Sex and age moderate the trajectory of guilt among children and adolescents with and without recent suicidal ideation

ABSTRACT

We aimed to examine whether the trajectories of ecologically derived guilt differ among a transdiagnostic sample of youth with and without recent suicidal ideation and whether sex and age moderated this association. We assessed guilt 3 times a day over a 2-week period via ecological momentary assessment (EMA) technology in 102 children recruited from the community, outpatient, and inpatient settings. The average age of children was 10.95 y.o. (SD = 2.26, range 8–16) and the majority were male (54.9%) and White (76.5%). We found that the real-world guilt during a two-week EMA period was higher among youth with greater suicidal ideation severity in the past six months. Moreover, there was a significant moderating effect of sex and age on this association, such that the association between suicidal ideation severity and guilt was particularly strong among females compared to males and youth who were 10 years old or older. The findings were maintained when we adjusted for the relevant demographic and clinical characteristics, including age, minority status, parental income, EMA response rate, and current internalising symptoms. These preliminary findings highlight the clinical relevance of assessing and targeting feelings of guilt in the day-to-day lives of youth, particularly for females and older youth.

KEYWORDS:

• Suicidal ideation
• guilt
• ecological momentary assessment (EMA)
• sex differences
• age differences

Acknowledgement

We would like to thank the children and families for participating in this study, without which this manuscript would not be possible. We further thank the PediMIND Program for their hard work and dedication.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This project was supported by National Institute of Mental Health grant R01MH111542 and K24MH110401 awarded to D.P. Dickstein, K23MH122587 awarded to A.Y. Kudinova, and T32 MH019927.