Anticipated Emotional Reactions as Indicators of Adolescents’ Perceived Social (dis) Connectedness During the Moment of Suicidal Crisis: A Reflexive Thematic Analysis

Suicide ideation and attempts account for over half of emergency department visits among adolescents in the United States. Social connectedness has been identified as a protective factor, yet little is known about its role in the moments during a suicidal crisis. We examined adolescents’ retrospective anticipation of others’ emotional reactions to their prospective death by suicide as an indicator of perceived social (dis)connectedness during a suicidal crisis. Qualitative responses from a clinical sample of 104 adolescents (79 female), ages 12–19, with recent suicide ideation or attempt were analyzed using reflexive thematic analysis. Three superordinate themes were developed: (1) living for others: social bonds as protective anchors, (2) social disconnection and emotional disengagement, and (3) navigating dynamic social connections: protective or risk amplifying. These findings suggest that suicide-related interventions should address adolescents’ perceptions of social (dis)connectedness and target both interpersonal and intrapersonal factors during moments of crisis to improve clinical outcomes.