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Although parental criticism within the\n                      <jats:italic>Expressed Emotion<\/jats:italic>\n                      (EE) framework has been linked to SI, the impact of a balance between positive and negative interaction remains understudied. This study introduces the\n                      <jats:italic>Positivity\u2010Negativity Difference of EE<\/jats:italic>\n                      (PND\u2010EE), investigates its relationship with SI, and examines whether dimensions of the\n                      <jats:italic>Interpersonal Theory of Suicide<\/jats:italic>\n                      (IPTS) mediate this relationship.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study included a combined clinical and population\u2010based sample of 46 adolescents (M\n                      <jats:sub>age<\/jats:sub>\n                      \u2009=\u200915.37, SD\n                      <jats:sub>age<\/jats:sub>\n                      \u2009=\u20091.37) and their mothers. Participants completed questionnaires assessing SI and the IPTS dimensions\n                      <jats:italic>Thwarted Belongingness<\/jats:italic>\n                      (TB) and\n                      <jats:italic>Perceived Burdensomeness<\/jats:italic>\n                      (PB). Mothers completed the\n                      <jats:italic>Preschool Five Minute Speech Sample<\/jats:italic>\n                      , which has proven suitable for assessing EE in adolescence. Simple and parallel mediation analyses were conducted using Hayes' PROCESS macro.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher PND\u2010EE was directly associated with lower SI in all analyses. Both TB and PB significantly mediated the effect of PND\u2010EE on SI in simple mediation analyses, but only PB remained statistically significant in the parallel mediation analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings highlight the potential of PND\u2010EE as a promising measure of EE in adolescents. Enhancing positive parent\u2010adolescent interactions and addressing TB and PB in clinical interventions may help reduce adolescent SI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/sltb.70089","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:02:44Z","timestamp":1774270964000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Expressed Emotion in Adolescent Suicidal Ideation: The Mediating Role of Thwarted Belongingness and Perceived Burdensomeness"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4380-7204","authenticated-orcid":false,"given":"Martina","family":"Preisig","sequence":"first","affiliation":[{"name":"Child and Adolescent Psychiatry and Psychotherapy Psychiatric University Hospital Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7428-7644","authenticated-orcid":false,"given":"Lukasz","family":"Smigielski","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry and Psychotherapy Psychiatric University Hospital Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"H\u00e4berling","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry and Psychotherapy Psychiatric University Hospital Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Rizk\u2010Hildbrand","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry and Psychotherapy Psychiatric University Hospital Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Semple","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry and Psychotherapy Psychiatric University Hospital Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-4458","authenticated-orcid":false,"given":"Michelle","family":"Roth","sequence":"additional","affiliation":[{"name":"Chair for Clinical Psychology for Children\/Adolescents and Couples\/Families, Department of Psychology University of Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Hess","sequence":"additional","affiliation":[{"name":"University Hospital of Child and Adolescent Psychiatry and Psychotherapy University of Bern  Berne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Hertel","sequence":"additional","affiliation":[{"name":"University Hospital of Child and Adolescent Psychiatry and Psychotherapy University of Bern  Berne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0031-7764","authenticated-orcid":false,"given":"Michael","family":"Kaess","sequence":"additional","affiliation":[{"name":"University Hospital of Child and Adolescent Psychiatry and Psychotherapy University of Bern  Berne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagmar","family":"Pauli","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry and Psychotherapy Psychiatric University Hospital Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Walitza","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry and Psychotherapy Psychiatric University Hospital Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor","family":"Berger","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry and Psychotherapy Psychiatric University Hospital Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.04.008"},{"key":"e_1_2_11_3_1","volume-title":"Cognitive Therapy and the Emotional Disorders","author":"Beck A. 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