• Bibtex: @auerbach2023
  • Bibliography: Auerbach, R. P., Lan, R., Galfalvy, H., Alqueza, K. L., Cohn, J. F., Crowley, R. N., Durham, K., Joyce, K. J., Kahn, L. E., Kamath, R. A., Morency, L.-P., Porta, G., Srinivasan, A., Zelazny, J., Brent, D. A., & Allen, N. B. (2023). Intensive Longitudinal Assessment of Adolescents to Predict Suicidal Thoughts and Behaviors. Journal of the American Academy of Child and Adolescent Psychiatry, S0890-8567(23)00241-1. https://doi.org/10.1016/j.jaac.2023.03.018

Example citation

My notes

  • Response rates for daily/weekly prompts were around 50%
  • K-means clustering based on mean, max, percent weeks with suicidal ideation, RMSSD
    • “In the past week, how often have you thought of killing yourself?”
  • They found that variability and mean was correlated: higher variability in the high severity group
  • I think a strength in our project is that we produce the sub-groups before treatment and therefore we can really say that it might help in clinical decision making


OBJECTIVE: Suicide is a leading cause of death among adolescents. However, there are no clinical tools to detect proximal risk for suicide. METHOD: Participants included 13-18-year-old adolescents (N=103) reporting a current depressive, anxiety, and/or substance use disorder who owned a smartphone; 62% reported current suicidal ideation with 25% indicating a past-year attempt. At baseline, participants were administered clinical interviews to assess lifetime disorders and suicidal thoughts and behaviors (STBs). Self-reports assessing symptoms and suicide risk factors also were obtained. Additionally, the Effortless Assessment of Risk States (EARS) app was installed on adolescent smartphones to acquire daily mood and weekly suicidal ideation severity during the 6-month follow-up period. Adolescents completed STB and psychiatric service use interviews at the 1-, 3-, and 6-month follow-up assessments. RESULTS: K-means clustering based on aggregates of weekly suicidal ideation scores resulted in a 3-group solution reflecting High- (n=26), Medium- (n=47), and Low-Risk groups (n=30). Fifty-eight percent of the High-Risk group reported suicidal events (i.e., suicide attempts, psychiatric hospitalizations, emergency department visits, ideation severity requiring an intervention) during the 6-month follow-up period. For participants in the High- and Medium-Risk groups (n=73), mood disturbances in the preceding 7 days predicted clinically significant ideation, with a 1SD decrease in mood doubling participants’ likelihood of reporting clinically significant ideation on a given week. CONCLUSION: Intensive longitudinal assessment through personal smartphones offers a feasible method to assess variability in adolescents’ emotional experiences and suicide risk. Translating these tools into clinical practice may help reduce the needless loss of life among adolescents. PDF: auerbach_2023_intensive_longitudinal_assessment_of_adolescents_to_predict_suicidal_thoughts.pdf