Adolescent Girls’ Risk for Suicide Across the Menstrual Cycle: Examining Stress and Negative Valence Systems Longitudinally

The project will longitudinally examine adolescent girls' risk for suicide across the menstrual cycle, specifically hypothesizing higher STB occurrence and severity during the peri-menstrual phase. It will investigate whether these increases are mediated by daily changes in negative affect and stress-reactivity, and if girls with greater cyclical hormone sensitivity are at higher long-term risk, especially during elevated interpersonal stress. The study will recruit 200 clinically-referred girls (ages 12-17, at least one year post-menarche) for a 70-day baseline phase of daily surveys (negative affect, STBs) and two counterbalanced laboratory visits (peri-menstrual and mid-follicular phases) to assess affective and physiological (autonomic, cortisol, genomic) responses to a standardized stressor. This will be followed by one year of weekly surveys measuring cycle phase, interpersonal stress, negative affect, and STBs.