Predicting the First Onset of Suicidal Thoughts and Behaviors in Adolescents Using Multimodal Risk Factors: A 4-Year Longitudinal Study

作者：Josh Nguyen, Dom Dwyer, Yara J. Toenders, Scott D. Tagliaferri, Laura S. van Velzen, Scott R. Clark, Isabelle Scott, Simon Hartmann, Johanna T. W. Wigman, Ashleigh Lin, Andrew Thompson, Cassandra Wannan, Caroline X. Gao, Stephen J. Wood, G. Paul Amminger, Alison R. Yung, Nikolaos Koutsouleris, Jessica Hartmann, Hok Pan Yuen, Christopher G. Davey, Angelica Ronald, Patrick D. McGorry, Christel M. Middeldorp, Barnaby Nelson, Lianne Schmaal · 发表于：Journal of the American Academy of Child & Adolescent Psychiatry · 年份：2025 · DOI：10.1016/j.jaac.2025.07.006 · 被引用次数：7 · 研究领域：Suicide and Self-Harm Studies、Mental Health Research Topics、Digital Mental Health Interventions

OBJECTIVE: Suicide is one of the leading causes of death among youth worldwide, yet existing studies that aimed to predict the first onset of suicidal thoughts and behaviors (STB) included a limited number of data modalities and/or focused on adult populations. This study aimed to prospectively predict first-onset STB across 4-year follow-ups in adolescents using an existing STB history classification model that was previously applied to baseline data and a new machine learning model with 195 biopsychosocial features. METHOD: Participants were 7,503 unrelated adolescents (54.5% female, ages 9-11 years at baseline) from the multisite, longitudinal Adolescent Brain Cognitive Development (ABCD) Study. An existing baseline STB history classification model was applied to predict longitudinal first-onset STB in adolescents compared with healthy controls and clinical controls (individuals with a mental health disorder but no STB). A new elastic net logistic regression model with 195 features was trained on data from 14 sites (n = 5,220), and the resulting top 15 features were validated at 7 independent sites (n = 2,283). RESULTS: The previously developed model to classify STB lifetime history also prospectively predicted first-onset STB in adolescents with an area under the curve (AUC) [95% CI] of 0.73 [0.70, 0.75], p < .001, compared with healthy controls and AUC [95% CI] of 0.63 [0.60, 0.66], p < .001, compared with clinical controls. The newly trained model with top 15 features p...