Suicidal Behavior in Adolescents and Executive Functions

Overview

Suicide is a major public health concern, particularly among young people. In France, around 400 adolescents die by suicide every year, and suicide attempts are most frequent during adolescence. This stage of life is marked by profound emotional, social, and biological changes, which can increase vulnerability to stress and psychological distress. Current research shows that suicidal behaviors do not result from a single cause. Instead, they emerge from a complex interaction between individual vulnerabilities and stressful life events. Among these vulnerabilities, cognitive functioning-and more specifically executive functions-has attracted growing scientific interest. Executive functions refer to a set of high-level mental abilities that allow individuals to regulate their thoughts, emotions, and actions. They include skills such as controlling impulses, adapting to new situations, planning ahead, and holding information in mind. These abilities are essential for everyday life, school learning, social interactions, and emotional regulation. Importantly, the brain networks supporting executive functions continue to develop throughout adolescence, making them particularly sensitive to psychological and environmental challenges. In adults, several studies have shown that people with suicidal ideation or a history of suicide attempts often present difficulties in executive functioning. Such difficulties may contribute to poorer emotional regulation, increased rumination, reduced impulse control, and impaired decision-making during periods of crisis. However, in adolescents, research in this area remains limited, often involving small samples or focusing on only one or two cognitive abilities. The main aim of this study is therefore to better understand the relationship between executive functions and suicidal behaviors in adolescents, using a comprehensive assessment tool specifically designed and validated for children and teenagers. This tool allows for a global evaluation of key executive components, including inhibition, working memory, cognitive flexibility, and planning. A secondary objective of the study is to compare executive functioning between adolescents who experience suicidal thoughts and those who have attempted suicide. Some findings in adults suggest that these two groups may show different cognitive profiles, but this distinction has rarely been explored in younger populations. In addition, cognitive difficulties may not only appear during testing but also have a real-life impact, affecting academic performance, emotional regulation, and social relationships. For this reason, the study also examines how executive difficulties affect everyday functioning, by collecting information from adolescents themselves, their parents, and the school environment. Finally, suicidal behaviors in adolescents are influenced by many other factors, particularly psychiatric disorders such as depression, anxiety, and the consequences of traumatic experiences. Depression, in particular, is one of the strongest risk factors for suicide. This study therefore also aims to explore how these psychiatric conditions may influence executive functioning and shape the relationship between cognitive difficulties and suicidal behavior. By improving our understanding of these mechanisms, this research seeks to support the development of more effective prevention strategies and better-targeted clinical interventions for adolescents at risk.