Family-related risk and protective factors for suicidal ideation in individuals with schizophrenia spectrum disorders.

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Suicide is the leading cause of premature death among those with schizophrenia (Palmer, Pankratz, & Bostwick, 2005). Although preventable, it has been challenging to identify risk factors. Many individuals with schizophrenia cannot live independently (National Alliance on Mental Illness, 2008) as 62% of individuals living with schizophrenia are either living in hospitals, nursing homes, supervised living facilities, jail, or with a family member (Comer & Comer, 2018). Moreover, 63% of people living with schizophrenia report having received financial support from family members, and 50% have relied on family for housing (Awad & Voruganti, 2008). Given the reliance on family for instrumental and emotional support, the present study assessed relationships between suicidal ideation (measured with the Brief Psychiatric Rating Scale; Ventura, Green, Shaner, & Liberman, 1993) and family-related factors including expressed emotion (measured with the Five-Minute Speech Sample; Magaña et al., 1986) and family cohesion (measured with the Family Environment Scale; Moos & Moos, 1994). Using a sample of 100 patients with a schizophrenia spectrum disorder and their caregivers, results supported hypotheses by indicating that greater family cohesion was associated with less suicidal ideation and greater caregiver criticism was associated with greater suicidal ideation. However, family cohesion was fully mediated through general emotional distress (measured with the depression, anxiety, and stress scale; Lovibond & Lovibond, 1995), whereas caregiver criticism was not. These results highlight the potential protective and exacerbating role that caregivers may play in whether individuals with schizophrenia spectrum disorders endorse suicidal ideation. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

Original languageEnglish (US)
Pages (from-to)537-544
Number of pages8
JournalProfessional Psychology: Research and Practice
Issue number6
StatePublished - 2020


  • expressed emotion
  • family cohesion
  • schizophrenia
  • suicidal ideation

ASJC Scopus subject areas

  • Psychology(all)


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