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

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

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

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).

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.

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.

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.

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.

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.

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.

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.

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.