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.