Poster #46 - Caregiver perceptions impact the relationship between treatment involvement and youth suicide risk outcomes

• In Event: Poster Session 11

Abstract

Suicide is a leading cause of death among 10-to-24-year-olds in the United States (CDC, 2018; 2020), and rates of youth suicidal thoughts and behaviors (STB) continue to rise (CDC, 2022). While some interventions for youth STB exist, and interventions that include both adolescents and their caregivers demonstrate promise in reducing adolescent STB (Kothgassner et al., 2020; McCauley et al., 2018; Ougrin et al., 2015), families are heterogenous with unique family stressors that may impact STB treatment engagement and outcomes. Further, caregiver perceptions of youth risk and their impact on family functioning may impact treatment outcomes and youth suicide risk. Thus, better understanding such caregiver factors may highlight important treatment targets for caregivers of youth presenting with STBs to improve treatment outcomes.

The current study examines data from youth presenting in a suicidal crisis and their caregivers who participated in a brief 4-session outpatient crisis stabilization intervention designed to include active intervention for both youth and their caregiver(s). Participants who completed at least two sessions were included in analyses (N = 171; mean youth age = 14.64 years, SD = 1.89; majority were cis-gender female [62%], mean number of sessions attended = 3.69, SD = 1.25). Analyses examined treatment engagement (i.e., number of sessions attended, completion of recommended number of sessions), parent perceptions and stressors before starting crisis intervention services (i.e., parent confidence in keeping child safe, confidence child will tell them if they’re feeling unsafe, confidence youth won’t attempt suicide, hopefulness for the future, and perceived burden of youth STB crisis), and youth self-reported suicide risk.

Moderation analyses examined how baseline caregiver perceptions of youth STB impacted the relationship between intervention participation and suicide risk at intervention completion, controlling for initial suicide risk. Results demonstrated that caregiver’s belief they could keep their child safe and confidence their child would not attempt suicide again significantly moderated the relationship between intervention participation and suicide risk, b = .17, t(151) = 2.12, p < .05; b = .51, t(60) = 2.89, p < .01. Caregiver hopefulness/optimism for the future also significantly moderated intervention participation and suicide risk, b = .24, t(152) = 2.39, p < .05, while caregiver reported relationship disruption moderated intervention participation and suicide risk outcomes inversely at trend level (p < .10).

Overall, results suggest that caregivers who were less hopeful and optimistic for the future, and less confident they could keep their child safe or keep them from attempting again attended the most sessions, and that attending more sessions had the greatest impact in reducing youth suicide risk. Thus, lower hopefulness and confidence regarding youth STB outcomes may contribute to caregivers taking youth STB risk more seriously, potentially leading to more protective monitoring, communication, and lethal means restriction at home – ultimately reducing youth STB risk. Together, findings suggest important assessment and intervention targets for working with youth and caregivers in crisis intervention services with implications for improving caregiver-youth crisis intervention engagement and youth STB outcomes.

Authors

• Sarah Danzo, University of Washington
  Presenting Author

• Molly Adrian

• Eileen Twohy, University of Washington

• Kalina Babeva, Seattle Children's

• Elizabeth McCauley