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Yang C, Huebner ES, Tian L. Prediction of suicidal ideation among preadolescent children with machine learning models: A longitudinal study. J Affect Disord 2024; 352:403-409. [PMID: 38387673 DOI: 10.1016/j.jad.2024.02.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Machine learning (ML) has been widely used to predict suicidal ideation (SI) in adolescents and adults. Nevertheless, studies of accurate and efficient models of SI prediction with preadolescent children are still needed because SI is surprisingly prevalent during the transition into adolescence. This study aimed to explore the potential of ML models to predict SI among preadolescent children. METHODS A total of 4691 Chinese children (54.89 % boys, Mage = 10.92 at baseline) and their parents completed relevant measures at baseline and the children provided 6-month follow-up data for SI. The current study compared four ML models: Random Forest (RF), Decision Tree (DT), Support Vector Machine (SVM), and Multilayer Perceptron (MLP), to predict SI and to identify variables with predictive value based on the best-performing model among Chinese preadolescent children. RESULTS The RF model achieved the highest discriminant performance with an AUC of 0.92, accuracy of 0.93 (balanced accuracy = 0.88). The factors of internalizing problems, externalizing problems, neuroticism, childhood maltreatment, and subjective well-being in school demonstrated the highest values in predicting SI. CONCLUSION The findings of this study suggested that ML models based on the observation and assessment of children's general characteristics and experiences in everyday life can serve as convenient screening and evaluation tools for suicide risk assessment among Chinese preadolescent children. The findings also provide insights for early intervention.
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Affiliation(s)
- Chi Yang
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou 510631, People's Republic of China; School of Psychology, South China Normal University, Guangzhou 510631, People's Republic of China
| | - E Scott Huebner
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Lili Tian
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou 510631, People's Republic of China.
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School connectedness and psychological resilience as mediators in the relationship between childhood abuse and suicidal ideation among Chinese adolescents. Eur J Psychotraumatol 2023; 14:2172650. [PMID: 37052111 PMCID: PMC9930799 DOI: 10.1080/20008066.2023.2172650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Background: Suicide among adolescents is a huge public health concern around the world. Although childhood abuse has been established as a substantial risk factor for suicide behaviours, potential mediators in this relationship remain unclear.Objective: This study aimed to examine the mediating roles of school connectedness and psychological resilience in the association between childhood abuse and suicidal ideation among Chinese high school students.Methods: The sample involved 1607 adolescents from four high schools in Central China. Structural equation modelling (SEM) was conducted to investigate the mediation effects of school connectedness and psychological resilience on the relationship between childhood abuse and suicidal ideation.Results: The prevalence of suicidal ideation during the past week was 21.9%. Childhood abuse was positively related to the development of suicidal ideation directly and indirectly through school connectedness and psychological resilience. School connectedness and psychological resilience were also partial mediators of all three types of childhood abuse (emotional abuse, physical abuse and sexual abuse) when the types were examined separately.Conclusions: Suicidal ideation was widespread among Chinese high school students. Psychological resilience and school connectedness could attenuate the detrimental impact of childhood abuse on suicidal ideation. Findings underscore the improvement of psychological resilience and the connection to the school would be beneficial to suicide prevention among Chinese adolescents with childhood abuse.
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Yao K, Chen P, Zhou H, Ruan J, Chen D, Yang X, Zhou Y. The effect of childhood trauma on suicide risk: the chain mediating effects of resilience and mental distress. BMC Psychiatry 2023; 23:865. [PMID: 37990217 PMCID: PMC10664623 DOI: 10.1186/s12888-023-05348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/04/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Suicide is the fourth leading cause of death among young people aged 15-29 years. A large number of studies have found that mental disorder in adulthood is closely related to childhood trauma, and the relationship between childhood trauma and suicide risk is influenced by resilience and mental distress. This study aimed to explore the effects of childhood trauma on suicide risk among young people and the potential roles of resilience and mental distress in the relationship between childhood trauma on suicide risk. METHODS A cross-sectional survey was conducted among 742 young adults who were in graduate school stage from multiple provinces and cities in China. The Childhood Trauma Questionnaire (CTQ-Short Form), Connor-Davison Resilience Scale (CD-RISC) and Suicide Behavior Questionnaire-Revised (SBQ-R) were used to measure young adults' childhood trauma, resilience and suicide risk, respectively. 9-items Patient Health Questionnaire (PHQ-9) and 7-items self-report Generalized Anxiety Disorder Scale (GAD-7) were used together to measure mental distress. Correlation analysis was performed to explore the initial relationships among the main variables. Structural equation modeling (SEM) was conducted to examine the chain mediating effects of resilience and mental distress in the relationship between childhood trauma and suicide risk. RESULTS The structural equation modeling produced goodness of fit indices (χ2 /df = 3.668, p < 0.001, RMSEA = 0.060, NFI = 0.959, CFI = 0.969, GFI = 0.969, TLI = 0.955). Childhood trauma significantly predicted suicide risk (β = 0.232, p < 0.001) and mental distress (β = 0.181, p < 0.001), which had negative effect on resilience (β = -0.233, p < 0.001). Resilience negatively affected mental distress (β = -0.483, p < 0.001) and suicide risk (β = -0.142, p = 0.001), while mental distress positively associated with suicide risk (β = 0.219, p < 0.001). CONCLUSION The current study revealed that resilience and mental distress played chain-mediating roles in the relationship between childhood trauma and suicide risk. This suggests that we should view the suicide risk of graduate students from a comprehensive perspective.
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Affiliation(s)
- Kaimin Yao
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
| | - Peiyi Chen
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, Guangdong, China
| | - Hui Zhou
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
| | - Jiajia Ruan
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
| | - Dan Chen
- Student Affairs Office, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Xueling Yang
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China.
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
| | - You Zhou
- Student Affairs Office, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
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Zhang B, Zhang W, Sun L, Jiang C, Zhou Y, He K. Relationship between alexithymia, loneliness, resilience and non-suicidal self-injury in adolescents with depression: a multi-center study. BMC Psychiatry 2023; 23:445. [PMID: 37337144 DOI: 10.1186/s12888-023-04938-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) behaviors are prevalent in adolescents and have adverse effects on physical and mental health. However, little is known about the relationship between NSSI and alexithymia, or the underlying mechanisms that could explain this relationship. This study aimed to elucidate the current status of NSSI in adolescent depression, and analyze the relationship between alexithymia, loneliness, resilience, and adolescent depression with NSSI, so as to provide a theoretical basis for psychotherapeutic interventions. METHOD The study sample involved inpatients and outpatients from 12 hospitals across China and adolescents with depression who met the DSM-5 diagnostic criteria for depression episode. The following scales were used: The Functional Assessment of Self-Mutilation, Toronto Alexithymia Scale, UCLA Loneliness Scale, and Connor Davidson Resilience Scale. RESULTS The detection rate of NSSI in adolescents with depression from 2021.01.01-2022.01.01 was 76.06% (1782/2343). Spearman's correlation analysis revealed a significant correlation between alexithymia, loneliness, resilience and NSSI in depressed adolescents, and the results of the non-parametric test showed that the differences between the two groups for each factor were statistically significant. Binary logistic regression results showed that alexithymia (B = 0.023, p = 0.003, OR = 1.023, 95% CI: 1.008-1.038) and depression (B = 0.045, p < 0.001, OR = 1.046, 95% CI: 1.026-1.066) are risk factors for NSSI, resilience (B = - 0.052, p < 0.001, OR = 0.949, 95% CI: 0.935 - 0.964) is a protective factor for NSSI. Alexithymia directly predicted NSSI and also indirectly influenced NSSI through the mediated effect of resilience. Loneliness moderates the first half of the path of this mediated model. CONCLUSION The present study confirms a moderated mediation effect: Alexithymia can have an impact on NSSI behaviors in depressed adolescents through the mediating role of resilience. Loneliness, as a moderating variable, moderated the first half of the pathway of the mediating model. We discuss perspectives for future research and interventions based on the findings of the study.
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Affiliation(s)
- Bing Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China
- Anhui Mental Health Center, 230022, Hefei, China
- Hefei Fourth People's Hospital, Hefei, China
| | - Wei Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China
- Anhui Mental Health Center, 230022, Hefei, China
- Hefei Fourth People's Hospital, Hefei, China
| | - Lingmin Sun
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China
- Anhui Mental Health Center, 230022, Hefei, China
- Hefei Fourth People's Hospital, Hefei, China
| | - Cheng Jiang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
| | - Yongjie Zhou
- Shenzhen Kangning Hospital, Shenzhen, China.
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China.
| | - Kongliang He
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China.
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China.
- Anhui Mental Health Center, 230022, Hefei, China.
- Hefei Fourth People's Hospital, Hefei, China.
- Psychological counseling department, Hefei Fourth People's Hospital, Anhui, 230000, China.
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Liang X, Chang W, Ran H, Fang D, Che Y, Wang S, Chen L, Sun H, Lu J, Xiao Y. Childhood maltreatment and suicidal ideation in Chinese children and adolescents: the mediating role of mindfulness. BMC Psychiatry 2022; 22:680. [PMID: 36333697 PMCID: PMC9635069 DOI: 10.1186/s12888-022-04336-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Childhood maltreatment (CM) has been associated with suicidal ideation (SI) in children and adolescents, yet the mediating role of mindfulness in this association remains unclear. This study aims to test the mediation of mindfulness in CM-SI association among a large sample of Chinese children and adolescents. METHODS A population-based cross-sectional study of 3455 children and adolescents aged 10-17 years from southwest China Yunnan province was conducted. Information from the participants was collected by using a comprehensive self-administered questionnaire. The Chinese version of the Childhood Trauma Questionnaire (CTQ), Five Facet Mindfulness Questionnaire (FFMQ), and the Beck Scale for Suicidal Ideation (BSSI) were used to measure CM, mindfulness and SI. Univariate and multivariate binary logistic regression models were used to estimate the crude and adjusted associations between CM, mindfulness and SI (one-week, one-year, lifetime). Pathway analysis was subsequently performed to test the mediation of mindfulness in CM-SI association. RESULTS The findings showed that mindfulness, CM and SI were significantly correlated with each other (p < 0.05). Mindfulness is a significant mediator in CM-SI association, accounted for 7.5, 11.4, and 17.6% of the total associations for one-week SI, one-year SI, and lifetime SI, respectively. For the five types of CM, the highest level of mediation via mindfulness had been found for physical neglect (PN) and one-year SI (34.3%), followed by emotional neglect (EN) and one-year SI (30.2%), sexual abuse (SA) and one-year SI (25.4%). CONCLUSIONS Our study findings highlight the intervention potential of mindfulness in preventing CM associated suicidal risk. Future longitudinal studies are warranted to corroborate the effectiveness of mindfulness-based intervention for Chinese children and adolescents.
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Affiliation(s)
- Xuemeng Liang
- grid.285847.40000 0000 9588 0960Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China
| | - Wei Chang
- grid.285847.40000 0000 9588 0960Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China
| | - Hailiang Ran
- grid.285847.40000 0000 9588 0960Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China
| | - Die Fang
- grid.285847.40000 0000 9588 0960Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China
| | - Yusan Che
- grid.285847.40000 0000 9588 0960Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China
| | - Sifan Wang
- grid.285847.40000 0000 9588 0960Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China
| | - Lin Chen
- grid.285847.40000 0000 9588 0960Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China
| | - Hao Sun
- grid.285847.40000 0000 9588 0960Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China
| | - Jin Lu
- Psychiatry department, The First Affiliated Hospital, Kunming Medical University, Kunming, China. .,Mental Health Institute of Yunnan, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China. .,Yunnan Clinical Research Center for Mental Health, Kunming, Yunnan, China.
| | - Yuanyuan Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China.
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Abstract
OBJECTIVE Suicide resilience is gaining increasing attention from researchers because of its potential role in preventing suicide. However, it has not been clearly analyzed, and there are various meanings and terms regarding this issue. The purpose of this analysis, therefore, was to conceptualize the concept of suicide resilience. METHODS Walker and Avant's method of concept analysis was used to identify the antecedents, attributes, and consequences of suicide resilience. The literature was searched using PubMed, PsychINFO, Embase, Web of Science, CINAHL, CNKI, and WanFang databases with no limitation on publication date. The search included peer-reviewed journal articles and dissertations related to suicide resilience published in English or Chinese. RESULTS 52 articles were identified to provide information for this concept analysis. Five defining attributes of suicide resilience were identified: social support, coping strategies, psychological capital, meaning in life, and sense of responsibility. Antecedents of suicide resilience were high suicide risk events, and consequences of suicide resilience were keeping vulnerable individuals stay away from or overcoming suicidality. CONCLUSIONS The result of the analysis provided a more clear definition of suicide resilience. The identified defining attributes, antecedents, and consequences can be further tested and used to develop potential interventions. Future research is needed and will help to advance our understanding of the scope.
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Affiliation(s)
- Xinlu Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Zhongqiu Lu
- Emergency Intensive Care Unit, Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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