ArticleJournal of the American Academy of Child and Adolescent Psychiatry2026
A Prospective Examination of the Predictive Validity of Three Transdiagnostic Assessments of Risk for Suicidal Behavior: Psychache, the Interpersonal Theory of Suicide, and Reasons for Living.
Article in Journal of the American Academy of Child and Adolescent Psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo assess the predictive validity (PV) of Psychache, the Interpersonal Theory of Suicide (IPTS), and Reasons for Living (RFL) regarding future suicide attempts (SA) in youth.
methodA total of 827 youth, aged 12 to 24 years, were assessed at baseline; 652 had at least 1 follow-up a mean of 27 weeks after intake. Participants were patients at the University of Pittsburgh Medical Center who sought mental health care within the previous month. Of the participants, 78% presented with suicidal ideation or behavior. The primary outcome was an SA during follow-up. Participants were administered scales for Psychache, the 3 constructs of the IPTS (Thwarted Belongingness, Perceived Burdensomeness, Acquired Capability for Suicidal Behavior), and RFL. The PV of each construct was assessed using the area under the receiver operating characteristic curve (AUROC), after adjusting for age and sex, and then additionally controlling for past SA/suicidal behavior (SA/SRB) and the Kiddie Computerized Adaptive Test-Suicide Scale (K-CAT-SS, a computerized adaptive test for SA risk) score.
resultsAge, sex, history of SA/SRB, and the K-CAT-SS were the most parsimonious set of demographic and clinical predictors of SA (AUROC = 0.844). The age and sex-adjusted PVs for all 3 transdiagnostic frames were also high (AUROCs from 0.813 to 0.830), not significantly different from the clinical predictors' AUROC, and predicted SA after adjusting for history of SA/SRB. After adding the K-CAT-SS to the regression, only Acquired Capability for Suicidal Behavior still predicted SA. SA/SRB history and the K-CAT-SS added to predictive power of IPTS and RFL, but not Psychache.
conclusionMeasures of Psychache, IPTS, and RFL are strongly predictive of SA, and delineate malleable treatment targets for suicidal youth. PLAIN LANGUAGE SUMMARY: This study examined some emotions and attitudes that could affect risk for future suicide attempts. The authors followed 652 at-risk youths. Emotional pain, feeling burdensome to others, and feeling disconnected from people increased the risk for suicide attempts. Fear of death and having reasons for staying alive protected against suicide attempts.
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