Interpersonal needs in relation to depression and suicidal ideation in early adolescents: the moderating roles of ADHD and sex

Adolescence is marked by significant developmental changes and an increased risk for depressive symptoms and suicidal ideation. This study aimed to evaluate the impact of interpersonal needs (i.e., thwarted belongingness, perceived burdensomeness) on depressive symptom severity and suicidal ideation in early adolescents, with a focus on the moderating effects of sex and attention-deficit/hyperactivity disorder (ADHD) status. Participants were 341 early adolescents (ages 10-12), approximately half of whom met diagnostic criteria for ADHD (48.7 %; n = 166). ADHD was established using a semi-structured diagnostic interview administered to caregivers, and adolescents completed ratings of depression and interpersonal needs and were administered an interview assessing history of suicidal ideation. Results indicated that higher levels of thwarted belongingness were associated with depressive symptom severity and suicidal ideation, particularly among females with ADHD compared to females without ADHD or males with or without ADHD. Perceived burdensomeness also predicted depressive symptom severity and suicidal ideation, though its interaction with sex and ADHD was not significant. These findings underscore the importance of addressing interpersonal needs in early adolescents, especially for females with ADHD, to mitigate the risk of depression and suicidal thoughts.