Citation

Herpers PCM, Neumann JEC, Staal WG. Tijdschr. Psychiatr. 2020; 62(4): 283-290.

Copyright

(Copyright © 2020, Uitgeverij de Tijdstroom)

DOI

unavailable

PMID

32388850

Abstract

Suicidality in adolescence is increasingly becoming a societal problem, especially because there remains a small group of patients in which treatment effectiveness is small. Existing formal guidelines often are of limited value in this group that often shows complex comorbidity.
AIM: To contribute to the diagnostic and aetiological perspective in order to better understand therapy refractory internalising behaviour.
METHOD: Integration of several scientific theoretical concepts into a holistic model.
RESULTS: Evidence shows that suicidality should be considered within a broader scope of therapy refractory internalising behaviour. Important underpinnings comprise a partially overprotective parenting style, disturbed attachment processes and social anxiety. Internalising and externalising behaviour problems are viewed as expressions of avoidance behaviour. Furthermore, we discuss important implications for treatment.
CONCLUSION: Applying an aetiological model for therapy refractory internalising behaviour may help to increase efficacy of treatment. Thus, transdiagnostic treatment can be offered, being less dependent on specific dsm-classifications. Focus of treatment is on restoration of basic trust between the youngster and his parents, and on ending avoidance behaviour that is based on social anxiety.

Language: nl

Keywords

Humans; Adolescent; Suicide; Parenting; Parents; Comorbidity; Problem Behavior