Exami̇nati̇on of resi̇li̇ence and EARLY maladapti̇ve schemas i̇n adolescents wi̇th sui̇ci̇dal ideati̇ons and attempts

Early maladaptive schemas (EDS) are among the risk factors for the development of psychopathology, and they may predispose to suicidal behavior (ID), as reported in studies conducted with adult samples. Psychological resilience (PD), on the other hand, is the most important internal protective factor that prevents a person from attempting suicide when faced with life stressors or suicide-related risk factors. In our study, the question of why some people only have suicidal ideation while others attempt suicide was investigated in the context of resilience and early maladaptive schemas. Patients aged 10-18 years who met the study criteria were included in the study after their psychiatric evaluations were made considering the DSM-5 diagnostic criteria. Three groups were formed as the group with suicide attempt in the last 3 months (SA), the group with suicidal ideation (SI) in the last 1 month, and the clinical control (CC) group. Suicidal behaviors were evaluated with the Columbia Suicide Risk Rating Scale; psychological resilience levels were evaluated with Adolescent Resilience Scale and Emotional Resilience Scale; maladaptive schemas were evaluated with the Early Maladaptive Schema Scales Questionnaires for Children and Adolescents. Compared to clinical controls, cigarette smoking was more common, a history of suicide attempts was higher, life-long aborted attempts were more frequent, the frequency of self-harming behaviors were higher, the total psychological resilience levels were lower in the SI and SA groups and also the scores were found higher in 5 schema areas in the SI group and in the 3 schema areas in the SA group. Alcohol use, history of interrupted attempts and history of actual attempts were significantly more frequent in the SA group than in the SI group, whereas no significant difference was found between the two groups in terms of psychiatric diagnoses, psychological resilience levels, emotional resilience levels, schema domain and schema subcale scores. It was remarkable that in the SI group, the scores of schema domains were higher. A moderate correlation was found between the Disconnection and Rejection Schema Domain and total psychological resilience levels.On the other hand, total emotional resilience levels were moderately correlated with the Other Orientation Schema Domain and highly correlated with all the remaining schema domains. Considering that the SI and SA groups have similar resilience characteristics; there is a need for studies on identifying possible triggers for the activation of early maladaptive schemas. In addition, similar resilience levels again draw attention to the importance of risk factors rather than protective factors in the differentiation of SI and SA groups.