Direct and indirect paths from subclinical symptoms of schizotypal personality to suicidal thinking among non-help-seeking adolescents.

Résumé

Clinical and subclinical symptoms of schizotypal personality predict concurrent and future suicidal ideation. We tested whether relationships of subclinical schizotypal symptoms with ideation operate solely via final common risk pathways for suicidal thinking, or whether there are distinctive ways that the schizotypal-ideation relationships bypass common pathways. Randomly selected 15- to 18-year-old school pupils (n = 177) self-reported on passive and active ideation; subclinical positive, negative, and disorganized symptoms, scored quantitatively; and theoretical final common pathways of thwarted belonging and burden, and of pain and hopelessness. Perceived burden and thwarted belonging, as final common pathways, provided a better account of ideation than pain and hopelessness. The relationships of schizotypal symptoms with passive ideation operated via burden and belonging. However, subclinical schizotypal symptoms had both common and distinctive links with active ideation. Some negative (excessive social anxiety) and positive symptoms (low magical thinking) bypassed burden and belonging to predict active ideation directly; for other schizotypal symptoms, only burden was a final common pathway. Negative symptoms predicted belonging but belonging was not a final common pathway to active ideation. Among adolescents with schizotypal personality, suicidal thinking may not be mitigated by improving belonging but by addressing social anxiety and perceived burden instead.