Poster #64 - Poor Negative Emotion Differentiation Predicts Increased Desire for Suicide in Recently Hospitalized Youth

• In Event: 1-061 - Poster Session 02
  In Poster Session: PS 02 Section - Developmental Psychopathology

Integrative Statement

Suicidal thoughts and behaviors (STBs) are relatively rare in childhood but prevalence rates rise drastically during adolescence. The rise of STBs in adolescence coincides with significant changes in emotional development. Clarifying how changes in emotional development may contribute to increased suicide risk during adolescence would improve our understanding of the etiology of STBs and potentially suggest important targets for suicide prevention and intervention.

Recent research has shown that negative emotion differentiation, or the ability to distinguish currently experienced negative emotions from each other (e.g., anger, agitation, sadness; Barrett, Gross, Christensen, & Benvenuto, 2001), undergoes a curvilinear change from childhood to adulthood, with adolescence being typified by particularly weak abilities to differentiate specific negative emotions (Nook, Sasse, Lambert, McLaughlin, & Somerville, 2018). However, there is considerable variability in the emotion differentiation capabilities of adolescents (Nook et al., 2018). Because poor negative emotion differentiation is associated with deficits in emotion regulation abilities and is common in adolescents with mood disorders and borderline personality disorder traits (Starr, Hershenberg, Li, & Shaw, 2017; Zaki, Coifman, Rafaeli, Berenson, Downey, 2013), it may be useful to examine whether within-person changes in negative emotion differentiation (in addition to changes in the intensity of negative emotion) are related to increased risk for STBs. The current study examined whether fluctuations in negative emotion differentiation (i.e., the ability to differentiate anger, sadness, agitation, guilt, and nervousness) predict changes in desire for suicide, over-and-above the intensity of those specific emotional experiences.

The current study used ecological momentary assessment (EMA) to examine the trajectory of suicidal thinking in adolescents recently discharged from psychiatric hospitalization for severe suicide ideation or a suicide attempt. As part of a larger, ongoing study, fifteen participants (M age=14.54; SD=1.27; 61.5% female) completed an average of three random assessments each day for four weeks after hospital discharge. Participants completed an average of 84 EMA assessments, yielding an approximate total sample size of 1,260 for within-person analyses. Each assessment included measures of negative emotion (PANAS–short form; Mackinnon et al., 1999) and suicide desire (i.e., “How intense is your desire to kill yourself right now?” Kleiman et al., 2017). Negative emotion differentiation was operationalized as the average difference of negative emotion ratings from the highest rated negative emotion (Nook et al., 2018). A two-level hierarchical linear model was used to test hypotheses.

Daily decreases in negative emotion differentiation predicted daily increases in suicidal desire (b=-.12, SE=.06, p=.036), over-and-above changes in the intensity of each negative emotion. That is, the worse adolescents were in differentiating their negative emotions from day to day, the higher their reported desire to kill themselves. Increases in the intensity of sadness (b=.23, SE=.09, p=.018) and guilt (b=.12, SE=.04, p<.001) were the only emotional states to significantly predict increases in suicidal desire, controlling for the other emotions and negative emotion differentiation.

Findings suggest that, in addition to increases in the intensity of specific emotion states (especially sadness and guilt), reductions in adolescents’ negative emotion differentiation may be an important risk factor for suicidal thinking.

Authors

• Andrew C. Porter, University of Rochester
  Presenting Author

• Evan M. Kleiman, Rutgers University
  Non-Presenting Author

• Linda J. Alpert-Gillis, University of Rochester Medical Center
  Non-Presenting Author

• Catherine R. Glenn, University of Rochester
  Non-Presenting Author