5 - (SYM 29) Interpersonal Risk Factors for Suicidal Ideation Among Psychiatrically-hospitalized Adolescents with Psychosis-spectrum Conditions

Teens with psychosis-spectrum (PS) conditions are at markedly high risk for suicide. Social deficits are prevalent among these teens and associated with suicidal ideation (SI), suggesting that interpersonal stressors may be one pathway to suicide risk in this population. Social media (SM) use is a salient aspect of social functioning for youth, with feelings of exclusion and negative social comparisons possibly linked to PS experiences (e.g., paranoia, stigma) and SI, however, there is a dearth of research exploring these links.

Psychiatrically hospitalized teens (72 with PS conditions, 100 in the clinical comparison [CC] group) completed intake surveys that probed: SI (SIQ-Jr), family functioning (FAD-GF), peer support (PROMIS), mental health distress, and SM use, including frequency of negative SM interactions (e.g., feeling hurt, excluded, or negative comparisons). Social risk factors linked to SI were compared across groups (t-tests), and regressions explored associations between risk factors and SI.

The PS group had higher SI and distress, more frequent negative SM interactions, and lower family and peer support. Linear regression indicated that PS diagnosis, distress, peer support, and negative SM interactions were all significantly associated with SI. In the PS group, two symptoms were correlated with SI and negative SM interactions: paranoia and feelings of going crazy. A second regression tested a three-way interaction between paranoia, group, and negative SM interactions. The interaction (B=2.01, p< .05) was probed to explore associations between paranoia and SI at low, mean, and high levels of negative SM interactions across groups. Within the PS group, paranoia was significantly associated with SI only at high levels of negative SM interactions (B=2.67, p< .05). 

Findings indicate that teens with PS conditions have elevations in several interpersonal risk factors linked to SI. Although there was no difference in time spent using SM across groups, PS teens reported more negative SM interactions. It is possible that PS youth have more negative SM interactions than peers, perhaps in part due to social deficits, and it is also likely that these teens may have more negatively skewed perceptions due to paranoia and/or self-stigma. Among PS youth with more negative SM interactions, paranoia is linked to SI. This may suggest that negative SM interactions exacerbate distress related to paranoia and contribute to SI. This study highlights the importance of addressing interpersonal risk factors for suicide among teens with PS conditions.