Cognitive reappraisal mediated the relationship between childhood emotional neglect and suicidality in depressed adolescents and young adults with NSSI behavior

Front Psychiatry. 2026 May 13;17:1792299. doi: 10.3389/fpsyt.2026.1792299. eCollection 2026.

ABSTRACT

BACKGROUND: Depressed adolescents and young adults with non-suicidal self-injury (NSSI) represent a high-risk group for suicide. Childhood trauma is a well-established distal risk factor for suicidality, but the specific associations between trauma subtypes and suicidal ideation, and the underlying psychological mechanisms-particularly the roles of emotion regulation strategies-remain unexplored in this comorbid population.

METHODS: A cross-sectional study involving 120 depressed adolescents and young adults (aged 11-22) with NSSI was conducted. Participants completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Beck Scale for Suicidal Ideation (BSS), and the Emotion Regulation Questionnaire (ERQ). Pearson correlation and stepwise linear regression analyses were employed to examine relationships between childhood trauma subtypes (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect), emotion regulation strategies (cognitive reappraisal, expressive suppression), and current suicidal ideation. Mediation analysis with 5,000 bootstrap samples was performed to test whether cognitive reappraisal and expressive suppression mediated the link between significant trauma predictor(s) and suicidal ideation.

RESULTS: Emotional neglect (68.3%), emotional abuse (55.8%), and physical neglect (52.5%) were the most prevalent trauma subtypes. Emotional abuse, emotional neglect, and physical neglect were positively correlated with suicidal ideation, while cognitive reappraisal was negatively correlated with both emotional neglect and suicidal ideation. Stepwise linear regression identified emotional neglect as a significant predictor of both lower cognitive reappraisal and higher suicidal ideation. Crucially, cognitive reappraisal partially mediated the relationship between childhood emotional neglect and current suicidal ideation, accounting for 16.9% of the total effect. No significant associations were found for expressive suppression.

CONCLUSION: This study highlights the predominance of emotional maltreatment in depressed youth with NSSI and identifies a specific psychological pathway: childhood emotional neglect contributes to increased suicidal ideation, partially through the impairment of cognitive reappraisal. These findings underscore the clinical importance of assessing emotional neglect and targeting cognitive reappraisal skills in therapeutic interventions aimed at reducing suicide risk in this vulnerable population.

PMID:42211195 | PMC:PMC13212354 | DOI:10.3389/fpsyt.2026.1792299