Childhood sexual abuse moderates the mediating pathways connecting cognitive distortions and suicidal ideation among homeless youth.

Cognitive distortions are conceptualized as one of the most potent predictors of suicide. However, little is known about the mediating and moderating mechanisms linking cognitive distortions and suicidal ideation. The present study examined a prospective moderated mediation model linking cognitive distortions and suicidal ideation, with drug use, social problem-solving, and perceived burdensomeness as the mediators and childhood sexual abuse as the moderator. Participants included 150 homeless youth who participated in a randomized clinical trial for suicide intervention. Participants were assessed at baseline, 3, 6, and 9 months post-baseline. We analyzed the data using a multiple-group path model. Findings showed that social problem-solving and perceived burdensomeness sequentially mediated the association between cognitive distortions and suicidal ideation regardless of childhood sexual abuse, whereas drug use mediated the association between cognitive distortions and suicidal ideation only among youth reporting no history of sexual abuse. Findings highlight how coping processes, both adaptive and maladaptive, operate differently to predict suicidal ideation contingent on the effects of childhood sexual abuse in the context of cognitive distortions. Findings also underscore the importance of addressing the effects of childhood abuse to facilitate the efficiency of interventions that seek to reduce suicidal ideation among a vulnerable population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).