Cognitive Factors Related to Suicidal Ideation and Resolution in Psychiatrically Hospitalized Children and Adolescents

• Published in: The American journal of psychiatry Vol. 157; no. 12; pp. 2017 - 2021
• Main Authors: Wagner, Karen Dineen, Rouleau, Mark, Joiner, Thomas
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01.12.2000; American Psychiatric Association
• Subjects: Adolescent; Adult and adolescent clinical studies; Attributional style; Biological and medical sciences; Child; Child clinical studies; Children; Children & youth; Cognition & reasoning; Cognition - classification; Cognitive aspects; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Emotions; Female; Hospitalization; Hospitals, Psychiatric; Humans; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - psychology; Miscellaneous; Personality - classification; Personality Inventory - statistics & numerical data; Psychiatric Status Rating Scales - statistics & numerical data; Psychiatric units; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Concept; Self image; Suicidal ideation; Suicide; Suicide - psychology; Suicides & suicide attempts; Surveys and Questionnaires; Teenagers; Human; Psychiatric hospital; Hospital discharge; Attitude; Hope hopelessness; Hospital admission; Prediction; Cognition; Attribution; School age; Treatment; Follow up study; Adolescent; Mental disorder; Self esteem; Clinical investigation; Diagnosis; Cognitive style; Suicide ideation; Child; Comparative study
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.157.12.2017

OBJECTIVE: This study was conducted to determine whether there are changes in the cognitive factors of attributional style, hopelessness, and self-esteem when suicidal ideation fades in psychiatrically hospitalized children and adolescents. METHOD: The cognitive factors of attributional style, hopelessness, and self-esteem were assessed in subjects aged 7-17 years (50 with and 50 without suicidal ideation) at admission and discharge from a psychiatric hospital. RESULTS: For subjects with suicidal ideation, attributional style became significantly more positive and hopelessness was decreased from admission to discharge, by which time suicidal ideation had faded. There was no association between self-esteem and suicidal ideation after control for depression. These changes in cognitive factors were not seen in the group without suicidal ideation. There were no significant differences between children and adolescents in the pattern of results. CONCLUSIONS: Change in attributional style was shown to be a factor significantly related to the resolution of suicidal ideation in children and adolescents. This cognitive style could be specifically addressed in psychotherapy with depressed children and adolescents as a means of reducing suicidal ideation. These results may have an implication for reducing the length of psychiatric inpatient stays.