(PS13-42) The Impact of Impulse Control Difficulties on Suicidal Ideation in Youth

During 2019, approximately eighteen-point eight percent of youths nationwide reported having serious suicidal ideations (SI), with eight-point nine percent attempting suicide (Ivey-Stephenson et al., 2020). Studies have shown that there is a connection between difficulty regulating emotions and suicidality (Klonsky & Muehlenkamp, 2008). One important component of emotion regulation is impulse control, which is defined as having difficulty remaining in control of one’s behavior when experiencing negative emotions (Hallion et al., 2018). Impulse control difficulties may be associated with increased self-harm and suicide attempts (Lockwood et al., 2017), but less is known about how it might influence SI. Further, less is understood about what could be contributing to difficulties with impulse control in youth, and if parent distress tolerance (DT) could play an influential role. The current study examined: 1) if child impulse control was a predictor of child SI, 2) if parent DT was a predictor of child SI, 3) if parent DT had an effect on child impulse control, and 4) if parent DT was a moderating factor between child impulse control and child SI. 

A total of 80 youth (Mage = 13.70, sd = 2.25; 66.3% female) and their caregivers completed assessments during intake procedures of an RCT evaluating treatments for anxiety and depression in youth. Youth met criteria for either a principal DSM-5 anxiety-based (GAD, SOC, SEP, PD, OCD) or depressive (MDD, PDD, Dep NOS) disorder. Measures included child ratings of the impulse control subscale of the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004), parent ratings of the Distress Tolerance Scale (DTS; Simons & Gaher, 2005), and item 13 (suicidal ideation) of the Children’s Depression Rating Scale (CDRS; Poznanski & Mokros, 1996).  

Hierarchical regression analysis showed that poor impulse control significantly predicted higher SI (β = .075, SE = .034, p = .033). Poor parent DT was not significantly associated with high child SI (p > 0.05), nor was it significantly associated with greater child impulse control difficulties (p > 0.05). However, the interaction between child impulse control difficulties and parent DT approached significance (β = .006, SE = .003, p = .067) in predicting child SI severity, which warrants further exploration.  

Contrary to expectations, parent DT did not significantly predict youth impulse control or SI risk. Instead, child impulse control difficulties emerged as a critical predictor of child SI. This finding suggests that youth who have a harder time coping with negative emotions may experience SI at a higher degree. Targeting these difficulties in intervention may be crucial to preventing SI risk in youth. Additionally, hierarchical regression analyses underscore the importance of further exploring the interaction between parent DT and child impulse control in affecting youth SI severity. Their interaction may suggest a need for a more integrated approach to treatment, leading to earlier and more effective intervention.