Changing the Direction of Suicide Prevention Research

Christensen, Helen; Cuijpers, Pim; Reynolds, Charles F.

doi:10.1001/jamapsychiatry.2016.0001

Cited by 40 publications

(30 citation statements)

References 6 publications

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“…Logistic regression analysis examined the strength of individual-level associations (i.e., odds ratios [OR]) between baseline risk factors with adverse patterns of STB. As this does not account for a population-level risk perspective 46 (i.e., high-prevalence risk factors carrying low individual risk for STB [i.e., low OR] may be equally or even more important to consider as low-prevalence risk factors carrying high risk for the affected individuals), population attributable risk proportions (PARP) 47 were calculated, thus allowing the risk factors that potentially attribute most to the persistence STB in student populations to be identified.…”

Section: Methodsmentioning

confidence: 99%

A Risk Algorithm for the Persistence of Suicidal Thoughts and Behaviors During College

Kiekens¹,

Auerbach²,

Cuijpers³

et al. 2017

J. Clin. Psychiatry

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OBJECTIVE The primary aims are to: (a) identify patterns of suicidal thoughts and behaviors (STB) during college among students with lifetime pre-matriculation STB and (b) develop a risk-screening algorithm for persistence of pre-matriculation STB during college. METHODS Data come from the Leuven College Surveys, a series of prospective cohort studies of all incoming KU Leuven University freshmen. In the academic year 2012 and 2013, 4,889 incoming freshmen (73.2% response rate) provided baseline data on socio-demographic variables, childhood-adolescent traumatic experiences, 12-month stressful experiences, 12-month mental disorders, 12-month STB, and severity markers of pre-matriculation STB. A total of 2,566 students (69.3% conditional response rate) participated in 12- and 24-month follow-up surveys during the first two college years. RESULTS Thirteen percent (weighted n=535) of incoming freshmen reported lifetime pre-matriculation STB. Of those, 28.0% reported 12-month STB in one follow-up assessment and another 27.7% in both follow-up assessments. High persistence of STB (i.e., 12-month STB in two follow-up assessments) was most strongly associated with severity markers of pre-matriculation STB, with odds ratios in the 2.4–10.3 range and population attributable risk proportions between 9.2% and 50.8%. When aiming for less than 50% of false positive cases (PPV=54.4%), a multivariate predictive risk algorithm (cross-validated AUC=0.79) situated 59.9% of highly persistent cases among the 30% respondents with highest baseline predicted risk. CONCLUSION An individualized web-based screening approach is a promising strategy to identify students at the onset of university who may be at high risk for STB persistence during their academic career.

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Section: Methodsmentioning

confidence: 99%

A Risk Algorithm for the Persistence of Suicidal Thoughts and Behaviors During College

Kiekens¹,

Auerbach²,

Cuijpers³

et al. 2017

J. Clin. Psychiatry

Self Cite

View full text Add to dashboard Cite

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“…First, previous studies have exclusively provided individual-level effect sizes for risk factors. This does not account for a population-level perspective (Christensen et al, 2016; Drum and Denmark, 2012), which finds that high-prevalence risk factors carrying low individual risk for STB may be equally or even more important to consider as low-prevalence risk factors carrying high risk for the affected individuals (Bruffaerts et al, 2015). This can be evaluated by calculating population attributable risk proportions (PARP; Krysinska and Martin, 2009), thus allowing the risk factors that potentially contribute most to the onset of STB in student populations to be identified.…”

Section: Introductionmentioning

confidence: 99%

First onset of suicidal thoughts and behaviours in college

Mortier

Demyttenaere

Auerbach

et al. 2017

Journal of Affective Disorders

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Background College students are a worldwide increasing group of young people at risk for suicidal thoughts and behaviours (STB). However, no previous studies have prospectively investigated the first onset of STB during the college period. Methods Using longitudinal data from the Leuven College Surveys, 2,337 (response rate [RR]=66.6%) incoming freshmen provided baseline data on STB, parental psychopathology, childhood-adolescent traumatic experiences, 12-month risk for mental disorders, and 12-month stressful experiences. A total of 1,253 baseline respondents provided data on 12-month STB in a two-year annual follow-up survey (conditional RR=53.6%; college dropout adjusted conditional RR=70.2%). Results One-year incidence of first-onset STB was 4.6–6.4%. Effect sizes of the included risk factors varied considerably whether viewed from individual-level (ORs 1.91–17.58) or population-level perspective (PARPs 3.4–34.3%). Dating violence prior to the age of 17, physical abuse prior to the age of 17, and 12-month betrayal by someone else than the partner were most strong predictors for first-onset suicidal ideation (ORs=4.23–12.25; PARPs=8.7–27.1%) and plans (ORs=6.57–17.58; PARPs=15.2–34.3%). Multivariate prediction (AUC=.84–.91) revealed that 50.7–65.7% of first-onset STB cases were concentrated in the 10% at highest predicted risk. Limitations As this is a first investigation of STB onset in college, future studies should use validation samples to test the accuracy of our multivariate prediction model. Conclusions The first onset of STB in college appears to be higher than in the general population. Screening at college entrance is a promising strategy to identify those students at highest prospective risk, enabling the cost-efficient clinical assessment of young adults in college.

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“…As just one example of an urgent opportunity, attempts to prevent suicide worldwide have been remarkably ineffective -including public-health measures to reduce stigma, raise awareness and reduce access to guns. Social media, just-in-time interventions and new analytical tools for prediction could change our understanding of risk and yield new strategies for prevention 11 . Tech companies, paired with other players, could start to solve this and many other historically intractable problems.…”

Section: Partners In Timementioning

confidence: 99%

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Nature

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Changing the Direction of Suicide Prevention Research

Cited by 40 publications

References 6 publications

A Risk Algorithm for the Persistence of Suicidal Thoughts and Behaviors During College

A Risk Algorithm for the Persistence of Suicidal Thoughts and Behaviors During College

First onset of suicidal thoughts and behaviours in college

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