1 - (SYM 18) Parental Attunement, Affect, and Emotion Regulation Following Their Adolescents' Psychiatric Hospitalization

Suicide is a leading cause of death for youth, and for every suicide death, there are four hospitalizations for attempts (CDC, 2018). After discharge, youth continue to report low mood, suicidal ideation (SI), and are at elevated risk for reattempts (Czyz et al., 2018). Parent conflict and negative emotionality are associated with youth suicide attempts (Greene-Palmer et al., 2015). Parents are also critical for support as youth transition out of acute care and often responsible for monitoring mood and safety. Parents’ ability to accurately monitor their child’s emotions, and the impact of their ability to self-regulate in this period is understudied. The present study assessed: (1) youth affect over time; (2) how attuned parents are in reporting their child’s affect; (3) associations between parent affect, emotion regulation, and child affect. Youth (N=21; M=15.25, SD=1.65; 73% cisgender, 7% transgender, 20% questioning/unsure) admitted to an inpatient or partial hospital program with past 30-day SI or attempt and their parents (N=21; M=45, SD=7.25; 81% female) completed a 14-day ecological momentary assessment protocol measuring affect and emotion regulation strategy use post discharge. Multilevel models included time, parent rated youth affect, parent self-reported affect, and parent emotion regulation as predictors of youth self-reported affect. Youth reported increased sadness (gamma=.10, p< .001) and decreased hopefulness (gamma=-.17, p< .001) over time. Parents were attuned to some of their child’s negative affect, including sadness (gamma=.15, p=.006) and anger (gamma=.14, p=.006), and positive affect, including happiness (gamma=.20, p< .001) and excitement (gamma=.12, p=.01), though did not accurately report anxiety (p=.08) or hopefulness (p=.86). Total parent emotion regulation use was unrelated to youth affect. By the symposium, the impact of parent’s specific emotion regulation strategies on their child’s concurrent and next day affect will be analyzed. Parental monitoring is essential for support and safety following acute care. Findings showed that parents are attuned to many of their child’s positive and negative emotional experiences following hospitalization. Yet, parents were not accurate reporters of their child’s anxiety and hopefulness, which may be related to distress during this time. Interventions supporting parents in emotional attunement and modeling effective emotion regulation skills may be helpful in reducing rehospitalization risk. Additional research in a large, diverse sample is needed.