Abstract

Although major depressive disorder (MDD) is associated with suicidal behaviors, some depressed individuals are not suicidal and others evidence various forms of suicidality. We thus investigated whether aspects of temperament and self-regulation of dysphoria represent risk factors for DSM-IV suicidality (recurrent thoughts of death, recurrent suicidal ideation, suicidal plan, and suicide attempt) in depressed youths. Using a sample of children with MDD (N = 407; ages 7–14 years), recruited from clinical sites across Hungary, we tested the hypotheses that: (a) suicidality is related to higher levels of trait negative emotionality as well as more maladaptive and fewer adaptive regulatory responses to dysphoria and (b) as the severity of suicidal behavior increases, levels of trait negative emotionality and dysfunctional emotion regulation also increase. We also explored if other aspects of temperament relate to suicidality. Children’s DSM-IV diagnoses were based on semi-structured interviews and best-estimate psychiatric consensus. Parents independently provided ratings of their children’s temperament, and children separately completed an inventory of emotion regulation (ER). Using multivariate models, we failed to confirm the hypothesized relations of negative trait emotionality and suicidality, but confirmed that high maladaptive and low adaptive ER response tendencies increase the odds of suicidal behaviors, above and beyond the risk posed by depressive illness severity. Unplanned interaction terms between temperament dimensions (other than negative emotionality) and ER suggested that at some high-extremes of temperament, ER has no impact on suicidality but in their absence, adaptive ER lowers the risk of suicidality. The practical implications of the findings are discussed.

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Notes

  1. We thank the anonymous reviewers for their suggestions in this regard.

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Acknowledgements

Members of the International Consortium for Childhood-Onset Mood Disorders include: Ildikó Baji M.D., István Benák, Emília Kaczvinszky M.D., Krisztina Kapornai M.D., Viola Kothencné Osváth M.S., László Mayer M.D., Szeged University Medical Faculty, Department of Child and Adolescent Psychiatry, Szeged. Márta Besnyő M.D., Julia Gádoros M.D., Ph.D., Vadaskert Hospital, Budapest. Judit Székely M.D. Semmelweis University I. Pediatric Department, Budapest. Edit Dombovári M.D., Heim Pál Hospital for Sick Children Outpatient Unit of Child Psychiatry, Budapest. Special thanks are due to the following participating physicians across various research sites in Hungary: Zsuzsa Bánk M.D., Katalin Bense M.D., Katalin Benkő M.D., Ferenc Dicső M.D., Emőke Endreffy Ph.D., Edina Farkas M.D., Gyöngyi Farkas M.D., Zsuzsanna Fekete M.D., Márta Fohn M.D., Magdolna Gácser M.D., Eszter Gyenge M.D., Éva Gyulai M.D., Mária Gyurcsó M.D., Rózsa Hasuly M.D., Ágnes Horváth M.D., Enikő Juhász M.D., Mária Károlyfalvi M.D., Dénes Kövendy M.D., Mária Mojzes M.D., Ilona Mógor M.D., Róza Oláh M.D., Mária Palaczky M.D., Mária Révhelyi M.D., Ilona Riegler M.D., Zsuzsanna Sörföző, M.D., Péter Steiner M.D., Zsuzsa Takács M.D. and Mariann Vados M.D, and to Charles J. George, MS, for his statistical comments on an earlier version of this manuscript.

This work was supported by Program Project Grant #MH056193 from the National Institute of Mental Health, HHS, Washington, D.C.

Disclosure

The Children’s Depression Inventory and the Feelings and Me Scales are published by MultiHealth Systems, Inc., from which Dr. Kovacs receives royalties.

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Authors and Affiliations

  1. Vadaskert Hospital, Budapest, Hungary

    Zsuzsanna Tamás & Júlia Gádoros

  2. University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA

    Maria Kovacs

  3. University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Amy L. Gentzler & Ping Tepper

  4. Department of Child and Adolescent Psychiatry, University of Szeged, Szeged, Hungary

    Enikő Kiss, Krisztina Kapornai & Ágnes Vetró

  5. Vadaskert Kórház, Hűvösvölgyi út 116, Budapest, 1021, Hungary

    Zsuzsanna Tamás

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  1. Zsuzsanna Tamás
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  2. Maria Kovacs
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Correspondence to Zsuzsanna Tamás.

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Tamás, Z., Kovacs, M., Gentzler, A.L. et al. The Relations of Temperament and Emotion Self-regulation with Suicidal Behaviors in a Clinical Sample of Depressed Children in Hungary. J Abnorm Child Psychol 35, 640–652 (2007). https://doi.org/10.1007/s10802-007-9119-2

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