***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The present prospect i ve study tested a portion of the  interpersonal-psychological theory of suicide ( IPTS ) in an adolescent clinical sample . Participants were 143 adolescents consecutively admitted to a partial hospitalization program who completed assessment s at intake and discharge from the program . Results partially supported the IPTS and suggest that ( 1 ) perceived burdensomeness may be an important socially based cognition for underst and ing concurrent risk for suicidal ideation ( SI ) ; ( 2 ) thwarted belongingness affects depression symptom severity over time , which indirectly predicts SI over a short follow-up time frame ; and ( 3 ) the IPTS constructs may function differently in a high-risk clinical adolescent sample , compared to adults , although findings are preliminary BACKGROUND There is great heterogeneity of clinical presentation and outcome in paediatric depression . AIMS To identify which clinical and environmental risk factors at baseline and during treatment predicted major depression at 28-week follow-up in a sample of adolescents with depression . METHOD One hundred and ninety-two British adolescents with unipolar major depression were enrolled in a r and omised controlled trial ( the Adolescent Depression Antidepressants and Psychotherapy Trial , ADAPT ) . Participants were treated for 28 weeks with routine psychosocial care and selective serotonin reuptake inhibitors ( SSRIs ) , with half also receiving cognitive-behavioural therapy ( CBT ) . Full clinical and demographic assessment was carried out at baseline and 28 weeks . RESULTS Depression at 28 weeks was predicted by the additive effects of severity , obsessive-compulsive disorder and suicidal ideation at entry together with presence of at least one disappointing life event over the follow-up period . CONCLUSIONS Clinicians should assess for severity , suicidality and comorbid obsessive-compulsive disorder at presentation and should monitor closely for subsequent life events during treatment Aims and method To assess the feasibility of conducting a larger , definitive r and omised controlled trial of manual-assisted cognitive therapy ( MACT ) , a brief focused therapy to address self-harm and promote engagement in services . We established recruitment , r and omisation and assessment of outcome within a sample of these complex patients admitted to a general hospital following self-harm . We assessed symptoms of depressed mood , anxiety and suicidality at baseline and at 3 months ’ follow-up . Results Twenty patients were r and omised to the trial following an index episode of self-harm , and those allocated to MACT demonstrated improvement in anxiety , depression and suicidal ideation . Clinical implication s It is feasible to recruit a sample of these complex patients to a r and omised controlled trial of MACT following an index episode of self-harm . There is preliminary support that MACT could be an acceptable and effective intervention in patients with personality disorder and substance misuse BACKGROUND Previous studies suggest that people attempt suicide because they are cognitively inflexible , but past research suggesting a link between cognitive inflexibility and suicidal thoughts and behavior has been limited by cross-sectional design s. This study examined whether cognitive inflexibility differentially and prospect ively predicted suicidal ideation among young adults with and without a history of a suicide attempt . METHODS A sample of 45 young adults with ( n = 13 ) or without ( n = 32 ) a suicide attempt history completed the  Wisconsin Card Sorting Test ( WCST ) , a diagnostic interview , and self-report measures of hopelessness , depressive symptoms , and suicidal ideation  , and were followed up 6 months later to reassess suicidal ideation . RESULTS Cognitive inflexibility , as measured by perseverative errors on the WCST , predicted suicidal ideation at 6-month follow-up , among suicide attempters , but not among nonattempters , adjusting for the presence of a baseline mood or anxiety diagnosis , hopelessness , and baseline suicidal ideation . CONCLUSIONS Cognitive inflexibility may increase vulnerability to suicidal ideation over time among individuals with a previous suicide attempt history . Implication s for interventions with suicide attempters are discussed Nonsuicidal self-injury ( NSSI ) has become a significant public health problem . Although numerous studies have examined cross-sectional psychological correlates of NSSI , there has been little research examining predictors of NSSI over time . The present study examined cross-sectional and longitudinal correlates of NSSI in 81 young adult self-injurers ( M age=19 , 74.1 % female , 51.9 % Caucasian ) , 51 of whom were followed up 1 year later . At baseline , participants completed self-report measures of NSSI , Axis-I disorders , borderline personality disorder ( BPD ) , and impulsivity , as well as an implicit measure of NSSI attitudes and identity . One year later , participants completed a Timeline Followback Method whereby they indicated their engagement in NSSI over the previous 12 months . Analyses replicated many known cross-sectional correlates of NSSI , including symptoms of several Axis-I disorders and BPD . However , many of these same variables failed to predict the course of NSSI over the 1-year follow-up . The only variables to prospect ively predict NSSI were past NSSI ( i.e. , frequency , methods , and recency of NSSI ) , participants ' behavioral forecast of their engagement in future NSSI , and BPD features . Findings suggest that many cross-sectional correlates of NSSI may not be useful for predicting subsequent NSSI . Instead , NSSI severity and BPD features appear to best predict continued engagement in NSSI BACKGROUND The implicit association hypothesis of nonsuicidal self-injury ( NSSI ) proposes that individuals who engage in self-injury develop , over time , strong associations between themselves and NSSI , and their identification with this behavior guides their future selection of NSSI to cope . Prior research has established a relationship between implicit NSSI associations ( using an Implicit Association Test for Self-Injury ) and engagement in NSSI . However , previous studies have been small and cross-sectional , and thus underpowered to examine the nature of this association and the extent to which implicit associations predict the persistence of NSSI . METHODS This study builds on previous research in a prospect i ve , longitudinal examination of implicit self- identification with NSSI in a large sample of middle school students .  NSSI behavior and implicit NSSI associations  were assessed annually in school at three time points . RESULTS Adolescents who engaged in NSSI exhibited stronger implicit self- identification with NSSI than adolescents who did not engage in NSSI . Moreover , implicit NSSI identification was stronger among adolescents who engaged in cutting , frequent NSSI , and recent NSSI . A reciprocal association was observed between NSSI frequency and implicit NSSI identification over 1 year . Notably , implicit NSSI identification uniquely and prospect ively predicted engagement in NSSI over the subsequent year . CONCLUSIONS Implicit self- identification with NSSI may track both trait- and state-related changes in the behavior and , importantly , may help predict continued engagement in NSSI Rates of suicidal ideation and behavior are extremely high in bipolar spectrum disorders ( BSDs ) . However , relatively little work has evaluated potentially synergistic relationships between cognitive and emotion-regulatory processes proposed by theoretical models of suicidality in BSDs . The present study evaluated whether negative cognitive style and subtypes of rumination would exacerbate the impact of self-criticism on suicidal ideation in a prospect i ve study of individuals with BSDs . Seventy-two young adults with BSDs ( bipolar II , bipolar NOS , or cyclothymia ) completed diagnostic interviews and trait measures of self-criticism , negative cognitive style , and brooding and reflective rumination at a baseline assessment . The occurrence of suicidal ideation was assessed as part of diagnostic interviews completed every 4 months for an average of 3 years of follow-up . Negative cognitive style and reflective rumination strengthened the association between self-criticism and the prospect i ve occurrence of suicidal ideation across follow-up . Individuals with high levels of self-criticism in conjunction with negative cognitive style or reflective rumination were most likely to experience the onset of suicidal ideation . Self-criticism may work synergistically with negative cognitive style and rumination to confer risk for suicidal ideation in bipolar spectrum disorders . These results support theoretical models of suicidality in BSDs and indicate that evaluating and underst and ing negative cognitive styles may help to identify individuals who are at risk of suicide OBJECTIVE Nonsuicidal self-injury ( NSSI ) is a public health concern and risk factor for suicide . The Emotional Cascade Model ( ECM ) proposes that NSSI partially functions as a distraction from cascades of negative affect and rumination . The purpose of this study was to examine the roles of trait rumination , and momentary instability of rumination and negative emotion , in NSSI . METHOD Experience sampling methods were used to monitor thoughts , emotions , and behaviors  in 47 individuals reporting dysregulated behaviors including NSSI .  Instability indices were generated for rumination and negative emotion using the momentary assessment s. RESULTS Twenty-five episodes of NSSI were reported during monitoring . Trait rumination prospect ively predicted NSSI episodes , and the instability indices interacted to predict NSSI . CONCLUSIONS Consistent with the ECM , the interaction between rumination instability and negative affect instability during monitoring significantly predicted NSSI , with the strongest effects occurring for sadness and rumination about past . These findings may enhance conceptualization and treatment of patients with NSSI BACKGROUND Suicidal thoughts and behaviors are major public health concerns in youth . Unfortunately , knowledge of reliable predictors of suicide risk in adolescents is limited . Promising research using a death stimuli version of the Implicit Association Test ( Death IAT ) indicates that stronger identification with death differs between adults with and without a history of suicidal thoughts and behaviors and uniquely predicts suicide ideation and behavior . However , research in adolescents is lacking and existing findings have been mixed . This study extends previous research by testing whether implicit identification with death predicts changes in suicide ideation during psychiatric treatment in adolescents . METHODS Participants included 276 adolescents , ages 13 - 19 , admitted to a short-term residential treatment program .  At hospital admission and discharge , adolescents completed the  Death IAT and measures of recent suicidal thoughts .  RESULTS At admission , implicit identification with death was associated with recent suicide ideation , but did not differ between those who engaged in prior suicidal behavior and those who did not . Prospect ively , adolescents ' implicit identification with death at admission significantly predicted their suicide ideation severity at discharge , above and beyond explicit suicide ideation . However , this effect only was significant for adolescents with longer treatment stays ( i.e. , more than 13 days ) . CONCLUSIONS Implicit identification with death predicts suicidal thinking among adolescents in psychiatric treatment . Findings clarify over what period of time implicit cognition about death may predict suicide risk in adolescents Adolescence is a developmental period associated with heightened risk for both the onset and escalation of suicidal ideation ( SI ) . Given that SI is a potent predictor of suicidal behavior , it is important to develop models of vulnerability for and protection against SI , particularly among young adolescents . This study examined the relative impact of several cognitive vulnerabilities , as well as protective factors , for SI among young adolescents over a 2-year interval encompassing their transition to mid-adolescence . At baseline , 324 adolescents ( M = 12.39 years ; SD = 0.63 ; 52.5 % female ) completed measures of depressive symptoms , self-referent information processing biases , negative inferential style , and responses to negative affect . Further , the adolescents and their mothers were administered a diagnostic interview to assess current and past depressive disorders and SI . Over follow-up , adolescents and their mothers were administered the diagnostic interview every 12 months and adolescents completed a self-report measure inquiring about SI  every 6 months to assess interviewer-rated and self-reported SI . Logistic regressions indicated that preferential endorsement of negative adjectives as self-referent ( only among girls ) , rumination in response to negative affect , and a negative inferential style prospect ively predicted SI . Additionally , young adolescents ’ tendency to respond to negative affect with distraction and problem-solving buffered against their risk for exhibiting SI . When these factors were entered simultaneously , preferential endorsement of negative adjectives as self-referent and the use of distraction and problem-solving skills remained the only significant prospect i ve predictors of SI . No previous studies have examined these variables as predictors of SI , thereby highlighting their potential utility in improving the predictive validity of extant models of suicide risk and resilience In conjunction with prospect i ve ratings of child maltreatment ( i.e. , sexual abuse , physical abuse , and physical neglect ) and measures of dissociation and somatization , this study examined prospect i ve pathways between child maltreatment and nonsuicidal , direct self-injurious behavior ( SIB ; e.g. , cutting , burning , self-hitting ) . Ongoing participants in the Minnesota Longitudinal Study of Parents and Children ( N = 164 ; 83 males , 81 females ) completed a semistructured interview about SIB when they were 26 years old . SIB emerged as a heterogeneous and prominent phenomenon in this low-income , mixed-gender , community sample . Child sexual abuse predicted recurrent injuring ( i.e. , three or more events ; n = 13 ) , whereas child physical abuse appeared more salient for intermittent injuring ( i.e. , one to two events ; n = 13 ) . Moreover , these relations appeared largely independent of risk factors that have been associated with child maltreatment and /or SIB , including child cognitive ability , socioeconomic status , maternal life stress , familial disruption , and childhood exposure to partner violence . Dissociation and somat 
    Output:
    
Our review reveals that  cognitive processes  , measured using self-report and behavioral measures , are most often linked to recurrent suicidal ideation .
First , SITB-themed cognitions were robust risk factors and proximally associated with SITB outcomes .
Second , negatively-valenced cognitive risk factors were the most commonly studied risk factors , relatively robust , and modestly related to SITB outcomes .
Third , cognitive deficits ( i.e. , basic cognitive processes not characterized by thematic content or negative valence ) produced mixed findings that suggest a more distal relationship to SITB outcomes .