Objective To investigate the impact of childhood trauma on suicidal ideation in adolescent patients with depression, and analyze the chain mediating roles of psychological resilience and attributional style.

Methods Adolescent patients with depression who visited Guangyuan Mental Health Center from December 2023 to July 2025 were enrolled as the depressive disorder group, and healthy adolescents were recruited during the same period as the control group. Baseline data and scores from the Childhood Trauma Questionnaire (CTQ), Positive and Negative Suicide Ideation Inventory (PANSI), Connor‑Davidson Resilience Scale (CD-RISC), and Attributional Style Questionnaire (ASQ) were compared. Pearson correlation analysis was used to explore the correlations among CTQ score, CD-RISC score, ASQ score, and PANSI score. Process macro was used to construct a model, verifying the mediating role of the chain pathway between psychological resilience and attributional style in the influence of childhood trauma on suicidal ideation.

Results A total of 250 subjects were included, consisting of 143 in the depressive disorder group and 107 in the control group. The CTQ, PANSI, and negative attribution scores in the depressive disorder group were significantly higher than those in the control group (P < 0.05). The CTQ score was positively correlated with PANSI score (r=0.523) and ASQ negative attribution score (r=0.457), and negatively correlated with ASQ positive attribution score (r=-0.421) and CD-RISC score (r=-0.404) (P < 0.05). Chain mediation model analysis revealed that the total effect of childhood trauma on suicidal ideation was 0.523 (P < 0.001). Psychological resilience and attributional style exerted significant partial mediating effects, with a total indirect effect of 0.340, accounting for 65.01% of the total effect. Among these, the chain-mediated pathway from CTQ to CD-RISC to ASQ negative attribution and ultimately to PANSI was statistically significant (effect size = 0.027, accounting for 5.16% of the total effect).

Conclusion Childhood trauma influences suicidal ideation in adolescents with depression, with psychological resilience and attributional style playing a chain-like mediating role. Clinically, enhancing patients' psychological resilience and improving negative and pessimistic attributional styles can alleviate the depressive stress caused by childhood trauma, thereby reducing risk of suicidal ideation and behaviour.

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