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Emotional Suppression Mediates the Relation Between Adverse Life Events and Adolescent Suicide: Implications for Prevention

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Suicidal ideation substantially increases the odds of future suicide attempts, and suicide is the second leading cause of death among adolescents. A history of adverse life events has been linked with future suicidal ideation and attempts, although studies examining potential mediating variables have been scarce. One probable mediating mechanism is how the individual copes with adverse life events. For example, certain coping strategies appear to be more problematic than others in increasing future psychopathology, and emotional suppression in particular has been associated with poor mental health outcomes in adults and children. However, no studies to date have examined the potential mediating role of emotional suppression in the relation between adverse life events and suicidal thoughts/behavior in adolescence. The goal of the current study was to examine emotional suppression as a mediator in the relation between childhood adversity and future suicidal thoughts/behaviors in youth. A total of 625 participants, aged 14-19 years, seeking ER services were administered measures assessing adverse life events, coping strategies, suicidal ideation in the last 2 weeks, and suicide attempts in the last month. The results suggest that emotional suppression mediates the relation between adversity and both (1) suicidal thoughts and (2) suicide attempts above and beyond demographic variables and depressive symptoms. This study has important implications for interventions aimed at preventing suicidal thoughts and behavior in adolescents with histories of adversity.
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... La exposición constante a situaciones de violencia puede generar un estado prolongado de miedo e hipervigilancia, obstaculizando el desarrollo de las capacidades emocionales, cognitivas y conductuales (Evans et al., 2008;Franzese et al., 2014;Moe et al., 2021), presentando dificultades para identificar, expresar y gestionar sus emociones (Gross, 2002). La violencia en el hogar se ha identificado como un factor predictivo de las autolesiones (Fleta, 2017), dado que las personas expuestas a este tipo de violencia suelen recurrir con mayor frecuencia a estrategias de afrontamiento de tipo evitativo (Kaplow et al., 2014), utilizando las autolesiones como un mecanismo para mitigar el malestar asociado a emociones intensas o situaciones difíciles (González-Arrimada et al., 2023). En este sentido, los datos reportados por UNICEF (2022) y MIMP (2024), junto con la evidencia teórica que respalda las consecuencias emocionales de crecer en un entorno violento, justifican el enfoque del presente estudio en la exposición a la violencia en casa (EVC), dada su alta frecuencia e impacto que tiene en el desarrollo socioemocional de los adolescentes. ...
... La supresión emocional (SE) es una estrategia de regulación emocional (RE) (Gross, 2001) que consiste en inhibir la expresión emocional (Gross, 2002;Gross y Cassidy, 2024;Thuillard y Dan-Glauser, 2020). Esta estrategia cuando se emplea con frecuencia puede generar un efecto rebote, intensificando las emociones que se intentan reprimir (Kaplow et al., 2014); así como presentar activación fisiológica y conductual ante estímulos emocionales (Gross y Levenson, 1993). ...
... No obstante, cuando las estrategias se utilizan de manera disfuncional, como sucede con el uso reiterado de la SE, pueden generar respuestas poco funcionales (Hervás y Vázquez, 2006), lo que reduce la capacidad para gestionar adecuadamente las emociones (Gross y John, 2003). Según, Kaplow et al. (2014), el uso frecuente de la SE como estrategia de afrontamiento incrementa significativamente la probabilidad de presentan conductas suicidas, lo que indica que esta forma de afrontamiento puede aumentar la vulnerabilidad emocional en los adolescentes. ...
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... Conventional views of masculinity often discourage men from expressing emotions and showing vulnerability, leading to repressed feelings that may contribute to mental health problems. 90 Furthermore, our findings indicated that a high proportion of male students reported inadequate sleep and relatively high screen time. These specific stressors, combined with societal expectations, likely contribute to the increased levels of anxiety and depression observed among male students in our study. ...
... This may be attributed to male students facing academic stress and societal pressures related to masculinity, which increase their risk by discouraging emotional expression and leading to repressed feelings that negatively impact mental health. [88][89][90] The study also identified a significant association between personal income and mental health, showing that students with lower incomes reported higher levels of anxiety and depression compared with their higher-earning peers. ...
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... Many participants noted the harmful impact distraction activities had on their health and wellbeing outcomes over time in line with previous studies which found that suppressing emotions increases the risk of future psychological distress (e.g. Glyshaw et al., 1989;Kaplow et al., 2013;Shapiro et al., 2012). ...
... This means that a higher level of AD among the participants is associated with a decreased level of PF. This result could be explained by the fact that adaptation is the key end result of emotional suppression [25][26][27], though this can lower PF in people who have experienced a difficult condition [22,41,42]. Emotional suppression is a strategy in which a person consciously cancels emotion-expressive behavior to keep out distressing or overwhelming feelings [43,44]. ...
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... During adolescence, adolescents undergo a series of special changes in both their body and mind, and they also experience many novel maladaptive features regarding personality and social development, such as a sudden increase in worries and a possible entry into a state of depression (Millar et al., 1993;Kaplow et al., 2013). With anxiety being a common problem, there is no clear definition of anxiety in academic fields; however, it is generally believed that anxiety is an unpleasant state accompanied by physical activation of fear and anxiety, which usually includes efforts and expectations to avoid danger and threats, as well as a sense ...
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