The Relations of Temperament and Emotion Self-regulation with Suicidal Behaviors in a Clinical Sample of Depressed Children in Hungary Zsuzsanna Tamás & Maria Kovacs & Amy L. Gentzler & Ping Tepper & Júlia Gádoros & Enikő Kiss & Krisztina Kapornai & Ágnes Vetró Published online: 25 May 2007 # Springer Science+Business Media, LLC 2007 Abstract Although major depressive disorder (MDD) is associated with suicidal behaviors, some depressed individuals are not suicidal and others evidence various forms of suicidality. We thus investigated whether aspects of tempera- ment and self-regulation of dysphoria represent risk factors for DSM-IV suicidality (recurrent thoughts of death, recurrent suicidal ideation, suicidal plan, and suicide attempt) in de- pressed youths. Using a sample of children with MDD (N = 407; ages 7–14 years), recruited from clinical sites across Hungary, we tested the hypotheses that: (a) suicidality is related to higher levels of trait negative emotionality as well as more maladaptive and fewer adaptive regulatory responses to dysphoria and (b) as the severity of suicidal behavior increases, levels of trait negative emotionality and dysfunc- tional emotion regulation also increase. We also explored if other aspects of temperament relate to suicidality. Children’ s DSM-IV diagnoses were based on semi-structured interviews and best-estimate psychiatric consensus. Parents indepen- dently provided ratings of their children’ s temperament, and children separately completed an inventory of emotion regulation (ER). Using multivariate models, we failed to confirm the hypothesized relations of negative trait emotion- ality and suicidality, but confirmed that high maladaptive and low adaptive ER response tendencies increase the odds of suicidal behaviors, above and beyond the risk posed by depressive illness severity. Unplanned interaction terms between temperament dimensions (other than negative emotionality) and ER suggested that at some high-extremes of temperament, ER has no impact on suicidality but in their absence, adaptive ER lowers the risk of suicidality. The practical implications of the findings are discussed. Keywords Temperament . Emotion regulation . Suicidal behaviors . Major depressive disorder . Children Suicidal behavior in children and adolescents has continued to receive considerable research attention, with particular interest in identifying clinically useful correlates as well as risk and vulnerability factors (for a review, see Bridge et al. 2006). Much of the past body of research has focused on the association of depression and suicidal behavior. Across diverse samples, such as those clinically referred (Haavisto et al. 2003; Kovacs et al. 1993; Myers et al. 1991a; Pfeffer et al. 1986) as well as those in the community (Bridge et al. 2006), findings have consistently shown that depressed children have high rates of suicidal behavior and that suicidal J Abnorm Child Psychol (2007) 35:640–652 DOI 10.1007/s10802-007-9119-2 Z. Tamás : J. Gádoros Vadaskert Hospital, Budapest, Hungary M. Kovacs University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA A. L. Gentzler : P. Tepper University of Pittsburgh Medical Center, Pittsburgh, PA, USA E. Kiss : K. Kapornai : Á. Vetró Department of Child and Adolescent Psychiatry, University of Szeged, Szeged, Hungary Z. Tamás (*) Vadaskert Kórház, Hűvösvölgyi út 116, Budapest 1021, Hungary e-mail: zsuzsa.tamas@chello.hu