Cognitive factors related to suicidal ideation and resolution in psychiatrically hospitalized children and adolescents

Objective: This study was conducted to determine whether there are changes in the cognitive factors of attributional style, hopelessness, and self-esteem when suicidal ideation fades in psychiatrically hospitalized children and adolescents. Method: The cognitive factors of attributional style, hopelessness, and self-esteem were assessed in subjects aged 7-17 years (50 with and 50 without suicidal ideation) at admission and discharge from a psychiatric hospital. Results: For subjects with suicidal ideation, attributional style became significantly more positive and hopelessness was decreased from admission to discharge, by which time suicidal ideation had faded. There was no association between self-esteem and suicidal ideation after control for depression. These changes in cognitive factors were not seen in the group without suicidal ideation. There were no significant differences between children and adolescents in the pattern of results. Conclusions: Change in attributional style was shown to be a factor significantly related to the resolution of suicidal ideation in children and adolescents. This cognitive style could be specifically addressed in psychotherapy with depressed children and adolescents as a means of reducing suicidal ideation. These results may have an implication for reducing the length of psychiatric inpatient stays.