An Examination of Episodic Future Thinking and Episodic Memory Among Suicidal and Nonsuicidal Adolescents

Abstract

ABSTRACT Objective Suicidal individuals experience ambivalent states where they simultaneously consider death and the continuation of their lives. But we have little understanding of how suicidal individuals, particularly youth, mentally construct their future lives. To address this knowledge gap, we aimed to examine episodic future thinking and the related cognitive process of episodic memory among suicidal and nonsuicidal adolescents. Method We administered a performance-based measure of episodic future thinking to community-based adolescents (N = 176, 15–19 years; 69.3% female at birth, 57.1% identifying with a racial minoritized group) and examined the concurrent and predictive validity of details generated within an imagined future event in relation to suicidal ideation (SI; ranging from passive desire of wanting to be dead to active desire to kill oneself). Results Greater difficulty imagining discrete actions within an imagined positive future event was associated with past and subsequent SI, although these associations were largely accounted for by depressive symptoms. In contrast, greater difficulty imagining action-related details tied to either positive or negative future events predicted SI 6 months later controlling for symptoms of both anxiety and depression, SI history, and narrative style. Conclusions Findings from this study offer an initial glimpse into how suicidal adolescents imagine their future and may inform the design of interventions intended to promote a stronger desire for life than death.