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

3. juli 2026 opdateret af: 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.

Studieoversigt

Status

Ikke rekrutterer endnu

Intervention / Behandling

Detaljeret beskrivelse

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.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

82

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

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Studiesteder

Deltagelseskriterier

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Berettigelseskriterier

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  • Barn

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Beskrivelse

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

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Diagnostisk
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: 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.

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.

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
Eksperimentel: 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.

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.

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

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
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
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Severity of suicidal intention
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbejdspartnere og efterforskere

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Efterforskere

  • Ledende efterforsker: Catherine Grosmaitre, PhD, Assistance Publique - Hôpitaux de Paris
  • Studieleder: Pauline MD, PhD Chaste, Assistance Publique - Hôpitaux de Paris

Publikationer og nyttige links

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Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juli 2026

Primær færdiggørelse (Anslået)

1. januar 2028

Studieafslutning (Anslået)

1. januar 2028

Datoer for studieregistrering

Først indsendt

22. juni 2026

Først indsendt, der opfyldte QC-kriterier

3. juli 2026

Først opslået (Faktiske)

7. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

7. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. juli 2026

Sidst verificeret

1. juni 2026

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