Abstract
Suicide is the second leading cause of death in adolescents and suicide rates in this population have increased in recent years. A critical step in preventing suicide is improving the accuracy of suicide risk assessment. Measurement of suicidal cognitions typically emphasizes assessment of verbal thoughts about suicide. Recent research suggests, however, that suicidal mental imagery, or mentally imagining suicide-related content, may be even more strongly associated with suicidal behavior. No research has evaluated suicidal mental imagery in adolescents, however. The present study evaluated suicidal mental imagery and suicidal verbal thoughts in a sample of adolescents (N = 159) admitted to an adolescent psychiatric inpatient unit. Of those adolescents who reported suicidal cognitions, 63.73% reported suicidal mental imagery. Adolescents who reported suicidal mental imagery had 2.40 greater odds of having made a suicide attempt, after accounting for history of suicidal verbal thoughts and relevant covariates. Findings suggest that suicidal mental imagery should be directly assessed when evaluating suicide risk, and that treatments may be optimized by targeting both suicidal verbal thoughts and suicidal mental imagery.
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27 May 2021
A Correction to this paper has been published: https://doi.org/10.1007/s10802-021-00827-8
Notes
The p value was rounded up but did not exceed .05.
The upper end of the CI was rounded up but did not exceed 1.00.
Findings regarding participants who reported only suicidal verbal thoughts or only suicidal mental imagery should be interpreted with caution given the small sample sizes of these subgroups.
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Funding
This research was supported in part by an American Foundation for Suicide Prevention (AFSP) grant awarded to Dr. Lawrence (PDF-0–095-19), an AFSP grant awarded to Dr. Nesi (PDF-010517), and a NIMH T32 grant (MH019927) awarded to Dr. Burke. Any opinions, findings, and conclusions or recommendations expressed in this material are solely the responsibility of the authors and do not necessarily represent the views of AFSP or NIMH.
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The lead author designed the study. HL, TS, RL, JH, and JW contributed to material preparation and data collection. Data analysis were performed by HL and JN. All authors contributed to writing the manuscript and commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The Lifespan Hospitals Institutional Review Board (IRB) approved this research.
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This study was classified as a retrospective chart review; thus, the requirement for informed consent for use of this information in research was waived.
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The original online version of this article was revised: We notice an error in the 2nd author's first name which is misspelled (Jaqueline should be Jacqueline).
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Lawrence, H.R., Nesi, J., Burke, T.A. et al. Suicidal Mental Imagery in Psychiatrically Hospitalized Adolescents. Res Child Adolesc Psychopathol 49, 393–399 (2021). https://doi.org/10.1007/s10802-020-00750-4
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DOI: https://doi.org/10.1007/s10802-020-00750-4