(SSCP1-3) SSCP Submission: The Impact of Age on Negative Emotion Dynamics and Suicidal Thoughts in High-risk Youth: Findings from a Real-time Monitoring Study

Rates of suicidal thoughts among adolescents have increased drastically over the past 10 years. Suicidal thoughts during adolescence are associated with significant impairment both concurrently and into adulthood. Most research to date has focused on distal risk factors for suicidal thoughts. Growing evidence points to the time-varying nature of suicidal thoughts over shorter time intervals, reflecting an imperative need to identify proximal risk factors. One promising proximal and developmentally relevant category of risk factor for suicidal thoughts in youth is negative emotion dynamics (i.e., intensity, variability of negative emotion states).

Prior research with adolescents demonstrates a trait-level association between heightened negative emotions and suicidal thoughts. However, far less is known about the state-level, real-time experiences of intense and frequent negative emotions, and how these experiences may be proximally linked to suicidal thoughts in adolescents. Furthermore, it is unclear if the proximal link between negative emotion dynamics and suicidal thoughts varies based on youth age, which may enhance our understanding of negative emotion dynamics as a developmental risk factor during adolescence—a sensitive developmental period. This poster will describe age-related associations between negative emotion dynamics and suicidal thoughts from a real-time monitoring study in a clinically high-risk sample of youth.

Adolescents (N=48, ages 12-18) completed ecological momentary assessments (EMA), 3-6 surveys daily, for 28 days following discharge from acute psychiatric care for suicide risk. Participants reported intensity of negative emotion states (nervous, sad, agitated, angry, and guilty) and suicidal thoughts via EMA multiple times per day. Negative emotion states were calculated as day-level aggregates of within-person metrics of worst-point intensity (mean of worst-point intensity of each emotion state) and variability (average of SD of each negative emotion state). Suicidal thought intensity was calculated as worst-point at the day-level. To test age-related associations between negative emotion dynamics and suicidal thoughts, multilevel modeling was used to examine age as a person-level moderator of the day-level within-person associations between negative emotion dynamics and suicidal thoughts. Results indicate that age significantly moderated the association between negative emotion intensity and suicidal thoughts (p< .001), and negative emotion variability and suicidal thoughts (p< .001). Specifically, the proximal association between negative emotion dynamics and suicidal thoughts was stronger among older adolescents.

Findings from this research provide novel insights about the age-related proximal associations between negative emotion dynamics and suicidal thoughts among high-risk youth. Among older youth, more intense and variable negative emotions (relative to each person’s own average) are linked to more intense suicidal thoughts that day. These findings enhance our understanding of developmental risk trajectories for suicidal thoughts during adolescence and help inform when targeted interventions may be indicated to reduce risk in vulnerable youth.