How Do Cognitive Distortions and Substance Related Problems Affect the Relationship Between Child Maltreatment and Adolescent Suicidal Ideation?

Abstract

The present study, informed by the cognitive-behavioral theory of suicide, is among the first studies to examine cognitive distortions and substance related problems as potential mediators and moderators of the relation between child maltreatment (CM) and suicidal ideation (SI) in adolescent psychiatric inpatients. The sample included 185 adolescents (71.4% female; 84% White) admitted to a psychiatric inpatient unit. Participants completed self-report measures assessing cognitive errors, negative cognitive triad, substance related problems, and SI. Participants and their parents completed a semi-structured diagnostic interview assessing CM history. In this clinical sample, we found that child maltreatment was associated with suicidal ideation only for youth with current substance abuse problems, indicating moderation. Contrary to predictions, substance related problems did not mediate the association between child maltreatment and adolescent SI. Further, cognitive errors and negative cognitive triad did not mediate or moderate the association between CM and SI. However, there were significant unique effects for both cognitive errors and negative cognitive triad on SI, suggesting that adolescents with more severe cognitive distortions report greater SI, regardless of CM history. Clinically, results suggest that practitioners should carefully screen for and address any substance misuse among victims of maltreatment to prevent clinically significant SI. Study results also suggest that interventions that incorporate cognitive restructuring may help decrease risk for severe SI in adolescent clinical samples in general.