Poster Session 05 Program Schedule
02/15/2024
02:30 pm - 03:45 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes
Final Abstract #92
Working Memory and Impulsivity Interact to Predict Suicidal Ideation: a Longitudinal Investigation of At-Risk Adolescents
Marissa Roth, Massachusetts General Hospital, Boston, United States
Kaitlin Lord, Massachusetts General Hospital, Boston, United States
Mary Colvin, Massachusetts General Hospital, Boston, United States
Richard Liu, Massachusetts General Hospital, Boston, United States
Category: Emotion Regulation
Keyword 1: depression
Keyword 2: inhibitory control
Keyword 3: working memory
Objective:
Cognitive control may play an important role in stabilization following psychiatric crises and predict future emotional functioning, including subsequent suicidal ideation (SI). Working memory and the tendency to favor immediate over future rewards (i.e., choice impulsivity) are two aspects of cognitive control that may be implicated, both for considering suicide and for implementing safety strategies. Understanding the connection between different aspects of neuropsychological functioning in relation to mental health outcomes is of critical importance for identifying patients that may benefit from more targeted or intensive intervention services prior to discharge. Here, we investigate whether two core aspects of cognitive control (working memory, choice impulsivity), assessed upon admission to an inpatient psychiatric unit, prospectively predict SI six months later in a sample of adolescents.
Participants and Methods:
Participants were 147 adolescents (72.1% female; age range = 12-17 years; M age= 14.88 ± 1.35 years) recruited from an inpatient psychiatric unit. Participants self-reported race was 82.3% White; 10.2% Black; 2.7% Asian; 4.8% Multiracial, and 17.7% Hispanic/Latinx. Working memory was assessed using the Letter-Number Sequencing task from the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV). Choice impulsivity was assessed with the Delay Discounting Task. Depression symptom severity was assessed using the Children’s Depression Inventory - Second Edition (CDI-2), with the SI item excluded from summed scores. SI was assessed with the Suicidal Ideation Questionnaire JR. All measures were administered at baseline and SI was assessed again six months post-discharge. The 6-month retention rate was 88.4%. All scores were z-transformed to aid in interpretability of effects. Linear regression was used to prospectively examine the main effects and interaction of working memory and choice impulsivity, assessed at baseline, on SI six months later. Adolescent age, sex, and baseline depression symptom severity were included as covariates.
Results:
While neither working memory nor choice impulsivity independently predicted SI six months later, the interaction between these two aspects of neurocognitive functioning prospectively predicted SI (β= 0.17, p<.05). Impulsive choice was more positively and more strongly associated with SI when working memory was high compared to when working memory was low. At or above 1.42 SD above the mean of working memory, the association between impulsivity and SI was significant (simple slope = 0.32, p<.05). As expected, among the covariates, depression symptom severity predicted SI six months later (β=0.42, p<.001).
Conclusions:
Findings suggest that working memory moderates the effect of choice impulsivity on SI such that impulsivity is more strongly (and positively) linked with SI when working memory abilities are higher. It is possible that SI relies partially on intact working memory skills that support goal-directed behavior. However, working memory skills may also be leveraged in safety planning interventions that support youth in identifying alternative thoughts and behaviors to keep themselves safe. Future directions include investigating associations between cognitive control and other aspects of suicidal thoughts and behavior (e.g., plans, impulsive versus non-impulsive attempts), and exploring whether cognitive control is an effective treatment target for reducing suicidal thoughts and behaviors in at-risk youth.
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