2 - (SYM 29) Social Problem-solving and Suicidal Behavior in Adolescent Girls: A Prospective Examination of Proximal and Distal Social Stress-related Risk Factors

Adverse social experiences are often linked to suicidal behavior (SB) in adolescents—perhaps particularly for girls, who are twice as likely as boys to attempt suicide (CDC 2019).  Social problem-solving abilities may indicate more or less adaptive responses to adverse social experiences that contribute to adolescent girls’ SB risk. While social problem-solving is implicated in cognitive and behavioral theories of SB, prior work is largely cross-sectional and examines bivariate associations between social problem-solving, assessed in neutral conditions, and SB. This study capitalized on performance-based paradigms and an objective life stress interview to assess state-dependent changes in social problem-solving and real-life interpersonal stress as predictors of SB.



Method: Using a novel performance-based task, social problem-solving behaviors were assessed before and after an experimentally-simulated social stressor in N=185 adolescent girls (M_age=14.66). Cross-sectional analyses examined proximal, stress-dependent changes in social problem-solving in relation to past-year SB. Prospective analyses tested whether greater declines in social problem-solving immediately following social stress predicted greater likelihood of SB over 9-month follow-up in contexts of elevated real-life interpersonal stress, assessed via contextual life stress interview.



Results: Adolescent girls showed significant declines in social problem-solving immediately following acute social stress exposure, t(181)=3.31, p=.001, d=0.25. Results revealed an interaction with past-year SB, F(1,180)=5.18, p=.02, such that this decline was specific to girls without past-year SB, p< .001. Consistent with cognitive-behavioral theories of SB, girls who showed greater changes (i.e., declines) in problem-solving effectiveness following acute social stress were more likely to exhibit SB over the following 9 months, but only if they also experienced elevated interpersonal stress in real life, OR=0.24, SE=0.57, p=.01.



Conclusion: State-dependent changes in social problem-solving may be a cognitive-behavioral vulnerability following social stress that, in combination with cumulative interpersonal stress in real life, distinguishes adolescent girls at greater risk for future SB. Findings highlight the importance of studying suicide risk factors under conditions that more closely mirror the interpersonal contexts in which adolescents’ SB risk may be elevated. Social problem-solving skills may be an effective target for SB prevention.