scholarly journals Predicting short-term suicidal thoughts in adolescents using machine learning: developing decision tools to identify daily level risk after hospitalization

2021 ◽  
pp. 1-10
Author(s):  
E. K. Czyz ◽  
H. J. Koo ◽  
N. Al-Dajani ◽  
C. A. King ◽  
I. Nahum-Shani
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Risk ◽  
Daily Life ◽  
Complex Model ◽  
Equivalent Model ◽  
Short Term ◽  
Suicidal Thoughts ◽  
Dynamic Risk Factors ◽  
Decision Tools

Abstract Background Mobile technology offers unique opportunities for monitoring short-term suicide risk in daily life. In this study of suicidal adolescent inpatients, theoretically informed risk factors were assessed daily following discharge to predict near-term suicidal ideation and inform decision algorithms for identifying elevations in daily level risk, with implications for real-time suicide-focused interventions. Methods Adolescents (N = 78; 67.9% female) completed brief surveys texted daily for 4 weeks after discharge (n = 1621 observations). Using multi-level classification and regression trees (CARTSs) with repeated 5-fold cross-validation, we tested (a) a simple prediction model incorporating previous-day scores for each of 10 risk factors, and (b) a more complex model incorporating, for each of these factors, a time-varying person-specific mean over prior days together with deviation from that mean. Models also incorporated missingness and contextual (study week, day of the week) indicators. The outcome was the presence/absence of next-day suicidal ideation. Results The best-performing model (cross-validated AUC = 0.86) was a complex model that included ideation duration, hopelessness, burdensomeness, and self-efficacy to refrain from suicidal action. An equivalent model that excluded ideation duration had acceptable overall performance (cross-validated AUC = 0.78). Models incorporating only previous-day scores, with and without ideation duration (cross-validated AUC of 0.82 and 0.75, respectively), showed relatively weaker performance. Conclusions Results suggest that specific combinations of dynamic risk factors assessed in adolescents' daily life have promising utility in predicting next-day suicidal thoughts. Findings represent an important step in the development of decision tools identifying short-term risk as well as guiding timely interventions sensitive to proximal elevations in suicide risk in daily life.

scholarly journals Development of a Smartphone App to Predict and Improve the Rates of Suicidal Ideation Among Transgender Persons (TransLife): Qualitative Study

10.2196/24023 ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. e24023
Author(s):  
Alex Dubov ◽  
Liana Fraenkel ◽  
Zil Goldstein ◽  
Hansel Arroyo ◽  
Derek McKellar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Mobile Phone ◽  
Suicide Risk ◽  
Ease Of Use ◽  
Research Approach ◽  
Short Term ◽  
Perceived Safety ◽  
Mhealth Intervention ◽  
Transgender Persons

Background Transgender people are at a high risk of suicidal ideation, suicide attempts, and deaths. Among transgender individuals, 77% and 41% engage in suicidal ideation and suicide attempt in their lifetime, respectively, which exceeds the general population rates (9.2% and 2.7%, respectively). Traditionally, suicide risk factors have been studied over a long period between measurements, making it difficult to understand the short-term variability in suicide risk. Mobile phone apps offer an opportunity to understand the immediate precursors of suicidality through the assessment of behaviors and moods in real time. This is the first study to use a mobile phone app (TransLife) to understand the short-term risk factors for suicide among transgender individuals. Objective This study aims to beta test the usability of an evidence-informed mobile health (mHealth) suicide prevention phone app, TransLife. The primary aims are to obtain preliminary data on user engagement and satisfaction with the app, and to assess the feasibility of completing ecological momentary assessments (mood logs) within the app. Methods We used qualitative methods and an exploratory research approach that combined naturalistic app use, focus groups, and semistructured phone interviews. The focus group was informed about the development of the prototype. We conducted a 3-week evaluation to determine engagement and obtain detailed user feedback about the app. After participation in the pilot, phone-based, semistructured, and audio-recorded exit interviews were conducted with the research participants. Results In total, 16 transgender individuals participated in this study. On average, users logged in 4 (SD 2.7) times a week and spent approximately 5 (SD 3.5) minutes on the app per log-in. A total of 6 major themes emerged in this study. These themes focused on the app’s functionality, satisfaction with using the app, perceived ease of use, perceived safety of providing personal data within the app, trusting the app enough to share personal feelings, and features that make this app engaging. These themes suggest that TransLife is an engaging, useful, and acceptable mHealth intervention. Participants reported that the app was easy to use and understand, supported mental self-care, promoted self-awareness, and helped them identify triggers of negative moods. Conclusions The results of this pilot study indicate that TransLife is an engaging, acceptable, and potentially effective mHealth intervention. Transgender participants reported many advantages of using TransLife, such as being able to track their mood, connecting to the community, and accessing local resources. This study provides initial support for the acceptability and usability of TransLife as an mHealth intervention designed for the transgender community.

Long- and Short-Term Risk Factors in the Prediction of Inpatient Suicide

Crisis ◽  
2005 ◽  
Vol 26 (2) ◽  
pp. 53-63 ◽  
Author(s):  
Clare Cassells ◽  
Brodie Paterson ◽  
Dawn Dowding ◽  
Rhona Morrison
Keyword(s):  
Risk Factors ◽  
Health Care Professionals ◽  
Suicide Risk ◽  
Short Term ◽  
Dynamic Risk Factors ◽  
Dynamic Risk ◽  
Inpatient Settings ◽  
Inpatient Suicide ◽  
Short Term Prediction

Abstract. The prediction of suicide remains a major challenge for health care professionals in inpatient settings. A clearer identification of factors specific to inpatient suicide is required to improve both practice and research within this area. This paper provides an overview of the inpatient suicide literature to date focusing on two particularly salient themes: Long term and short term prediction of suicide. Since the concept of short-term suicide risk dominates clinical practice, issues in relation to dynamic risk factors are emphasized.

scholarly journals What Has Clinical Research in Suicide Prevention Done for You Lately?

CNS Spectrums ◽  
2006 ◽  
Vol 11 (6) ◽  
pp. 440-441 ◽  
Author(s):  
Jan Fawcett
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Clinical Status ◽  
Panic Attacks ◽  
Current Evidence ◽  
Suicide Risk Assessment ◽  
Short Term ◽  
The Past ◽  
Standard Risk ◽  
Suicide Plan

What have you heard or read over the past 10 years that has improved you ability to assess and manage suicide risk in your patients?There has been a paucity of data. What little data there is reviewed in this month's articles.They highlight findings that you should know about. Clinicians seem to cling to the familiar, unless some intense marketing is done.For instance, are you aware that the current evidence shows that a denial of suicide thoughts, plans, or intent—even a contract for safety—means absolutely nothing in the absence of a full suicide risk assessment?Yet clinicians seem to rely on these ’reassurances“ from their patients and are shocked when the patient later commits suicide. Why should a patient who is deciding that life is too painful to live tell you the truth? Robert I. Simon, MD, and Daniel W. Shuman, JD, review these facts.Are you aware that severe psychic anxiety, panic attacks, agitation, and severe insomnia often precede suicide within hours, days, or weeks and can be rapidly modified with treatment?On the other hand, standard risk factors for suicide such as suicidal ideation, hopelessness, and past suicidal attempts are not good predictors of suicide in the short term. A suicide plan, recent high intent attempt, or refusal to contract for safety may well indicate immediate risk, but a denial of suicidal ideation or intent and a contract for no harm mean absolutely nothing without a full suicide assessment that takes current clinical status, past suicidal tendencies, social support, and willingness to accept help into account.

scholarly journals Do Feelings of Defeat and Entrapment Change over Time? An Investigation of the Integrated Motivational—Volitional Model of Suicidal Behaviour Using Ecological Momentary Assessments

2020 ◽  
Vol 17 (13) ◽  
pp. 4685
Author(s):  
Jana-Sophie Stenzel ◽  
Inken Höller ◽  
Dajana Rath ◽  
Nina Hallensleben ◽  
Lena Spangenberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Real Time ◽  
Clinical Samples ◽  
Short Term ◽  
Change Over Time ◽  
Longitudinal Association ◽  
Ecological Momentary ◽  
Over Time ◽  
Short Term Variability

(1) Background. Defeat and entrapment have been highlighted as major risk factors of suicidal ideation and behavior. Nevertheless, little is known about their short-term variability and their longitudinal association in real-time. Therefore, this study aims to investigate whether defeat and entrapment change over time and whether defeat predicts entrapment as stated by the integrated motivational–volitional model of suicidal behavior. (2) Methods. Healthy participants (n = 61) underwent a 7-day smartphone-based ecological momentary assessment (EMA) on suicidal ideation/behavior and relevant risk factors, including defeat and entrapment and a comprehensive baseline (T0) and post (T2) assessment. (3) Results. Mean squared successive differences (MSSD) and intraclass correlations (ICC) support the temporal instability as well as within-person variability of defeat and entrapment. Multilevel analyses revealed that during EMA, defeat was positively associated with entrapment at the same measurement. However, defeat could not predict entrapment to the next measurement (approximately two hours later). (4) Conclusion. This study provides evidence on the short-term variability of defeat and entrapment highlighting that repeated measurement of defeat and entrapment—preferably in real time—is necessary in order to adequately capture the actual empirical relations of these variables and not to overlook significant within-person variability. Further research—especially within clinical samples—seems warranted.

Suicide Risk in Cancer Patients – Are We Prepared?

2017 ◽  
Vol 41 (S1) ◽  
pp. S667-S667
Author(s):  
M. Alves ◽  
A. Tavares
Keyword(s):  
Suicidal Ideation ◽  
General Population ◽  
Cancer Patients ◽  
Suicide Risk ◽  
Active Listening ◽  
Suicidal Thoughts ◽  
Increased Risk ◽  
Wish To Die ◽  
Physical Risk Factors ◽  
Competing Interest

IntroductionIndividuals with cancer are at increased risk for suicidal ideation and behaviour when compared to the general population. Suicidal thoughts are sometimes minimized and considered by clinicians as a normal reaction to diagnosis of oncological disease. Less severe forms of suicidal ideation, such a fleeting wish to die may happen in all stages of the disease.ObjectivesWe aim to highlight the cases of cancer patients that present an imminent suicide risk and its related psychopathological aspects, psychosocial and physical risk factors that may increase the probability of suicidal attempt.MethodsNon systematic literature review through the Medline and Clinical Key databases, with time constraints.ResultsIndividuals with cancer have twice the risk of suicide compared to the general population. It was found that suicidal thoughts are more common in patients with advanced disease, in hospital or in palliative care settings or in those who are experiencing severe pain, depression, cognitive impairment or delirium. The first months following the diagnosis are the period of greatest risk and the highest suicide risk occurs in men with respiratory cancers. Death by suicide occurs more often in cancer patients in the advanced stages of disease.ConclusionsAn appropriate therapeutic response should include empathy, active listening, management of realistic expectations and permission to discuss psychological distress. The first intervention should focus on determining imminent risk of suicidal behaviour and act for patient safety.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Physical Activity, Suicide Risk Factors, and Suicidal Ideation in a Veteran Sample

2015 ◽  
Vol 46 (3) ◽  
pp. 284-292 ◽  
Author(s):  
Peter M. Gutierrez ◽  
Collin L. Davidson ◽  
Ariel H. Friese ◽  
Jeri E. Forster
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Risk ◽  
Suicide Risk Factors

Associations Between Suicide Risk Factors and Favorite Songs

Crisis ◽  
2019 ◽  
Vol 40 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Benedikt Till ◽  
Michael Fraissler ◽  
Martin Voracek ◽  
Ulrich S. Tran ◽  
Thomas Niederkrotenthaler
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Risk ◽  
Online Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Music Preferences ◽  
Small Effect Size ◽  
Suicide Risk Factors ◽  
Cross Sectional Design

Abstract. Background: For several decades, the question of whether personal suicidality is reflected in individual music preferences has been the subject of debate in suicide research. Despite many studies investigating the relationship between music use and suicidal behavior, it is still unclear whether suicide risk is reflected in individual music preferences. Aims: The present study aimed to assess whether music preferences are reflected in suicide risk factors. Method: We assessed suicidal ideation, depression, and hopelessness among 943 participants in a cross-sectional online survey. Participants provided up to five examples of their favorite music. We conducted a content analysis and coded all reported songs as suicide-related, coping-related, or unrelated to suicide. Results: Multivariate analyses controlling for gender, age, education level, and amount of daily music use indicated associations of preferences for suicide-related songs with suicidal ideation and depression. Limitations: Limitations of the present study include the use of a convenience sample and a cross-sectional design, the small number of participants with preferences for coping-related songs, and the relatively small effect size of the associations found. Conclusion: Music preferences appear to reflect suicide risk factors, with individuals who prefer suicide-related songs scoring higher in terms of suicidal ideation and depression.

Suicide in Mexican Prisons: Mental Health Symptomology and Risk Factors for Suicidal Ideation and Suicidal Behavior

2021 ◽  
Vol 101 (6) ◽  
pp. 675-698
Author(s):  
Berenice Pérez-Ramírez ◽  
Juan J. Barthelemy ◽  
Robin E. Gearing ◽  
Lindamarie Olson ◽  
Natalia Giraldo-Santiago ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Adverse Childhood Experiences ◽  
Suicide Risk ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Male Prisoners ◽  
Growing Population

In Mexico, suicide and suicidal behaviors (SB) have increased 275% since 1990. Prisoners constitute a growing population in Mexico and have been identified as high suicide risk. Using a sample of 194 male prisoners, we measure what demographics and mental health symptomology are associated with suicidal ideation (SI) and SB, and identify what demographics and mental health symptomology predict SI and SB. Global Severity and Adverse Childhood Experiences (ACEs) were significant predictors of experiencing SI, whereas global severity, ACEs, and age were significant predictors of experiencing SB. Findings support increased identification and comprehensive mental health services addressing suicidality in prisons.

Suicide Precautions for Psychiatric Inpatients: A Review

1992 ◽  
Vol 26 (4) ◽  
pp. 592-598 ◽  
Author(s):  
Peter Cheung
Keyword(s):  
Risk Factors ◽  
Suicide Risk ◽  
Psychiatric Inpatients ◽  
Legal Aspects ◽  
Short Term ◽  
Factors Associated ◽  
Suicide Intent ◽  
Psychiatric Conditions ◽  
Constant Observation ◽  
Patient Relationships

This paper reviews the literature on the assessment and management of suicide risk of psychiatric inpatients. Even though a large number of scales have been developed to assist the prediction of suicide for patients admitted for suicide ideas and attempts, none of them were designed to predict suicide in the short term. However the Modified Suicide Intent Scale and the Hopelessness Scale appear to have the potential to predict immediate suicide risk. Risk factors associated with specific psychiatric conditions were all derived retrospectively and their predictive validities have not been established by prospective studies. Important issues relating to the management of suicidal inpatients, such as staff-patient relationships, use of constant observation and medical-legal aspects are reviewed.

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