Parent–Child Relationship Characteristics and Psychiatric Symptoms as Predictors of Passive Suicidal Ideation among Adolescents in Outpatient Substance Use Treatment

Abstract Adolescents with substance use disorders (SUDs) are at higher risk for negative outcomes including suicidal ideation (SI). This is due in part to high rates of comorbid psychiatric disorders among adolescents diagnosed with a SUD. Among adolescents, SI is a sign of psychological distress that may interfere with substance use treatment engagement and completion. Identification of factors that are significant predictors of SI among adolescents engaged in risky substance use can provide valuable information for customized treatment planning. The present study is a secondary analysis of data from a racially and ethnically diverse sample of 396 adolescents receiving outpatient substance use treatment services to identify predictors of SI. Hierarchical multiple regression analyses were conducted by entering variables sequentially in four blocks: (a) gender, (b) internalizing psychiatric symptoms, externalizing psychiatric symptoms, (c) drug abuse and dependence symptoms, alcohol abuse and dependence symptoms, and (d) negative parent relations, positive parent relations to determine the unique contribution of each block. This analysis revealed that internalizing psychiatric disorder symptoms, gender, and alcohol abuse and dependence symptoms were each significant predictors of mean SI scores. Overall, the results suggested that female clients entering substance abuse treatment may have higher levels of distress than male clients and require more careful screening. Additionally, tailored integrated treatment planning for clients with complex patterns of comorbid internalizing disorder symptoms and alcohol use disorder symptoms may lead to better overall treatment outcomes.