Bridge symptoms between parenting styles and proximal psychological risk factors associated with adolescent suicide: a network analysis

Background: Parenting styles and the associated proximal psychological factors are suggested to increase suicidal risks in adolescents. However, how the two risky factors interact and confer risks on adolescent suicide remains unclear. Herein, we used a network approach to investigate their interrelationship and explore whether the network properties predict adolescent suicide. Methods Self-report questionnaires were completed by 1,171 students aged 12–16. Network analyses were performed by Gaussian graphical models estimating the adolescent psychosocial network structure of parenting styles and psychological variables including depression, anxiety, affective lability, rumination, and resilience. Furthermore, we re-examined the network by adding a variable of active suicidal thoughts. Moreover, we conducted linear regressions to examine the predictive utility of bridge symptoms for adolescent suicide. Results Resilience, Afraid, Rumination, Concentration, and affective lability (Anger) had the highest bridge strengths in the adolescent psychosocial network. Among the identified bridge symptoms, Resilience was negatively correlated with active suicidal thoughts (regularized edge weights = -0.181, bootstrapped 95% CIs: [-0.043, -0.155]), whereas affective lability (from Anxiety to Depression, Anger), Rumination, and Afraid were positively correlated with active suicidal thoughts, with edge weights (bootstrapped 95% CIs) ranging from 0.057 (0.001, 0.112) to 0.081(0.026, 0.136). Regression analysis showed that bridge strength was significantly correlated with active suicidal thoughts (R 2  = 0.432, P  = 0.001). Conclusion Negative parenting styles may drive and maintain active suicidal thoughts by modifying the key proximal psychological variables. Our findings highlight the important role of bridge symptoms, which may serve as potential prevention and intervention targets for adolescent suicide.