Parents’ responses during conflict may predict suicidal thoughts in adolescent girls, study suggests

New research published in Development and Psychopathology suggests that how parents respond to their daughters during emotionally charged conversations may help identify who is at risk of developing suicidal thoughts. The study found that girls whose parents were less likely to reciprocate eye contact and happy facial expressions during conflict discussions were more likely to report suicidal ideation one year later.

Suicide is one of the leading causes of death among adolescents, and rates of suicidal thoughts and behaviors have been rising, especially among girls. While much is known about how feelings of social isolation, rejection, and family conflict contribute to suicide risk, the moment-to-moment dynamics of how people interact have received less attention. This study aimed to fill that gap by focusing on subtle, second-by-second behaviors during real interactions between parents and early adolescent girls.

The research was guided by a framework from the National Institute of Mental Health that encourages looking at basic behavioral processes, like how people communicate with one another. In particular, the team was interested in whether eye contact and facial expressions—key signals in social communication—could offer clues about future suicidal thinking. Prior studies have relied heavily on self-reports, which may miss nonverbal and unconscious behaviors. By analyzing actual interactions, the researchers hoped to capture more nuanced indicators of risk.

“Suicide is a leading cause of death for teens in the United States and rates of suicidality have dramatically increased in recent decades. Research shows that family and peer relationship factors can play a role in risk for suicidality,” said study author Kiera M. James, a research assistant professor at the University of Pittsburgh.

“However, most prior studies have looked at relationship factors broadly, using, for example, questionnaires that assess aspects of youths’ relationships globally. For this reason, we know less about the small, moment-to-moment (or second-to-second) ways that social interactions might contribute to youths’ risk for suicidality.”

“These fine-grained social interaction processes, like eye-gaze and facial expressions, play an important role in how close or connected youth feel to the person with whom they are interacting, which is important because social connectedness is a key protective factor for suicidality. Our goal was to examine how the exchange of eye-contact and facial expressions of happiness may differ during parent-child interactions in families in which the youth later experienced suicidal thoughts.”

The study involved 129 girls between the ages of 11 and 13 and their parents, who were participating in a larger longitudinal project on mental health. Most of the girls had temperamental traits that are known to increase the risk of depression, such as shyness and fearfulness. At the start of the study, each girl and her parent took part in a standardized task called the “Hot Topics” discussion, where they were asked to talk through a conflict they had recently experienced.

During the interaction, the researchers measured two key behaviors: how much time each person spent looking at the other’s eyes and how often they displayed happy facial expressions. Eye contact was measured using mobile eye-tracking glasses, and facial expressions were analyzed with facial recognition software. These data were collected and analyzed in one-second intervals, allowing the team to look at how one person’s behavior influenced the other’s in real time.

The girls’ suicidal ideation was assessed at the start of the study and again 12 months later using a questionnaire that asked how often they had certain thoughts, such as “life is not worth living” or “thought about killing myself.” While none of the participants reported active suicidal intent or planning at the time of the study, a small portion reported suicidal thoughts during the follow-up.

Using statistical models that account for how behaviors influence each other within dyads, the researchers found that in pairs where parents were less likely to return their daughter’s eye contact or reciprocate her expressions of happiness, the girls were more likely to report suicidal thoughts one year later. This pattern held even after accounting for symptoms of depression and anxiety. Importantly, these effects were specific to future suicidal ideation—there was no link between the parent-child communication patterns and whether a girl had suicidal thoughts at the start of the study.

The findings suggest that social communication during emotionally stressful interactions might serve as an early behavioral signal of suicide risk. Reciprocal behaviors—such as returning eye contact or mirroring a smile—are thought to foster feelings of connection and trust. When these responses are absent during conflict, adolescents may feel emotionally disconnected from their parents. This sense of disconnection could, over time, contribute to a greater risk of suicidal thoughts.

Interestingly, the researchers also found that among girls who went on to experience suicidal ideation, their parents tended to sustain their own happy expressions more during the conflict. While at first this might seem like a positive sign, it may actually indicate a mismatch in emotional tone—where a parent’s smiling expression is not responsive to the emotional needs of the child, potentially reinforcing feelings of misunderstanding or rejection.

“Our findings suggest that parental effort to match their child’s body language (like eye-contact and positive facial expressions) really matters during parent-child interactions,” James told PsyPost. “Youth whose parents were less likely to reciprocate their efforts to make eye-contact – or exchange a smile – were more likely to report higher levels of suicidality a year later.”

The study’s strengths include its use of real, naturalistic interactions rather than simulated tasks or hypothetical scenarios. The fine-grained analysis of second-by-second behaviors allowed the researchers to detect subtle patterns that would be missed by broader measures. The researchers also controlled for other factors like symptoms of anxiety and depression to isolate the effects of eye-gaze and facial affect.

But as with all research, the study has limitations. The number of girls who reported suicidal ideation at follow-up was small, which means that the findings should be interpreted cautiously until replicated in larger samples. The measure of suicidal ideation did not assess plans or intent, so the results may not extend to more severe forms of suicidality. Additionally, the study included only girls, so it remains unknown whether similar patterns would be found in boys.

“The youth in this study were not recruited to be at high risk for suicidality,” James noted. “Consequently, the number of participants who reported suicidal thoughts over the course of the study was small. Our findings should, therefore, be considered preliminary. However, with support from the American Foundation for Suicide Prevention, I am currently conducting another study aimed at replicating and extending these findings in a larger and higher risk sample of teens.”

“The long-term goal for my research in this area is to determine how to improve and sustain beneficial social connection processes, which may be crucial to reducing suicidality during adolescence and into adulthood. Ultimately, beneficial social connection processes, like eye-contact or the exchange of smiles, may prove to be promising treatment targets to reduce risk for future suicidality in youth. These efforts may also enhance the ability to savor moments of connectedness.”

The study, “Girls with higher levels of suicidal ideation experienced less parental reciprocity of eye-contact and positive facial affect during conflictual interactions: A pilot study,” was authored by Kiera M. James, Aleksandra Kaurin, Amelia Lint, Samantha Wert, Kirsten M. McKone, Emily A. Hutchinson, Rebecca B. Price, Cecile D. Ladouceur, and Jennifer S. Silk.