Spotlight Research 6 - Understanding Suicide Ideation Subtypes to Improve Clinical Assessment Among Adolescents

Clinicians who assess adolescents presenting to emergency departments with suicide ideation (SI) or suicide attempts (SAs) often have a short amount of time to assess their suicide-related risk prior to making a triage decision. Available risk assessments are limited in their ability to predict imminent risk of suicidal behavior. Furthermore, our insufficient understanding of SI, itself, and its relative neglect in the youth suicide literature, has been a missed opportunity to use information about adolescents’ suicidal thoughts to better inform our clinical assessments and interventions. We will present research that has leveraged the Adolescent Suicide Ideation Interview (Miranda et al., 2021, 2023) to understand SI subtypes among ethnoracially diverse adolescents in a way that can inform clinical decision-making about which adolescents with SI or SA might be prioritized for intervention. Dr. Miranda and Dr. Ortin-Peralta will describe research with 131 adolescents (84% Latine) recruited from New York City hospitals, and classified as presenting with brief, intermittent, or persistent SI, based on the frequency of their ideation in the previous month, and followed up over 12 months. Persistent SI was associated with over 3 times higher odds of making a future SA, compared to brief SI, adjusting for relevant covariates, and both intermittent and persistent SI were associated with a shorter time-to-attempt among 36 adolescents who attempted suicide during the follow-up period. Classifying SI subtypes may thus identify adolescents who should be prioritized for clinical care to prevent future SAs. Similarly, Dr. Gulbas will describe ways in which qualitative methods can also be used to identify pathways of suicide-related risk among ethnoracially diverse adolescents (Gulbas et al., 2019), along with the first application of cultural consensus analysis to adolescent suicide research via the use of body mapping to identify suicide-related warning signs among adolescents. Finally, Dr. Ortin-Peralta will describe an ongoing adaptation of these methods for assessment of SI among children that builds on analysis of data from the Adolescent Brain Cognitive Development (ABCD) Study (Ortin-Peralta et al., 2023).