Family risk factors for child and adolescent suicidal behavior.

In this review, the author evaluates the empirical support for the claims that various aspects of family dysfunction are risk factors for completed suicide or suicidal symptoms in childhood or adolescence. There is consistent evidence that a history of physical or sexual abuse is a risk factor and some evidence for other risk factors, including poor family or parent-child communication, loss of caregiver to separation or death, and psychopathology in first-degree relatives. However, the researchers of the vast majority of studies did not attend to whether the putative risk factors preceded the development of suicidal symptoms; thus, most of the claims regarding family risk factors are not justified by their research designs and findings.