Disrupted physiological reactivity among children with a history of suicidal ideation: Moderation by parental expressed emotion-criticism

- Physiological reactivity is critically involved in psychopathology among children.
- Impact of contextual factors on physiological reactivity in youth with SI is unclear.
- We found parental criticism moderates the link between child SI and RSA reactivity.
- The highest-risk children failed to engage the typical RSA suppression response.
- Findings suggest a specific physiological mechanism that may increase future risk.

ObjectiveThe goal of this study was to examine physiological reactivity during parent-child interactions in children with and without a history of suicidal ideation (SI), a group known to be at increased risk for suicidal thoughts and behaviors in the future. We also examined the potential moderating role of parental expressed emotion-criticism (EE-Crit) to determine whether the presence of parental criticism may help to identify a subgroup of children with a history of SI most at risk for physiological dysregulation.MethodParticipants were 396 children (age 7-11; 54% male, 71.7% Caucasian) and their biological parent. Children's levels of high frequency heart rate variability (HF-HRV) were assessed during a resting baseline period followed by a positive and negative discussion with their parent. Additionally, parents completed the Five-Minute Speech Sample to determine levels of EE-Crit toward their child, and children completed an interview assessing their history of SI.ResultsConsistent with our hypothesis, we found that exposure to parental criticism moderated the relation between a child's history of SI and their HF-HRV reactivity to the discussions. Specifically, while most children exhibited the typical pattern of HF-HRV suppression from baseline to both interactions, the highest risk children (i.e., children with a history of SI who also had highly critical parents) did not display any change in HF-HRV across the tasks, suggesting a failure to engage a typical psychophysiological response during emotional contexts.ConclusionsThese results suggest a specific physiological mechanism that may place these children at risk for suicidal thoughts and behaviors in the future.