2 - (SYM 18) Testing Relations Among Emotion Regulation, Rumination, and Suicidal Ideation Among Hospitalized Depressed Adolescents

Suicidal ideation (SI) surges in adolescence, and research has consistently demonstrated that emotion regulation (ER) deficits are implicated in suicide risk. A key component of ER is accessing effective strategies to modulate negative emotional states. Among adolescents receiving psychiatric treatment, a lack of access to ER strategies is cross-sectionally associated with a history of SI. Additionally, research suggests that rumination (i.e., repetitive negative thought patterns often pertaining to negative emotions) is associated with SI among youth and that greater emotion dysregulation is associated with a greater tendency to ruminate. While cognitive and affective factors often interact, it is less understood how a perceived lack of access to ER strategies may influence the relationship between rumination and SI among psychiatric adolescents. In the present study, we examined concurrent and prospective associations between rumination, access to ER strategies, and SI among hospitalized adolescents. We expect limited access to ER strategies and greater levels of rumination to be associated with SI, and for the association between rumination and SI to be stronger among adolescents with more limited access to ER strategies.

Our sample consisted of 61 adolescents (M_age = 15.83) who had been recently hospitalized for severe internalizing symptoms and/or safety concerns. All adolescents met criteria for Major Depressive Disorder. Adolescents’ perceived access to ER strategies was assessed using the Difficulties in Emotion Regulation Scale (DERS). Rumination in response to sad moods was measured using the Children’s Response Styles Questionnaire (CRSQ). Finally, SI severity was measured using the Scale for Suicidal Ideation (SSI).

Preliminary analyses revealed that as expected, lower scores on access to ER strategies were significantly associated with greater SI (β=.44, p= < .001, R²= .19). However, rumination was not concurrently associated with SI (β=.22, p= .12), and access to strategies did not significantly moderate the association between rumination and SI (β= .01, p= .96).  

Our preliminary analyses suggest hospitalized adolescents’ perceived lack of access to ER strategies are cross-sectionally implicated in the severity of SI. Additional analyses will explore prospective (1- and 3- month) associations between rumination, access to strategies, and the presence, frequency, and severity of SI, in addition to potential moderating effects of ER strategies.