Negative affect and cognitive biases in suicidal and nonsuicidal hospitalized adolescents

Objective: To examine the main and interactive effects of suicidal behavior and gender on negative affect and cognitive biases in hospitalized adolescents (N = 228) aged 13 to 18 years, identified as suicide ideators (n = 68), attempters (n = 90), and nonsuicidal (n = 70). Method: Standardized measures of negative affect (depression, anxiety, anger) and cognitive biases (hopelessness, self-concept) were administered upon admission. Results: Suicide ideators reported significantly greater hopelessness and poorer self-concept than did nonsuicidal controls; suicide attempters did not differ from either group. Regression analysis indicated that negative affect and cognitive bias variables accounted for 48% of the variability in suicidal ideation; however, only anxiety and depression were uniquely related to suicidal ideation. Females reported greater depression severity and anxiety than did males; no interaction effects were evident. Conclusions: Suicide ideators and attempters may have different psychological profiles, with the former reporting greater cognitive biases than nonsuicidal adolescents. The findings regarding suicidal ideation support a mediational model in which negative views of the self and the future contribute to negative affect, and ultimately, suicidal ideation. An integrated assessment of suicidal ideation and affective and cognitive variables is recommended for early risk detection and treatment.