Executive functions and cognitive disengagement syndrome as predictors of suicidal behaviour: the mediating role of psychotic-like experiences
Karim AbdolmohamadiBackground
Suicidal behaviour remains one of the leading causes of mortality and disability worldwide, yet the cognitive processes associated with suicidality are not fully understood. Although affective disorders have been extensively examined, comparatively less attention has been paid to cognitive factors such as executive functioning difficulties and cognitive disengagement syndrome (CDS). This study examined the associations between executive functioning difficulties, CDS and suicidal behaviour among adolescents and explored the potential mediating role of psychotic-like experiences (PLEs).
Methods
A cross-sectional, correlational design was employed. The sample consisted of 2196 adolescents aged 15–20 years recruited through a multistage cluster sampling approach across several major cities in Iran, with additional convenience and snowball sampling within clusters, both in-person and online. Participants completed the Executive Skills Questionnaire–Revised (higher scores indicate greater executive functioning difficulties), Adult Concentration Inventory, Prodromal Questionnaire–Brief and the Suicidal Behaviour Assessment Scale (SENTIA). Pearson correlations and structural equation modelling (SEM) were conducted using AMOS software.
Results
Executive functioning difficulties and CDS were significantly associated with suicidal behaviour. Higher CDS levels showed a stronger association with suicidal behaviour, whereas executive functioning difficulties showed a smaller but significant association. PLEs were significantly associated with suicidal behaviour and statistically mediated the associations between executive functioning difficulties and suicidal behaviour (Z=4.45), as well as between CDS and suicidal behaviour (Z=4.63). The final SEM demonstrated acceptable fit indices (Comparative Fit Index (CFI)=0.94, Root Mean Square Error of Approximation (RMSEA)=0.05) and accounted for 24% of the variance in suicidal behaviour. Using gender-specific 95th percentile thresholds, 11.57% of participants showed markedly elevated SENTIA scores.
Conclusions
The findings suggest that executive functioning difficulties and cognitive disengagement are meaningfully associated with suicidal behaviour in adolescents, with PLEs emerging as an important correlational pathway linking these cognitive factors to suicidality. These results highlight the potential relevance of cognitive and perceptual experiences in understanding adolescent suicidal behaviour, while underscoring the need for longitudinal research to clarify temporal and causal relationships.