A Latent Class Analysis of Suicidal Behaviors in Adolescents

Psychiatry Investig. 2023 Feb;20(2):93-100. doi: 10.30773/pi.2022.0199. Epub 2023 Feb 23.

Abstract

Objective: The purpose of the present study was to identify adolescents' suicide subgroups using five indicators (depression, anxiety, suicide ideation, and planned and attempted suicide), and explore the distinctive features of each subgroup.

Methods: This study included 2,258 teenagers from four schools. Both adolescents and their parents, who voluntarily agreed to participate in the study, completed a series of self-reported questionnaires on depression, anxiety, suicide, self-harm, self-esteem, impulsivity, childhood maltreatment, and deviant behaviors. The data were analyzed using latent class analysis, a person-centered method.

Results: Four classes were detected: "high risk for suicide without distress," "high risk for suicide with distress," "low risk for suicide with distress," and "healthy." The "high risk for suicide with distress" class was the most severe on all evaluated psychosocial risk factors, namely, impulsivity, low self-esteem, self-harming behaviours, deviant behaviour problems, and childhood maltreatment, followed by "high risk for suicide without distress."

Conclusion: This study identified two high risk subgroups for adolescent' suicidality, "high risk for suicide with or without distress." Both high risk subgroups for suicide showed higher scores for all psychosocial risk factors than low risk subgroups for suicide. Our findings suggest that special attention needs to be paid to the latent class "high risk for suicide without distress," as this group's "cry for help" might be relatively difficult to detect. Specific interventions for each group (e.g., distress safety plans for "suicidal potential with or without emotional distress") need to be developed and implemented.

Keywords: Adolescence; Anxiety; Depression; Latent class analysis; Non-suicidal self injury; Suicide.