(PS4-A11) The Importance of Emotion Regulation Strategies on Suicide Ideation in Depressed and Anxious Youth

Growing evidence suggests a link between emotion regulation difficulties and suicide ideation and behavior. Several studies cite that adults and adolescents who have difficulty regulating their emotions report greater suicide ideation and attempts than those who do not have difficulty with emotion regulation (Colmenero-Navarrete et al., 2022). However, less is known about what specific aspects of emotion regulation difficulties predict suicide ideation. Are difficulties in impulse control, awareness of emotions, acceptance of emotions, emotional clarity, access to emotion regulation strategies, or initiation of goal directed-behaviors all predictive of suicide ideation? Or does one aspect act as a stronger predictor? This study is a secondary analysis of data collected from an RCT evaluating treatments for anxiety and depression in youth.

137 youth, ages 9-17, and their caregivers completed a diagnostic assessment that included the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) which contains 6 sub scales: non acceptance of emotional responses, difficulty engaging in goal-directed behavior, impulse control difficulties, lack of emotional awareness, lack of emotion clarity, and limited access to emotion regulation strategies. Suicide ideation was measured by item 13 of the Children’s Depression Rating Scale Revised (CDRS-R; Poznanski & Mokros, 1996). Of the 137 youth, 35 reported a score of 3 or more on the CDRS-R, indicating suicide ideation.

Two multiple regressions were conducted regressing SI on either DERS total score or the six subscales. DERS total score was positively associated with SI, 𝑅2 = 0. 130, 𝐹 (1, 135) = 20. 236, 𝑝 < . 001 . The overall model of the six DERS subscales
was positively associated with SI, 𝑅2 = 0. 205, 𝐹 (6, 130) = 5. 575, 𝑝 < . 001.The subscales: limited access to emotion regulation strategies, β = 0. 98, 𝑝 = . 002, and impulse control difficulties, β = − 0. 066, 𝑝 = . 031, were significantly associated with SI, while the four remaining subscales were not significantly associated with SI. Limited access to emotion regulation strategies was the strongest predictor of suicide ideation within the DERS subscales.

Preliminary analyses indicate that difficulties in emotion regulation significantly predict suicide ideation in adolescents. Limited access to emotion regulation strategies was the strongest predictor in our sample, suggesting that poor emotion regulation strategies is a risk factor for SI. One limitation in our study included methodological procedures related to CDRS-R screen-outs and the focus on outpatient treatment-seeking youth. Recruiting from more intensive treatment settings may help provide a greater range of SI to review. Overall, findings suggests that limited access to emotion regulation strategies increase the risk of suicide ideation. For mental health and educational providers, teaching emotion regulation strategies such as cognitive reappraisal may be an effective and promising way to decrease suicide ideation in anxious and depressed youth.