Childhood sexual abuse moderates the mediating pathways connecting cognitive distortions and suicidal ideation among homeless youth.

Abstract

Cognitive distortions are conceptualized as one of the most potent predictors of suicide. However, little is known about the mediating and moderating mechanisms linking cognitive distortions and suicidal ideation. The present study examined a prospective moderated mediation model linking cognitive distortions and suicidal ideation, with drug use, social problem-solving, and perceived burdensomeness as the mediators and childhood sexual abuse as the moderator. Participants included 150 homeless youth who participated in a randomized clinical trial for suicide intervention. Participants were assessed at baseline, 3, 6, and 9 months post-baseline. We analyzed the data using a multiple-group path model. Findings showed that social problem-solving and perceived burdensomeness sequentially mediated the association between cognitive distortions and suicidal ideation regardless of childhood sexual abuse, whereas drug use mediated the association between cognitive distortions and suicidal ideation only among youth reporting no history of sexual abuse. Findings highlight how coping processes, both adaptive and maladaptive, operate differently to predict suicidal ideation contingent on the effects of childhood sexual abuse in the context of cognitive distortions. Findings also underscore the importance of addressing the effects of childhood abuse to facilitate the efficiency of interventions that seek to reduce suicidal ideation among a vulnerable population. Public Policy Relevance StatementFindings from this study suggest different coping processes that can be targeted in suicide prevention interventions for homeless youth. Further, it is important to understand and address the effects of childhood abuse in order to facilitate the efficiency of related suicide prevention interventions among a high-risk group of youth. aaa H igh rates of suicidal ideation and attempts have been observed among homeless youth, with national samples indicating that up to 68% of homeless youth report at least one-lifetime suicide attempt (Rotheram-Borus & Milburn, 2004;Yoder et al., 2010). Cognitive distortions, referring to distorted cognitive patterns of information processing that result in maladaptive behavior and emotions in the face of stressful situations (Alford & Beck, 1997), have been conceptualized as one of the most pernicious factors relevant to the development and maintenance of suicidal ideation and behaviors (Jager-Hyman et al., 2014;Joiner, 2005;Wenzel et al., 2009). Despite theoretical attention paid to cognitive distortions of suicidal individuals, empirical research This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

The relationship between social problem-solving and suicidal ideation and behavior in adults: A systematic review and meta-analysis.

“…Overall, findings suggest perceived burdensomeness and impulsivity are pathways linking social problem-solving to suicidal ideation (Gonzalez & Neander, 2018; Zhang et al, 2021a). Next, social problem-solving is a pathway through which cognitive distortions relate to suicidal ideation (Zhang et al, 2021b), and through which insomnia relates to suicidal ideation (Bozzay et al, 2016). In addition, the relationship between social problem-solving and suicidal ideation is stronger when emotional reactivity is high (Nezu et al, 2017), and the relationship between perfectionism and suicidal ideation is stronger when social problem-solving is poor (Chang, 2002).…”