Mental pain and lifetime suicide attempts in early adolescence: a preliminary study

The primary aim of the present study was to examine the association of four complementary measures-suicidal cognitions, entrapment, mental pain, and depression-with past suicide attempts in early adolescence. The sample consisted of 657 adolescents aged 12-15 years (M = 12.68, SD = ± 0.82; 49.16% female, 49.47% male and 1.22% non-binary), all enrolled in the first stage of secondary education (ISCED 2, first year) in schools in Spain. The study employed a three-phase analytical approach: (1) ROC/AUC analysis to evaluate the performance of each measure, (2) logistic regression models to assess their association with past suicide attempts, and (3) validating the first-phase classification results by accounting for the possibility of response imbalances on each of four measures. The results showed that high intensity of mental pain most strongly associated with past suicide attempts, exhibiting the highest sensitivity and reliability across models. Suicidal cognitions and entrapment also showed utility in assessing suicide risk, although their impact was less pronounced than mental pain. Depressive symptomatology showed limited utility distinguishing adolescents with a history of suicide attempts. These findings underscore the importance of incorporating mental pain and related constructs in community-based strategies for suicide prevention with early adolescence-aged children. By combining these factors, practitioners can gain a more comprehensive understanding of risk, facilitating early identification and intervention in adolescents at risk for suicide.