Social Communication, Connectedness, and Suicidal Thoughts and Behaviors in Adolescent Girls

In the United States, suicide is the second leading cause of death among adolescents aged 13-17 and rates of suicide are rising, particularly among girls. Critically, rates of serious suicidal thoughts and behaviors (STB) among girls are even higher. Both theory and empirical research suggest that social factors play a putative role in risk for suicide among youth. Moreover, prior research implicates social communication – facial and non-facial cues exchanged during social interaction – in these social factors related to STB (e.g., connectedness). Yet, research examining fine-grained neurobehavioral processes involved in social communication during interaction is extremely limited. The goal of this proposal, therefore, is to take a multiple-units-of-analysis approach to examine adolescent girls’ social communication during actual social interactions, and determine the extent to which alterations in neurobehavioral processes involved in social communication directly and independently contribute to girls’ subsequent (i) day-to-day social connectedness and (ii) STB. An additional, exploratory aim will be to examine the extent to which these neurobehavioral processes indirectly impact girls’ STB through their effects on day-to-day social connectedness. Neurobehavioral processes in the proposed study will include adolescents’ and parents’ eye-gaze and facial affect, which will be assessed using Tobii mobile eye-tracking glasses and FaceReader during a standardized, laboratory-based interaction paradigm involving positively- and negatively-valenced parent-adolescent discussions. Thus, this proposal will examine the extent to which girls from parent-adolescent dyads who demonstrate disrupted social communication (i.e., reduced eye-gaze and positive facial affect reciprocity; attenuated gaze-contingent positive facial affect responses) are less likely to exhibit future day-to-day social connectedness with their parents and peers (Hypothesis 1). Next, this proposal will examine the extent to which girls from dyads who demonstrate disruptions in the same neurobehavioral processes will be more likely to report higher levels of future STB (Hypothesis 2). Finally, exploratory analyses will examine day-to-day social disconnectedness as a potential mechanism through which deficits in social communication increase girls’ STB. Participants for the proposed study will be girls (aged 12-17) drawn from a longitudinal R01 grant, involving a baseline diagnostic interview, follow-up ecological momentary assessment of day-to-day social connectedness five weeks later, and STB assessments 6 and 12 months after baseline. As a part of the current proposal, participants and their parents will also complete a laboratory-based parent-adolescent interaction task at baseline involving multimodal assessment (i.e., eye-gaze and facial affect). The final sample size will comprise 177 dyads. 75% of the sample (N = 133) will be at high-risk for suicide based on one or more of the following: (a) recurrent suicidal ideation within the past 6 weeks, (b) five or more episodes of NSSI in past year, or (c) suicide attempt in past year. This type of nuanced, integrative research is essential to the identification of mechanisms of risk (e.g., barriers to social connectedness) that can be therapeutically targeted in prevention and intervention efforts to reduce STB during key windows of risk. This research is also crucial to determine how to improve and sustain beneficial social connection processes to reduce STB during adolescence and into adulthood.