Recent studies have documented the presence of suicide risk in adults with pediatric-onset IBD. However, little is known about suicidal ideation in youth with IBD. Even less is known about potential psychosocial correlates of suicidal ideation in this population. Interestingly, the pediatric IBD literature has identified two key cognitive appraisal variables associated with depressive symptoms in youth with IBD (i.e., stigma and thwarted belongingness) that have also been linked to suicidal ideation in other populations.

The present study investigated the contributions of illness stigma and thwarted belongingness to suicidal ideation in a sample of youth with IBD (N = 180). Based on previous studies examining depressive symptoms in this population, the current investigation examined: 1) the rate of suicidal ideation in a sample of youth with IBD; 2) the direct effects of illness stigma and thwarted belongingness on suicidal ideation; and 3) the indirect association between illness stigma and suicidal ideation through the mediating influence of thwarted belongingness.

Results indicated that 10% of youth (N = 18) reported mild suicidal ideation. Notably, of the 18 youth who reported suicidal ideation, 14 (78%) endorsed clinically elevated depressive symptoms. Primary results revealed significant direct associations between illness stigma and thwarted belongingness and between thwarted belongingness and suicidal ideation. Mediation analysis revealed a significant illness stigma→thwarted belongingness→suicidal ideation path, indicating that stigma had an indirect effect on suicidal ideation - mediated by the influence of thwarted belongingness.

Consistent with previous studies demonstrating a mediating effect for thwarted belongingness in the association between illness stigma and depressive symptoms, the present results suggest that youth who experience decreased social connectedness (i.e., thwarted belongingness) as a function of IBD-related stigma may also be at increased risk for suicidal ideation. Given the high rate of clinically elevated depressive symptoms observed among youth endorsing suicidal ideation, the current findings point to the importance of regular screening for depressive symptoms (and suicidal ideation more specifically) to allow for early identification and appropriate clinical intervention for youth with IBD who may be experiencing significant emotional adjustment challenges.