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NCT Number: NCT07688798

Mentalization and Social Cognition in Adolescents After Suicide Attempt

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.

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Key information

Conditions

Violent Suicide Attempts in Adolescents Mental Disorders Nervous System Diseases Parasomnias Sleep Wake Disorders

Age range

12 year–16 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Test

Other

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.

questionnaires

Other

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

Primary outcomes

  1. 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).

Secondary outcomes

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

Study contacts

Contact information is provided by the study sponsor or research team.

Catherine Grosmaitre, PhD

CONTACT

[email protected]

033144494561

Hélène Morel

CONTACT

[email protected]

Sponsors and collaborators

Lead sponsor

Assistance Publique - Hôpitaux de Paris

Other

Collaborators

  • URC-CIC Paris Descartes Necker Cochin

Registry information

Acronym: MENTACOG-TS

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Jul 7, 2026
Registry last updated
Jul 7, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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