Mentalization and Social Cognition in Adolescents After Suicide Attempt (MENTACOG-TS)

July 3, 2026 updated by: Assistance Publique - Hôpitaux de Paris

This study investigates the risk of violent suicide attempts in adolescents, with a particular focus on social cognition and sleep disturbances, to better understand the cognitive and behavioral mechanisms involved and to inform more targeted prevention strategies.

Violent suicide attempts are defined as the use of methods with a high immediate lethal potential. They are associated with distinct clinical profiles and specific risk factors, including an increased risk of recurrence and completed suicide.

Although the association between suicidal behavior and psychiatric disorders is well established, evidence regarding the underlying neurocognitive factors remains inconsistent. In particular, little is known about the role of social cognition in suicidal risk among adolescents. Research in this area is limited, leaving an important gap in our understanding of the cognitive processes that may contribute to the emergence of suicidal thoughts and behaviors during adolescence.

In addition, studies conducted in community-based adolescent cohorts have shown that insufficient sleep duration is independently associated with increased suicidal ideation and suicidal behavior, even after accounting for depressive symptoms.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This research examines violent suicide risk in adolescents through the study of social cognition and sleep disturbances, with the aim of clarifying the cognitive and behavioral mechanisms involved and informing more targeted prevention strategies. Violent suicide attempts are defined as attempts involving methods associated with a high risk of fatal outcome. Such attempts have been associated with distinct clinical characteristics and risk profiles, including a greater risk of recurrence and completed suicide. Although the association between suicidal risk and psychiatric history is well documented, evidence regarding the neurocognitive factors involved remains limited and inconsistent. Social cognition refers to the cognitive processes involved in perceiving, interpreting, and responding to social information. Adolescence is a critical developmental period for social cognition, characterized both by ongoing maturation of socio-emotional and prefrontal brain networks and by increasing social demands, including greater reliance on peer relationships, heightened sensitivity to social evaluation, and the emergence of more complex interpersonal interactions. These developmental changes may influence how adolescents interpret and respond to interpersonal stressors associated with suicidal vulnerability. However, the relationship between social cognition and suicidal risk in adolescents remains poorly understood, and relatively few studies have specifically investigated the cognitive mechanisms that may contribute to the emergence of suicidal thoughts and behaviors in this population. Finally, studies conducted in community adolescent samples suggest that insufficient sleep duration is associated with increased suicidal ideation and suicidal behaviors, independently of depressive symptoms.

Study Type

Interventional

Enrollment (Estimated)

82

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adolescents aged 12 to 16 years, inclusive
  • Having made a violent or non-violent suicide attempt
  • Hospitalized in the Department of Child and Adolescent Psychiatry at Necker Children's Hospital
  • No intellectual disability (IQ > 70)
  • Sufficient proficiency in French to complete the study assessments; at least one parent or legal guardian must also have sufficient proficiency in French
  • Written informed consent obtained from the holders of parental authority and assent obtained from the adolescent
  • Covered by a health insurance scheme

Exclusion Criteria:

  • Current psychotic disorder or documented history of a psychotic disorder
  • Current manic or hypomanic episode
  • Severe neurological or medical condition likely to significantly affect cognitive performance
  • Moderate-to-severe substance use disorder requiring specialized treatment
  • Acute intoxication or withdrawal state at the time of assessment- Written informed consent obtained from parents or legal guardians and assent obtained from the adolescent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Adolescents who have attempted violent suicide

Adolescents aged 12 to 16 inclusive who have attempted violent suicide and are hospitalized at Necker Children's Hospital :

  • Hospitalization lasting more than 24 hours.
  • One criterion among: treatment in a specialized department, surgery under general anesthesia, intensive medical treatment, attempted suicide by methods involving a high risk of mortality (hanging, firearm, etc.).

And their parents.
Other: Test

Clinical Assessment of Social Cognition, including :

  • PERSO: measurement of social reasoning, through the analysis and interpretation of social situations, the understanding of the emotions and intentions of others, as well as the adaptation of responses to the relational context;
  • Movie for the Assessment of Social Cognition (MASC): video task measuring understanding of the mental states, intentions and emotions of others (theory of mind),
  • Ambiguous Intentions Hostility Questionnaire (AIHQ): measurement of attribution biases and hostile interpretations in social interactions.
Other: Questionnaires

To explore the associations between performance on the most discriminative social cognition measures (derived from the Clinical Assessment of Social Cognition [ClaCoS] battery) and several secondary variables that may influence socio-cognitive functioning or the characteristics of the suicide attempt, including:

  • Suicidal intent, assessed using the Suicide Intent Scale (SIS)
  • Anxiety symptoms, assessed using the Screen for Child Anxiety Related Emotional Disorders (SCARED)
  • Depressive symptoms, assessed using the Major Depressive Disorder (MDD) module of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS)
  • Socioeconomic vulnerability, assessed using the EPICES deprivation score
  • Attachment styles, assessed using the Adolescent Relationship Scale Questionnaire (ARSQ)
  • Sleep characteristics, assessed using the Sleep Disturbance Scale for Children (SDSC) and the Disturbing Dreams and Nightmare Severity Index (DDNSI)
  • Everyday social cognition skills, assessed us
Experimental: Adolescents who have attempted nonviolent suicide

Adolescents aged 12 to 16 inclusive who have attempted non-violent suicide (low or moderate lethality means) and are hospitalized at Necker Children's Hospital and matched with adolescents who have attempted violent suicide according to three control variables: gender, main psychiatric diagnosis, and socio-economic precariousness (binary score from a validated scale).

And their parents.
Other: Test

Clinical Assessment of Social Cognition, including :

  • PERSO: measurement of social reasoning, through the analysis and interpretation of social situations, the understanding of the emotions and intentions of others, as well as the adaptation of responses to the relational context;
  • Movie for the Assessment of Social Cognition (MASC): video task measuring understanding of the mental states, intentions and emotions of others (theory of mind),
  • Ambiguous Intentions Hostility Questionnaire (AIHQ): measurement of attribution biases and hostile interpretations in social interactions.
Other: Questionnaires

To explore the associations between performance on the most discriminative social cognition measures (derived from the Clinical Assessment of Social Cognition [ClaCoS] battery) and several secondary variables that may influence socio-cognitive functioning or the characteristics of the suicide attempt, including:

  • Suicidal intent, assessed using the Suicide Intent Scale (SIS)
  • Anxiety symptoms, assessed using the Screen for Child Anxiety Related Emotional Disorders (SCARED)
  • Depressive symptoms, assessed using the Major Depressive Disorder (MDD) module of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS)
  • Socioeconomic vulnerability, assessed using the EPICES deprivation score
  • Attachment styles, assessed using the Adolescent Relationship Scale Questionnaire (ARSQ)
  • Sleep characteristics, assessed using the Sleep Disturbance Scale for Children (SDSC) and the Disturbing Dreams and Nightmare Severity Index (DDNSI)
  • Everyday social cognition skills, assessed us

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Level of performance in social cognition in the two groups of adolescents hospitalized following a suicide attempt, distinguishing: adolescents who made a violent suicide attempt and those who made a non-violent suicide attempt
Time Frame: 1 day
Social cognition will be assessed using three subtests from the Clinical Assessment of Social Cognition (ClaCoS) battery. The PERSO task evaluates social reasoning through the interpretation of social situations and yields a total score based on the number of correct responses. The MASC (Movie for the Assessment of Social Cognition) assesses theory of mind using a video-based task and provides a total score corresponding to the number of correctly inferred mental states. The AIHQ assesses attributional biases in ambiguous social situations and generates scores reflecting hostile and intentionality attribution biases. For all three measures, scores will be analysed as continuous variables, with higher scores indicating better social cognitive performance (PERSO, MASC) or stronger attributional biases (AIHQ).
1 day

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Severity of suicidal intention
Time Frame: 1 day
Measurement of the severity of suicidal intention by the Suicide Intent Scale (SIS) rated by the service psychologist based on information collected in the clinical file in the two groups of adolescents hospitalized following a suicide attempt, distinguishing: adolescents who made a violent suicide attempt and those who made a non-violent suicide attempt.
1 day
Level of socio-economic precariousness
Time Frame: 1 day
Level of precariousness and social vulnerability score using the EPICES questionnaire in the two groups of adolescents hospitalized following a suicide attempt, distinguishing: adolescents who made a violent suicide attempt and those who made a non-violent suicide attempt.
1 day
Level of anxiety
Time Frame: 1 day
Level of anxiety assessed using the Screen for Child Anxiety Related Emotional Disorders (SCARED), a self-report questionnaire measuring specific and generalized anxiety symptoms in the two groups of adolescents hospitalized following a suicide attempt, distinguishing: adolescents who made a violent suicide attempt and those who made a non-violent suicide attempt.
1 day
Level of depressive disorder
Time Frame: 1 day
Assessment of depression by the Major Depressive Disorder (MDD) section of the K-SADS (Kiddie Schedule for Affective Disorders and Schizophrenia), a semi-structured interview tool used to diagnose a major depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders criteria in the two groups of adolescents hospitalized following a suicide attempt, distinguishing: adolescents who made a violent suicide attempt and those who made a non-violent suicide attempt.
1 day
Evaluation of attachment styles
Time Frame: 1 day
Evaluation of attachment styles, assessed by a self-reported questionnaire, the Adolescent Relationship Scale Questionnaire (ARSQ), in order to examine the quality of emotional bonds and perceived relational security in the two groups of adolescents hospitalized following a suicide attempt, distinguishing: adolescents who made a violent suicide attempt and those who made a non-violent suicide attempt.
1 day
Level of sleep disturbances
Time Frame: 1 day
Sleep disturbances assessed using the Sleep Disturbance Scale for Children (SDSC), a 26-item caregiver-report questionnaire rated on a 5-point Likert scale. Total scores range from 26 to 130, with higher scores indicating greater sleep disturbance.
1 day
Evaluation of socio-developmental / social-cognition skills
Time Frame: 1 day
Everyday socio-cognitive skills are assessed using the Socio-developmental Skills Questionnaire (SOCODEV), a 20-item parent-completed questionnaire evaluating mentalization, emotion recognition, social motivation, and prosocial behaviors. Each item is rated on a 5-point Likert scale ranging from 1 (never) to 5 (always). Total scores range from 20 to 100, with higher scores indicating better socio-developmental skills. SOCODEV total scores are compared between adolescents hospitalized following a violent versus a non-violent suicide attempt.
1 day
Severity of nightmares
Time Frame: 1 day
Nightmare severity assessed using the Disturbing Dreams and Nightmare Severity Index (DDNSI). Total scores range from 0 to 37, with higher scores indicating greater nightmare severity.
1 day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assistance Publique - Hôpitaux de Paris

Collaborators

URC-CIC Paris Descartes Necker Cochin

Investigators

  • Principal Investigator: Catherine Grosmaitre, PhD, Assistance Publique - Hôpitaux de Paris
  • Study Director: Pauline MD, PhD Chaste, Assistance Publique - Hôpitaux de Paris

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2026

Primary Completion (Estimated)

January 1, 2028

Study Completion (Estimated)

January 1, 2028

Study Registration Dates

First Submitted

June 22, 2026

First Submitted That Met QC Criteria

July 3, 2026

First Posted (Actual)

July 7, 2026

Study Record Updates

Last Update Posted (Actual)

July 7, 2026

Last Update Submitted That Met QC Criteria

July 3, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • APHP251891
  • 2025-A02756-43 (Other Identifier: ID RCB number)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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