Emotion Regulation and Attachment Style as Predictors of Psychiatric Hospitalization Duration in Suicidal Adolescents

Emotion regulation and attachment styles are interrelated and are critical factors in psychopathology and treatment outcomes, particularly in youths with suicidal behavior receiving psychiatric inpatient care. This study examined the influence of emotion regulation and attachment style on psychiatric hospitalization duration among adolescents admitted due to suicidal ideation or behavior.

Participants included 79 Israeli adolescents (mean age 15.35 years, 87.3% female) admitted to a tertiary psychiatric inpatient unit following a suicidal crisis. Data was collected using the Difficulties in Emotion Regulation Scale (DERS), the Experience in Close Relationships Scale (ECR), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), the Patient Health Questionnaire (PHQ-9), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Data were analyzed using correlation and multiple regression analyses.

Analysis revealed that greater emotion regulation difficulties predicted longer hospitalization duration (β = 0.41, p < 0.001), while avoidant attachment style was associated with shorter hospitalization duration (β = -0.35, p < 0.001). Notably, the level of suicidality as well as psychopathology symptoms (depression and anxiety) did not predict hospitalization duration.

These findings underscore the important role of emotion regulation and attachment style in determining treatment duration in suicidal adolescents, beyond the severity of psychopathology and suicidality, suggesting their unique contribution to treatment planning. Clinical interventions targeting emotion regulation and attachment styles could enhance inpatient care effectiveness, offer a more personalized treatment approach and potentially reducing hospitalization duration.