(PS2-A4) Examining Thematic Content of Future-oriented Thoughts in Clinically Acute Adolescents: A Longitudinal Investigation Predicting Suicidal Ideation and Attempt After Hospital Discharge

Among the many possible psychological risk factors for suicide, poor future thinking has been shown to predict suicidal ideation. Prior research on future thinking in suicidal individuals has focused on how specifically suicidal individuals imagine their future, and less on what exactly these imagined future events pertain to—hereafter referred to as thematic content. The only prior investigation of thematic content of future-oriented thoughts, conducted among hospitalized adults, yielded a counterintuitive finding, that high levels of intrapersonally themed positive future thoughts (i.e., pertaining to one’s own well-being) predicted suicide attempts after hospital discharge. One possible explanation for this finding is that such future thoughts may be less achievable and thereby fuel eventual disappointment and distress. There remain knowledge gaps around whether these findings generalize to a younger population and to thematic content of negative future thoughts. To address these knowledge gaps, the current study examines thematic content of future-oriented thoughts of 180 hospitalized adolescents (M=14.9, SD=1.35, 71.7% female-identifying). To capture clinical outcomes, psychiatrically hospitalized adolescents were administered measures pertaining to their suicidal thoughts and behaviors at baseline and then 6, 12, and 18 months after hospital discharge. To capture adolescents’ future thinking, the Future Thinking Task (FTT) was administered during their inpatient stay, in which adolescents were asked to generate as many autobiographical positive and negative future events as possible. The listed future events were then separately coded by the research team using O’Connor et al.’s (2015) criteria, which categorized imagined future events across several mutually exclusive themes: Social/Interpersonal (e.g., future event involving at least one other person); Achievement(e.g., academic progress); Intrapersonal (e.g., well-being of oneself); Leisure/pleasure (e.g., sports, hobbies); Health of Others (e.g., well-being of other people); Financial and home (e.g., chores around the home, allowance); Other. Preliminary coding of positive future thoughts imagined by a subsample of hospitalized adolescents (n=35) thus far reveal that their positive future thoughts most commonly pertain to Achievement (M=2.26, SD=1.22) and Social/Interpersonalevents (M=1.57, SD=1.01). Thus far, the least commonly reported themes are Intrapersonal (M=0.23, SD=0.49) andHealth of Others (M=0.06, SD=0.24). Once all positive and negative future-oriented thoughts are coded, they will be merged with prospective data on suicidal thoughts and behaviors and used to test their predictive validity of these clinical outcomes 6, 12, and 18 months after hospital discharge. Testing this will demonstrate whether the observed effects of positive future thinking in an older sample can be detected at a much earlier point in life.