How do adolescents with Adjustment Disorder cope with stressful situations? Relationship with suicidal risk

Laia Ferrer; Teresa Kirchner

doi:10.1016/j.rpsm.2018.11.002

How do adolescents with Adjustment Disorder cope with stressful situations? Relationship with suicidal risk

Rev Psiquiatr Salud Ment (Engl Ed). 2020 Apr-Jun;13(2):63-72. doi: 10.1016/j.rpsm.2018.11.002. Epub 2018 Dec 14.

[Article in English, Spanish]

Authors

Laia Ferrer¹, Teresa Kirchner²

Affiliations

¹ Child and Youth Mental Health Center, Vidal i Barraquer Foundation, Santa Coloma de Gramenet, Barcelona, Spain. Electronic address: laia.ferrer3@gmail.com.
² University of Barcelona, Spain; Institute of Neurosciences, Barcelona, Spain; Group of Studies about Measure Invariance and Analysis of Change (GEIMAC), Barcelona, Spain.

PMID: 30558955
DOI: 10.1016/j.rpsm.2018.11.002

Abstract

Objective: Little is known about the role of coping in relation to suicidal risk in adolescents with Adjustment Disorder (AD). The present study aimed to assess the relation between suicidal ideation and intention and coping strategies in a clinical sample of adolescents with AD, paying special attention to gender differences.

Material and method: Self-reported questionnaires about suicidal ideation and intention and coping strategies were administered to 108 adolescents with an AD diagnosis.

Results: Compared with the normative population, adolescents with an AD diagnosis made more use of Acceptance-Resignation (an avoidance-type coping strategy) and less use of Positive Reappraisal (an approach-type coping strategy). Nevertheless, gender introduced some peculiarities. A relationship was observed between the use of certain coping strategies and suicidal ideation and intention, but with notable differences depending on gender: significant and high correlations were found between these two variables in AD boys, both in the total approach score (r=.53, p<.01) and in the total avoidant score (r=.60, p<.01), with coping strategies explaining 41% of suicidal ideation and intention; in girls, in contrast, the only significant relationship was with an avoidant strategy, Emotional Discharge (r=.25, p<.05), although it had low explanatory power.

Conclusions: Coping strategies must be taken into consideration when assessing and treating adolescents with AD at risk of suicide, especially in the case of boys. The absence of association between coping strategies and suicidal risk in girls is discussed, and some therapeutic proposals are presented.

Keywords: Adjustment disorder; Adolescence; Adolescencia; Coping strategies; Diferencias de género; Estrategias de afrontamiento; Gender differences; Ideación suicida e intención suicida; Suicidal ideation and intention; Trastorno adaptativo.