Symposium 18 - Understanding Cognitive and Affective Processes in Adolescents at High Risk for Suicide During Clinical Transition Periods

Chair(s)

• RS

  Rachel Siciliano, M.S. (she/her/hers)

  Clinical Psychology Graduate Student
  Vanderbilt University Medical Center
  Nashville, Tennessee

Discussant(s)

• RL

  Richard Liu, Ph.D. (he/him/his)

  Associate Professor
  Massachusetts General Hospital, Harvard Medical School
  Boston, Massachusetts

Presenter(s)

• RS

  Rachel Siciliano, M.S. (she/her/hers)

  Clinical Psychology Graduate Student
  Vanderbilt University Medical Center
  Nashville, Tennessee
• NP

  Neha Parvez, M.A.

  PhD Student
  Queen's University
  Kingston, Ontario, Canada
• LV

  Lisa Venanzi, M.Ed. (she/her/hers)

  Vanderbilt University
  Nashville, Tennessee

Suicide is a leading cause of death for youth and rates of suicide attempts and associated psychopathologies (e.g., depression) are increasing (CDC, 2020). Despite the attention that the increased prevalence of suicidal thoughts and behaviors (STBs) has received, little progress has been made in understanding the etiology of STBs and in effective treatment of STBs among adolescents (Fox et al., 2020). Adolescents at high-risk for STBs often present to inpatient and partial hospital level treatment, and are at elevated risk for STBs in the months following intensive psychiatric treatment (Yen et al., 2013; Czyz et al., 2018). Understanding factors that contribute to risk and wellbeing during this period is needed to inform best clinical practices and reduce risk for suicide and rehospitalization. This symposium highlights novel research findings of cognitive and affective processes in adolescents during a critical clinical transition period.  

First, Rachel Siciliano will present findings from an ecological momentary assessment study examining emotional responses in parents and adolescents following psychiatric hospitalization for STBs. Results show that parents accurately report their teen's sadness, anger, happiness, and excitement during this high-risk period, yet were not attuned to their teen’s reports of anxiety and hopefulness. She will discuss and integrate findings of parental attunement with integration of parents in cognitive behavioral interventions to provide support, monitoring, and modeling of adaptive emotion regulation to youth during this high-risk period. Second, Neha Parvez will present findings from a study of recently hospitalized adolescents assessing the contributions of rumination and access to emotion regulation strategies to suicidal ideation severity. Findings highlight that lower access to emotion regulation strategies was associated with greater suicidal ideation and will include prospective analyses. Third, Lisa Venanzi will present novel research demonstrating how neural responsiveness to reward improved the classification of STBs beyond clinical and self-report measures in adolescents following hospital discharge. Results suggest reward responsiveness may help to differentiate adolescents with suicide attempt histories from those with suicidal ideation history only, and could be an important target for monitoring risk following hospitalization. She will describe efforts to integrate feasible and economical assessments of brain function to improve psychiatric treatment. Dr. Richard Liu, an expert in adolescent suicide and depression risk processes, will serve as the symposium discussant and facilitate conversation about next steps in this research and applications to suicide prevention efforts.  

Consistent with the conference theme, these presentations underscore the importance of identifying factors that may be associated with both positive and negative outcomes in adolescents vulnerable to STBs. Together, this diverse group of presentations will provide important insight into relevant cognitive and emotional processes in adolescents and can directly inform novel approaches to cognitive-behavioral interventions during a high-risk clinical transition period.