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. 2017 Dec:95:253-259.
doi: 10.1016/j.jpsychires.2017.09.003. Epub 2017 Sep 9.

Suicidal ideation and behavior in institutions of higher learning: A latent class analysis

Joel Bernanke  1 , Hanga C Galfalvy  2 , Maggie G Mortali  3 , Laura A Hoffman  3 , Christine Moutier  3 , Charles B Nemeroff  4 , Barbara H Stanley  1 , Paula Clayton  5 , Jill Harkavy-Friedman  3 , Maria A Oquendo  1
Affiliations

Suicidal ideation and behavior in institutions of higher learning: A latent class analysis

Joel Bernanke et al. J Psychiatr Res. 2017 Dec.

Abstract

Suicide is the second leading cause of death among undergraduate students, with an annual rate of 7.5 per 100,000. Suicidal behavior (SB) is complex and heterogeneous, which might be explained by there being multiple etiologies of SB. Data-driven identification of distinct at-risk subgroups among undergraduates would bolster this argument. We conducted a latent class analysis (LCA) on survey data from a large convenience sample of undergraduates to identify subgroups, and validated the resulting latent class model on a sample of graduate students. Data were collected through the Interactive Screening Program deployed by the American Foundation for Suicide Prevention. LCA identified 6 subgroups from the undergraduate sample (N = 5654). In the group with the most students reporting current suicidal thoughts (N = 623, 66% suicidal), 22.5% reported a prior suicide attempt, and 97.6% endorsed moderately severe or worse depressive symptoms. Notably, LCA identified a second at-risk group (N = 662, 27% suicidal), in which only 1.5% of respondents noted moderately severe or worse depressive symptoms. When graduate students (N = 1138) were classified using the model, a similar frequency distribution of groups was found. Finding multiple replicable groups at-risk for suicidal behavior, each with a distinct prevalence of risk factors, including a group of students who would not be classified as high risk with depression-based screening, is consistent with previous studies that identified multiple potential etiologies of SB.

Keywords: Adolescent behavior; Depression; Suicidal ideation; Suicide.

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Figures

Figure 1
Figure 1
Profile plot of the 6 classes showing the proportion of each class endorsing the following. Attempt: reported history of suicide attempt. Thoughts: recent thoughts of suicide. Hopeless: hopeless a lot or most of the time. Depressed: moderately severe or severe depression on the PHQ9. Disrupted: disrupted sleep a lot or most of the time in past 2 weeks. Anxious: intensely anxious/panicked a lot or most of the time in past 4 weeks. Angry: intensely angry a lot or most of the time in past 4 weeks.
Figure 2
Figure 2
Expected and observed proportion of respondents reporting thoughts of suicide in each class among the undergraduates.
See this image and copyright information in PMC

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