Adolescents are contemplating and attempting suicide at alarming rates, constituting a public health crisis. To address this crisis, we must identify transdiagnostic and proximal risk factors for suicidal thoughts and behaviors (STBs) that can be modified in treatment. One such risk factor is social anhedonia, or reduced interest and pleasure in social interactions. Social anhedonia is associated with depression, social anxiety, and psychosis, all of which increase risk for STBs. Though a few studies have linked social anhedonia to STBs, limitations of this work are notable. First, social anhedonia is often assessed using one or two questions, which fails to realize the complexity of this construct. A more thorough assessment of social anhedonia is needed, particularly in relation to how youth experience social anhedonia in their daily social interactions. Moreover, little is known about how state versus trait levels of social anhedonia confer risk for STBs. Second, social anhedonia is most frequently studied in relation to suicidal ideation (SI); associations between social anhedonia and suicidal behaviors need to be established. Third, social anhedonia is typically studied in adults with SI; extension of this work to adolescents is critical. Social anhedonia may be particularly likely to confer risk for STBs during adolescence because social relationships are so salient during this developmental period.
The current study provides a thorough assessment of associations between social anhedonia and STBs in 50 adolescents (ages 14-16 years) recruited from a partial hospitalization program at Brown-affiliated Bradley Hospital. All participants will be recruited with clinically significant SI, and half of the sample will have a history of attempted suicide. We will assess how state and trait measures of social anhedonia are associated with SI, preparatory behaviors (e.g., writing a suicide note), and a history of suicide attempts. We will employ a multi-method assessment of social anhedonia, including a behavioral assessment of trait social anhedonia and a 14-day ecological momentary assessment (EMA) protocol to study social anhedonia in daily life (i.e., momentary social motivation, social engagement, and social reward experienced in daily interactions with peers).
The aims of this study are as follows: 1) Examine how state social anhedonia (i.e., social anhedonia in daily life) and trait social anhedonia are associated with STBs in adolescents, and 2) Investigate how interactions between state and trait social anhedonia confer risk for STBs. Importantly, both state social anhedonia and STBs are measured at multiple times each day (for two weeks) via EMA. This will allow us to examine whether higher social anhedonia increases risk for STBs throughout the day/week in the same individual. We hypothesize that higher state and trait social anhedonia will be associated with more frequent and severe STBs, and that youth with higher levels of both state and trait social anhedonia will be at highest risk for STBs. Finally, differences in social anhedonia between youth with and without a history of suicide attempts will be explored. Findings from this project may support the development of novel treatments (e.g., just-in-time interventions) that target social anhedonia in youth with STBs.
