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ViewAttendees 3

Symposia

Suicide and Self-Injury

Session: Longitudinal Predictors of Self-injurious Thoughts and Behaviors Among Clinical Populations Across the Lifespan

1 - (SYM 39) Adolescent Social and Generalized Anxiety Disorder Symptoms as Predictors of Suicidal Ideation: Longitudinal Mediation Modeling

Friday, November 17, 2023
2:30 PM – 4:00 PM PST
Location: Skykomish (604), Level 6
Research indicates that anxiety and suicidal ideation (SI) are positively related in adolescents (Hill et al., 2011; Covert & Friare, 2019). However, many questions remain as to the directionality of the relationship, whether specific anxiety disorders may be uniquely related to SI, and what mediators may exist to explain this relationship. Joiner’s Interpersonal Theory of Suicide suggests that thwarted belongingness (TB) and perceived burdensomeness (PB) lead to SI (Joiner, 2005); these constructs may explain a pathway through which anxiety and SI are related. It has been theorized that social anxiety disorder (SAD) symptoms, such as social avoidance and difficulty maintaining social relationships, lead to TB, which in turn, precipitates SI (Covert & Friare, 2019; Herres et al., 2019). Additionally, it is possible that youth with the chronic and persistent worry of generalized anxiety disorder (GAD) may grow to fear that their anxiety-related difficulties and treatment needs are a burden on others (Hill et al., 2017); this PB may then lead to SI. We hypothesized that TB may specifically mediate the relation between SAD symptoms and SI, and PB may specifically mediate the relation between GAD symptoms and SI. Participants included 147 youth (Mage = 14.91, 76.2% female, 85.5% White) in a larger randomized controlled trial (RCT) which recruited high risk adolescents hospitalized for severe SI or a suicide attempt. Participants completed self-report measures of current anxiety symptoms (SCARED; including SAD and GAD symptom subscales), PB/TB (INQ), SI severity (SIQ-JR), and depressive symptoms (CDI-2) at baseline, 6 months, and 12 months. Two path models were run in Mplus, with PB as a single mediator of the relation between SAD symptoms and 12-month SI, and TB as a single mediator of the relation between GAD symptoms and 12-month SI. Covariates included age, sex, treatment condition and baseline SI severity, depressive symptoms, and PB or TB. TB at 6-months did not significantly mediate the relation between baseline SAD symptoms and 12-month SI severity. There was also not a direct effect of baseline SAD or GAD symptoms on 12-month SI severity. However, 6-month PB mediated the relation between baseline GAD symptoms and 12-month SI severity. Findings suggest that PB may be an important mechanism underlying the relation between GAD symptoms and SI maintenance, whereas baseline SAD symptoms may not be related to TB. Findings suggest that interventions addressing feelings of PB in youth with significant GAD symptoms may help reduce suicide risk.