[Suicidality in adolescents with therapy refractory internalising behaviour]

Area of Science:

• Adolescent psychology
• Clinical psychology
• Developmental psychology

Background:

• Adolescent suicidality presents a growing societal challenge, particularly in treatment-resistant cases with complex comorbidities.
• Current guidelines offer limited support for this patient group.
• Understanding therapy-refractory internalizing behavior is crucial.

Purpose of the Study:

• To enhance the diagnostic and etiological understanding of therapy-refractory internalizing behavior in adolescents.
• To develop a holistic model integrating various theoretical concepts.
• To inform more effective treatment strategies.

Main Methods:

• Integration of multiple scientific theoretical concepts.
• Development of a holistic etiological model.
• Review of evidence on underpinnings of internalizing behavior.

Main Results:

• Suicidality should be viewed within the broader context of therapy-refractory internalizing behavior.
• Key contributing factors include overprotective parenting, disturbed attachment, and social anxiety.
• Internalizing and externalizing behaviors are conceptualized as manifestations of avoidance.

Conclusions:

• An etiological model for therapy-refractory internalizing behavior can improve treatment effectiveness.
• Transdiagnostic treatment approaches, less reliant on specific DSM classifications, are recommended.
• Treatment should focus on restoring basic trust and addressing social anxiety-driven avoidance behavior.