Examining harsh parenting as a moderator in the association between childhood irritability and adolescent suicidal behaviors

Abstract

Background Childhood irritability increases the risk of later suicidal behaviors, but the moderators of this association have not been identified. We investigated harsh parenting as a moderator in the association of childhood irritability with adolescent suicide attempt and self-harm, and possible sex differences in these associations. Method Data were from 9,480 children from the Millennium Cohort Study. We averaged parent ratings of child irritability and harsh parenting at ages 3, 5, and 7 years (range 1-3). Suicide attempt and self-harm were self-reported at age 17. Logistic regression models were used to estimate associations of irritability with suicide attempt and self-harm, adjusting for confounding factors. Interaction analyses were used to test the moderating role of harsh parenting and sex in these associations. Results Children with greater irritability scores were at increased risk to attempt suicide (OR=1.72, 95% CI=1.42-2.08). Interaction analyses suggested that this risk in males was elevated regardless of harsh parenting. However, high levels of harsh parenting interacted with irritability in increasing the risk of suicide attempt in females. Children with high irritability were also more at risk of self-harm (OR = 1.16, 95% CI = 1.03-1.31) but this association was not moderated by harsh parenting in either sex. Conclusion Parental behaviors may play an important role in the pathway to suicide attempt of children with irritability, especially for females, who may have a heightened sensitivity to interpersonal stressors. Parenting interventions may be helpful in suicide prevention among females with irritability.