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Developmental psychopathology in suicidal and nonsuicidal adolescent girls
1Laboratory of Developmental Psychology and Developmental Psychopathology, Harvard Medical School, Belmont, MA.
Objective:
This study presents two distinct profiles of female suicide attempters based on social-cognitive development and investigates the relationship of both developmental and suicide risk variables in these profiles.
Method:
The sample included 139 girls, aged 13-16, admitted to an inpatient psychiatric hospital. Patients were divided into four groups based on their suicidal status (attempter/nonsuicidal) and ego development (preconformist/conformist level).
Results:
Results support two developmental types of female suicide attempters that differed significantly on symptomatology, diagnoses, and defensive style. Preconformist attempters, the "angry-defiant" suicidal type, present with both depression and aggression as well as externalizing defense mechanisms. Conformist attempters, the "self-blaming" suicidal type, present with depression, and use more internalizing defenses to cope with conflict. Comparing suicide attempters and nonsuicidal girls, depression was found to be a risk factor for suicide at all developmental levels. Defense mechanisms were only associated with suicide at the preconformist developmental level.
Conclusions:
Social-cognitive development has an important impact on the expression of suicidal behavior in adolescent girls.