Theory of mind and suicide ideation and attempt in adolescent inpatients

Abstract

Background: Suicide ideation and attempt are alarmingly prevalent in adolescents, and even more so for youth in psychiatric settings. Interpersonal factors have been emphasized as important in the etiology and maintenance of suicide ideation and attempt in adolescents. Evaluating social cognitive deficits offers important insight into processes underlying interpersonal problems associated with suicide ideation and attempt; however little social-cognitive research has been conducted in this area. The aim of the current study was to explore the relation of theory of mind (ToM) impairments and suicide ideation and attempt among adolescent inpatients.

Methods: A sample of 391 adolescent inpatients completed measures on ToM, suicidal ideation and attempt, clinical symptoms and sociodemographics.

Results: Binary logistic regression analyses revealed significant relations between excessive ToM (hypermentalizing) and two suicide outcome variables (suicide ideation in the past four weeks, suicide attempt in the past year), while covarying for sociodemographics and multiple clinical symptom scales.

Conclusions: Excessive ToM, or over-attributing the mental/emotional states of others, appears to share a salient relation to recent suicidal thoughts and behavior in adolescent inpatients. Current findings may indicate that interventions incorporating social cognitive components (e.g., Mentalization Based Therapy and Cognitive Behavioral Therapy) may be of promise to treating youth with suicidal thoughts and behaviors and excessive ToM.

Limitations: The current study uses cross-sectional data and discrepancies exist in time periods assessed by primary measures.

Keywords: Psychiatric adolescents; Social cognition; Suicidal behavior; Theory of mind.