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Is Adolescent Suicidal Ideation Continuous or Categorical? A Taxometric Analysis

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Abstract

Despite the strong association between suicidal ideation and suicidal behavior, a relative minority of ideators transition to attempting suicide. Clarifying the latent structure of suicidal ideation has direct implications for theory, as well as suicidal risk assessment and prevention efforts. Taxometric analysis is a statistical technique specifically designed to assess whether a latent construct is taxonic (i.e., categorical) or continuous (i.e., dimensional) in nature. Although this statistical approach has been increasingly used over the past decade to elucidate the latent structure of various forms of psychopathology and related risk factors, there are no taxometric studies to date of suicidal ideation. The aim of the current project is to apply taxometric methods to a sample of clinically depressed, treatment-seeking adolescents (n = 334). Current suicidal ideation was measured using the Suicidal Ideation Questionnaire-Jr., (SIQ-Jr.). The results of two mathematically non-redundant taxometric approaches (i.e., MAXEIG and L-Mode) are consistent with a continuous latent structure for suicidal ideation. The current findings suggest that suicidal ideation in depressed adolescents is dimensional. The implication of these findings for research, theory, and suicidal risk assessment strategies are discussed.

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Notes

  1. It has been traditionally recommend that within-group correlations for constructed indicators be under 0.3, and interindicator correlation within the entire sample be above 0.3 (Meehl 1995). It has been suggested more recently, however, that the magnitude of difference between the full-group and within-group indicator correlations is more important than having absolute within-group correlation values below 0.3 (Ruscio et al. 2006; Walters 2008).

  2. For discussions of high-risk research designs, see Carter and Garber 2011; Goodman and Gotlib 1999.

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington: American Psychiatric Association.

    Google Scholar 

  • Beauchaine, T. P. (2003). Taxometrics and developmental psychopathology. Development and Psychopathology, 15, 501–527. doi:10.1017/S0954579403000270.

    Article  PubMed  Google Scholar 

  • Beauchaine, T. P., & Waters, E. (2003). Pseudotaxonicity in MAMBAC and MAXCOV analyses of rating-scale data: turning continua into classes by manipulating observer’s expectations. Psychological Methods, 8, 3–15.

    Article  PubMed  Google Scholar 

  • Becker-Weidman, E. G., Jacobs, R. H., Reinecke, M. A., Silva, S. G., & March, J. S. (2010). Social problem-solving among adolescents treated for depression. Behaviour Research and Therapy, 48, 11–18. doi:10.1016/j.brat.2009.08.006.

    Article  PubMed Central  PubMed  Google Scholar 

  • Brent, D., Emslie, G., Clarke, G., Wagner, K. D., Asarnow, J. R., Keller, M., & Zelazny, J. (2008). Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: the TORDIA randomized controlled trial. JAMA, 299, 901–913. doi:10.1001/jama.299.8.901.

    Article  PubMed Central  PubMed  Google Scholar 

  • Brent, D. A., Emslie, G. J., Clarke, G. N., Asarnow, J., Spirito, A., Ritz, L., & Keller, M. B. (2009a). Predictors of spontaneous and systematically assessed suicidal adverse events in the treatment of SSRI-resistant depression in adolescents (TORDIA) study. American Journal of Psychiatry, 166, 418–426. doi:10.1176/appi.ajp.2008.08070976.

    Article  PubMed Central  PubMed  Google Scholar 

  • Brent, D. A., Greenhill, L. L., Compton, S., Emslie, G., Wells, K., Walkup, J. T., Vitiello, B., et al. (2009b). The treatment of adolescent suicide attempters study (TASA): predictors of suicidal events in an open treatment trial. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 987–996. doi:10.1097/CHI.0b013e3181b5dbe4.

    Article  PubMed Central  PubMed  Google Scholar 

  • Busch, K. A., Fawcett, J., & Jacobs, D. G. (2003). Clinical correlates of inpatient suicide. Journal of Clinical Psychiatry, 64, 14–19.

    Article  PubMed  Google Scholar 

  • Carter, J. S., & Garber, J. (2011). Predictors of the first onset of a major depressive episode and changes in depressive symptoms across adolescence: stress and negative cognitions. Journal of Abnormal Psychology, 120, 779–796. doi:10.1037/a0025441.

    Article  PubMed  Google Scholar 

  • Casey, P. R., Dunn, G., Kelly, B. D., Birkbeck, G., Dalgard, O. S., Lehtinen, V., Britta, S., et al. (2006). Factors associated with suicidal ideation in the general population: five-centre analysis from the ODIN study. British Journal of Psychiatry, 189, 410–415. doi:10.1192/bjp.bp.105.017368.

    Article  PubMed  Google Scholar 

  • Casey, B. J., Craddock, N., Cuthbert, B. N., Hyman, S. E., Lee, F. S., & Ressler, K. J. (2013). DSM-5 and RDoC: progress in psychiatry research? Nature Reviews Neuroscience, 14, 810–814. doi:10.1038/nrn3621.

    Article  PubMed Central  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2013). Web-based Injury Statistics Query and Reporting System (WISQARS). Atlanta, GA: Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/injury/wisqars/LeadingCauses.html.

  • Cohen, J. (1983). The cost of dichotomization. Applied Psychological Measurement, 7, 249–253. doi:10.1177/014662168300700301.

    Article  Google Scholar 

  • Cole, D. A., Ciesla, J. A., Dallaire, D. H., Jacquez, F. M., Pineda, A. Q., LaGrange, B., Truss, A. E., et al. (2008). Emergence of attributional style and its relation to depressive symptoms. Journal of Abnormal Psychology, 117, 16–31. doi:10.1037/0021-843X.117.1.16.

    Article  PubMed  Google Scholar 

  • Fraley, R. C., & Waller, N. G. (1998). Adult attachment patterns: A test of the typology models. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 77–114). New York: Guilford Press.

    Google Scholar 

  • Garrison, C. Z., Addy, C. L., Jackson, K. L., & McKeown, R. E. (1991). A longitudinal study of suicidal ideation in young adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 597–603. doi:10.1097/00004583-199107000-00011.

    Article  PubMed  Google Scholar 

  • Golden, R. R., & Meehl, P. E. (1979). Detection of the schizoid taxon with MMPI indicators. Journal of Abnormal Psychology, 88, 217–233. doi:10.1037/0021-843X.88.3.217.

    Article  PubMed  Google Scholar 

  • Goodman, S. H., & Gotlib, I. H. (1999). Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission. Psychological Review, 106, 458–490.

    Article  PubMed  Google Scholar 

  • Guy, W. (1976). Clinical global improvement scale. Rockville: National Institute of Mental Health.

    Google Scholar 

  • Hankin, B. L., Fraley, R. C., Lahey, B. B., & Waldman, I. D. (2005). Is depression best viewed as a continuum or discrete category? A taxometric analysis of childhood and adolescent depression in a population-based sample. Journal of Abnormal Psychology, 114, 96–110. doi:10.1037/0021-843X.114.1.96.

    Article  PubMed  Google Scholar 

  • Haslam, N., Holland, E., & Kuppens, P. (2012). Categories versus dimensions in personality and psychopathology: a quantitative review of taxometric research. Psychological Medicine, 42, 903–920. doi:10.1017/S0033291711001966.

    Article  PubMed  Google Scholar 

  • Husky, M. M., Olfson, M., He, J., Nock, M. K., Swanson, S. A., & Merikangas, K. R. (2012). Twelve-month suicidal symptoms and use of services among adolescents: results from the national comorbidity survey. Psychiatric Services, 63, 989–996. doi:10.1176/appi.ps.201200058.

    Article  PubMed  Google Scholar 

  • Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., Sanislow, C., et al. (2010). Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167, 748–751. doi:10.1176/appi.ajp.2010.09091379.

    Article  PubMed  Google Scholar 

  • Joiner, T. E. (2005). Why people die by suicide. Cambridge: Harvard University Press.

    Google Scholar 

  • Joiner, T. E., Van Orden, K. A., Witte, T. K., Selby, E. A., Ribeiro, J. D., Lewis, R., & Rudd, M. D. (2009). Main predictions of the interpersonal–psychological theory of suicidal behavior: empirical tests in two samples of young adults. Journal of Abnormal Psychology, 118, 634–646. doi:10.1037/a0016500.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kaufman, J., Birmaher, B., Brent, D., & Rao, U. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988. doi:10.1097/00004583-199707000-00021.

    Article  PubMed  Google Scholar 

  • King, C. A., Hovey, J. D., Brand, E., & Ghaziuddin, N. (1997). Prediction of positive outcomes for adolescent psychiatric inpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1434–1442. doi:10.1097/00004583-199710000-00026.

    Article  PubMed  Google Scholar 

  • Klonsky, E. D., & May, A. M. (2014). Differentiating suicide attempters from suicide ideators: a critical frontier for suicidology research. Suicide & Life-Threatening Behavior, 44, 1–5. doi:10.1111/sltb.12068.

    Article  Google Scholar 

  • MacCallum, R. C., Zhang, S., Preacher, K. J., & Rucker, D. D. (2002). On the practice of dichotomization of quantitative variables. Psychological Methods, 7, 19–40. doi:10.1037/1082-989X.7.1.19.

    Article  PubMed  Google Scholar 

  • Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., Hegerl, U., et al. (2005). Suicide prevention strategies: a systematic review. JAMA, 294, 2064–2074. doi:10.1001/jama.294.16.2064.

    Article  PubMed  Google Scholar 

  • Maxwell, S. E., & Delaney, H. D. (1993). Bivariate median splits and spurious statistical significance. Psychological Bulletin, 113, 181–190. doi:10.1037/0033-2909.113.1.181.

    Article  Google Scholar 

  • Meehl, P. E. (1977). Specific etiology and other forms of strong influence: some quantitative meanings. Journal of Medicine and Philosophy, 2, 33–53.

    Article  Google Scholar 

  • Meehl, P. E. (1995). Bootstraps taxometrics: solving the classification problem in psychopathology. American Psychologist, 50, 266–275. doi:10.1037/0003-066X.50.4.266.

    Article  PubMed  Google Scholar 

  • Meehl, P. E. (2004). What’s in a taxon? Journal of Abnormal Psychology, 113, 39–43. doi:10.1037/0021-843X.113.1.39.

    Article  PubMed  Google Scholar 

  • Meehl, P. E., & Golden, R. (1982). Taxometric methods. In P. Kendall & J. Butcher (Eds.), Handbook of research methods in clinical psychology (pp. 127–181). New York: Wiley.

    Google Scholar 

  • Meehl, P. E., & Yonce, L. J. (1996). Taxometric analysis: II. Detecting taxonicity using covariance of two quantitative indicators in successive intervals of a third indicator (Maxcov procedure). Psychological Reports, 78, 1091–1227.

    Article  Google Scholar 

  • National Action Alliance for Suicide Prevention. (2014). A prioritized research agenda for suicide prevention: An action plan to save lives. Rockville: National Institute of Mental Health and the Research Prioritization Task Force.

    Google Scholar 

  • Nisbett, R. E., & Wilson, T. D. (1977). Telling more than we can know: verbal reports on mental processes. Psychological Review, 84, 231–259. doi:10.1037/0033-295X.84.3.231.

    Article  Google Scholar 

  • Nock, M. K., Park, J. M., Finn, C. T., Deliberto, T. L., Dour, H. J., & Banaji, M. R. (2010). Measuring the suicidal mind: implicit cognition predicts suicidal behavior. Psychological Science, 21, 511–517. doi:10.1177/0956797610364762.

    Article  PubMed  Google Scholar 

  • Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the national comorbidity survey replication adolescent supplement. JAMA Psychiatry, 70, 300–310. doi:10.1001/2013.jamapsychiatry.55.

    Article  PubMed  Google Scholar 

  • Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., et al. (2011). The Columbia–suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168, 1266–1277. doi:10.1176/appi.ajp.2011.10111704.

    Article  PubMed Central  PubMed  Google Scholar 

  • Poznanski, E. O., Freeman, L. N., & Mokros, H. B. (1984). Children’s depression rating scale-revised. Psychopharmacology Bulletin, 21, 979–989.

    Google Scholar 

  • Prinstein, M. J., Nock, M. K., Simon, V., Aikins, J. W., Cheah, C. S. L., & Spirito, A. (2008). Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization. Journal of Consulting and Clinical Psychology, 76, 92–103. doi:10.1037/0022-006X.76.1.92.

    Article  PubMed Central  PubMed  Google Scholar 

  • Reynolds, W. (1988). Suicidal ideation questionnaire: Professional manual. Odessa: Psychological Assessment Resources.

    Google Scholar 

  • Reynolds, W. M., & Mazza, J. J. (1999). Assessment of suicidal ideation in inner-city children and young adolescents: reliability and validity of the suicidal ideation questionnaire-JR. School Psychology Review, 28, 17–30.

    Google Scholar 

  • Richey, J. A., Schmidt, N. B., Lonigan, C. J., Phillips, B. M., Catanzaro, S. J., Laurent, J., Gerhardstein, R. R., et al. (2009). The latent structure of child depression: a taxometric analysis. Journal of Child Psychology and Psychiatry, 50, 1147–1155. doi:10.1111/j.1469-7610.2009.02085.x.

    Article  PubMed  Google Scholar 

  • Ruscio, J. (2012). Taxometric programs for the R computing environment: User’s manual.

  • Ruscio, J., & Ruscio, A. M. (2000). Informing the continuity controversy: a taxometric analysis of depression. Journal of Abnormal Psychology, 109, 473–487. doi:10.1037/0021-843X.109.3.473.

    Article  PubMed  Google Scholar 

  • Ruscio, A. M., & Ruscio, J. (2002). The latent structure of analogue depression: should the beck depression inventory be used to classify groups? Psychological Assessment, 14, 135–145. doi:10.1037/1040-3590.14.2.135.

    Article  PubMed  Google Scholar 

  • Ruscio, J., & Ruscio, A. M. (2004). Clarifying boundary issues in psychopathology: the role of taxometrics in a comprehensive program of structural research. Journal of Abnormal Psychology, 113, 24–38. doi:10.1037/0021-843X.113.1.24.

    Article  PubMed  Google Scholar 

  • Ruscio, J., Ruscio, A. M., & Keane, T. M. (2004). Using taxometric analysis to distinguish a small latent taxon from a latent dimension with positively skewed indicators: the case of involuntary defeat syndrome. Journal of Abnormal Psychology, 113, 145–154. doi:10.1037/0021-843X.113.1.145.

    Article  PubMed  Google Scholar 

  • Ruscio, J., Haslam, N., & Ruscio, A. M. (2006). Introduction to the taxometric method: A practical guide. Mahwah: Lawrence Erlbaum Associates.

    Google Scholar 

  • Ruscio, J., Ruscio, A. M., & Meron, M. (2007a). Applying the bootstrap to taxometric analysis: generating empirical sampling distributions to help interpret results. Multivariate Behavioral Research, 42, 349–386. doi:10.1080/00273170701360795.

    Article  Google Scholar 

  • Ruscio, J., Zimmerman, M., McGlinchey, J. B., Chelminski, I., & Young, D. (2007b). Diagnosing major depressive disorder XI: a taxometric investigation of the structure underlying DSM-IV symptoms. Journal of Nervous and Mental Disease, 195, 10–19. doi:10.1097/01.nmd.0000252025.12014.c4.

    Article  PubMed  Google Scholar 

  • Ruscio, J., Walters, G. D., Marcus, D. K., & Kaczetow, W. (2010). Comparing the relative fit of categorical and dimensional latent variable models using consistency tests. Psychological Assessment, 22, 5–21. doi:10.1037/a0018259.

    Article  PubMed  Google Scholar 

  • Shneidman, E. S. (1998). Perspectives on suicidology. Further reflections on suicide and psychache. Suicide & Life-Threatening Behavior, 28, 245–250.

    Google Scholar 

  • Solomon, A., Ruscio, J., Seeley, J. R., & Lewinsohn, P. M. (2006). A taxometric investigation of unipolar depression in a large community sample. Psychological Medicine, 36, 973–985. doi:10.1017/S0033291706007689.

    Article  PubMed  Google Scholar 

  • Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010). The interpersonal theory of suicide. Psychological Review, 117, 575–600. doi:10.1037/a0018697.

    Article  PubMed Central  PubMed  Google Scholar 

  • Vilhjalmsson, R., Krisjansdottir, G., & Sveinbjarnardottir, E. (1998). Factors associated with suicide ideation in adults. Social Psychiatry and Psychiatric Epidemiology, 33, 97–103. doi:10.1007/s001270050028.

    Article  PubMed  Google Scholar 

  • Wahlström, L., Michélsen, H., Schulman, A., & Backheden, M. (2010). Childhood life events and psychological symptoms in adult survivors of the 2004 Tsunami. Nordic Journal of Psychiatry, 64, 245–252. doi:10.3109/08039480903484092.

    Article  PubMed  Google Scholar 

  • Waller, N., & Meehl, P. E. (1998). Multivariate taxometric procedures: Distinguishing types from continua. Advanced quantitative techniques in the social sciences, 9. Thousand Oaks: Sage Publications.

    Google Scholar 

  • Walters, G. D. (2008). The latent structure of alcohol use disorders: a taxometric analysis of structured interview data obtained from male federal prison inmates. Alcohol and Alcoholism, 43, 326–333. doi:10.1093/alcalc/agm165.

    Article  PubMed  Google Scholar 

  • Walters, G. D., & Ruscio, J. (2010). Where do we draw the line? Assigning cases to subsamples for MAMBAC, MAXCOV, and MAXEIG taxometric analyses. Assessment, 17, 321–333. doi:10.1177/1073191109356539.

    Article  PubMed  Google Scholar 

  • Walters, G. D., & Ruscio, J. (2013). Trajectories of youthful antisocial behavior: categories or continua? Journal of Abnormal Child Psychology, 41, 653–666. doi:10.1007/s10802-012-9700-1.

    Article  PubMed  Google Scholar 

  • Widiger, T. A. (2001). What can be learned from taxometric analyses? Clinical Psychology: Science and Practice, 8, 528–533. doi:10.1093/clipsy.8.4.528.

    Google Scholar 

  • Yoder, K. A., Whitbeck, L. B., Hoyt, D. R., & LaFromboise, T. (2006). Suicide ideation among American Indian youths. Archives of Suicide Research, 10, 177–190. doi:10.1080/13811110600558240.

    Article  PubMed  Google Scholar 

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Acknowledgments

Preparation of this manuscript was supported in part by the American Foundation for Suicide Prevention (Grant PDF-0-10-252) and the National Institute of Mental Health of the National Institutes of Health under Award Number R01MH101138 to the first author. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

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Liu, R.T., Jones, R.N. & Spirito, A. Is Adolescent Suicidal Ideation Continuous or Categorical? A Taxometric Analysis. J Abnorm Child Psychol 43, 1459–1466 (2015). https://doi.org/10.1007/s10802-015-0022-y

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